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...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.展开更多
AIM： To determine whether listening to music decreases the requirement for dosages of sedative drugs, patients＇ anxiety, pain and dissatisfaction feelings during colonoscopy and makes the procedure more comfortable ...AIM： To determine whether listening to music decreases the requirement for dosages of sedative drugs, patients＇ anxiety, pain and dissatisfaction feelings during colonoscopy and makes the procedure more comfortable and acceptable. METHODS： Patients undergoing elective colonoscopy between October 2005 and February 2006 were randomized into either listening to music （Group 1, n = 30） or not listening to music （Group 2, n = 30）. Anxiolytic and analgesic drugs （intravenous midazolam and meperidine） were given according to the patients＇ demand. Administered medications were monitored. We determined their levels of anxiety using the State-Trait Anxiety Inventory Test form. Patients＇ satisfaction, pain, and willingness to undergo a repeated procedure were self-assessed using a visual analog scale. RESULTS： The mean dose of sedative and analgesic drugs used in group 1 （midazolam： 2.1 ± 1.4, meperidine： 18.1 ± 11.7） was smaller than group 2 （midazolam： 2.4 ± 1.0, meperidine： 20.6 ± 11.5）, but without a significant difference （P 〉 0.05）. The mean anxiety level in group 1 was lower than group 2 （36.7 ± 2.2 vs 251.0 ± 1.9, P 〈 0.001）. The mean satisfaction score was higher in group 1 compared to group 2 （87.8 ± 3.1 vs 58.1 ± 3.4, P 〈 0.001）. The mean pain score in group i was lower than group 2 （74.1 ± 4.7 vs 39.0 ± 3.9, P 〈 0.001）. CONCLUSION： Listening to music during colonoscopy helps reduce the dose of sedative medications, as well as patients＇ anxiety, pain, dissatisfaction during the procedure. Therefore, we believe that listening to music can play an adjunctive role to sedation in colonoscopy. It is a simple, inexpensive way to improve patients＇ comfort during the procedure.展开更多
Objective： To evaluate the clinical efficacy and safety of patient-controlled intravenous analgesia （PCIA） with fentanyl for cystospasm after transurethral resection of the prostate. Methods： Sixty benign prostati...Objective： To evaluate the clinical efficacy and safety of patient-controlled intravenous analgesia （PCIA） with fentanyl for cystospasm after transurethral resection of the prostate. Methods： Sixty benign prostatic hyperplasia （BPH） patients scheduled for transurethral resection of the prostate （TURP） under general anesthesia with laryngeal mask airway （LMA） were randomly divided into groups F and S. Group F （n=30） received PCIA device with fentanyl 10 ug/kg＋8 mg ondansetron, and Group S （n=30） received placebo （PCIA device with 8 mg ondansetron）. The visual analog scale （VAS） scores for pain were evaluated at 0, 2, 4, 8, 16, 24, and 48 h by the same staff. And recorded were incidence of cystospasm, side effects, application of hemostatic, duration of drawing Foley catheter and continuous bladder irrigation, time of exhaust after operation, time of post-operative stay and cost of hospitalization. Results： The incidence of cystospasm in Group F was significantly lower than that in Group S in the 48 h after operation （P〈0.05）, the VAS scores for pain in Group F was significantly lower than that in Group S within the 48 h after operation （P〈0.01）. The time of exhaust after operation in Group F was significantly later than in Group S （P〈0.05）. No significant difference was observed in applications of hemostatic, duration of drawing Foley catheter, duration of continuous bladder irrigation, time of post-operative stay and cost of hospitalization between the 2 groups. Conclusion： PCIA with fentanyl （10 ug/kg） relieves pain with little side effect and reduces cystospasm satisfactorily.展开更多
AIM:To study the blood-brain barrier integrity,brain edema, animal behavior and ammonia plasma levels in prehepatic portal hypertensive rats with and without acute liver intoxication. METHODS:Adults male Wistar rats w...AIM:To study the blood-brain barrier integrity,brain edema, animal behavior and ammonia plasma levels in prehepatic portal hypertensive rats with and without acute liver intoxication. METHODS:Adults male Wistar rats were divided into four groups.Group Ⅰ:sham operation;Ⅱ:Prehepatic portal hypertension,produced by partial portal vein ligation;Ⅲ: Acetaminophen intoxication and Ⅳ:Prehepatic portal hypertension plus acetaminophen.Acetaminophen was administered to produce acute hepatic injury.Portal pressure,liver serum enzymes and ammonia plasma levels were determined.Brain cortex water content was registered and trypan blue was utilized to study blood brain barrier integrity.Reflexes and behavioral tests were recorded. RESULTS:Portal hypertension was significantly elevated in groups Ⅱ and Ⅳ.Uver enzymes and ammonia plasma levels were increased in groups Ⅱ,Ⅲ and Ⅳ.Prehepatic portal hypertension (group Ⅱ),acetaminophen intoxication (group Ⅲ) and both (group Ⅳ) had changes in the blood brain-barrier integrity (trypan blue) and hyperammonemia.Cortical edema was present in rats with acute hepatic injury in groups Ⅲ and Ⅳ.Behavioral test (rota rod) was altered in group Ⅳ. CONCLUSION:These results suggest the possibility of another pathway for cortical edema production because blood brain barrier was altered (vasogenic) and hyperammonemia was registered (oltotoxic).Group Ⅳ,with behavioral altered test,can be considered as a model for study at an early stage of portal-systemic encephalopathy.展开更多
