Comparison of Propofol and Fentanyl for Preventing Emergence Agitation Following Sevoflurane Anesthesia in Pediatric Patients: A Single-Center Study in Bangladesh

Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.

Fentanyl and xylazine crisis:Crafting coherent strategies for opioid overdose prevention

The United States is in the throes of a severe opioid overdose epidemic,primarily fueled by the pervasive use of fentanyl and the emerging threat of xylazine,a veterinary sedative often mixed with fentanyl.The high potency and long duration of fentanyl is compounded by the added risks from xylazine,heightening the lethal danger faced by opioid users.Measures such as enhanced surveillance,public awareness campaigns,and the distribution of fentanylxylazine test kits,and naloxone have been undertaken to mitigate this crisis.Fentanyl-related overdose deaths persist despite these efforts,partly due to inconsistent policies across states and resistance towards adopting harm reduction strategies.A multifaceted approach is imperative in effectively combating the opioid overdose epidemic.This approach should include expansion of treatment access,broadening the availability of medications for opioid use disorder,implementation of harm reduction strategies,and enaction of legislative reforms and diminishing stigma associated with opioid use disorder.

Manner of Death and Fentanyl Related Drug Overdose Trends in Marion County, Indiana, US from 2018 to 2021

The purpose of this research was to investigate the manner of deaths in Marion County, throughout the years of 2018 to 2021 to see if there were any correlative increases in homicide, suicide, natural, accidental, or drug overdose related deaths. We surveyed the incidence of all deaths that occurred from 2018 through 2021 which came through the Marion County Coroner’s Office, Indiana. The data was then divided into two halves. According to the data, the leading manner of death in the first half and second half was accidental. This study revealed a total of 8732 cases: 3817 of them were observed to be accidental, 3092 natural, 956 homicide, 689 suicide, and 178 were undetermined. There were initially 318 drug overdose related deaths in 2018 and they increased to 2163 by 2021. In 2018, the number of deaths due to fentanyl related overdoses increased from 195 to 799 in 2021. This research will contribute to the forensic science field by providing information about the manner of death and fentanyl trends in Marion County over the last four years.

环泊酚与异丙酚在纤维支气管镜检查中的有效性和安全性对比

目的比较接受纤维支气管镜检查的患者使用环泊酚与异丙酚的有效性和安全性。方法选取2023年3—6月在山东省聊城市人民医院接受纤维支气管镜检查的92例患者,随机数字表法均分为环泊酚组和异丙酚组。主要观察指标是纤维支气管镜检查的成功率,次要结果包括人口统计学特征、时间指标、血流动力学、咳嗽严重程度、插管条件、最低氧饱和度、患者和内镜医生的满意度评分、患者重复纤维支气管镜检查意愿以及不良事件的发生率。结果与异丙酚组相比,环泊酚组患者时间指标差异无统计学意义(P>0.05);重复纤维支气管镜检查的意愿、血流动力学、最低氧饱和度以及患者和内镜医生的满意度显著提高(P<0.05)。环泊酚组纤维支气管镜检查成功完成率为91.30%(42/46,95%CI 82.80%~99.80%),异丙酚组纤维支气管镜检查成功完成率为89.13%(41/46,95%CI 79.80%~98.50%)。2组纤维支气管镜检查成功完成率的差异为2.17%(95%CI 1.30%~3.00%)。因此,在接受纤维支气管镜检查的患者中,环泊酚组被认为不劣于异丙酚组(χ^(2)=0.123,P>0.05)。结论环泊酚组患者在纤维支气管镜检查中的有效性不低于丙泊酚组,同时,患者重复纤维支气管镜检查的意愿和满意度均显著提高。

表面增强拉曼光谱技术在新精神活性物质检测中的应用

表面增强拉曼光谱技术具有高灵敏的吸附增强效应,提供更强的拉曼信号,通过观察到的特有分子指纹信息可以对分析物做出鉴别.各类新精神活性物质均有相应的特征拉曼信号,因此将表面增强拉曼光谱技术应用于合成大麻素类、合成卡西酮类、哌嗪类、色胺类、氯胺酮及苯环利定类和芬太尼类等新精神活性物质检测中.方法具有灵敏度高、样品处理简单和检测快速的优点,可为鉴定新精神活性物质的结构类别提供科学依据.本文介绍近年来表面增强拉曼光谱技术在各类新精神活性物质检测中的应用进展,旨在为新精神活性物质的筛查提供参考.

