右美托咪定复合靶控输注丙泊酚在无痛人工流产术中的麻醉效果观察

目的探讨右美托咪定复合靶控输注丙泊酚在无痛人工流产术中的麻醉效果。方法在我院拟行无痛人工流产术的患者212例为观察对象,随机分为A组(右美托咪定复合靶控输注丙泊酚组),B组(靶控输注丙泊酚组)。比较两组患者的麻醉效果。结果 A组的诱导时间、唤醒时间优于B组,P均<0.05,有统计学意义。结论右美托咪定复合靶控输注丙泊酚在无痛人工流产术中的麻醉中,患者的麻醉效果较好,麻醉较为安全。

舒芬太尼和芬太尼在腹腔镜手术中的麻醉效果比较

目的分析舒芬太尼和芬太尼在腹腔镜手术中的麻醉效果。方法选取2012-2014年进行腹腔镜全麻手术的患者136例，随机1：1配对分为：A组68例（舒芬太尼组），B组68例（芬太尼组）。观察并比较两组患者的血压以及心率情况。结果A组患者的收缩压，舒张压以及心率情况优于B组，P〈0.05，差异有统计学意义。结论舒芬太尼在腹腔镜手术中的麻醉效果较好，可作为腹腔镜手术全麻患者的首选药品。

右美托咪定对膝关节置换术患者临床麻醉疗效以及短期睡眠状况的影响研究

目的:研究右美托咪定对膝关节置换术患者临床麻醉疗效以及短期睡眠状况的影响,为临床治疗提供科学依据。方法:选取2016年2月至2017年2月内蒙古赤峰市第二医院麻醉科收治的准备实施膝关节置换术的患者172例,随机分为观察组(n=85)和对照组(n=87)。观察组使用右美托咪定联合坐骨神经及股神经阻滞麻醉进行治疗,对照组使用坐骨神经及股神经阻滞麻醉进行治疗。比较2组疗效及血流动力学指标变化。结果:1)手术开始30 min内2组患者MAP均有明显变化,且观察组直至手术完成,2组HR与麻醉前比较,差异有统计学意义(P <0. 05)。患者术后12 h测评疼痛与心态指数观察组优势明显(P <0. 05)。2) 2组患者临床疗效比较,观察组明显优于骨股组(P <0. 05)。3) 2组患者麻醉疗效比较,观察组明显优于骨股组(P <0. 05)。4)比较2组患者短期睡眠状况发现观察组明显优于对照组(P <0. 05)。结论:右美托咪定联合坐骨神经及股神经阻滞麻醉对膝关节置换术的临床效果明显,控制患者术间血液流动,减轻置换术对患者术后带来的负面影响。

七氟烷复合瑞芬太尼在腹腔镜胆囊切除术中的麻醉效果观察

目的：观察七氟烷复合瑞芬太尼在腹腔镜胆囊切除术中的麻醉效果。方法：选取2010年2月～2014年2月于本院行腹腔镜胆囊切除术的58例患者，分为观察组29例和对照组29例，观察组患者采用七氟烷与瑞芬太尼复合麻醉，对照组患者采用丙泊酚与瑞芬太尼复合麻醉，对比观察两组患者在腹腔镜胆囊切除术中的麻醉效果。结果：观察组29例患者的平均苏醒时间为（7.7±2.7）min，平均拔管时间为（10.6±2.5）min，苏醒评分为（5.0±1.9）分；对照组29例患者的平均苏醒时间为（13.9±3.8）min，平均拔管时间为（15.1±3.6）min，苏醒评分为（4.1±1.2）分。观察组明显优于对照组，P＜0.05，差异具有统计学意义。结论：七氟烷复合瑞芬太尼在腹腔镜胆囊切除术中的麻醉效果良好，苏醒时间和拔管时间较短，且苏醒恢复质量较好。

不含局麻药单用吗啡行术后硬膜外持续镇痛的可行性

Objective To evaluate the feasibility of morphine without local anesthetics for continuous epidural infusion of postoperative analgesia.Methods Nine-hundred and twenty-five ASA physical status ofⅠorⅡpatients undergoing abdominal or leg surgery were randomly divided into three groups : the morphine-ondansetron group(group MO,n=312),the morphine-bupivacaine-droperidol group(group MBD,n=307),and the morphine-bupivacaine-ondansetron group(group MBO,n=306).In all patients,epidural puncture were performed at L1-2 interspace and a catheter was advanced 3～4cm in the epidural space.Anesthesia was maintained with 1.73% lidocaine carbonate injection.Different loading dose was given via epidural catheter at the end of surgery : group MO,morphine 2mg(5ml);group MBD,morphine 2mg+bupivacaine 20 mg+ droperiodl 1mg(5ml);group MBO,morphine 2mg+bupivacaine 20 mg(5ml).Then different continuous dose in 2ml/h was given in the ward and maintained for 48h: group MO,morphine 4mg and ondansetron 8mg mixture diluted in 0.09% sodium chloride injection to 100ml;group MBD,morphine 4mg+bupivacaine 125mg+droperiodl 3mg mixture diluted in 0.09% sodium chloride injection 100ml;group MBO,morphine 4mg+bupivacaine 125mg+ondansetron 8mg mixture diluted in 0.09% sodium chloride injection to 100ml.MAP,HR,RR,VAS,Prine Henry Score(PHS),and Sedation Scale(SS) were recorded at 2,4,8,16,48h postoperatively.The side effects such as nausea and vomiting(PONV),itching,urinary retention were observed.Results There was no significant difference in MAP,HR,RR,VAS,and PHS among three groups.The SS was significantly higher in group MBD than in other two groups at the same time,(P<0.05).In group MBD,the SS was(2.5±0.5)scores,(2.6±1.3)scores,(2.7±1.4)scores at 2,4,8h postoperatively.The rate of side effects was significantly higher in group MBD than in other two groups.There were 37 cases(12.1%) of SS more than 3 scores in group MBD and no case of SS more than 3 scores in group MO(P<0.01).The rate of urinary retention was 3.8% in group MO and 8.4% in group MBD and 7.5% in group MBO(P<0.05).The rate of nausea and vomiting was 11.1%(37 cases) in group MBD.There was significant difference between group MBD and MO(P<0.01).Conclusion There are potentially dangerous of local anesthetics and droperidol during continuous epidural analgesia with morphine combined bupivacaine and/or droperidol.Morphine combined ondansetron is satisfactory and safe during continuous epidural analgesia.