Splanchnic blood flow during halothane-relaxant anaesthesia in elderly patients

We have previously found that halothane-relaxant anaesthesia in elderly patients causes a change towards a hyperkinetic circulation, with a decrease in the arterial-mixed venous oxygen content difference. This could be attributed to vasodilation. In the present study the splanchnic contribution to these changes was investigated. Nine patients were studied during halothane-relaxant anaesthesia prior to surgery. During anaesthesia splanchnic blood flow was markedly reduced, while splanchnic oxygen uptake decreased only moderately compared with the awake level. This resulted in an increase in splanchnic oxygen extraction. It is concluded that the splanchnic vascular bed does not contribute to the "hyperkinetic" circulation during halothane anaesthesia.     

Central mediation of the conditioned taste aversion induced in rats by harmaline

The assumption that drugs used as unconditioned stimuli in conditioned taste aversion (CTA) studies act centrally was tested by comparing the effects of systemic and intracerebral injections of harmaline hydrochloride (H) in 340 rats. Intraperitoneal injection of 5–20 mg/kg but not of 2.5 mg/kg H administered 5 min after 15-min saccharin (0.1%) drinking decreased saccharin-water preference in a two-choice retention test, performed 48 h later, from 55% to 20%. Since CTA was not diminished when H (10 mg/kg) was injected into rats anesthetised immediately after saccharin drinking by pentobarbital (40 mg/kg), H (1.7–50 g) was administered intracerebrally to anesthetised rats fixed in the stereotaxic apparatus. Injection of 3–6 g H into the inferior olive elicited CTA comparable to that of systemic injection of 10 mg/kg H. Injections of 6 and 50 g H into cerebellum and bulbar reticular formation elicited weaker CTA while neocortical, hypothalamic and mesencephalic applications were ineffective. CTA could also be elicited when 50 g but not 6 g H was injected into the inferior olive 1 or 2 h after saccharin drinking. This delay-dependent effect and failure of non-contingent H administration to change saccharin preference indicates that the H-induced CTA is not contaminated by a non-specific increase in neophobia. It is concluded that H probably elicits CTA by activation of caudal bulbar structures, including the nucleus of the solitary tract, area postrema and lateral reticular formation.     

Ejaculatory incompetence: a theoretical formulation and case illustration

Three theoretical formulations of ejaculatory incompetence have been proposed in the literature. They include: (1) aversive conditioned inhibition of the ejaculatory reflex, (2) an "autosexual" orientation associated with discrepant levels in the cognitive and physiological dimensions of sexual arousal, and (3) a discriminative learning model. These three models are discussed in relation to their theoretical and therapeutic implications. Clinical data supporting the discriminative view is presented.     

异丙酚麻醉下行钳刮术82例临床观察

目的 :探讨异丙酚麻醉下行孕 10～ 13周钳刮术镇痛效果及安全性。方法 :应用异丙酚静脉给药麻醉后钳刮 (观察组 )。与无任何镇痛方法钳刮 (对照组 )。结果 :观察组与对照组在宫口松驰度 ,手术时间 ,出血量方面相比无明显差异 (P >0 .0 5 ) ,人工流产综合征发生率观察组 0 ,对照组 5 9%。结论 :异丙酚麻醉下行钳刮术能安全镇痛 ,避免人流综合征的发生     

恩丹西酮预防椎管内阻滞后寒战的效果

①目的观察麻醉前静脉注射恩丹西酮预防椎管内阻滞后寒战的效果和对腋温的影响.②方法选择腰麻-硬膜外联合麻醉下行经腹全子宫切除术病人160例,随机分为两组,实验组(n=80)麻醉前静脉注射恩丹西酮8mg;对照组(n=80)麻醉前静脉注射生理盐水4mL,观察两组术中平均动脉压、心率、腋温变化和寒战发生情况.③结果实验组8例出现寒战(10.0%),对照组26例出现寒战(32.5%),两组比较差异有显著性(x2=7.05,P＜0.01).两组平均动脉压、心率、腋温变化差异无显著性(t=0.14～1.71,P均＞0.05).④结论恩丹西酮可预防椎管内阻滞后寒战的发生,但对腋温无影响.     

推进整体护理提高护理质量

介绍了四川省以点带面开展整体护理的做法,取得的成效,存在的问题与对策,并提出了下一步的工作目标与计划设想.要求转变观念,加强培训;保证人力配备,提高综合素质.     

Vía clínica de recuperación intensificada en cirugía cardiaca. Documento de consenso de la Sociedad Española de Anestesiología,Reanimación y Terapéutica del Dolor (SEDAR), la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE) y la Asociación Española de Perfusionistas (AEP)

The ERAS guidelines are intended to identify, disseminate and promote the implementation of the best, scientific evidence-based actions to decrease variability in clinical practice. The implementation of these practices in the global clinical process will promote better outcomes and the shortening of hospital and critical care unit stays, thereby resulting in a reduction in costs and in greater efficiency. After completing a systematic review at each of the points of the perioperative process in cardiac surgery, recommendations have been developed based on the best scientific evidence currently available with the consensus of the scientific societies involved.     

艺术大学生自我效能、主观幸福感及其关系的研究

目的研究艺术大学生自我产能与主观幸福感的关系。方法用幸福感指数量表、一般自我效能感量表494艺术大学生进行了测量。结果①艺术大学生的主观幸福感和自我效能感有显着的独生和性别差异。②艺术大学生的高、低自我效能与主观幸福感存在显着的差异和相关。结论自我效能是影响幸福感的重要因素。