环泊酚复合芬太尼在胃镜检查中的应用剂量分析

目的分析环泊酚复合芬太尼在胃镜检查中的应用剂量。方法选取2021年6月-2023年6月该院收治的99例胃镜检查患者作为研究对象,采用随机数表法分为3组,各33例。A组给予0.3 mg/kg环泊酚+1.5μg/kg芬太尼麻醉,B组给予0.4 mg/kg环泊酚+1.5μg/kg芬太尼麻醉,C组给予0.5 mg/kg环泊酚+1.5μg/kg芬太尼麻醉。比较3组患者麻醉情况、检查情况、脑电双频指数(BIS)、平均动脉压(MAP)、心率(HR)和不良反应发生情况。结果A组首次麻醉成功率低于B组和C组,胃镜检查时间长于B组和C组,苏醒时间和离院时间短于B组和C组,B组苏醒时间和离院时间短于C组,A组T_(2)、T_(3)、T_(4)和T_(5)时点的BIS高于B组和C组,A组T_(2)、T_(3)、T_(4)和T_(5)时点MAP和HR水平低于B组和C组,A组体动和呛咳发生率高于B组和C组,C组低血压和恶心呕吐发生率高于A组和B组,差异均统计学有意义(P<0.05);A组和C组各1例患者因低氧血症停止胃镜操作,B组未出现低氧血症,差异无统计学意义(P>0.05);A组4例、B组6例和C组10例因低血压给予血管活性药物干预,差异有统计学意义(P<0.05)。结论胃镜检查采用0.4 mg/kg环泊酚+1.5μg/kg芬太尼麻醉方案,能够获取较佳的麻醉效果,缩短检查时间和离院时间,稳定患者生命体征,降低不良反应发生率。

Transdermal Fentanyl for Management of Cancer Pain in Elderly Patients in China

Objective: Objective: To assess the effect and adverse effects of transdermal fentanyl for elderly patients with cancer pain in China. Methods: A total of 1664 elderly patients (aged 65-90 with mean age of 72.6) with cancer pain enrolled in the multicenter study from 136 institutes in China. Of them, 408 (28.8%) patients were 75 years old or older. All patients received transdermal fentanyl for the management of cancer pain. The patients were asked to record the attacks of pain, quality of life, and any side effects of the treatment. Results: Baseline mean of pain intensity was 7.34. On day 1, 3, 6, 9 15, and 30, the pain mean scores were decreased to 3.82, 2.80, 2.43, 2.11, 1.83, 1.64 (P=0.000). The effective rate was 97.18%. The mean doses of fentanyl was 31.34 g/h (25-150 g/h) initially, and 40.59 g/h and 47.50 g/h (25-200 g/h) at day 15 and day 30. At treatment day 15, the dose of fentanyl was ranger from 25 to 50 g/h in 91.8% of patients, 75 to 100 g/h in 7.5% patients, and 125 to 200 g/h only in 0.8% patients. The fine quality of life was in 25.4% patients before treatment, and was 71.15% and 73.04% at day 15 and day 30 respectively (P=0.0000). The common side effects were constipation (10.70%), nausea (11.96%), dizzy (6.85%), vomiting (3.85%), sedation (2.40%), Respiratory depression (0.12%). 86.2% patients preferred continue treated by transdermal fentanyl. Conclusions: Transdermal fentanyl for the elderly with cancer pain is effective, safe, convenient, and can improve the quality of life. Transdermal fentanyl can be recommended as a first-line drug for the treatment of elderly patients with moderate to severe cancer pain, and the initial doses is recommended as 25 g/h.

