硫酸镁、硝苯地平和酚妥拉明治疗妊高症

目的探讨对妊娠高血压综合征患者给予硫酸镁联合硝苯地平以及酚妥拉明治疗的临床效果。方法抽取医院在2018年2月-2019年2月所接收的156例妊娠高血压综合征患者,将其按照数字随机表的方法分为单纯组和联合组,每组分别为78例。单纯组给予单纯的硫酸镁进行治疗,联合组在单纯组给予硝苯地平以及酚妥拉明进行联合治疗,比较患者的治疗效果。结果联合组的治疗有效率显著高于单纯组,治疗前血压水平差异无统计学意义(P>0.05),治疗后联合组的收缩压和舒张压水平均低于单纯组,P<0.05,两组差异有统计学意义。结论对妊娠高血压综合征患者给予硫酸镁联合硝苯地平和酚妥拉明进行联合治疗,有效改善患者的血压水平。     

Dexamethasone as an adjuvant for peripheral nerve blockade: a randomised,triple-blinded crossover study in volunteers

Background

The efficacy of dexamethasone in extending the duration of local anaesthetic block is uncertain. In a randomised controlled triple blind crossover study in volunteers, we tested the hypothesis that neither i.v. nor perineurally administered dexamethasone prolongs the sensory block achieved with ropivacaine.

甲磺酸罗比卡因与盐酸罗比卡因用于硬膜外阻滞的效应比较

目的 评价甲磺酸罗比卡因用于硬膜外阻滞的效应和安全性。方法 45例择期行下腹或下肢手术病人,随机分别接受用甲磺酸罗比卡因(8.94 mg/ml,观察组)或盐酸罗比卡因(7.5mg/ml,对照组)施行的硬膜外阻滞。观察两组在感觉阻滞、运动阻滞、镇痛和肌肉松弛方面的效果,同时观察用药前后肝肾功能变化。结果 观察组和对照组感觉阻滞平面达到T6以上的病例分别为84.3％和76％(P>0.05),Bromage≥3级的病例分别90％和92％(P>0.05)。两组感觉阻滞平面固定时间、Bromage达到最大级别时间、最大级别维持时间和运动阻滞维持时间均无显著性差异(P>0.05)。两组镇痛及肌松满意率无显著性差异。观察组术中2例发生低血压,2例发生心动过缓,而对照组仅1例发生低血压。两组术后24 h天冬氨酸氨基转移酶(AST)、天冬氨酸转氨酶(ALT)、尿素氮(BUN)和肌酐(Cr)均在正常范围。结论 甲磺酸罗比卡因与盐酸罗比卡因行硬膜外阻滞的效应基本相同,且无明显毒性。     

Effects of Phentolamine on Hemorrheology and Hemodynamics in Dogs with Acute Liver Damage

ＥｆｆｅｃｔｓｏｆＰｈｅｎｔｏｌａｍｉｎｅｏｎＨｅｍｏｒｒｈｅｏｌｏｇｙａｎｄＨｅｍｏｄｙｎａｍｉｃｓｉｎＤｏｇｓｗｉｔｈＡｃｕｔｅＬｉｖｅｒＤａｍａｇｅＤＡＮＺｉｌｉ（但自力）；ＺＨＡＮＧＷｅｎｙｉｎｇ（张文英）；ＬＩＳｈａｏｂａｉ（李绍白）（Ｉｎ...     

电刺激膈神经中枢端引起降压反应的外周机理

电刺激麻醉家兔膈神经中枢端呆引起动脉血压下降，此降压反应不能被剪断双侧迷走神经所阻断；但可被静脉注射心得１．０ｍｇ／ｋｇ部分阻断；也可被静注射酚妥拉明２．０ｍｇ／ｋｇ部分阻断，去除缓冲神经后其降压效应更为明显。     

Local analgesic and vascular effects of intradermal ropivacaine and bupivacaine in various concentrations with and without addition of adrenaline in man

