AIM To compare the results of midazolam-ketaminepropofol sedation performed by an endoscopy nurse and anaesthetist during colonoscopy in terms of patient satisfaction and safety.METHODS American Statistical Associatio...AIM To compare the results of midazolam-ketaminepropofol sedation performed by an endoscopy nurse and anaesthetist during colonoscopy in terms of patient satisfaction and safety.METHODS American Statistical Association(ASA) Ⅰ-Ⅱ 60 patients who underwent colonoscopy under sedation were randomly divided into two groups: sedation under the supervision of an anaesthetist(SSA) and sedation under the supervision of an endoscopy nurse(SSEN). Both groups were initially administered 1 mg midazolam, 50 mg ketamine and 30-50 mg propofol. Continuation of sedation was performed by the anaesthetist in the SSAgroup and the nurse with a patient-controlled analgesia(PCA) pump in the SSEN group. The total propofol consumption, procedure duration, recovery times, pain using the visual analogue scale(VAS) and satisfaction score of the patients, and side effects were recorded. In addition, the patients were asked whether they remembered the procedure and whether they would prefer the same method in the case of re-endoscopy.RESULTS Total propofol consumption in the SSEN group was significantly higher(P < 0.05) than that in the SSA group. When the groups were compared in terms of VAS score, recovery time, patient satisfaction, recall of the procedure, re-preference for the same method in case of re-endoscopy, and side effects, there were no significant differences(P > 0.05) between the two groups. No long-term required intervention side effects were observed in either group.CONCLUSION Colonoscopy sedation in ASA Ⅰ-Ⅱ patients can be safely performed by an endoscopy nurse using PCA pump with the incidence of side effects and patient satisfaction levels similar to sedation under anaesthetist supervision.展开更多
Objective:To compare the effect of ketamine,lidocaine,acetaminophen,and dexmedetomidine combined with morphine patient-controlled analgesia for opium addicts after tibial fracture surgery.Methods:This double-blind cli...Objective:To compare the effect of ketamine,lidocaine,acetaminophen,and dexmedetomidine combined with morphine patient-controlled analgesia for opium addicts after tibial fracture surgery.Methods:This double-blind clinical trial included opium-addicted patients undergoing tibia fracture surgery.Patients were recruited and randomized to four different groups including the ketamine group,the lidocaine group,the acetaminophen group,and the dexmedetomidine group.The hemodynamic parameters such as heart rate(HR),mean arterial pressure,and arterial SaO2,alongside visual analog scale pain scores,sedation assessed by Ramsay score,nausea and vomiting,and opioid use were recorded and compared among the four groups.Results:This study included 140 patients,aged 37(32,41)years,with 92 males and 48 females,and each group had 35 patients.Dexmedetomidine-sedated