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Application of dezocine patient-controlled epidural analgesia in postoperative analgesia in patients with total myomectomy
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作者 Feng-Feng Ning Ting-Ting Yao Xiao-Xia Wang 《World Journal of Clinical Cases》 SCIE 2024年第20期4265-4271,共7页
BACKGROUND Uterine fibroids are common benign gynecological conditions.Patients who experience excessive menstruation,anemia,and pressure symptoms should be administered medication,and severe cases require a total hys... BACKGROUND Uterine fibroids are common benign gynecological conditions.Patients who experience excessive menstruation,anemia,and pressure symptoms should be administered medication,and severe cases require a total hysterectomy.This procedure is invasive and causes severe postoperative pain,which can affect the patient’s postoperative sleep quality and,thus,the recovery process.AIM To evaluate use of dezocine in patient-controlled epidural analgesia(PCEA)for postoperative pain management in patients undergoing total myomectomy.METHODS We selected 100 patients undergoing total abdominal hysterectomy for uterine fibroids and randomized them into two groups:A control group receiving 0.2%ropivacaine plus 0.06 mg/mL of morphine and an observation group receiving 0.2%ropivacaine plus 0.3 mg/mL of diazoxide in their PCEA.Outcomes assessed included pain levels,sedation,recovery indices,PCEA usage,stress factors,and sleep quality.RESULTS The observation group showed lower visual analog scale scores,shorter postoperative recovery indices,fewer mean PCEA compressions,lower cortisol and blood glucose levels,and better polysomnographic parameters compared to the control group(P<0.05).The cumulative incidence of adverse reactions was lower in the observation group than in the control group(P<0.05).CONCLUSION Dezocine PCEA can effectively control the pain associated with total myomectomy,reduce the negative impact of stress factors,and have less impact on patients’sleep,consequently resulting in fewer adverse effects. 展开更多
关键词 DIAZOXIDE patient-controlled epidural analgesia Total hysterectomy Sleep impacts Adverse effects
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Safety of applying midazolam-ketamine-propofol sedation combination under the supervision of endoscopy nurse with patient-controlled analgesia pump in colonoscopy 被引量:2
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作者 Selda Kayaalt? mer Kayaalt? 《World Journal of Clinical Cases》 SCIE 2018年第16期1146-1154,共9页
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
关键词 Midazolam-ketamine-propofol combination patient-controlLED analgesia pump nurse-administered SEDATION Colonoscopy
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APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES 被引量:26
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作者 HongZhao Tie-huYe +3 位作者 Zhi-yiGong YangXue Zhang-gangXue Wen-qiHuang 《Chinese Medical Sciences Journal》 CAS CSCD 2005年第1期59-62, ,共4页
Objective To assess the efficacy and safety of lornoxicam, one non-steroidal anti-inflammatory drug (NSAID) in patient-controlled analgesia (PCA) in patients undergoing abdominal surgeries. Methods Thirty-nine patient... Objective To assess the efficacy and safety of lornoxicam, one non-steroidal anti-inflammatory drug (NSAID) in patient-controlled analgesia (PCA) in patients undergoing abdominal surgeries. Methods Thirty-nine patients scheduled for abdominal surgeries were randomly assigned to different PCA treatment groups using either lornoxicam or fentanyl postoperatively. Pain intensity difference (PID) and sum of pain intensity difference (SPID) were used to assess the analgesic efficacy of both drugs during a 24-hour period. Results The analgesic efficacy of lornoxicam is 1/66 of fentanyl, which was shown by SPID value of 3.250 and 3.058, respectively (P > 0.05). Lornoxicam caused fewer adverse events than fentanyl (33% vs. 68%, P < 0.05). Conclusion In clinic, we can use lornoxicam to treat postoperative pain effectively and with less adverse reactions com-pared with fentanyl. 展开更多