Objective To investigate the roles of sympathetic and vagus nerves in hypotension and bradycardia induced by fentanyl. Methods Fourteen rabbits were divided into 2 groups: normal and vagotomized rabbits. Rabbits were ...Objective To investigate the roles of sympathetic and vagus nerves in hypotension and bradycardia induced by fentanyl. Methods Fourteen rabbits were divided into 2 groups: normal and vagotomized rabbits. Rabbits were anesthetized, paralyzed, and artificial ventilated. Right renal sympathetic nerve was exposed and prepared for recording electrical activity. Fentanyl was injected intravenously in incremental doses of 1, 4, 15, 30, and 50 μg/kg at 10 minutes intervals. Results Fentanyl significantly reduced the spontaneous activity of renal sympathetic nerve, mean arterial pressure, and heart rate above a total dose of 20 μg/kg in both normal and vagotomized rabbits. However, normal rabbits spontaneous sympathetic nerve activity and mean arterial pressure were more depressed than vagotomized rabbits at total doses of 50 and 100 μg/kg. There were no significant difference in the reduction of heart rate between normal and vagotomized rabbits. Conclusion Fentanyl induction of bradycardia and hypotension in rabbits is mainly due to depression of sympathetic nerve activity.展开更多
Objective To observe the analgesia effectiveness and safety of electroacupuncture at Neimadian （内麻点 Extra） after abdominal surgery. Methods One hundred and twenty patients with routine abdominal surgery were rand...Objective To observe the analgesia effectiveness and safety of electroacupuncture at Neimadian （内麻点 Extra） after abdominal surgery. Methods One hundred and twenty patients with routine abdominal surgery were randomly divided into an acupuncture group and a medication group, 60 cases in each group. The acupuncture group was treated with electroacupuncture at Neimadian （内麻点 Extra）, which was located on the medial side of lower leg, 7 cun above the medial malleolus and about 0.5 cun from post edge of tibia. The medication group was treated with patient-controlled intravenous analgesia （PCIA） with Sufentanil. After the treatment, the Visual Analogue Scale （VAS）, the security, the analgesic effect and plasma β-endorphin content in the two groups were compared.Results The postoperative VAS scores at 2, 4, 8, 16, 24 and 48 h in the acupuncture group were lower than those in the medication group （all P〈0.05）. The analgesic effects at 2, 4, 16 and 24 h after surgery in the acupuncture group were superior to those in the medication group （P〈0.05, P〈0.01）. The plasma β-endorphin contents at 0, 8, 16 and 48 h after surgery in both groups were increased, and the acupuncture group was superior to the medication group （all P〈0.05）. The security class after surgery in the acupuncture group was higher than that in the medication group （P〈0.05）. Two cases in acupuncture group stopped treatment due to overstress and fear of needling, 24 cases in medication group presented adverse reactions, among them, 3 cases stopped the treatment due to nausea, vomiting. Conclusion The analgesic effect and safety of electroacupuncture at Neimadian （内麻点 Extra） after abdominal surgery are superior to those of the PCIA with Sufentanil.展开更多
Objective:To observe the clinical efficacy of auricular point sticking at different points to relieve the pain in arteriovenous fistula puncture.Methods:A total of 42 patients with arteriovenous fistula were randomize...Objective:To observe the clinical efficacy of auricular point sticking at different points to relieve the pain in arteriovenous fistula puncture.Methods:A total of 42 patients with arteriovenous fistula were randomized into a Shenmen(TF4)group and an Elbow(SF3)group by the random number table method,with 21 cases in each group.After enrolled into different groups,before the dialysis,patients were given auricular point sticking with Wang Bu Liu Xing(Semen Vaccariae)seeds at Shenmen(TF4)and Elbow(SF3),respectively.Patients were asked to press the seeds themselves for 2 min each time,four times a day,and an additional 5-15 min before the arteriovenous fistula puncture.Intensive pressing was offered duri ng the pun cture,15・20 presses for each time,and the plasters were cha nged every 2-3 d.The nu merical rati ng scale(NRS)was used to score the pain level one week before and after auricular point sticking.The NRS score was then compared and analyzed.Results:The intra-group comparison showed that the changes of NRS score in both groups were statistically sigrdficant after auricular point sticking(both P<0.05).After the treatment,there was no sigrdficant differenee in NRS score between the two groups(P>0.05).Conclusion:Auricular point sticking at Shenmen(TF4)or Elbow(SF3)can effectively relieve the pain of arteriovenous fistula puncture,and these two points have equivale nt an algesic effect.展开更多
文摘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.
