目的分析不同剂量右美托咪定(Dex)复合腰硬联合麻醉对产科手术中麻醉效果、血压及视觉模拟评分法(VAS)评分的影响。方法200例产妇作为观察对象,根据Dex剂量不同分为对照组(C组)、低剂量组(D1组)、中剂量组(D2组)、中-高剂量组(D3组)和...目的分析不同剂量右美托咪定(Dex)复合腰硬联合麻醉对产科手术中麻醉效果、血压及视觉模拟评分法(VAS)评分的影响。方法200例产妇作为观察对象,根据Dex剂量不同分为对照组(C组)、低剂量组(D1组)、中剂量组(D2组)、中-高剂量组(D3组)和高剂量组(D4组),每组40例。对比五组不同时段Ramsay评分、视觉模拟评分法(VAS)评分、血压水平、不良反应发生率、新生儿1 min及5 min Apgar评分。结果入室麻醉后平卧位即刻(T0),五组产妇Ramsay、VAS评分对比差异无统计学意义(P>0.05);胎儿娩出时(T1),D2组、D3组及D4组产妇Ramsay评分分别为(4.92±0.11)、(4.95±0.13)、(4.88±0.11)分,明显高于C组的(2.84±0.24)分与D1组的(3.12±0.14)分,VAS评分分别为(2.06±0.22)、(2.03±0.19)、(2.02±0.19)分,明显低于C组的(4.13±0.24)分与D1组的(3.13±0.27)分,且D1组产妇Ramsay评分明显高于C组,VAS评分明显低于C组(P<0.05);术后12 h(T2),D2组、D3组及D4组产妇VAS评分分别为(2.46±0.37)、(2.49±0.36)、(2.42±0.34)分,明显低于C组的(5.13±0.24)分与D1组的(4.05±0.71)分,且D1组产妇VAS评分明显低于C组(P<0.05);D2组、D3组及D4组产妇T1时的Ramsay、VAS评分及T2时的VAS评分对比差异无统计学意义(P>0.05)。五组新生儿1 min及5 min Apgar评分对比差异无统计学意义(P>0.05)。T0时,五组产妇收缩压及舒张压水平对比差异无统计学意义(P>0.05);T1、T2时,D2组、D3组及D4组产妇收缩压及舒张压水平明显低于C组与D1组,且D1组产妇收缩压及舒张压水平明显低于C组(P<0.05);D2组、D3组及D4组产妇T1、T2时的收缩压及舒张压水平对比差异无统计学意义(P>0.05)。D2组产妇不良反应发生率2.5%(1/40)低于C组的15.0%(6/40)、D1组的15.0%(6/40)、D3组的15.0%(6/40)、D4组的17.5%(7/40)(P<0.05)。结论0.5μg/kg Dex有助于稳定血压水平,提高麻醉效果,减轻术中疼痛,降低麻醉后不良反应发生率,且不会对新生儿出生造成不利影响,可作为最佳调控剂量。展开更多
Background and Aims:A visual analogue score (VAS),based on application of a visual analogue scale,has been widely used to assess pruritus in clinical studies of patients with cholestatic liver disease.A VAS is a numer...Background and Aims:A visual analogue score (VAS),based on application of a visual analogue scale,has been widely used to assess pruritus in clinical studies of patients with cholestatic liver disease.A VAS is a numerical score of the severity of the perception of pruritus,and,hence,is inherently subjective.The objective of this study was to assessthe reliability of a VAS as an index of pruritus in cholestatic patients.Methods:In 8 patients with chronic pruritus due to primary biliary cholangitis,values for a VAS of pruritus were compared with corresponding measurements of scratching activity,which were generated by a monitoring system specifically designed to quantitate this activity.The relationship between individual values for the VAS and corresponding values for scratching activity during a specific interval immediately preceding the recording of the VAS was examined by determining the Spearman's rank correlation coefficient.Results:The mean Spearman's rank correlation coefficient between individual values for the VAS and corresponding mean values for scratching activity was 0.072;the range of these coefficients was-0.04 to 0.26.A VAS of pruritus is an unreliable index of scratching activity,and,hence,of the pathophysiological process responsible for the pruritus of cholestasis.Conclusion:It is concluded that the use of a VAS as a primary quantitative endpoint in trials of the efficacy of potential therapies for the pruritus of cholestasis may be inappropriate.展开更多