The Effect of Test Dose Fentanyl on Predicting Postoperative Respiratory Depression in Patients with Continuous Intravenous Morphine Analgesia

Objective: To evaluate the effect of test dose fentanyl on predictingpostoperative analgesia and respiratory depression. Methods: Preoperatively the lowest pulseoximeter saturation (SpO_2) under room air breathing was measured after 2 μg/kg of fentanyl givenintravenously in 35 patients who were scheduled with continuous intravenous morphine analgesia (12μg·kg^(-1)·h^(-1)) postoperatively. Results: The test dose fentanyl resulted in respiratorydepression in 19 of 35 cases, while 8 (42.1%) of the 19 cases developed respiratory depressionpostoperatively. However in the rest 16 patients, no patient (0) developed respiratory depression (P< 0.01). The fentanyl-induced lowest SpO_2 significantly correlated with the lowest SpO_2postoperatively (P < 0.01). The analgesia effect in terms of verbal analogue scale was correlatedneither with the fentanyl-induced lowest SpO_2 nor with the lowest SpO_2 postoperatively (P > 0.05).Conclusion: The patient who was sensitive to fentanyl-induced respiratory depression would take ahigh risk to develop postoperative respiratory depression with intravenous morphine analgesia andthe patient with respiratory depression does not always go with satisfactory analgesia.

鞘内注射舒芬太尼与芬太尼对高龄股骨粗隆骨折PFNA内固定术患者的镇痛效果及安全性对比

目的:对比鞘内注射舒芬太尼与芬太尼对高龄股骨粗隆骨折近端股骨钉抗旋(PFNA)内固定术患者的镇痛效果及安全性对比。方法:选取2019年1月—2022年12月于常熟市第五人民医院接受股骨粗隆骨折PFNA内固定术的108例高龄患者作为研究对象,根据随机数表法将患者分为研究组54例与常规组54例。研究组采用鞘内注射舒芬太尼,常规组采用鞘内注射芬太尼。比较两组手术时间、镇痛时间、术后6 h、12 h视觉模拟评分法(VAS)评分及不良反应发生情况。结果:两组手术时间比较,差异无统计学意义(P>0.05);研究组镇痛时间长于常规组,差异有统计学意义(P<0.05)。研究组术后6 h、12 h VAS评分低于常规组,且两组术后12 h VAS评分低于术后6 h,差异有统计学意义(P<0.05)。研究组不良反应发生率低于常规组,差异有统计学意义(P<0.05)。结论:相比芬太尼,舒芬太尼在高龄股骨粗隆骨折PFNA内固定术患者中的镇痛作用显著,能缓解术后疼痛,还可降低不良反应发生率。