关键词 LORNOXICAM FENTANYL patient-controlled analgesia
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Combined lumbar muscle block and perioperative comprehensive patient-controlled intravenous analgesia with butorphanol in gynecological endoscopic surgery 被引量:6
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作者 Rong-Yu Zhu Si-Qu Xiang Dou-Ren Chen 《World Journal of Clinical Cases》 SCIE 2021年第34期10540-10548,共9页
BACKGROUND Laparoscopic surgery has become a common surgical approach for the clinical treatment of intra-abdominal lesions in recent years.We hypothesized that lumbar block with postoperative patient-controlled intra... BACKGROUND Laparoscopic surgery has become a common surgical approach for the clinical treatment of intra-abdominal lesions in recent years.We hypothesized that lumbar block with postoperative patient-controlled intravenous analgesia(PCIA)by butorphanol after gynecological surgery under general anesthesia would be more effective than PCIA by butorphanol alone.AIM To investigate the effect of lumbar block with PCIA by butorphanol after gynecological surgery under general anesthesia.METHODS This study assessed 120 women scheduled for laparoscopic surgery at our hospital between May 2017 and May 2020.They were divided using a random number table into a research group(those who received quadratus lumborum block combined with PCIA analgesia by butorphanol)and a control group(those who received only PCIA analgesia by butorphanol),with 60 patients in each group.Demographic factors,visual analog scale scores for pain,serum inflammatory markers,PCIA compressions,Ramsay scores,and adverse events were compared between groups using a t-test,analysis of variance,orχ2 test,as appropriate.RESULTS There were no significant differences in demographic factors between groups(all P>0.05).The visual analog scale scores of the research group in the resting state 12 h and 24 h postoperatively were significantly lower than those of the control group(P<0.05).Two hours after surgery,there were no significant differences in the levels of serum tumor necrosis factor-α,interleukin(IL)-6,or IL-8 between groups(P>0.05).The serum tumor necrosis factor-αlevels of the research group 24 h postoperatively were significantly lower than those of the control group(P<0.05).The levels of serum IL-6 and IL-8 in the study group 24 h and 48 h postoperatively were significantly lower than those in the control group(P<0.05).CONCLUSION Lumbar block with PCIA with butorphanol after gynecological surgery under general anesthesia significantly improves the analgesic effect and reduces the degree of inflammation,instances of PCIA compression,and adverse reactions. 展开更多
关键词 Quadratus lumborum block BUTORPHANOL patient-controlled intravenous analgesia Analgesic effect
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Comparative efficacy of ketamine,lidocaine,acetaminophen,and dexmedetomidine combined with morphine patient-controlled analgesia in treating opium-addicted patients undergoing tibia fracture surgery:A randomized clinical trial 被引量:1
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作者 Hesameddin Modir Esmail Moshiri +2 位作者 Mehran Azami Maryam Joshaghani Zad Amir Almasi Hashiani 《Journal of Acute Disease》 2022年第5期181-187,共7页
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
关键词 ACETAMINOPHEN DEXMEDETOMIDINE KETAMINE LIDOCAINE MORPHINE Opium-addicted patients Tibia fracture surgery patient-controlled analgesia pump Postoperative pain