subjects had the lowest blood pressure from 1 to 24 h after surgery,decreased HR at 12 and 24 h after surgery,and more satisfactory sedation(P<0.05).Notwithstanding no significant difference was noted in the pain scores,or nausea and vomiting among the groups(P>0.05).Conclusions:Dexmedetomidine has a better sedation effect compared to ketamine,lidocaine,and acetaminophen for pain control,but the final choice hinges on the patients’physical condition and the anesthesiologist's preference.Clinical registration:It is registered in Iranian Registry Clinical Trial by code IRCT20141209020258N146.展开更多
目的探讨脉冲泵椎管内分娩镇痛失败中转剖宫产的麻醉方式。方法120例脉冲泵椎管内分娩镇痛失败中转剖宫产产妇为研究对象,按随机数字表法分为A、B、C三组,各40例。A组实施腰硬联合麻醉,B组使用分娩镇痛留置的导管行硬膜外麻醉,C组实施...目的探讨脉冲泵椎管内分娩镇痛失败中转剖宫产的麻醉方式。方法120例脉冲泵椎管内分娩镇痛失败中转剖宫产产妇为研究对象,按随机数字表法分为A、B、C三组,各40例。A组实施腰硬联合麻醉,B组使用分娩镇痛留置的导管行硬膜外麻醉,C组实施气管插管全身麻醉(全麻)。比较三组围麻醉期并发症发生率,入室至切皮时间及麻醉至胎儿取出时间,新生儿出生时、出生1 min和出生5 min Apgar评分。结果C组围麻醉期高血压、低血压、恶心呕吐发生率显著低于A组和B组(P<0.05);三组围麻醉期误吸发生率比较差异无统计学意义(P>0.05)。C组入室至切皮时间和麻醉至胎儿取出时间分别为(8.2±1.6)、(5.3±0.7)min,均短于A组的(15.7±2.6)、(12.2±2.5)min和B组的(15.6±2.7)、(11.5±2.3)min(P<0.05)。C组新生儿出生时、出生1 min和出生5 min Apgar评分分别为(7.8±1.4)、(8.6±0.4)、(9.1±0.7)分,均显著高于A组的(7.0±0.7)、(7.4±0.6)、(8.0±0.5)分和B组的(7.1±0.8)、(7.5±0.6)、(8.1±0.5)分(P<0.05)。结论气管插管全麻用于脉冲泵椎管内分娩镇痛分娩失败中转剖宫产者,具有并发症少,快速娩出胎儿,减少新生儿窒息风险等优势。展开更多
镇痛泵是一种常用于术后镇痛的医疗设备,通过输送镇痛药物直接到患者体内,提供持续的镇痛效果。许多研究表明,镇痛泵在术后镇痛中具有一定的优势。首先,它可以提供更精确的药物输送,确保患者在术后期间得到恰当的镇痛效果。其次,镇痛泵...镇痛泵是一种常用于术后镇痛的医疗设备,通过输送镇痛药物直接到患者体内,提供持续的镇痛效果。许多研究表明,镇痛泵在术后镇痛中具有一定的优势。首先,它可以提供更精确的药物输送,确保患者在术后期间得到恰当的镇痛效果。其次,镇痛泵可以减少系统性副作用的发生,如恶心、呕吐和意识模糊等。这对于那些不能耐受口服镇痛药物的患者尤为重要。此外,镇痛泵还有助于提高患者的满意度,缓解疼痛并促进康复。本研究旨在对镇痛泵在术后镇痛中的应用进行全面评估,包括利与弊的综合分析,并提供数据支持。我们通过回顾相关文献和临床研究,总结了镇痛泵在术后镇痛中的关键优点和限制。利方面的数据支持显示,镇痛泵在术后镇痛中具有显著的效果。例如,一项针对腹部手术的研究发现,使用镇痛泵的患者在术后24h内的疼痛评分显著低于常规镇痛组(3.2 VS 5.8,P<0.001)。此外,镇痛泵组的患者还呈现较少的镇痛药物需要量(22.5 mg VS 47.6 mg,P<0.001)。另一项研究发现,镇痛泵在膝关节置换手术中的应用可以显著减少术后的镇痛药物副作用,如恶心和呕吐的发生率降低到5%以下。然而,弊端方面的数据也需要考虑。一些研究指出,使用镇痛泵可能存在并发症和风险,如感染、药物过量或药物误用。这需要医疗团队在使用镇痛泵时严密监测和管理,以减少潜在的风险。此外,使用镇痛泵也涉及到额外的成本和资源需求。一项经济评估研究发现,与传统的镇痛方法相比,镇痛泵的使用会增加术后镇痛的总费用。综合评估表明,镇痛泵在术后镇痛中具有明显的优势,但同时也伴随着一些限制。因此,在应用镇痛泵时,医疗团队应该充分考虑患者的情况和需要,并权衡其利与弊。同时,确保适当的监测和管理以减少并发症的风险,并进行合理的资源利用,将有助于确保镇痛泵的安全有效应用。展开更多
目的探讨智能化自控镇痛泵对初产妇分娩镇痛效果、妊娠结局及泌乳功能的影响。方法将2021年4月至2022年8月在河北省衡水市妇幼保健院产科行无痛分娩的220例初产妇用随机数字表法分为两组,均实施硬膜外麻醉,对照组采取常规镇痛泵(PCA),...目的探讨智能化自控镇痛泵对初产妇分娩镇痛效果、妊娠结局及泌乳功能的影响。方法将2021年4月至2022年8月在河北省衡水市妇幼保健院产科行无痛分娩的220例初产妇用随机数字表法分为两组,均实施硬膜外麻醉,对照组采取常规镇痛泵(PCA),观察组使用智能化自控镇痛泵(Ai-PCA),对比两组的镇痛情况及血流动力学、各项分娩指标、妊娠结局、产后出血及泌乳情况。结果观察组T1-T3的VAS疼痛评分低于对照组(P<0.05),而两组各时间点的MAP、HR相当(P>0.05);观察组产程时间短于对照组,罗哌卡因及舒芬太尼用量少于对照组,PCA追加次数少于对照组,镇痛满意度评分高于对照组(P<0.05),两组镇痛时间、10 min Apgar评分相当(P>0.05);观察组中转剖宫产、侧切率与对照组相当(P>0.05),低血压、恶心呕吐、皮肤瘙痒、尿潴留、发热等不良反应发生率低于对照组(P<0.05);观察组产后2h及24h出血量少于对照组,产后开始泌乳时间短于对照组,泌乳率高于对照组(P<0.05)。结论Ai-PCA对初产妇分娩镇痛有显著效果,能缩短产程,减少镇痛药物用量,对妊娠结局影响小,且能减少产后出血量,缩短泌乳时间。展开更多