基于Cite Space文献分析并观察不同剂量艾司氯胺酮在无痛人工流产术应用效果

目的:运用Cite Space对中国知网(CNKI)数据库主题词“无痛人工流产”和“艾司氯胺酮”的文献进行分析,寻找无痛人工流产研究热点,探讨不同剂量艾司氯胺酮在无痛人工流产术中应用效果。方法:分别以“无痛人工流产”“艾司氯胺酮”为主题词,检索CNKI数据库,将检索得到文献导入CiteSpace软件,荟聚分析2012年1月-2023年1月国内外无痛人工流产研究的前沿热点。选取2023年3-6月本院门诊行无痛人工流产者160例,采用队列分组,艾司氯胺酮(0.1mg/kg)+丙泊酚(E1组),艾司氯胺酮(0.2mg/kg)+丙泊酚(E2组),艾司氯胺酮(0.3mg/kg)+丙泊酚(E3组),芬太尼(1ug/kg)+丙泊酚(F组)。观察各组诱导前(T1)、宫口扩张时(T2)及手术结束(T3)时的心率(HR)、血压(BP)、血氧饱和度(SPO_(2))。记录受术者术后苏醒时间、丙泊酚用量、苏醒后15minVAS评分、麻醉效果以及不良反应发生率。结果:纳入分析的中文文献2210篇,热点变迁分析显示艾司氯胺酮关临床研究文献增多,为无痛人工流产研究热点。临床观察显示,E1组、E2组、E3组T2、T3时MAP和SPO_(2)均高于F组,T2时HR均高于F组(均P<0.05),T3时各组HR无差异(P>0.05)。E2和E3组VAS评分均低于E1组和F组,E1、E2、F组苏醒时间和嗜睡发生率均优于E3组,E1组、E2组、E3组麻醉效果优良率(95.0%、97.5%、97.5%)均优于F组(80.0%),呼吸抑制发生率(5.0%、7.5%、5.0%)均低于F组(27.5%)(均P<0.05)。各组头晕头痛、恶心呕吐、注射痛发生率无差异(P>0.05)。结论:基于CNKI数据库文献荟萃分析发现艾司氯胺酮是目前无痛人工流产领域研究热点,本文临床观察0.2mg/kg艾司氯胺酮复合丙泊酚用于无痛人工流产效果及安全性最佳。

芬太尼类物质的荧光适配体传感器构建及应用

近年来报道,新精神活性物质伪装成零食、饮料等形式进入并潜伏在大众日常生活中。其中芬太尼类物质是典型代表,市场监管和公安侦查均迫切需要现场快速筛查技术和产品的支撑。基于适配体的快速检测技术发展迅速,然而特异性芬太尼类物质适配体研究相对缺乏。该文以芬太尼类物质的核心结构类似物的裁剪适配体为识别元件,以Fe_(3)O_(4)作为猝灭剂和磁分离剂,利用荧光猝灭技术构建适配体传感平台,对芬太尼类物质实现广谱识别。结果表明,该荧光传感器检测芬太尼类物质为100~500μg/L,R为0.9977,检测限为19.7μg/L,相对标准偏差为5.91%~7.51%,在非居民用水和居民用水中加标回收率分别为81.14%~91.54%和106.7%~117.4%,可用于水样芬太尼类物质的快速筛查,填补芬太尼总量广谱快速检测方面研究的空白。

白噪声联合握力球干预对心房颤动射频消融术患者的影响

目的探讨白噪声联合握力球干预对心房颤动射频消融术患者的影响。方法将177例行射频消融术的心房颤动患者按照随机数字表法分为三组各59例。对照组术中给予常规护理;握力球组在对照组的基础上持握力球,术中不适时随意加压握力球;白噪声+握力球组(联合组)在握力球组的基础上进入手术室即佩戴耳机播放预先选择的白噪声音乐。结果三组分别有51、52、50例完成研究。干预后,在消融术10 min时(T2)、消融到左右肺静脉前壁(T3)和后壁(T4)时,三组疼痛评分、焦虑评分、芬太尼使用总剂量比较,差异有统计学意义,且联合组显著低于或少于握力球组和对照组(均P<0.05)。三组T2、T3、T4的生命体征比较,差异有统计学意义,联合组心率及收缩压的稳定性优于握力球组和对照组(均P<0.05)。结论白噪声联合握力球干预可有效缓解心房颤动患者在射频消融术中的疼痛感和焦虑情绪,维持患者生命体征稳定。

