BACKGROUND Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases.However,current anesthesia methods,such as spray,nebuliz...BACKGROUND Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases.However,current anesthesia methods,such as spray,nebulized inhalation,and cricothyroid membrane puncture,have their own advantages and disadvantages.Recently,studies have shown that bronchoscopic direct-view glottis anesthesia is a simple and inexpensive method that shortens the examination time and provides excellent anesthetic results.AIM To evaluate the effectiveness of bronchoscopic direct vision glottis anesthesia for bronchoscopy.METHODS The study included 100 patients who underwent bronchoscopy during thoracic surgery.A random number table method was used to divide the patients into control and observation groups(50 patients each).The control and observation groups were anesthetized using the nebulized inhalation and bronchoscopic direct vision glottis method,respectively.Hemodynamic indices[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),and oxygen saturation(SpO_(2))before(T1),5 min after anesthesia(T2),and at the end of the operation(T3)]serum stress hormone indices[norepinephrine(NE),epinephrine(E),adrenocorticotropic hormone(ACTH),and cortisol(Cor)before and after treatment]were compared between the 2 groups.Adverse effects were also RESULTS At T2 and T3,SBP,DBP,and HR were lower in the observation group than the control group,whereas SpO_(2) was higher than the control group[(119.05±8.01)mmHg vs(127.05±7.83)mmHg,(119.35±6.66)mmHg vs(128.39±6.56)mmHg,(84.68±6.04)mmHg vs(92.42±5.57)mmHg,(84.53±4.97)mmHg compared to(92.57±6.02)mmHg,(74.25±5.18)beats/min compared to(88.32±5.72)beats/min,(74.38±5.31)beats/min compared to(88.42±5.69)beats/min,(97.36±2.21)%vs(94.35±2.16)%,(97.42±2.36)%vs(94.38±2.69%],with statistically significant differences(all P<0.05).After treatment,NE,E,ACTH,and Cor were significantly higher in both groups than before treatment,but were lower in the observation group than in the control group[(68.25±8.87)ng/mL vs(93.35±14.00)ng/mL,(53.59±5.89)ng/mL vs(82.32±10.70)ng/mL,(14.32±1.58)pg/mL vs(20.35±3.05)pg/mL,(227.35±25.01)nmol/L vs(322.28±45.12)nmol/L],with statistically significant differences(all P<0.05).The incidence of adverse reactions was higher in the control group than in the observation group[12.00%(12/50)vs 6.00%(3/50)](P<0.05).CONCLUSION The use of bronchoscopic direct vision glottis anesthesia method for bronchoscopy patients is beneficial for stabilizing hemodynamic indices during bronchoscopy and reducing the level of patient stress,with good safety and practicality.展开更多
目的分析无痛分娩中转为剖宫产麻醉方法选择的影响因素、术中指标和新生儿结局,为产妇提供安全有效的麻醉管理。方法收集2018年1月至2023年7月我院接受无痛分娩中转为剖宫产的单胎初产妇临床资料,根据麻醉方式分为全身麻醉(GA)组、持续...目的分析无痛分娩中转为剖宫产麻醉方法选择的影响因素、术中指标和新生儿结局,为产妇提供安全有效的麻醉管理。方法收集2018年1月至2023年7月我院接受无痛分娩中转为剖宫产的单胎初产妇临床资料,根据麻醉方式分为全身麻醉(GA)组、持续硬膜外麻醉(CEA)组、腰硬联合麻醉(CSEA)组,分析选择不同麻醉方法的影响因素、术中指标及新生儿结局。结果研究共纳入404例中转剖宫产的产妇,中转原因为胎儿宫内窘迫、头盆不称、产程异常、持续性枕横(后)位及社会因素。根据麻醉方法分为GA组39例、CEA组277例、CSEA组88例。CEA组、CSEA组胎儿宫内窘迫占比低于GA组,差异有统计学意义(P<0.05);CSEA组社会因素占比高于CEA组,差异有统计学意义(P<0.05)。CEA组、CSEA组产妇入室至切皮时间长于GA组,且CSEA组长于CEA组,差异有统计学意义(P<0.05);GA组、CEA组产妇术中补液量低于CSEA组,且CEA组低于GA组,差异有统计学意义(P<0.05);GA组、CEA组产妇术中低血压发生率明显低于CSEA组,差异有统计学意义(P<0.05);CEA组与CSEA组比较,CEA组麻醉平面更低、转化GA率及术中镇痛补救率更高、恶心呕吐发生率更低,差异有统计学意义(P<0.05)。新生儿出生后1 min、5 min、10 min Apgar评分差异无统计学意义(P>0.05)。结论无痛分娩中转剖宫产麻醉方法主要采用CEA,其次为CSEA,GA占比最低,3种麻醉方式均不影响新生儿评分;GA在胎儿宫内窘迫等紧急情况下采用更广泛,CEA与CSEA各具特点。展开更多
基金Hebei Science and Technology Program,No.162777232(to Xing SS).