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COMPARISON OF PATIENT-CONTROLLED ANALGESIA WITH TRAMADOL VS MORPHINE IN PATIENTS UNDERGOING ABDOMINAL GYNECOLOGICAL SURGERY
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作者 龚志毅 叶铁虎 +1 位作者 于广祥 秦小涛 《Chinese Medical Sciences Journal》 CAS CSCD 2003年第3期180-184,共5页
Objective.To c ompare the analgesic efficacy and adverse effects of patient-controlled analges iawith tramadol and with morphine for postoperative middle or severe pain .Methods.Fifty-nine patients,scheduled for elect... Objective.To c ompare the analgesic efficacy and adverse effects of patient-controlled analges iawith tramadol and with morphine for postoperative middle or severe pain .Methods.Fifty-nine patients,scheduled for elective hysterectomy or hystero myomectomy ,were ran-domly divided into Group Tand Group M.The2drugs were administered intravenously v ia a patient-controlled analgesia device till24h postoperatively.Efficacy wa s assessed by comparing total pain reliefand the sum of pain intensity differencevalues over24h.Results.Statistically significant equival ence of tramadol and morphine was shown by TOTPAR values(15.9±4.4and1 6.4±3.5,respectively)and SPID values(9.2±4.7and9.0±2.0, respectively).Tramadol caused fewer adverse events than morphin e(16.7%and26.7%of patients,respectively).Conclusion.The analgesic efficacy of PCA with tramadol and with morphine were equivalent in the treatme nt of postoperative pain,and tramadol can cause slighter gastrointestinal adve rse effects. 展开更多
关键词 TRAMADOL MORPHINE patient-controlled analgesia
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Effects of oxycodone and fentanyl patient-controlled intravenous analgesia on pain, immune response and stress response after laparoscopic surgery
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作者 Wei-Ning Liao He Zhang +1 位作者 Wen-Li Dong Jin He 《Journal of Hainan Medical University》 2018年第8期32-35,共4页
Objective:To study the effects of oxycodone and fentanyl patient-controlled intravenous analgesia on pain, immune response and stress response after laparoscopic surgery.Methods:Patients undergoing laparoscopic surger... Objective:To study the effects of oxycodone and fentanyl patient-controlled intravenous analgesia on pain, immune response and stress response after laparoscopic surgery.Methods:Patients undergoing laparoscopic surgery in Xianning Central Hospital between June 2015 and February 2017 were selected and randomly divided into oxycodone group and fentanyl group who received postoperative oxycodone and fentanyl patient-controlled intravenous analgesia respectively. 3 d after surgery and 5 d after surgery, the serum contents of pain-related transmitters, immune indexes, stress-related molecules as well as peripheral blood contents of immune cells were measured.Results: 3 d after surgery and 5 d after surgery, CRP, TNF-α, IL-8, sICAM-1, YKL-40, Cor, C-P, FT3, FT4 and HO-1 contents in serum of oxycodone group were significantly lower than those of fentanyl group whereas CD3+CD4+T cell and CD3+CD8+T cell contents in peripheral blood as well as C3 and C4 contents in serum were significantly higher than those of fentanyl group.Conclusion:oxycodone patient-controlled intravenous analgesia after laparoscopic surgery is better than fentanyl and can reduce the pain degree, inhibit the stress response and improve the immune response. 展开更多
关键词 LAPAROSCOPE patient-controlLED intravenous analgesia OXYCODONE FENTANYL Stress RESPONSE Immune RESPONSE
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Comparison of Efficacy and Safety of Oxycodone Versus Fentanyl for Intravenous Patient-Controlled Analgesia in Postoperative Pain Management:A Systematic Review and Meta-Analysis
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作者 Peng Chen Jie-Xin Lei +1 位作者 Fu-Chao Chen Ben-Hong Zhou 《Asian Toxicology Research》 2020年第1期22-36,共15页