文摘AIM To compare the results of midazolam-ketaminepropofol sedation performed by an endoscopy nurse and anaesthetist during colonoscopy in terms of patient satisfaction and safety.METHODS American Statistical Association(ASA) Ⅰ-Ⅱ 60 patients who underwent colonoscopy under sedation were randomly divided into two groups: sedation under the supervision of an anaesthetist(SSA) and sedation under the supervision of an endoscopy nurse(SSEN). Both groups were initially administered 1 mg midazolam, 50 mg ketamine and 30-50 mg propofol. Continuation of sedation was performed by the anaesthetist in the SSAgroup and the nurse with a patient-controlled analgesia(PCA) pump in the SSEN group. The total propofol consumption, procedure duration, recovery times, pain using the visual analogue scale(VAS) and satisfaction score of the patients, and side effects were recorded. In addition, the patients were asked whether they remembered the procedure and whether they would prefer the same method in the case of re-endoscopy.RESULTS Total propofol consumption in the SSEN group was significantly higher(P < 0.05) than that in the SSA group. When the groups were compared in terms of VAS score, recovery time, patient satisfaction, recall of the procedure, re-preference for the same method in case of re-endoscopy, and side effects, there were no significant differences(P > 0.05) between the two groups. No long-term required intervention side effects were observed in either group.CONCLUSION Colonoscopy sedation in ASA Ⅰ-Ⅱ patients can be safely performed by an endoscopy nurse using PCA pump with the incidence of side effects and patient satisfaction levels similar to sedation under anaesthetist supervision.
文摘Objective:To compare the effect of ketamine,lidocaine,acetaminophen,and dexmedetomidine combined with morphine patient-controlled analgesia for opium addicts after tibial fracture surgery.Methods:This double-blind clinical trial included opium-addicted patients undergoing tibia fracture surgery.Patients were recruited and randomized to four different groups including the ketamine group,the lidocaine group,the acetaminophen group,and the dexmedetomidine group.The hemodynamic parameters such as heart rate(HR),mean arterial pressure,and arterial SaO2,alongside visual analog scale pain scores,sedation assessed by Ramsay score,nausea and vomiting,and opioid use were recorded and compared among the four groups.Results:This study included 140 patients,aged 37(32,41)years,with 92 males and 48 females,and each group had 35 patients.Dexmedetomidine-sedated subjects had the lowest blood pressure from 1 to 24 h after surgery,decreased HR at 12 and 24 h after surgery,and more satisfactory sedation(P<0.05).Notwithstanding no significant difference was noted in the pain scores,or nausea and vomiting among the groups(P>0.05).Conclusions:Dexmedetomidine has a better sedation effect compared to ketamine,lidocaine,and acetaminophen for pain control,but the final choice hinges on the patients’physical condition and the anesthesiologist's preference.Clinical registration:It is registered in Iranian Registry Clinical Trial by code IRCT20141209020258N146.
