Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our...Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion.展开更多
Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have redu...Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.展开更多
Objective: To discuss the effect of combined spinal and epidural anesthesia on the levels of pain media, stress indicators and inflammatory factors in patients undergoing high altitude cesarean section. Methods: Eight...Objective: To discuss the effect of combined spinal and epidural anesthesia on the levels of pain media, stress indicators and inflammatory factors in patients undergoing high altitude cesarean section. Methods: Eighty patients who underwent cesarean section in our hospital from January 2017 to April 2019 were enrolled in the hospital. They were divided into two groups according to the patient's anesthesia. Fourty patients receiving epidural anesthesia were included in the control group, and another 40 patients received lumbar stiffness. The combined anesthesia patient was included in the observation group. Changes in pain mediators [Serum neuropeptide Y (NPY), endorphin (β-EP), substance P (SP)], stress indicators [Serum cortisol (Cor), C-peptide (C-P), advanced oxidative protein product (AOPP)], inflammatory factor levels [Hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α)], and immunoglobulin levels [Serum IgA, IgG, IgM] were compared between the two groups. Results: Before anesthesia, there were no significant difference in pain media, stress index, inflammatory factor level and immunoglobulin level between the two groups (P>0.05). At 12 h after operation, the two groups of patients were NPY, β-EP, SP, Cor. The levels of C-P, AOPP, hs-CRP and TNF-α were higher than those before operation (P<0.05). The levels of IgA, IgG and IgM were lower than those before operation (P<0.05). Among them, observation group NPY, β-EP, SP, Cor, C-P, AOPP, hs-CRP and TNF-α were significantly lower than those of the control group (P<0.05). The serum levels of IgA, IgG and IgM were significantly higher than those of the control group (P<0.05). Conclusion: Combined spinal and epidural anesthesia can more effectively alleviate maternal pain in high altitude cesarean section, more effectively reduce the inflammatory stress response of patients, promote the humoral immune function of patients, and is beneficial to the early recovery of maternal postoperative, and has high clinical value.展开更多
目的研究腰-硬联合麻醉在无痛分娩中的应用效果。方法选取2021年1月至2022年12月景德镇市第二人民医院收治的100例无痛分娩的产妇作为研究对象。依据麻醉方案不同将其分成观察组(n=52)和对照组(n=48)。对照组接受硬膜外麻醉,观察组接受...目的研究腰-硬联合麻醉在无痛分娩中的应用效果。方法选取2021年1月至2022年12月景德镇市第二人民医院收治的100例无痛分娩的产妇作为研究对象。依据麻醉方案不同将其分成观察组(n=52)和对照组(n=48)。对照组接受硬膜外麻醉,观察组接受腰-硬联合麻醉。比较两组患者的麻醉起效时间、产程、疼痛程度、麻醉不良反应、妊娠结局及新生儿Apgar评分。结果观察组产妇的麻醉起效时间短于对照组,差异有统计学意义(P<0.05);观察组产妇的第一、第二产程短于对照组,差异有统计学意义(P<0.05);两组第三产程比较,差异无统计学意义(P>0.05);观察组产妇麻醉后5、30和60 min的疼痛评分低于对照组,差异有统计学意义(P<0.05);观察组产妇的麻醉相关不良反应发生率低于对照组,差异有统计学意义(P<0.05);观察组新生儿的出生后1 min Apgar评分高于对照组,差异有统计学意义(P<0.05)。结论无痛分娩中选择硬膜外麻醉与腰-硬联合麻醉均可实现镇痛效果,但腰-硬联合麻醉方案优势更为明显,主要体现在麻醉起效迅速,术中可获得良好镇痛效果,缩短产程,可提高麻醉安全性避免相关并发症的出现,具备临床推广价值。展开更多
基金Weifang Municipal Science and Technology Bureau(Medical)Project“Effects and Mechanisms of Oxycodone and Alfentanil on IgFs in Mouse Ovarian Granulosa Cells”(2021YX035)。
文摘Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion.
文摘Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.
基金supported by Scientific Project of Sichuan Hygiene and Family Planning Committee(No.18PJ169).
文摘Objective: To discuss the effect of combined spinal and epidural anesthesia on the levels of pain media, stress indicators and inflammatory factors in patients undergoing high altitude cesarean section. Methods: Eighty patients who underwent cesarean section in our hospital from January 2017 to April 2019 were enrolled in the hospital. They were divided into two groups according to the patient's anesthesia. Fourty patients receiving epidural anesthesia were included in the control group, and another 40 patients received lumbar stiffness. The combined anesthesia patient was included in the observation group. Changes in pain mediators [Serum neuropeptide Y (NPY), endorphin (β-EP), substance P (SP)], stress indicators [Serum cortisol (Cor), C-peptide (C-P), advanced oxidative protein product (AOPP)], inflammatory factor levels [Hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α)], and immunoglobulin levels [Serum IgA, IgG, IgM] were compared between the two groups. Results: Before anesthesia, there were no significant difference in pain media, stress index, inflammatory factor level and immunoglobulin level between the two groups (P>0.05). At 12 h after operation, the two groups of patients were NPY, β-EP, SP, Cor. The levels of C-P, AOPP, hs-CRP and TNF-α were higher than those before operation (P<0.05). The levels of IgA, IgG and IgM were lower than those before operation (P<0.05). Among them, observation group NPY, β-EP, SP, Cor, C-P, AOPP, hs-CRP and TNF-α were significantly lower than those of the control group (P<0.05). The serum levels of IgA, IgG and IgM were significantly higher than those of the control group (P<0.05). Conclusion: Combined spinal and epidural anesthesia can more effectively alleviate maternal pain in high altitude cesarean section, more effectively reduce the inflammatory stress response of patients, promote the humoral immune function of patients, and is beneficial to the early recovery of maternal postoperative, and has high clinical value.
文摘目的研究腰-硬联合麻醉在无痛分娩中的应用效果。方法选取2021年1月至2022年12月景德镇市第二人民医院收治的100例无痛分娩的产妇作为研究对象。依据麻醉方案不同将其分成观察组(n=52)和对照组(n=48)。对照组接受硬膜外麻醉,观察组接受腰-硬联合麻醉。比较两组患者的麻醉起效时间、产程、疼痛程度、麻醉不良反应、妊娠结局及新生儿Apgar评分。结果观察组产妇的麻醉起效时间短于对照组,差异有统计学意义(P<0.05);观察组产妇的第一、第二产程短于对照组,差异有统计学意义(P<0.05);两组第三产程比较,差异无统计学意义(P>0.05);观察组产妇麻醉后5、30和60 min的疼痛评分低于对照组,差异有统计学意义(P<0.05);观察组产妇的麻醉相关不良反应发生率低于对照组,差异有统计学意义(P<0.05);观察组新生儿的出生后1 min Apgar评分高于对照组,差异有统计学意义(P<0.05)。结论无痛分娩中选择硬膜外麻醉与腰-硬联合麻醉均可实现镇痛效果,但腰-硬联合麻醉方案优势更为明显,主要体现在麻醉起效迅速,术中可获得良好镇痛效果,缩短产程,可提高麻醉安全性避免相关并发症的出现,具备临床推广价值。