Backgroud:Intravenous opioid patient-controlled analgesia(IV-PCA)has been suggested as an effective method in postoperative pain management.There are several randomized controlled trials(RCTs)of comparison of oxycodon... Backgroud:Intravenous opioid patient-controlled analgesia(IV-PCA)has been suggested as an effective method in postoperative pain management.There are several randomized controlled trials(RCTs)of comparison of oxycodone and fentanyl for IV-PCA in surgical patients.The purpose of this study was to perform a meta-analysis to compare the efficacy and safety of oxycodone and fentanyl for IV-PCA in surgical patients from current data.Methods:The RCTs of oxycodone versus fentanyl for IV-PCA were gathered from PubMed,Embase,Cochrane library,CNKI and VIP data.After data extraction and quality assessment of the included RCTs,the RevMan 5.3 software was applied for meta-analysis of numerical rating scale(NRS)scores,accumulated IV-PCA consumption of oxycodone and fentanyl,patient satisfaction,postoperative nausea and vomiting(PONV),and other adverse events(AEs).Results:Results reported from eight RCTs involving 600 patients are included in the meta-analysis.The NRS score at rest and upon movement of group oxycodone was significantly lower than that of group fentanyl(WMD=-3.85,95%CI-4.93^-2.76,P<0.00001;WMD=-4.31,95%CI-5.79^-2.84,P<0.00001);however,the incidence of PONV and dizziness was obviously increased in group oxycodone than in group fentanyl(OR=2.41,95%CI 1.60~3.63,P<0.0001;OR=3.69,95%CI 2.17~6.26,P<0.00001).Accumulated IV-PCA consumption in group oxycodone was less than in group fentanyl overall the 48 hours postoperatively(WMD=-12.11,95%CI-18.42^-5.80,P=0.0002).There was no significant difference in patient satisfaction between oxycodone and fentanyl(OR=0.73,95%CI 0.11~5.04,P=0.75).Conclusion:According to the evidence,this meta-analysis suggest that oxycodone for IV-PCA is superior to fentanyl in postoperative pain relief,whereas the higher incidence of PONV and dizziness was accompanied with oxycodone.Further large-scale,prospective,observational studies are needed to summarize and analyse the data to draw a fair conclusion. 展开更多
关键词 OXYCODONE FENTANYL patient-controlled analgesia META-ANALYSIS
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Effect of buprenorphine transdermal patch combined with patient-controlled intravenous analgesia on the serum pain-related biochemical indexes in elderly patients with intertrochanteric fracture
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作者 Lei Xu Wu-Wei Huang 《Journal of Hainan Medical University》 2017年第17期67-70,共4页
Objective:To study the effect of buprenorphine transdermal patch combined with patient-controlled intravenous analgesia on the serum pain-related biochemical indexes in elderly patients with intertrochanteric fracture... Objective:To study the effect of buprenorphine transdermal patch combined with patient-controlled intravenous analgesia on the serum pain-related biochemical indexes in elderly patients with intertrochanteric fracture.Methods: A total of 92 elderly patients with intertrochanteric fracture who received surgical treatment in the hospital between August 2014 and January 2017 were collected and divided into control group (n=46) and observation group (n=46) according to the random number table method. The control group received patient-controlled intravenous analgesia, and the observation group received buprenorphine transdermal patch combined with patient-controlled intravenous analgesia. Differences in serum levels of inflammatory factors, oxidative stress indexes and pain mediators of two groups of patients were measured before and 24h after surgery.Results: Differences in serum levels of