高效液相色谱法测定枸橼酸芬太尼注射液有关物质含量

目的建立测定枸橼酸芬太尼注射液中有关物质含量的高效液相色谱(HPLC)法。方法色谱柱为Shim-packscepter C_(18)-120柱(150 mm×4.6 mm,5μm),流动相为0.01 mol/L氯化铵溶液-乙腈(950∶50,V/V)-0.01 mol/L氯化铵溶液-乙腈(400∶600,V/V),梯度洗脱,流速为1.0 mL/min,检测波长为210 nm,柱温为40℃,进样量为100μL。结果杂质Ⅰ、杂质Ⅱ、杂质Ⅲ、杂质Ⅺ的质量浓度分别在0.02~0.50μg/mL、0.02~0.50μg/mL、0.02~0.49μg/mL、0.02~0.50μg/mL范围内与峰面积线性关系良好(r>0.993);检测限分别为1.00,1.00,0.98,1.00 ng,定量限分别为2.01,2.00,1.97,2.01 ng;重复性试验结果各杂质的RSD均小于2.0%(n=6);中间精密度试验结果各杂质的RSD均小于3.0%(n=12);平均加样回收率分别为98.03%,100.04%,97.94%,101.03%,RSD分别为1.61%,1.09%,0.98%,1.36%(n=9);2种规格(各3批)的中试样品中各特定杂质及未知杂质的含量均小于0.05%(忽略限)。结论该方法操作简便,专属性强,灵敏度、耐用性好,准确度、精密度较高,各杂质分离度优于《中国药典》《英国药典》中的方法,可用于枸橼酸芬太尼注射液中有关物质的含量测定。拟订样品中含杂质Ⅰ、杂质Ⅱ和杂质Ⅺ不得过标示量的0.5%,最大未知杂质不得过0.2%,总未知杂质不得过0.75%。

布托啡诺联合右美托咪定在重症急性胰腺炎患者中的应用

目的探讨布托啡诺联合右美托咪定在重症急性胰腺炎(SAP)患者中的镇痛镇静效果。方法将2017年1月至2022年10月空军军医大学西京医院重症医学科收治的符合入组标准的SAP患者63例纳入本研究。布托啡诺联合右美托咪定组28例(A组),芬太尼联合右美托咪定组35例(B组)。观察两组间镇静镇痛效果及预后的影响。将两组患者心率、呼吸、Richmond躁动镇静评分(RASS)以及重症监护疼痛观察量表(CPOT)及胃残余量进行对比。结果统计分析发现,A组患者心率、呼吸频率、CPOT评分、RASS评分及胃残余量较B组均降低,差异均有统计学意义[(82.16±7.41)次/min vs(104.64±10.30)次/min,(19.43±3.92)次/min vs(27.18±4.21)次/min,(0.94±0.31)分vs(2.32±0.35)分,(1.20±0.44)分vs(0.91±0.47)分,(89.74±12.28)mL vs(142.43±18.57)mL]。结论对SAP患者采用布托啡诺联合右美托咪定方案镇痛镇静效果确切有效,并发症较少,可提高临床治疗效果,血流动力学稳定,安全性较高,值得临床推广应用。

环泊酚与丙泊酚复合芬太尼在重症监护室清醒患者中行无痛支气管镜检查的应用效果对比

目的对比环泊酚与丙泊酚复合芬太尼在重症监护室(ICU)清醒患者中行无痛纤维支气管镜检查的麻醉效果和安全性。方法选取2022年10月-2023年1月该院行无痛纤维支气管镜检查的清醒患者60例。按照随机数表法,分为对照组(丙泊酚1.5 mg/kg+芬太尼1μg/kg,30例)和实验组(环泊酚0.4 mg/kg+芬太尼1μg/kg,30例)。记录两组患者麻醉前(T_(1))、检查中(T_(2))和检查完成时(T_(3))的收缩压、舒张压、心率、呼吸频率和经皮动脉血氧饱和度(SpO_(2)),比较两组患者全身麻醉诱导成功率、麻醉诱导时间、支气管镜操作时间、睁眼时间、药物使用总量、注射痛发生率和术中不良反应(低血压、呼吸抑制、心动过缓和呛咳)发生率。结果两组患者不同时点的收缩压、舒张压、心率和呼吸频率的组间、时间和交互作用比较,差异均有统计学意义(P<0.05);实验组麻醉诱导时间为1.40(1.10,1.62)min,短于对照组的1.60(1.30,2.10)min,差异有统计学意义(P<0.05);实验组药物使用总量为(21.40±1.82)mg,少于对照组的(78.75±6.71)mg,差异有统计学意义(P<0.05);实验组注射痛发生率为3.33%,呼吸抑制发生率为6.67%,低于对照组的36.67%和30.00%,差异均有统计学意义(P<0.05)。结论环泊酚复合芬太尼用于无痛支气管镜检查,麻醉效果好,安全性高,且不良反应发生率低,值得应用于临床。

