目的:观察经皮穴位电刺激辅助全凭静脉麻醉在开腹行直肠癌根治术中对减少丙泊酚和舒芬太尼用量以及术后镇痛的效果。方法:选取中国医科大学附属第一医院2017年12月至2018年12月收治的全身麻醉下开腹行直肠癌根治术的40例患者为研究对象...目的:观察经皮穴位电刺激辅助全凭静脉麻醉在开腹行直肠癌根治术中对减少丙泊酚和舒芬太尼用量以及术后镇痛的效果。方法:选取中国医科大学附属第一医院2017年12月至2018年12月收治的全身麻醉下开腹行直肠癌根治术的40例患者为研究对象,年龄18~65岁,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ~Ⅱ级。采用随机数字表法,将其分为电刺激组和对照组(每组20例)。患者均采用全凭静脉麻醉,先予舒芬太尼、丙泊酚、顺式阿曲库铵行麻醉诱导后插入气管导管,靶控输注丙泊酚以维持脑电双频指数为40~60,根据血压和心率水平间断静脉注射舒芬太尼维持镇痛,顺式阿曲库铵维持骨骼肌松弛;仅对电刺激组患者给予经皮穴位电刺激。记录并比较术中丙泊酚和舒芬太尼用量、术后补救性镇痛情况、躁动评分(ramsay score,RS),拔管即刻和术后24 h的视觉模拟评分法(visual analogue scale,VAS)评分,患者对麻醉满意度的评分。结果:电刺激组在舒芬太尼用量、麻醉后监测治疗室(postanesthesia care unit,PACU)内补救性镇痛率、拔管即刻的VAS评分、术后24 h的VAS评分、RS等方面均显著低于对照组,差异均有统计学意义(均P<0.05);电刺激组患者对麻醉满意度评分高于对照组(P<0.05);两组术中丙泊酚用量和术后病房24 h内补救镇痛率差异无统计学意义(P>0.05)。结论:经皮穴位电刺激辅助全凭静脉麻醉应用于开腹行直肠癌根治术中可减少术中舒芬太尼用量和PACU内补救性镇痛率,降低术后RS和VAS评分,提高患者的麻醉满意度。展开更多
The purpose of this study was to evaluate local anesthesia with sedation for vaginal surgery for advanced genital prolapse. Study design: Five sacrospinous ligament suspensions and 12 vaginal paravaginal defect repair...The purpose of this study was to evaluate local anesthesia with sedation for vaginal surgery for advanced genital prolapse. Study design: Five sacrospinous ligament suspensions and 12 vaginal paravaginal defect repairs performed under local anesthesia in 2004 were identified. Medical records and patient satisfaction questionnaire were reviewed. Patient demographics, degree of prolapse, duration of surgery, hospital stay, and responses to an anesthesia satisfaction questionnaires were recorded. Results: All repairs incorporated placement of dermal allograft. Concomitant procedures included: 6 tension-free vaginal tape (TVTs), 12 posterior and 4 enterocele repairs. Mean patient age was 66.1 years. All patients had prolapse of apex or anterior wall ≥ grade 3. Mean OR time was 132 minutes. Average hospital stay was 1.2 days. No patient was converted to general anesthesia. All 17 patients were “ very satisfied” with their surgical experience. Conclusion: Local anesthesia with sedation can be successfully employed for most vaginal reconstructive surgeries with advanced genital prolapse. Patients report a high level of satisfaction.展开更多
目的:比较蛛网膜下腔麻醉患者通过静脉给予丙泊酚与右美托咪定中度镇静的临床效果。方法:选取 2017 年 1 月至 2018 年 1 月行蛛网膜下腔麻醉患者 106 例,随机分为观察组和对照组各 53 例,对照组采取丙泊酚中度麻醉,观察组给予右美托咪...目的:比较蛛网膜下腔麻醉患者通过静脉给予丙泊酚与右美托咪定中度镇静的临床效果。方法:选取 2017 年 1 月至 2018 年 1 月行蛛网膜下腔麻醉患者 106 例,随机分为观察组和对照组各 53 例,对照组采取丙泊酚中度麻醉,观察组给予右美托咪定麻醉中度麻醉,对比效果。结果:改良 OAA/S 评分恢复至不低于 4 分所需时间、不良反应发生率、有效麻醉时间均低于对照组 (P<0.05);观察组满意度高于对照组 (P<0.05)。结论:静脉给予右美托咪定实施状膜下腔麻醉中度镇静的效果明显优于丙泊酚,且安全性较高。Abstract:Objective: To compare the clinical effects of intravenous propofol and dexmedetomidine for moderate sedation in patients with subarachnoid anesthesia. Methods: A total of 106 patients who underwent subarachnoid anesthesia from February 2019 to January 2020 were selected and randomly divided into the observation group and the control group with 53 patients in each group. The control group received moderate anesthesia with propofol and the observation group received moderate anesthesia with dexmedetomidine. Results: The time required for the modified OAA/S score to recover to no less than 4 points, the incidence of adverse reactions and effective anesthesia time were all lower than those in the control group (P<0.05). The satisfaction of observation group was higher than that of control group (P<0.05). Conclusion: Intravenous administration of dexmedetomidine for moderate sedation under submembranous anesthesia is significantly better than propofol, and has higher safety.展开更多