inflammatory factors, oxidative stress indexes and pain mediators were not statistically significant between the two groups before surgery;24 h after surgery, serum IL-1β, IL-6, IL-8, TNF-α, MDA, SP, PGE2, 5-HT, HA and NPY levels of both groups of patients increased significantly while SOD, TAC and CAT levels decreased significantly, and serum IL-1β, IL-6, IL-8, TNF-α, MDA, SP, PGE2, 5-HT, HA and NPY levels of observation group were lower than those of control group while SOD, TAC and CAT levels were higher than those of control group.Conclusion: Buprenorphine transdermal patch combined with patient-controlled intravenous analgesia can effectively inhibit the expression of pain-related indexes and relieve early postoperative pain intensity in elderly patients with intertrochanteric fracture. 展开更多
关键词 INTERTROCHANTERIC fracture BUPRENORPHINE TRANSDERMAL patch patient-controlLED INTRAVENOUS analgesia Pain
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Trigeminal extracranial thermocoagulation along with patientcontrolled analgesia with esketamine for refractory postherpetic neuralgia after herpes zoster ophthalmicus:A case report 被引量:6
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作者 Jia-Chun Tao Bing Huang +3 位作者 Ge Luo Zhi-Qiang Zhang Bing-Yue Xin Ming Yao 《World Journal of Clinical Cases》 SCIE 2022年第13期4220-4225,共6页
BACKGROUND Primary trigeminal neuralgia can achieve satisfactory results through clinical treatment and intervention.The pathogenesis of neuralgia caused by varicellazoster virus infection of the trigeminal nerve is m... BACKGROUND Primary trigeminal neuralgia can achieve satisfactory results through clinical treatment and intervention.The pathogenesis of neuralgia caused by varicellazoster virus infection of the trigeminal nerve is more complex,and it is still difficult to relieve the pain in some patients simply by drug treatment or surgical intervention.CASE SUMMARY A 66-year-old woman was hospitalized with herpetic neuralgia after herpes zoster ophthalmicus(varicella-zoster virus infects the ophthalmic branch of the trigeminal nerve).On admission,the patient showed spontaneous,electric shocklike and acupuncture-like severe pain in the left frontal parietal region,and pain could be induced by touching the herpes area.The numerical rating scale(NRS)was 9.There was no significant pain relief after pulsed radiofrequency and thermocoagulation of the ophthalmic branch of the trigeminal nerve.Combined with patient-controlled intravenous analgesia(PCIA)with esketamine,neuralgia was significantly improved.The patient had no spontaneous pain or allodynia at discharge,and the NRS score decreased to 2 points.The results of follow-up 2 mo after discharge showed that the NRS score was≤3,and the Pittsburgh Sleep Quality Index score was 5 points.There were no adverse reactions.CONCLUSION Trigeminal extracranial thermocoagulation combined with esketamine PCIA may be a feasible method for the treatment of refractory herpetic neuralgia after herpes zoster ophthalmicus. 展开更多
关键词 Herpes zoster ophthalmicus Postherpetic neuralgia Esketamine patient-controlled intravenous analgesia Case report
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Comparison of oxycodone and sufentanil in patient-controlled intravenous analgesia for postoperative patients:a meta-analysis of randomized controlled trials 被引量:4
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作者 Xixia Feng Pingliang Yang +3 位作者 Zaibo Liao Ruihao Zhou Lu Chen Ling Ye 《Chinese Medical Journal》 SCIE CAS CSCD 2023年第1期45-52,共8页