4-取代Fentanyl类化合物电子结构及构效关系研究

本文对十一个4-取代Fentanyl类化合物进行了量子化学(INDO)计算,研究了它们的电子结构及构效关系.结果表明,这些化合物同其他Fentanyl类化合物在主要活性部位和电子结构趋势上基本相同.酰胺氧原子是最重要的负电中心,哌啶氮原子在季铵化后发挥正电中心作用.4-取代基的极性基团可能以电荷转移作用或氢键接受体形式与受体极性部位结合,并能影响其他活性部位电子密度,另外,4-取代基的立体因素与疏水因素同生物活性相关.

艾司氯胺酮联合丙泊酚用于危重症患者无痛纤维支气管镜检查中的有效性及安全性

目的 观察艾司氯胺酮联合丙泊酚用于危重症患者无痛纤维支气管镜(FOB)检查中的有效性及安全性。方法 选择2021年2月至2022年10月行无痛FOB检查的80例危重症患者,按照随机数字表法将其分为对照组和观察组,各40例。两组均静脉泵入丙泊酚行麻醉诱导,对照组静脉注射芬太尼,观察组静脉注射艾司氯胺酮。比较两组不同时间的收缩压(SBP)、舒张压(DBP)、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO_(2));比较两组干预前、干预后8 h的白细胞介素-6(IL-6)和C-反应蛋白(CRP)水平;比较两组的不良事件发生情况。结果 静脉注射芬太尼或艾司氯胺酮1 min时(T_(1))、检查结束5 min(T_(3)),观察组的SBP、DBP、HR、RR高于对照组(P <0.05);支气管镜置入近气管隆突处(T_(2)),观察组的SBP、HR、RR低于对照组(P<0.05);T_(1)~T_(3),观察组的SpO_(2)高于对照组(P<0.05)。干预前、干预后8 h,两组的IL-6、CRP水平无显著差异(P>0.05)。观察组的低血压、心动过缓、低氧饱和度、RR下降发生率低于对照组(P<0.05);两组的憋气反应、呛咳反应、体动反应发生率无显著差异(P>0.05)。结论 艾司氯胺酮联合丙泊酚应用于ICU危重症患者床边无痛FOB检查中的效果显著,患者血流动力学更稳定、不良反应发生率更低。

Randomized Double-Blind Controlled Clinical Study of Ciprofol and Propofol in Patients with Painless Artificial Abortion