文摘AIM： To determine whether listening to music decreases the requirement for dosages of sedative drugs, patients＇ anxiety, pain and dissatisfaction feelings during colonoscopy and makes the procedure more comfortable and acceptable. METHODS： Patients undergoing elective colonoscopy between October 2005 and February 2006 were randomized into either listening to music （Group 1, n = 30） or not listening to music （Group 2, n = 30）. Anxiolytic and analgesic drugs （intravenous midazolam and meperidine） were given according to the patients＇ demand. Administered medications were monitored. We determined their levels of anxiety using the State-Trait Anxiety Inventory Test form. Patients＇ satisfaction, pain, and willingness to undergo a repeated procedure were self-assessed using a visual analog scale. RESULTS： The mean dose of sedative and analgesic drugs used in group 1 （midazolam： 2.1 ± 1.4, meperidine： 18.1 ± 11.7） was smaller than group 2 （midazolam： 2.4 ± 1.0, meperidine： 20.6 ± 11.5）, but without a significant difference （P 〉 0.05）. The mean anxiety level in group 1 was lower than group 2 （36.7 ± 2.2 vs 251.0 ± 1.9, P 〈 0.001）. The mean satisfaction score was higher in group 1 compared to group 2 （87.8 ± 3.1 vs 58.1 ± 3.4, P 〈 0.001）. The mean pain score in group i was lower than group 2 （74.1 ± 4.7 vs 39.0 ± 3.9, P 〈 0.001）. CONCLUSION： Listening to music during colonoscopy helps reduce the dose of sedative medications, as well as patients＇ anxiety, pain, dissatisfaction during the procedure. Therefore, we believe that listening to music can play an adjunctive role to sedation in colonoscopy. It is a simple, inexpensive way to improve patients＇ comfort during the procedure.
文摘Objective： To evaluate the clinical efficacy and safety of patient-controlled intravenous analgesia （PCIA） with fentanyl for cystospasm after transurethral resection of the prostate. Methods： Sixty benign prostatic hyperplasia （BPH） patients scheduled for transurethral resection of the prostate （TURP） under general anesthesia with laryngeal mask airway （LMA） were randomly divided into groups F and S. Group F （n=30） received PCIA device with fentanyl 10 ug/kg＋8 mg ondansetron, and Group S （n=30） received placebo （PCIA device with 8 mg ondansetron）. The visual analog scale （VAS） scores for pain were evaluated at 0, 2, 4, 8, 16, 24, and 48 h by the same staff. And recorded were incidence of cystospasm, side effects, application of hemostatic, duration of drawing Foley catheter and continuous bladder irrigation, time of exhaust after operation, time of post-operative stay and cost of hospitalization. Results： The incidence of cystospasm in Group F was significantly lower than that in Group S in the 48 h after operation （P〈0.05）, the VAS scores for pain in Group F was significantly lower than that in Group S within the 48 h after operation （P〈0.01）. The time of exhaust after operation in Group F was significantly later than in Group S （P〈0.05）. No significant difference was observed in applications of hemostatic, duration of drawing Foley catheter, duration of continuous bladder irrigation, time of post-operative stay and cost of hospitalization between the 2 groups. Conclusion： PCIA with fentanyl （10 ug/kg） relieves pain with little side effect and reduces cystospasm satisfactorily.
基金Supported by Grant #TB 56 from the University of Buenos Aires,Argentina
文摘AIM:To study the blood-brain barrier integrity,brain edema, animal behavior and ammonia plasma levels in prehepatic portal hypertensive rats with and without acute liver intoxication. METHODS:Adults male Wistar rats were divided into four groups.Group Ⅰ:sham operation;Ⅱ:Prehepatic portal hypertension,produced by partial portal vein ligation;Ⅲ: Acetaminophen intoxication and Ⅳ:Prehepatic portal hypertension plus acetaminophen.Acetaminophen was administered to produce acute hepatic injury.Portal pressure,liver serum enzymes and ammonia plasma levels were determined.Brain cortex water content was registered and trypan blue was utilized to study blood brain barrier integrity.Reflexes and behavioral tests were recorded. RESULTS:Portal hypertension was significantly elevated in groups Ⅱ and Ⅳ.Uver enzymes and ammonia plasma levels were increased in groups Ⅱ,Ⅲ and Ⅳ.Prehepatic portal hypertension (group Ⅱ),acetaminophen intoxication (group Ⅲ) and both (group Ⅳ) had changes in the blood brain-barrier integrity (trypan blue) and hyperammonemia.Cortical edema was present in rats with acute hepatic injury in groups Ⅲ and Ⅳ.Behavioral test (rota rod) was altered in group Ⅳ. CONCLUSION:These results suggest the possibility of another pathway for cortical edema production because blood brain barrier was altered (vasogenic) and hyperammonemia was registered (oltotoxic).Group Ⅳ,with behavioral altered test,can be considered as a model for study at an early stage of portal-systemic encephalopathy.