文摘BACKGROUND Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases.However,current anesthesia methods,such as spray,nebulized inhalation,and cricothyroid membrane puncture,have their own advantages and disadvantages.Recently,studies have shown that bronchoscopic direct-view glottis anesthesia is a simple and inexpensive method that shortens the examination time and provides excellent anesthetic results.AIM To evaluate the effectiveness of bronchoscopic direct vision glottis anesthesia for bronchoscopy.METHODS The study included 100 patients who underwent bronchoscopy during thoracic surgery.A random number table method was used to divide the patients into control and observation groups(50 patients each).The control and observation groups were anesthetized using the nebulized inhalation and bronchoscopic direct vision glottis method,respectively.Hemodynamic indices[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),and oxygen saturation(SpO_(2))before(T1),5 min after anesthesia(T2),and at the end of the operation(T3)]serum stress hormone indices[norepinephrine(NE),epinephrine(E),adrenocorticotropic hormone(ACTH),and cortisol(Cor)before and after treatment]were compared between the 2 groups.Adverse effects were also RESULTS At T2 and T3,SBP,DBP,and HR were lower in the observation group than the control group,whereas SpO_(2) was higher than the control group[(119.05±8.01)mmHg vs(127.05±7.83)mmHg,(119.35±6.66)mmHg vs(128.39±6.56)mmHg,(84.68±6.04)mmHg vs(92.42±5.57)mmHg,(84.53±4.97)mmHg compared to(92.57±6.02)mmHg,(74.25±5.18)beats/min compared to(88.32±5.72)beats/min,(74.38±5.31)beats/min compared to(88.42±5.69)beats/min,(97.36±2.21)%vs(94.35±2.16)%,(97.42±2.36)%vs(94.38±2.69%],with statistically significant differences(all P<0.05).After treatment,NE,E,ACTH,and Cor were significantly higher in both groups than before treatment,but were lower in the observation group than in the control group[(68.25±8.87)ng/mL vs(93.35±14.00)ng/mL,(53.59±5.89)ng/mL vs(82.32±10.70)ng/mL,(14.32±1.58)pg/mL vs(20.35±3.05)pg/mL,(227.35±25.01)nmol/L vs(322.28±45.12)nmol/L],with statistically significant differences(all P<0.05).The incidence of adverse reactions was higher in the control group than in the observation group[12.00%(12/50)vs 6.00%(3/50)](P<0.05).CONCLUSION The use of bronchoscopic direct vision glottis anesthesia method for bronchoscopy patients is beneficial for stabilizing hemodynamic indices during bronchoscopy and reducing the level of patient stress,with good safety and practicality.
文摘目的分析无痛分娩中转为剖宫产麻醉方法选择的影响因素、术中指标和新生儿结局,为产妇提供安全有效的麻醉管理。方法收集2018年1月至2023年7月我院接受无痛分娩中转为剖宫产的单胎初产妇临床资料,根据麻醉方式分为全身麻醉(GA)组、持续硬膜外麻醉(CEA)组、腰硬联合麻醉(CSEA)组,分析选择不同麻醉方法的影响因素、术中指标及新生儿结局。结果研究共纳入404例中转剖宫产的产妇,中转原因为胎儿宫内窘迫、头盆不称、产程异常、持续性枕横(后)位及社会因素。根据麻醉方法分为GA组39例、CEA组277例、CSEA组88例。CEA组、CSEA组胎儿宫内窘迫占比低于GA组,差异有统计学意义(P<0.05);CSEA组社会因素占比高于CEA组,差异有统计学意义(P<0.05)。CEA组、CSEA组产妇入室至切皮时间长于GA组,且CSEA组长于CEA组,差异有统计学意义(P<0.05);GA组、CEA组产妇术中补液量低于CSEA组,且CEA组低于GA组,差异有统计学意义(P<0.05);GA组、CEA组产妇术中低血压发生率明显低于CSEA组,差异有统计学意义(P<0.05);CEA组与CSEA组比较,CEA组麻醉平面更低、转化GA率及术中镇痛补救率更高、恶心呕吐发生率更低,差异有统计学意义(P<0.05)。新生儿出生后1 min、5 min、10 min Apgar评分差异无统计学意义(P>0.05)。结论无痛分娩中转剖宫产麻醉方法主要采用CEA,其次为CSEA,GA占比最低,3种麻醉方式均不影响新生儿评分;GA在胎儿宫内窘迫等紧急情况下采用更广泛,CEA与CSEA各具特点。