Ropivacaine, a new long–acting amino–amide local anaesthetic agent, and bupivacaine, in various concentrations with or without addition of adrenaline, were tested in a randomized, double–blind study using intradermal wheals. Ten non–smoking, healthy, young male volunteers participated. In series I plain solutions of ropivacaine (0.25%, 0.5%, 0.75% and 1%) and bupivacaine (0.25%, 0.5% and 0.75%) were injected intradermally and in series II the same concentrations, with the addition of adrenaline 5 ug ml^-1 ( 1 :200 000), were used. The same volunteers took part in both series, with an interval of at least three weeks between the experiments. Saline was included as control in both series. Pin–pricking was used to assess the dermal analgesia. Plain solutions of ropivacaine produced significantly longer durations of dermal analgesia than did plain solutions of bupivacaine, in all tested concentrations. A significant increase in duration was seen for both local anaesthetics when adding adrenaline. Local vascular effects at the injected areas were determined by visual inspection (nil, pink, pale). Local blanching (pale) was significantly more frequent for plain solutions of ropivacaine, in all tested concentrations. Local redness (pink) was significantly more frequent with plain bupivacaine, in a dose–dependent relation. An initial redness was frequently observed for both local anaesthetics containing adrenaline, followed by blanching at most sites.     

两种局麻药术后镇痛效果及副作用比较

目的：观察比较0．2％罗哌卡因和0．15％布比卡因两种同麻药在硬膜外自控镇痛(PCEA)中的镇痛效果及副作用。方法：选用0．2％罗哌卡因和0．15％布比卡因两种同麻药用于PCEA中．对其效果进行对比分析。结果：0．2％罗哌卡因、0．15％布比卡因分别与0．1mg芬太尼联合用于PCEA中，镇痛效果确切．毒副作用轻微，并发症少。结论：将0．2％罗哌卡因替代0．15％布比卡因与0．1mg芬太尼合用后．病人术后行走能力的早期恢复可得到改善。     

多巴酚丁胺 硝酸甘油 酚妥拉明治疗顽固性心力衰竭38例分析

目的 观察多巴酚丁胺、硝酸甘油、酚妥拉明对顽固性心衰（RHF）患者的疗效。方法 静脉点滴多巴酚丁胺、硝酸甘油、酚妥拉明治疗RHF患者38例,观察其临床疗效及治疗前后临床指标的变化。结果 心功能改善Ⅱ级20例（占52．6％）,改善Ⅰ级（占42．1％）,总有效率为94．7％。用药后心率、血压、呼吸明显好转,X线心胸比率、腹围、BUN、MOC明显下降,尿量明显增多（P值均＜0．01）,未见不良反应。结论 多巴酚丁胺、硝酸甘油、酚妥拉明治疗RHF安全有效。     

Wide Awake Open Carpal Tunnel Release: The Effect of Local Anesthetics in the Postoperative Outcome

Introduction  Wide awake open carpal tunnel decompression is a procedure performed under local anesthesia. This study aimed to present the effect of various local anesthetics in peri and postoperative analgesia in patients undergoing this procedure. Materials and Methods  A total of 140 patients, with 150 hands involved, underwent carpal tunnel release under local anesthesia. Patients were divided in five groups according to local anesthetic administered: lidocaine 2%, ropivacaine 0.75%, ropivacaine 0.375%, chirocaine 0.5%, and chirocaine 0.25%. Total 400 mg of gabapentin were administered to a subgroup of 10 cases from each group (50 cases totally), 12 hours before surgery. Patients were evaluated immediately, 2 weeks and 2 months after surgery according to VAS pain score, grip strength, and two-point discrimination. Results  In all patients, pain and paresthesia improved significantly postoperatively, while the use of gabapentin did not affect outcomes. Grip strength recovered and exceeded the preoperative value 2 months after surgery, without any difference between the groups. No case of infection, hematoma, or revision surgery was reported. Conclusion  Recovery after open carpal tunnel release appears to be irrelevant of the type of local anesthetic used during the procedure. Solutions of low local anesthetic concentration (lidocaine 2%, ropivacaine 0.375%, and chirocaine 0.25%) provide adequate intraoperative analgesia without affecting the postoperative course.