This study aimed to investigate the protective effect of oral steroid premedication in terms of adverse reactions to non-ionic contrast media. We investigated the incidence of adverse reactions among patients who unde...This study aimed to investigate the protective effect of oral steroid premedication in terms of adverse reactions to non-ionic contrast media. We investigated the incidence of adverse reactions among patients who underwent contrast-enhanced computed tomography. Patients in the premedication group took 30 mg of prednisolone orally the night before and on the morning of the scheduled computed tomography. Sixty-five patients received the same contrast media. Among them, 56 took prednisolone orally prior to the procedure (premedication without change of contrast media group) and nine without premedication (no premedication and no change of contrast media group). In total, 379 patients received different contrast media. Among them, 340 took prednisolone orally (premedication with change of contrast media group), while 39 did not take the premedication (no premedication with change of contrast media group). The adverse reaction rates in the premedication with change of contrast media and no premedication with change of contrast media groups were 1.8% (6/340 cases) and 2.6% (1/39 cases) (P = 0.54), respectively. The incidence of adverse reaction after the administration of non-ionic iodinated contrast media did not differ significantly based on whether an oral steroid was administered prior to compute tomography. Our evaluation is limited due to the small sample size of the contrast media-changed group. However, even if premedication with steroids is effective, it may only result in an adverse reaction reduction rate of ≤3%.展开更多
目的回顾性分析右美托咪定用于硬膜外分娩镇痛突破性疼痛的安全性和有效性。方法通过提取厦门大学附属妇女儿童医院手术麻醉电子病历系统中的分娩镇痛记录单数据。回顾性分析2019年8月—2022年7月在厦门大学附属妇女儿童医院产房行分娩...目的回顾性分析右美托咪定用于硬膜外分娩镇痛突破性疼痛的安全性和有效性。方法通过提取厦门大学附属妇女儿童医院手术麻醉电子病历系统中的分娩镇痛记录单数据。回顾性分析2019年8月—2022年7月在厦门大学附属妇女儿童医院产房行分娩镇痛后出现突破性疼痛的单胎头位初产妇284例,年龄20~40岁,美国麻醉医师协会(American society of anesthesiologists,ASA)Ⅰ或Ⅱ级,所有产妇使用相同的硬膜外镇痛方式和相同的镇痛配方。当实施完分娩镇痛的产妇出现突破性疼痛时,根据麻醉药物不同分为右美托咪定(dexmedetomidine)组(RD组,n=128)和对照组(R组,n=156)。RD组硬膜外腔推注0.08%罗哌卡因+右美托咪定0.5μg/mL,R组给予0.08%罗哌卡因。比较两组产妇疼痛视觉模拟评分(visual analog score,VAS)评分、镇静评分Ramsay评分、运动阻滞Bromage评分、给药时间间隔、给药次数、产程时间、产后出血量,记录新生儿Apgar评分和产妇不良反应。结果与给药前(T_(0))比较,T_(1)、T_(2)、T_(3)时两组产妇的VAS均明显降低(P<0.05),RD组在T_(2)时点相比R组VAS明显下降(P<0.05);Remsay评分在T_(2)时点最高,比R组显著升高(P<0.05)。RD组的VAS评分在T_(1)、T_(2)和T_(3)时明显低于R组(P<0.05);Remsay评分在T_(1)、T_(2)时明显高于R组(P<0.05)。RD组给药时间间隔长于R组,给药次数少于R组(P<0.05)。结论低浓度罗哌卡因(0.08%)复合右美托咪定(0.5µg/mL)可以显著减轻硬膜外分娩镇痛中的突破性疼痛,不良反应少,安全性高,推荐临床广泛使用。展开更多
文摘This study aimed to investigate the protective effect of oral steroid premedication in terms of adverse reactions to non-ionic contrast media. We investigated the incidence of adverse reactions among patients who underwent contrast-enhanced computed tomography. Patients in the premedication group took 30 mg of prednisolone orally the night before and on the morning of the scheduled computed tomography. Sixty-five patients received the same contrast media. Among them, 56 took prednisolone orally prior to the procedure (premedication without change of contrast media group) and nine without premedication (no premedication and no change of contrast media group). In total, 379 patients received different contrast media. Among them, 340 took prednisolone orally (premedication with change of contrast media group), while 39 did not take the premedication (no premedication with change of contrast media group). The adverse reaction rates in the premedication with change of contrast media and no premedication with change of contrast media groups were 1.8% (6/340 cases) and 2.6% (1/39 cases) (P = 0.54), respectively. The incidence of adverse reaction after the administration of non-ionic iodinated contrast media did not differ significantly based on whether an oral steroid was administered prior to compute tomography. Our evaluation is limited due to the small sample size of the contrast media-changed group. However, even if premedication with steroids is effective, it may only result in an adverse reaction reduction rate of ≤3%.
文摘目的回顾性分析右美托咪定用于硬膜外分娩镇痛突破性疼痛的安全性和有效性。方法通过提取厦门大学附属妇女儿童医院手术麻醉电子病历系统中的分娩镇痛记录单数据。回顾性分析2019年8月—2022年7月在厦门大学附属妇女儿童医院产房行分娩镇痛后出现突破性疼痛的单胎头位初产妇284例,年龄20~40岁,美国麻醉医师协会(American society of anesthesiologists,ASA)Ⅰ或Ⅱ级,所有产妇使用相同的硬膜外镇痛方式和相同的镇痛配方。当实施完分娩镇痛的产妇出现突破性疼痛时,根据麻醉药物不同分为右美托咪定(dexmedetomidine)组(RD组,n=128)和对照组(R组,n=156)。RD组硬膜外腔推注0.08%罗哌卡因+右美托咪定0.5μg/mL,R组给予0.08%罗哌卡因。比较两组产妇疼痛视觉模拟评分(visual analog score,VAS)评分、镇静评分Ramsay评分、运动阻滞Bromage评分、给药时间间隔、给药次数、产程时间、产后出血量,记录新生儿Apgar评分和产妇不良反应。结果与给药前(T_(0))比较,T_(1)、T_(2)、T_(3)时两组产妇的VAS均明显降低(P<0.05),RD组在T_(2)时点相比R组VAS明显下降(P<0.05);Remsay评分在T_(2)时点最高,比R组显著升高(P<0.05)。RD组的VAS评分在T_(1)、T_(2)和T_(3)时明显低于R组(P<0.05);Remsay评分在T_(1)、T_(2)时明显高于R组(P<0.05)。RD组给药时间间隔长于R组,给药次数少于R组(P<0.05)。结论低浓度罗哌卡因(0.08%)复合右美托咪定(0.5µg/mL)可以显著减轻硬膜外分娩镇痛中的突破性疼痛,不良反应少,安全性高,推荐临床广泛使用。