文摘目的分析不同剂量右美托咪定(Dex)复合腰硬联合麻醉对产科手术中麻醉效果、血压及视觉模拟评分法(VAS)评分的影响。方法200例产妇作为观察对象,根据Dex剂量不同分为对照组(C组)、低剂量组(D1组)、中剂量组(D2组)、中-高剂量组(D3组)和高剂量组(D4组),每组40例。对比五组不同时段Ramsay评分、视觉模拟评分法(VAS)评分、血压水平、不良反应发生率、新生儿1 min及5 min Apgar评分。结果入室麻醉后平卧位即刻(T0),五组产妇Ramsay、VAS评分对比差异无统计学意义(P>0.05);胎儿娩出时(T1),D2组、D3组及D4组产妇Ramsay评分分别为(4.92±0.11)、(4.95±0.13)、(4.88±0.11)分,明显高于C组的(2.84±0.24)分与D1组的(3.12±0.14)分,VAS评分分别为(2.06±0.22)、(2.03±0.19)、(2.02±0.19)分,明显低于C组的(4.13±0.24)分与D1组的(3.13±0.27)分,且D1组产妇Ramsay评分明显高于C组,VAS评分明显低于C组(P<0.05);术后12 h(T2),D2组、D3组及D4组产妇VAS评分分别为(2.46±0.37)、(2.49±0.36)、(2.42±0.34)分,明显低于C组的(5.13±0.24)分与D1组的(4.05±0.71)分,且D1组产妇VAS评分明显低于C组(P<0.05);D2组、D3组及D4组产妇T1时的Ramsay、VAS评分及T2时的VAS评分对比差异无统计学意义(P>0.05)。五组新生儿1 min及5 min Apgar评分对比差异无统计学意义(P>0.05)。T0时,五组产妇收缩压及舒张压水平对比差异无统计学意义(P>0.05);T1、T2时,D2组、D3组及D4组产妇收缩压及舒张压水平明显低于C组与D1组,且D1组产妇收缩压及舒张压水平明显低于C组(P<0.05);D2组、D3组及D4组产妇T1、T2时的收缩压及舒张压水平对比差异无统计学意义(P>0.05)。D2组产妇不良反应发生率2.5%(1/40)低于C组的15.0%(6/40)、D1组的15.0%(6/40)、D3组的15.0%(6/40)、D4组的17.5%(7/40)(P<0.05)。结论0.5μg/kg Dex有助于稳定血压水平,提高麻醉效果,减轻术中疼痛,降低麻醉后不良反应发生率,且不会对新生儿出生造成不利影响,可作为最佳调控剂量。
文摘Background and Aims:A visual analogue score (VAS),based on application of a visual analogue scale,has been widely used to assess pruritus in clinical studies of patients with cholestatic liver disease.A VAS is a numerical score of the severity of the perception of pruritus,and,hence,is inherently subjective.The objective of this study was to assessthe reliability of a VAS as an index of pruritus in cholestatic patients.Methods:In 8 patients with chronic pruritus due to primary biliary cholangitis,values for a VAS of pruritus were compared with corresponding measurements of scratching activity,which were generated by a monitoring system specifically designed to quantitate this activity.The relationship between individual values for the VAS and corresponding values for scratching activity during a specific interval immediately preceding the recording of the VAS was examined by determining the Spearman's rank correlation coefficient.Results:The mean Spearman's rank correlation coefficient between individual values for the VAS and corresponding mean values for scratching activity was 0.072;the range of these coefficients was-0.04 to 0.26.A VAS of pruritus is an unreliable index of scratching activity,and,hence,of the pathophysiological process responsible for the pruritus of cholestasis.Conclusion:It is concluded that the use of a VAS as a primary quantitative endpoint in trials of the efficacy of potential therapies for the pruritus of cholestasis may be inappropriate.