文摘目的探讨脉冲泵椎管内分娩镇痛失败中转剖宫产的麻醉方式。方法120例脉冲泵椎管内分娩镇痛失败中转剖宫产产妇为研究对象,按随机数字表法分为A、B、C三组,各40例。A组实施腰硬联合麻醉,B组使用分娩镇痛留置的导管行硬膜外麻醉,C组实施气管插管全身麻醉(全麻)。比较三组围麻醉期并发症发生率,入室至切皮时间及麻醉至胎儿取出时间,新生儿出生时、出生1 min和出生5 min Apgar评分。结果C组围麻醉期高血压、低血压、恶心呕吐发生率显著低于A组和B组(P<0.05);三组围麻醉期误吸发生率比较差异无统计学意义(P>0.05)。C组入室至切皮时间和麻醉至胎儿取出时间分别为(8.2±1.6)、(5.3±0.7)min,均短于A组的(15.7±2.6)、(12.2±2.5)min和B组的(15.6±2.7)、(11.5±2.3)min(P<0.05)。C组新生儿出生时、出生1 min和出生5 min Apgar评分分别为(7.8±1.4)、(8.6±0.4)、(9.1±0.7)分,均显著高于A组的(7.0±0.7)、(7.4±0.6)、(8.0±0.5)分和B组的(7.1±0.8)、(7.5±0.6)、(8.1±0.5)分(P<0.05)。结论气管插管全麻用于脉冲泵椎管内分娩镇痛分娩失败中转剖宫产者,具有并发症少,快速娩出胎儿,减少新生儿窒息风险等优势。
文摘镇痛泵是一种常用于术后镇痛的医疗设备,通过输送镇痛药物直接到患者体内,提供持续的镇痛效果。许多研究表明,镇痛泵在术后镇痛中具有一定的优势。首先,它可以提供更精确的药物输送,确保患者在术后期间得到恰当的镇痛效果。其次,镇痛泵可以减少系统性副作用的发生,如恶心、呕吐和意识模糊等。这对于那些不能耐受口服镇痛药物的患者尤为重要。此外,镇痛泵还有助于提高患者的满意度,缓解疼痛并促进康复。本研究旨在对镇痛泵在术后镇痛中的应用进行全面评估,包括利与弊的综合分析,并提供数据支持。我们通过回顾相关文献和临床研究,总结了镇痛泵在术后镇痛中的关键优点和限制。利方面的数据支持显示,镇痛泵在术后镇痛中具有显著的效果。例如,一项针对腹部手术的研究发现,使用镇痛泵的患者在术后24h内的疼痛评分显著低于常规镇痛组(3.2 VS 5.8,P<0.001)。此外,镇痛泵组的患者还呈现较少的镇痛药物需要量(22.5 mg VS 47.6 mg,P<0.001)。另一项研究发现,镇痛泵在膝关节置换手术中的应用可以显著减少术后的镇痛药物副作用,如恶心和呕吐的发生率降低到5%以下。然而,弊端方面的数据也需要考虑。一些研究指出,使用镇痛泵可能存在并发症和风险,如感染、药物过量或药物误用。这需要医疗团队在使用镇痛泵时严密监测和管理,以减少潜在的风险。此外,使用镇痛泵也涉及到额外的成本和资源需求。一项经济评估研究发现,与传统的镇痛方法相比,镇痛泵的使用会增加术后镇痛的总费用。综合评估表明,镇痛泵在术后镇痛中具有明显的优势,但同时也伴随着一些限制。因此,在应用镇痛泵时,医疗团队应该充分考虑患者的情况和需要,并权衡其利与弊。同时,确保适当的监测和管理以减少并发症的风险,并进行合理的资源利用,将有助于确保镇痛泵的安全有效应用。
文摘目的探讨智能化自控镇痛泵对初产妇分娩镇痛效果、妊娠结局及泌乳功能的影响。方法将2021年4月至2022年8月在河北省衡水市妇幼保健院产科行无痛分娩的220例初产妇用随机数字表法分为两组,均实施硬膜外麻醉,对照组采取常规镇痛泵(PCA),观察组使用智能化自控镇痛泵(Ai-PCA),对比两组的镇痛情况及血流动力学、各项分娩指标、妊娠结局、产后出血及泌乳情况。结果观察组T1-T3的VAS疼痛评分低于对照组(P<0.05),而两组各时间点的MAP、HR相当(P>0.05);观察组产程时间短于对照组,罗哌卡因及舒芬太尼用量少于对照组,PCA追加次数少于对照组,镇痛满意度评分高于对照组(P<0.05),两组镇痛时间、10 min Apgar评分相当(P>0.05);观察组中转剖宫产、侧切率与对照组相当(P>0.05),低血压、恶心呕吐、皮肤瘙痒、尿潴留、发热等不良反应发生率低于对照组(P<0.05);观察组产后2h及24h出血量少于对照组,产后开始泌乳时间短于对照组,泌乳率高于对照组(P<0.05)。结论Ai-PCA对初产妇分娩镇痛有显著效果,能缩短产程,减少镇痛药物用量,对妊娠结局影响小,且能减少产后出血量,缩短泌乳时间。