Background and Objectives: Propofol is a commonly used intravenous anesthetic for painless artificial abortion, but the injection pain and related adverse reactions such as those related to respiration and circulation it induces have also been criticized. We aimed to conduct a comparative study on the efficacy, safety and comfort of ciprofol and propofol applied in painless artificial abortion. Materials and Methods: A total of 140 early pregnant patients undergoing painless induced abortion were selected and randomly divided into the ciprofol combined with fentanyl group (Group C) and the propofol combined with fentanyl group (Group P), with 70 cases in each group. The anesthetic effect, depth of anesthesia sedation (NI), onset time, recovery time, recovery time of orientation, retention time in the anesthesia recovery room and total amount of intravenous anesthetic drug were recorded in both groups. The respiratory rate (RR), oxygen saturation (SpO2), mean arterial pressure (MAP), and heart rate (HR) at different time points were recorded. The occurrence of perioperative adverse events, injection pain, postoperative nausea and vomiting, and dizziness were compared. The pain score at 30 minutes after operation and the satisfaction of patients and surgeons with anesthesia were evaluated. Results: The success rate of anesthesia in both groups was 100%. There were no statistically significant differences in the NI value at each time point, intraoperative body movement, recovery time, recovery time of orientation, retention time in the anesthesia recovery room, and total dosage of sedative drugs (ml) between the two groups;the onset time in Group C was longer than that in Group P, with a statistically significant difference (P Conclusion: The efficacy of ciprofol in painless induced abortion is equivalent to that of propofol, and the incidence of adverse reactions is lower than that of propofol, with higher safety and comfort.

双侧MUBSCPB复合全身麻醉对甲状腺开放性手术患者麻醉恢复情况及阿片类药物用量的影响

目的探讨双侧改良超声引导双侧颈浅丛阻滞(MUBSCPB)复合全身麻醉对甲状腺开放性手术患者疼痛、麻醉恢复情况及阿片类药物用量的影响,以期为临床治疗提供参考。方法选取2023年1—12月于新疆医科大学附属肿瘤医院行甲状腺开放性手术治疗的100例患者为研究对象。根据患者麻醉方法分组,将接受全身麻醉的49例患者纳入全麻组,将接受双侧MUBSCPB复合全身麻醉的51例患者纳入联合组。比较2组患者围术期指标[手术时间、麻醉时间及平均动脉压(MBP)、心率(HR)波动水平];观察2组患者清醒时、术后4 h、术后12 h、术后24 h疼痛程度[疼痛数字评价(NRS)评分];比较2组患者麻醉恢复情况(睁眼时间、自主呼吸时间、拔管时间、答问切题时间)及术中芬太尼、术后吗啡用量;比较2组患者术后24 h恢复质量[40项恢复质量评分量表(QoR-40)评分]。结果2组患者手术时间、麻醉时间比较,差异均无统计学意义(P>0.05);联合组患者MBP、HR波动水平小于全麻组,差异均有统计学意义(P<0.05)。清醒时、术后4 h、术后12 h,联合组患者NRS评分均低于全麻组,差异均有统计学意义(P<0.05)。术后24 h,2组患者NRS评分比较,差异无统计学意义(P>0.05)。联合组患者术中芬太尼用量、术后吗啡用量均小于全麻组患者,差异有统计学意义(P<0.05)。联合组患者睁眼、自主呼吸、拔管及答问切题时间均短于全麻组,差异均有统计学意义(P<0.05)。术后24 h,联合组患者QoR-40中身体舒适、情绪状态、自理能力、心理支持、疼痛评分均高于全麻组,差异均有统计学意义(P<0.05)。结论双侧MUBSCPB复合全身麻醉可缩小甲状腺开放性手术患者血流动力学指标波动范围,减轻术后疼痛,减少术中芬太尼用量及术后吗啡用量,同时促进麻醉恢复和术后康复,值得推广应用。

战术区战创伤镇痛策略的研究现状与展望

战创伤后的剧烈疼痛会引起伤员一系列不良反应,甚至危及生命。及时有效的战术区镇痛可以减轻伤员的痛苦,减少并发症的发生,对改善伤员预后和恢复轻伤员的战斗力具有重要意义。近年来,战创伤镇痛的研究向着提高药物应用安全性及优化给药策略的方向发展。本综述总结了目前国际上战创伤镇痛采用的主流药物和镇痛技术,并对其在战术区中的适用性进行了详细分析,介绍了战场针灸、连续周围神经阻滞、冷冻神经消融术、经皮周围神经电刺激和经皮给药系统等重要战创伤镇痛技术,展望了战创伤镇痛未来可能的发展方向,以期为今后该领域的研究提供参考。