文摘Objective To investigate the roles of sympathetic and vagus nerves in hypotension and bradycardia induced by fentanyl. Methods Fourteen rabbits were divided into 2 groups: normal and vagotomized rabbits. Rabbits were anesthetized, paralyzed, and artificial ventilated. Right renal sympathetic nerve was exposed and prepared for recording electrical activity. Fentanyl was injected intravenously in incremental doses of 1, 4, 15, 30, and 50 μg/kg at 10 minutes intervals. Results Fentanyl significantly reduced the spontaneous activity of renal sympathetic nerve, mean arterial pressure, and heart rate above a total dose of 20 μg/kg in both normal and vagotomized rabbits. However, normal rabbits spontaneous sympathetic nerve activity and mean arterial pressure were more depressed than vagotomized rabbits at total doses of 50 and 100 μg/kg. There were no significant difference in the reduction of heart rate between normal and vagotomized rabbits. Conclusion Fentanyl induction of bradycardia and hypotension in rabbits is mainly due to depression of sympathetic nerve activity.
文摘Objective To observe the analgesia effectiveness and safety of electroacupuncture at Neimadian （内麻点 Extra） after abdominal surgery. Methods One hundred and twenty patients with routine abdominal surgery were randomly divided into an acupuncture group and a medication group, 60 cases in each group. The acupuncture group was treated with electroacupuncture at Neimadian （内麻点 Extra）, which was located on the medial side of lower leg, 7 cun above the medial malleolus and about 0.5 cun from post edge of tibia. The medication group was treated with patient-controlled intravenous analgesia （PCIA） with Sufentanil. After the treatment, the Visual Analogue Scale （VAS）, the security, the analgesic effect and plasma β-endorphin content in the two groups were compared.Results The postoperative VAS scores at 2, 4, 8, 16, 24 and 48 h in the acupuncture group were lower than those in the medication group （all P〈0.05）. The analgesic effects at 2, 4, 16 and 24 h after surgery in the acupuncture group were superior to those in the medication group （P〈0.05, P〈0.01）. The plasma β-endorphin contents at 0, 8, 16 and 48 h after surgery in both groups were increased, and the acupuncture group was superior to the medication group （all P〈0.05）. The security class after surgery in the acupuncture group was higher than that in the medication group （P〈0.05）. Two cases in acupuncture group stopped treatment due to overstress and fear of needling, 24 cases in medication group presented adverse reactions, among them, 3 cases stopped the treatment due to nausea, vomiting. Conclusion The analgesic effect and safety of electroacupuncture at Neimadian （内麻点 Extra） after abdominal surgery are superior to those of the PCIA with Sufentanil.
文摘Objective:To observe the clinical efficacy of auricular point sticking at different points to relieve the pain in arteriovenous fistula puncture.Methods:A total of 42 patients with arteriovenous fistula were randomized into a Shenmen(TF4)group and an Elbow(SF3)group by the random number table method,with 21 cases in each group.After enrolled into different groups,before the dialysis,patients were given auricular point sticking with Wang Bu Liu Xing(Semen Vaccariae)seeds at Shenmen(TF4)and Elbow(SF3),respectively.Patients were asked to press the seeds themselves for 2 min each time,four times a day,and an additional 5-15 min before the arteriovenous fistula puncture.Intensive pressing was offered duri ng the pun cture,15・20 presses for each time,and the plasters were cha nged every 2-3 d.The nu merical rati ng scale(NRS)was used to score the pain level one week before and after auricular point sticking.The NRS score was then compared and analyzed.Results:The intra-group comparison showed that the changes of NRS score in both groups were statistically sigrdficant after auricular point sticking(both P<0.05).After the treatment,there was no sigrdficant differenee in NRS score between the two groups(P>0.05).Conclusion:Auricular point sticking at Shenmen(TF4)or Elbow(SF3)can effectively relieve the pain of arteriovenous fistula puncture,and these two points have equivale nt an algesic effect.
