Measurement of post-operative pain and narcotic administration in infants using a new clinical scoring system

We developed a clinical neurologic and behavioral scoring system composed of 10 items to measure the post-operative pain levels in infants: (1) sleep during preceeding hour, (2) facial expression of pain, (3) quality of cry, (4) spontaneous motor activity, (5) Spontaneous excitability, (6) flexion of fingers and toes, (7) sucking, (8) global evaluation of tone, (9) consolability and (10) sociability. Using this system, a group of infants ranging from one to seven months in age and undergoing minor surgical procedures was studied. The infants were randomly assigned to two groups: Group I received Fentanyl intravenously (3 g/kg) prior to surgery, and Group II received a placebo. The infants then were studied post-operatively in the recovery room at 30, 60, 90 and 120 min intervals. Over the entire post-operative observation period, 54% of the infants in Group I had satisfactory analgesia compared to 18% in Group II. There were no significant differences in Group I and Group II in oxygenation, carbon dioxide elimination, blood pressure, heart rate or temperature.     

Report of the symposium

Summary The past decades have seen considerable shifts of emphasis in surgical care. The recognition that pus was not laudable, was followed by a realisation that not all complications were inevitable and that prophylaxis could effectively reduce the incidence of most common problems in the post-operative period. As anaesthesia has become safer, it has been possible to embark on more intricate and prolonged procedures and for sufficient time to be available to ensure adequate intraoperative care.These two phenomena have firstly increased the complexity of management in the post-operative period, and have brought this aspect of surgical care more obviously to the limelight. However, many separate disciplines are involved in the care of the patient post-operatively, and the Symposium was organised¹ to bring the different groups together to identify the areas of recent development in the different specialities and to integrate the overall care of the individual patient.Abbreviations ARDS adult respiratory distress syndrome - DIC disseminated intravascular clotting     

糖尿病患者白内障超声乳化术后的中药调理

将108例糖尿病白内障患者随机分成两组,经白内障超声乳化及人工晶体植入术后,中药组51例给予口服益气补肝肾及活血化瘀的方药,每日1剂,14天为1个疗程;西药组57人口服强的松30mg,每日1次,逐日递减,一周后改服消炎痛25mg,连服一周.结果:两组疗效比较无显著性差异,但中药解除了糖尿病患者手术后用激素治疗所致的血糖增高的后患.     

芳香疗法用于妇科恶性肿瘤患者术后恶心呕吐的效果研究

目的 探讨芳香疗法缓解妇科恶性肿瘤术后患者恶心呕吐的效果.方法 选取2019年1月至2019年8月间中国医学科学院肿瘤医院收治的行手术治疗的202例妇科恶性肿瘤患者,按病房号奇偶数随机分为试验组(102例)和对照组(100例).对照组患者采用常规护理,试验组患者在常规护理基础上采用嗅柠檬香氛作为芳香疗法进行干预,比较两...     

宫颈癌全子宫切除术后发生毛细血管渗漏综合征 1例

目的探讨宫颈癌病人术后发生毛细血管渗漏综合征( capillary leakage syndrome,CLS)的病因、临床表现及处理措施,为临床医师提供可靠经验,提高此类疾病诊治水平。方法分析 1例 2022年 7月于潍坊医学院附属医院术前诊断为子宫颈原位癌而术后病理为浸润性宫颈癌的病人术后发生 CLS的过程及诊疗经过,结合相关文献报道,总结宫颈癌病人术后发生 CLS的机制及处理措施。结果病人术中生命体征平稳,手术结束恢复体位时出现血压下降,给予去甲肾上腺素升压,待血压升至 100/60 mmHg返回病房后陆续出现胸闷、憋气及双下肢中度水肿,行 CT检查提示大量胸腹腔积液,给予地塞米松、羟乙基淀粉、血浆及人血白蛋白改善毛细血管通透性,补充血容量,限制性补液并间断性给予利尿剂等处理,经过积极治疗后病人病情好转。结论针对宫颈癌术后的病人,医务人员需严密观察,对胸闷、憋气、双下肢水肿等症状提高警惕,首先排除是否出现 CLS,一旦确诊立即给予相应的处理。     

保留乳头乳晕复合体乳腺癌改良根治术后主要并发症的防治

目的 探讨保留乳头乳晕复合体(nipple-areola complex, NAC)乳腺癌改良根治术后主要并发症的防治.方法 对手术治疗124例NAC乳腺癌改良根治术临床资料行回顾性总结,分析发生并发症的原因,提出预防和处理方法.结果 124例术后发生乳头坏死18例(14.52%),皮瓣感染、坏死9例(7.26%),皮下积液7例(5.65%),上肢淋巴水肿5例(4.03%),胸肌挛缩伴同侧上臂运动障碍3例(2.42%),术腔继发性出血2例(1.61%).结论 精细的手术操作能有效降低保留NAC乳腺癌改良根治术并发症的发生率;保留NAC术后出现的并发症进行积极处理能明显改善患者预后.     

远程无线镇痛泵常见报警原因分析及对策

目的：针对远程无线镇痛泵常见的报警问题分析原因并提出预防及解决方法。方法统计分析2013年1～3月，应用无线镇痛泵的2732例手术患者在使用中所出现的报警问题。结果2732例共出现报警问题1287次，其中，有镇痛不足、堵塞、气泡或无液、电量报警等，经随访人员及时处理，所有报警问题均得以顺利解决。结论在使用远程无线镇痛系统时，预见性评估并解决可能出现的报警问题，正确掌握处理无线镇痛泵报警问题的方法，可有效减少报警发生率，保证镇痛效果，提高患者使用满意度。