Background:Managing acute postoperative pain is challenging for anesthesiologists,surgeons,and patients,leading to adverse events despite making significant progress.Patient-controlled intravenous analgesia(PCIA)is a ... Background:Managing acute postoperative pain is challenging for anesthesiologists,surgeons,and patients,leading to adverse events despite making significant progress.Patient-controlled intravenous analgesia(PCIA)is a recommended solution,where oxycodone has depicted unique advantages in recent years.However,controversy still exists in clinical practice and this study aimed to compare two drugs in PCIA.Methods:We performed a literature search in PubMed,Embase,the Cochrane Central Register of Controlled Trials,Web of Science,Chinese National Knowledge Infrastructure,Wanfang,and VIP databases up to December 2020 to select specific randomized controlled trials(RCTs)comparing the efficacy of oxycodone with sufentanil in PCIA.The analgesic effect was the primary outcome and the secondary outcome included PCIA consumption,the Ramsay sedation scale,patients’satisfaction and side effects.Results:Fifteen RCTs were included in the meta-analysis.Compared with sufentanil,oxycodone showed lower Numerical Rating Scale scores(mean difference[MD]=-0.71,95%confidence interval[CI]:-1.01 to-0.41;P<0.001;I^(2)=93%),demonstrated better relief from visceral pain(MD=-1.22,95%CI:-1.58 to-0.85;P<0.001;I^(2)=90%),promoted a deeper sedative level as confirmed by the Ramsay Score(MD=0.77,95%CI:0.35-1.19;P<0.001;I^(2)=97%),and resulted in fewer side effects(odds ratio[OR]=0.46,95%CI:0.35-0.60;P<0.001;I^(2)=11%).There was no statistical difference in the degree of patients'satisfaction(OR=1.13,95%CI:0.88-1.44;P=0.33;I^(2)=72%)and drug consumption(MD=-5.55,95%CI:-14.18 to 3.08;P=0.21;I^(2)=93%).Conclusion:Oxycodone improves postoperative analgesia and causes fewer adverse effects,and could be recommended for PCIA,especially after abdominal surgeries.Registration:PROSPERO;https://www.crd.york.ac.uk/PROSPERO/;CRD42021229973. 展开更多
关键词 OXYCODONE SUFENTANIL patient-controlled intravenous analgesia PAIN POSTOPERATIVE
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术后患者自控镇痛:北京协和医院30年临床管理经验 被引量:1
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作者 赵琳 任立英 +11 位作者 聂卫华 陈雅琪 张捷 张圣洁 王英丽 刁翠翠 马慧颖 张征 周力 申乐 王惠珍 黄宇光 《协和医学杂志》 CSCD 北大核心 2024年第2期239-245,共7页
术后疼痛严重影响患者的康复进程,从而导致住院时间延长,照护成本增加。合理应用患者自控镇痛装置可有效缓解围术期急性疼痛。北京协和医院于1994年引入患者自控镇痛技术,并于2004年成立了急性疼痛服务工作组,以麻醉医生为指导、手术室... 术后疼痛严重影响患者的康复进程,从而导致住院时间延长,照护成本增加。合理应用患者自控镇痛装置可有效缓解围术期急性疼痛。北京协和医院于1994年引入患者自控镇痛技术,并于2004年成立了急性疼痛服务工作组,以麻醉医生为指导、手术室疼痛专科护士为基础,联合实施基于患者自控镇痛的全流程、规范化管理,并不断改进和创新工作方法,为术后疼痛管理的发展奠定了坚实基础。本文从临床工作重点、护理管理经验、疼痛治疗理念的推广与传播、新形势下急性疼痛服务模式的发展等方面对该项工作进行系统回顾与总结,以期为全面加强患者诊疗过程中的疼痛管理、提升患者围术期镇痛服务满意度提供有价值的参考。 展开更多
关键词 患者自控镇痛 急性疼痛服务 护理管理 虚拟疼痛病房
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硬膜外分娩镇痛产妇产间发热风险预测模型的构建与验证
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作者 陈晨 钱夏丽 +3 位作者 于建海 刘皓昕 李彩娟 崔晓花 《护理研究》 北大核心 2024年第3期426-431,共6页
目的:构建硬膜外分娩镇痛产妇产间发热(ERMF)风险预测模型并验证效果。方法:采用前瞻性研究方法,选取2022年1月—2022年7月于江苏省某三级甲等妇产医院产房接受硬膜外分娩镇痛的780名产妇为研究对象,根据是否诊断为ERMF分为ERMF组(n=148... 目的:构建硬膜外分娩镇痛产妇产间发热(ERMF)风险预测模型并验证效果。方法:采用前瞻性研究方法,选取2022年1月—2022年7月于江苏省某三级甲等妇产医院产房接受硬膜外分娩镇痛的780名产妇为研究对象,根据是否诊断为ERMF分为ERMF组(n=148)与非ERMF组(n=632)。使用Logistic回归分析确定ERMF的独立危险因素,构建风险预测模型。采用受试者工作特征(receiver operating characteristic,ROC)曲线与Hosmer-Lemeshow检验评价该模型的预测效能与拟合优度。选取2022年8月—10月住院的170名产妇作为模型的验证组,对预测模型进行验证。结果:建模组ERMF发生率为19.0%,验证组ERMF发生率20.6%。阴道指检次数、缩宫素使用、产程、胎膜破裂至分娩结束时间、罗哌卡因用量、舒芬太尼用量是ERMF的独立危险因素。预测模型的ROC曲线下面积为0.987,灵敏度为0.912,特异度为0.796,约登指数为0.888。验证组ROC曲线下面积为0.893,灵敏度为0.886,特异度为0.785。结论:该预测模型具有较好的区分度和校准度,对于识别高危ERMF产妇具有一定的预测价值,可以给临床护理工作提供一定的借鉴与参考,从而制定相应的护理措施以减少ERMF风险。 展开更多
关键词 硬膜外麻醉 分娩镇痛 产间发热 预测模型 护理
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Transcranial direct current stimulation efficacy in trigeminal neuralgia
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作者 Theodoros Fasilis Stylianos Gatzonis +2 位作者 Panayiotis Patrikelis Stefanos Korfias Athanasia Alexoudi 《World Journal of Clinical Cases》 SCIE 2024年第5期1036-1038,共3页
Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility ... Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility in managing pain.There-fore,the introduction of alternative,non-invasive,safe,and effective methods should be considered in treating patients with trigeminal neuralgia unresponsive to conventional treatment. 展开更多
关键词 Trigeminal neuralgia patient-controlled intravenous analgesia NEUROMODULATION Transcranial direct current stimulation
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正念减压联合多模式镇痛在膝/髋关节置换病人中的应用
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作者 王靖雯 李琳 +1 位作者 何晓红 闫观丽 《护理研究》 北大核心 2024年第11期2048-2052,共5页
目的:探讨正念减压联合多模式镇痛对膝/髋关节置换病人的应用效果。方法:选取2021年7月—2023年6月在我院骨关节外科行膝/髋关节置换的80例病人为研究对象,随机分为对照组和试验组各40例。对照组给予多模式镇痛,试验组给予正念减压联合... 目的:探讨正念减压联合多模式镇痛对膝/髋关节置换病人的应用效果。方法:选取2021年7月—2023年6月在我院骨关节外科行膝/髋关节置换的80例病人为研究对象,随机分为对照组和试验组各40例。对照组给予多模式镇痛,试验组给予正念减压联合多模式镇痛的镇痛方式。比较两组干预后的正念水平、焦虑情况、生活质量、关节炎症状、疼痛程度及生活质量。结果:干预后,试验组焦虑自评量表(SAS)、骨关节炎指数(WOMAC)、数字疼痛评分表(NRS)评分低于对照组,QoR-40术后康复质量评分量表、五因素正念量表(FFMQ)、健康调查简表(SF-36)评分高于对照组,差异均有统计学意义(P<0.05)。结论:正念减压联合多模式镇痛可以缓解膝/髋关节置换病人疼痛、焦虑及骨关节炎症状,提高病人正念水平及生活质量。 展开更多
关键词 正念减压 多模式镇痛 关节置换 术后恢复 生活质量 护理
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基于eCASH理念的镇静镇痛护理模式在重症脑外伤患者术后应用的价值研究
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作者 陈颖 沈理霞 郑晓明 《中外医疗》 2024年第8期129-133,共5页
目的探讨基于舒适化浅镇静策略(Early Comfort Using Analgesia,Minimal Sedatives and Maximal Hu⁃mane Care,eCASH)理念的镇静镇痛护理模式在重症脑外伤患者术后应用的价值。方法随机选取2021年1月—2023年1月福建医科大学附属协和医... 目的探讨基于舒适化浅镇静策略(Early Comfort Using Analgesia,Minimal Sedatives and Maximal Hu⁃mane Care,eCASH)理念的镇静镇痛护理模式在重症脑外伤患者术后应用的价值。方法随机选取2021年1月—2023年1月福建医科大学附属协和医院收治的重症脑外伤患者90例为研究对象,按随机数表法分为对照组和镇静镇痛护理模式组,每组45例。对照组患者接受临床重症脑外伤手术患者常规护理,镇静镇痛护理模式组患者在常规护理基础上加入基于eCASH理念的镇静镇痛护理模式。对比两组患者的镇静镇痛效果、生活质量。结果干预1周后,镇静镇痛护理模式组患者疼痛行为量表的面部表情、上肢活动、呼吸机顺应性评分值均低于对照组患者(P均<0.05)。出院当日,镇静镇痛护理模式组生活质量综合评定量表中躯体功能(16.11±2.54)分、生理状态(17.74±2.04)分、心理功能(15.11±2.12)分、社会功能(16.71±2.88)分均高于对照组(t=4.580、6.548、7.450、5.838,P均<0.05)。结论基于eCASH理念的镇静镇痛护理模式应用于重症脑外伤手术患者中,可有效提高镇痛镇静效果、促进术后康复、提升生活质量。 展开更多
关键词 重症脑外伤 eCASH理念 镇静镇痛护理模式 康复进度 生活质量
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A comparative study of three concentrations of intravenous nalbuphine combined with hydromorphone for post-cesarean delivery analgesia 被引量:22
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作者 Chun-Yun Huang Shu-Xi Li +2 位作者 Mei-Juan Yang Li-Li Xu Xin-Zhong Chen 《Chinese Medical Journal》 SCIE CAS CSCD 2020年第5期523-529,共7页
Background:Nalbuphine has been suggested to be used for post-cesarean section(CS)intravenous analgesia.However,ideal concentration of nalbuphine for such analgesia remains unclear.The present study was conducted to ex... Background:Nalbuphine has been suggested to be used for post-cesarean section(CS)intravenous analgesia.However,ideal concentration of nalbuphine for such analgesia remains unclear.The present study was conducted to explore an ideal concentration of nalbuphine for post-CS intravenous analgesia by evaluating the analgesic effects and side-effects of three different concentrations of nalbuphine combined with hydromorphone for post-CS intravenous analgesia in healthy parturients.Methods:One-hundred-and-fourteen parturients undergoing elective CS were randomly allocated to one of three groups(38 subjects per group)according to an Excel-generated random number sheet to receive hydromorphone 0.05 mg/mL+nalbuphine 0.5 mg/mL(group LN),hydromorphone 0.05 mg/mL+nalbuphine 0.7 mg/mL(group MN),and hydromorphone 0.05 mg/mL+nalbuphine 0.9 mg/mL(group HN)using patient-controlled analgesia(PCA)pump.Visual analog scale(VAS)for pain,PCA bolus demands,cumulative PCA dose,satisfaction score,Ramsay score,and side-effects such as urinary retention were recorded.Results:The number of PCA bolus demands and cumulative PCA dose during the first 48 h after CS were