文摘目的:观察经皮穴位电刺激辅助全凭静脉麻醉在开腹行直肠癌根治术中对减少丙泊酚和舒芬太尼用量以及术后镇痛的效果。方法:选取中国医科大学附属第一医院2017年12月至2018年12月收治的全身麻醉下开腹行直肠癌根治术的40例患者为研究对象,年龄18~65岁,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ~Ⅱ级。采用随机数字表法,将其分为电刺激组和对照组(每组20例)。患者均采用全凭静脉麻醉,先予舒芬太尼、丙泊酚、顺式阿曲库铵行麻醉诱导后插入气管导管,靶控输注丙泊酚以维持脑电双频指数为40~60,根据血压和心率水平间断静脉注射舒芬太尼维持镇痛,顺式阿曲库铵维持骨骼肌松弛;仅对电刺激组患者给予经皮穴位电刺激。记录并比较术中丙泊酚和舒芬太尼用量、术后补救性镇痛情况、躁动评分(ramsay score,RS),拔管即刻和术后24 h的视觉模拟评分法(visual analogue scale,VAS)评分,患者对麻醉满意度的评分。结果:电刺激组在舒芬太尼用量、麻醉后监测治疗室(postanesthesia care unit,PACU)内补救性镇痛率、拔管即刻的VAS评分、术后24 h的VAS评分、RS等方面均显著低于对照组,差异均有统计学意义(均P<0.05);电刺激组患者对麻醉满意度评分高于对照组(P<0.05);两组术中丙泊酚用量和术后病房24 h内补救镇痛率差异无统计学意义(P>0.05)。结论:经皮穴位电刺激辅助全凭静脉麻醉应用于开腹行直肠癌根治术中可减少术中舒芬太尼用量和PACU内补救性镇痛率,降低术后RS和VAS评分,提高患者的麻醉满意度。
文摘The purpose of this study was to evaluate local anesthesia with sedation for vaginal surgery for advanced genital prolapse. Study design: Five sacrospinous ligament suspensions and 12 vaginal paravaginal defect repairs performed under local anesthesia in 2004 were identified. Medical records and patient satisfaction questionnaire were reviewed. Patient demographics, degree of prolapse, duration of surgery, hospital stay, and responses to an anesthesia satisfaction questionnaires were recorded. Results: All repairs incorporated placement of dermal allograft. Concomitant procedures included: 6 tension-free vaginal tape (TVTs), 12 posterior and 4 enterocele repairs. Mean patient age was 66.1 years. All patients had prolapse of apex or anterior wall ≥ grade 3. Mean OR time was 132 minutes. Average hospital stay was 1.2 days. No patient was converted to general anesthesia. All 17 patients were “ very satisfied” with their surgical experience. Conclusion: Local anesthesia with sedation can be successfully employed for most vaginal reconstructive surgeries with advanced genital prolapse. Patients report a high level of satisfaction.
文摘目的:比较蛛网膜下腔麻醉患者通过静脉给予丙泊酚与右美托咪定中度镇静的临床效果。方法:选取 2017 年 1 月至 2018 年 1 月行蛛网膜下腔麻醉患者 106 例,随机分为观察组和对照组各 53 例,对照组采取丙泊酚中度麻醉,观察组给予右美托咪定麻醉中度麻醉,对比效果。结果:改良 OAA/S 评分恢复至不低于 4 分所需时间、不良反应发生率、有效麻醉时间均低于对照组 (P<0.05);观察组满意度高于对照组 (P<0.05)。结论:静脉给予右美托咪定实施状膜下腔麻醉中度镇静的效果明显优于丙泊酚,且安全性较高。Abstract:Objective: To compare the clinical effects of intravenous propofol and dexmedetomidine for moderate sedation in patients with subarachnoid anesthesia. Methods: A total of 106 patients who underwent subarachnoid anesthesia from February 2019 to January 2020 were selected and randomly divided into the observation group and the control group with 53 patients in each group. The control group received moderate anesthesia with propofol and the observation group received moderate anesthesia with dexmedetomidine. Results: The time required for the modified OAA/S score to recover to no less than 4 points, the incidence of adverse reactions and effective anesthesia time were all lower than those in the control group (P<0.05). The satisfaction of observation group was higher than that of control group (P<0.05). Conclusion: Intravenous administration of dexmedetomidine for moderate sedation under submembranous anesthesia is significantly better than propofol, and has higher safety.