significantly higher in group LN(21±16 bolus,129±25 mL)than those in group MN(15±10 bolus,120±16 mL)(both P<0.05)and group HN(13±9 bolus,117±13 mL)(both P<0.01),but no difference was found between group HN and group MN(both P>0.05).VAS scores were significantly lower in group HN than those in group MN and group LN for uterine cramping pain at rest and after breast-feeding within 12 h after CS(all P<0.01)and VAS scores were significantly higher in group LN than those in groupMNand group HN when oxytocin was intravenously infused within 3 days after CS(all P<0.05),whereas VAS scores were not statistically different among groups for incisional pain(all P>0.05).Ramsay sedation scale score in groupHNwas significantly higher than that in group MN at 8 and 12 h after CS(all P<0.01)and group LN at 4,8,12,24 h after CS(all P<0.05).Conclusions:Hydromorphone 0.05 mg/mL+nalbuphine 0.7 mg/mL for intravenous PCA could effectively improve the incisional pain and uterine cramping pain management and improve comfort in patients after CS. 展开更多
关键词 HYDROMORPHONE NALBUPHINE CESAREAN section Post-operative analgesia patient-controlLED INTRAVENOUS analgesia
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麻醉护士干预的椎管内分娩镇痛护理的研究
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作者 程思思 杨春梅 +3 位作者 全娅群 雷雅雯 董佩娴 杨丹丹 《昆明医科大学学报》 CAS 2024年第3期198-202,共5页
目的探讨麻醉护士干预的椎管内分娩镇痛护理对产妇分娩镇痛效果及分娩结局的影响。方法选取2022年7月至12月在昆明医科大学第一附属医院接受椎管内分娩镇痛的200例初产妇为研究对象,按便利抽样的方法分为对照组和观察组,每组各100例。... 目的探讨麻醉护士干预的椎管内分娩镇痛护理对产妇分娩镇痛效果及分娩结局的影响。方法选取2022年7月至12月在昆明医科大学第一附属医院接受椎管内分娩镇痛的200例初产妇为研究对象,按便利抽样的方法分为对照组和观察组,每组各100例。对照组由助产士实施常规护理,观察组由麻醉护士实施麻醉护理。比较2组产妇分娩疼痛程度、分娩结局、麻醉相关并发症发生率以及护理满意度。结果观察组产妇分娩疼痛程度明显低于对照组(P<0.05);观察组产妇产程时长短于对照组(P<0.05);观察组产妇麻醉相关并发症发生率显著低于对照组(P<0.05);观察组产妇对分娩镇痛护理的满意度高于对照组(P<0.05)。结论麻醉护士干预的分娩镇痛护理能够有效减轻分娩疼痛程度、缩短产程、降低麻醉相关并发症发生率、提高分娩镇痛护理满意度,为产妇提供安全、舒适、有效的分娩过程,值得临床推广。 展开更多
关键词 麻醉护士 分娩镇痛 镇痛管理 分娩结局
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手术病人术后自控镇痛的疗效观察
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作者 马丽芳 陈晓霞 陈英 《循证护理》 2024年第12期2275-2277,共3页
目的:观察病人自控镇痛(PCA)对手术后急性疼痛的疗效和安全性。方法:对2021年1月—2023年3月在兰州大学第二医院行手术治疗并于麻醉恢复室转运的病人临床资料进行回顾性研究;根据病人出麻醉室时是否携带PCA分为两组,比较两组病人术后24 ... 目的:观察病人自控镇痛(PCA)对手术后急性疼痛的疗效和安全性。方法:对2021年1月—2023年3月在兰州大学第二医院行手术治疗并于麻醉恢复室转运的病人临床资料进行回顾性研究;根据病人出麻醉室时是否携带PCA分为两组,比较两组病人术后24 h和48 h的视觉疼痛评分(VAS)及恶心、干呕、呕吐、头晕和头痛的发生率。结果:结果显示,携带PCA的病人于术后24 h(χ^(2)=1 099.1,P<0.001)和48 h(χ^(2)=2 146.5,P<0.001)均表现出更低的VAS评分,而两组病人的恶心(χ^(2)=1.600,P>0.05)、干呕(χ^(2)=2.011,P>0.05)、呕吐(χ^(2)=2.131,P>0.05)、头晕(χ^(2)=2.732,P>0.05)及头痛(χ^(2)=1.267,P>0.05)的发生率比较差异均无统计学意义。结论:PCA可以减轻手术后病人24 h和48 h的急性疼痛,并且没有增加麻醉相关不良反应,是加速康复外科及增加护理满意度的理想镇痛方式。 展开更多
关键词 病人自控镇痛 术后 疼痛 麻醉 护理
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超前镇痛理念用于腹腔镜胆囊切除术后镇痛的效果观察
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作者 李晨扬 温金燕 于化梅 《护士进修杂志》 2024年第21期2338-2342,共5页
目的观察超前镇痛理念用于腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术后镇痛的效果。方法采用随机对照研究方法选取2022年1-10月在内蒙古医科大学附属医院肝胆外科行LC患者80例为研究对象。随机分为观察组(40例,行超前镇痛理... 目的观察超前镇痛理念用于腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术后镇痛的效果。方法采用随机对照研究方法选取2022年1-10月在内蒙古医科大学附属医院肝胆外科行LC患者80例为研究对象。随机分为观察组(40例,行超前镇痛理念)和对照组(40例,行术后常规镇痛)。采用疼痛数字评分(numerical rating scale,NRS)、睡眠质量评估(匹兹堡睡眠质量指数量表PSQI)、自控镇痛泵按压次数、护理质量满意度及术后住院时长进行对比分析。结果观察组术后即刻、术后4 h、12 h、24 h的疼痛评分[(6.21±0.74)分、(4.62±0.61)分、(3.28±0.75)分、(2.18±0.47)分]明显低于对照组,其差异均具有统计学意义(P<0.05)。观察组护理满意度总分[(13.70±0.85)分]高于对照组[(12.02±1.32)分],其差异具有统计学意义(P<0.01)。观察组术后12 h、24 h、48 h睡眠质量评分[(4.55±1.23)分、(4.72±0.56)分、(2.45±0.87)分]均高于对照组,差异均具有统计学意义(P<0.01)。观察组术后8 h、12 h、24 h PCA按压次数频率[(0.37±0.49)次、(0.40±0.49)次、(0.50±0.50)次]均少于对照组,差异均具有统计学意义(P<0.01)。观察组住院时长<3 d的人数[29(72.5%)]高于对照组[11(27.5%)],而住院时长>3 d的人数低于对照组,差异有统计学意义(P<0.05)。结论超前镇痛理念应用于LC术后患者,对降低术后疼痛感、改善术后睡眠质量、减少PCA按压次数、提升护理满意度、缩短住院时长效果显著,具有临床应用价值。 展开更多
关键词 超前镇痛 腹腔镜胆囊切除术 术后镇痛 疼痛管理 护理
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