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Study on Effects of Different Injection Speeds on Anesthesia Effect and Hemodynamics during Combined Spinal-Epidural Anesthesia
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作者 ZHANGLe 《外文科技期刊数据库(文摘版)医药卫生》 2022年第5期186-189,共4页
Objective: Lumbar-dural combination is the most common anesthesia method, depending on the rate of injection, and thus affecting the patients anesthesia and hemodynamics. Methods: All of the 120 subjects in this surve... Objective: Lumbar-dural combination is the most common anesthesia method, depending on the rate of injection, and thus affecting the patients anesthesia and hemodynamics. Methods: All of the 120 subjects in this survey underwent surgery, using waist-hard-soft anesthesia, during the hospital stay of our hospital.[September 2020, August 2021], grouped by lottery, group A (n40), B (n40) at speeds of 10s, 15s, 20s and C (n40), respectively. The anesthesia effect of the three groups was evaluated, and the main parameters selected were: maximum block plane, T6 block time, anesthesia effect, action block, etc., and the patient was monitored for blood dynamics.(1) Comparison: Group A (maximum block plane between groups) and T6 block (T6 block) (no significant difference between groups) (no significant difference between groups) (maximum block plane 8.28 ± 1.26 min, T6) (no significant difference between groups) were significantly better than Group A (8.28 ± 1.26 min, T6 block 7.47 ± 1.45 min), P 0.05. (2) Anesthesia (Group A 97.50%, Group B 100.00%, Group C) anesthesia block (Group A 2.540.58), Group B (Bromage) score (2.720.39), Group C (Bromage) (2.63 + 0.64), and Group C (Bromage) (2.63 + 0.64).(3) Three groups of patients before anesthesia heart rate, arterial pressure, oxygen saturation hemodynamic index level is similar, there is no significant statistical significance (P> 0.05), the index after anesthesia level changes larger, and there are significant statistical significance (P 0.05), the lowest in heart rate, the highest in arterial pressure and oxygen saturation group C, p 0.05. Conclusion: In clinical practice, hard lumbar puncture anesthesia should maintain the anesthesia rate of 15 seconds or 20 seconds, while the hemodynamic effect is at least within 20 seconds, and the optimal injection rate can be determined according to the patients condition. 展开更多
关键词 spinal-epidural anesthesia different injection speed anesthesia effect HEMODYNAMICS
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Observation on the Anesthesia Effect of Ultrasound-Guided Nerve Block for Elderly Patients with Lower Limb Fractures
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作者 Lihong Cheng Shanzhi Luo 《Proceedings of Anticancer Research》 2021年第3期11-14,共4页
Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in ou... Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in our hospital were divided into experimental group(25 cases,general anesthesia+femoral nerve and sciatic nerve block)and control group(25 cases,general body anesthesia).Compare the MAP,HR,anesthesia effect,and adverse reactions between the two groups at each time period.Results:Before induction,the difference in MAP and HR between the two groups of patients did not form,p>0.05;the MAP and HR of the experimental group were compared with the control group at the time of skin incision,1 hour during the operation,and removal of the laryngeal mask,P<0.05;the time of extubation in the experimental group(14.28±3.18)min,awake time(5.57±1.32)min,orientation recovery time(11.89±2.23)min,propofol dosage(191.36±22.48)mg,remifentanil dosage(0.23±0.04)mg,Compared with the control group,P<0.05;the adverse reaction rate of the experimental group(8%,2/25)was lower than that of the control group(32%,8/25),P<0.05.Conclusion:The use of ultrasound-guided femoral nerve and sciatic nerve block for elderly patients with lower limb fractures can enhance the effect of anesthesia,effectively reduce the use of anesthetics,and have fewer adverse reactions.It is worthy of promotion. 展开更多
关键词 Ultrasound guidance Nerve block Lower limb fracture anesthesia effect
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Clinical Anesthesia Effect of Lumbar Anesthesia-epidural Combined Block Anesthesia and Epidural Anesthesia Alone
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作者 XUJinwen ZHAOXia 《外文科技期刊数据库(文摘版)医药卫生》 2022年第1期177-180,共4页
As a means of pain relief, anesthesia is becoming more and more recognized and used by the medical community. Epidural anesthesia is the injection of a local anesthetic into the epidural cavity to block the spinal ner... As a means of pain relief, anesthesia is becoming more and more recognized and used by the medical community. Epidural anesthesia is the injection of a local anesthetic into the epidural cavity to block the spinal nerve root and temporarily paralyze the innervated area. Combined lumbar anesthetic-epidural block anesthesia is the injection of a local anesthetic into the cerebrospinal fluid. Blocking is produced by acting directly on the anterior and posterior roots of the spinal nerve and spinal cord. Waist anesthesia-epidural combined block anesthesia is effective in maintaining normal cardiopulmonary function and works quickly. In this study, 100 patients treated from April 2018 to June 2021 were randomly divided into observation and control groups, with 50 patients in each group. The control group underwent epidural anesthesia, and the observation group performed both lumbar anesthesia and epidural anesthesia to analyze the anesthesia effect. The results are reported as follows. 展开更多
关键词 lumbar anesthesia-epidural combined block anesthesia simple epidural anesthesia anesthesia effect
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Clinical effect of ultrasound-guided nerve block and dexmedetomidine anesthesia on lower extremity operative fracture reduction 被引量:10
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作者 Cheng-Bin Ao Ping-Lei Wu +2 位作者 Liang Shao Jian-Ying Yu Wei-Guo Wu 《World Journal of Clinical Cases》 SCIE 2022年第13期4064-4071,共8页
BACKGROUND Lower extremity fractures are mainly treated by surgical reduction,but this operation is often affected by the patient’s level of agitation and the type of anesthesia used.The main treatment for lower-extr... BACKGROUND Lower extremity fractures are mainly treated by surgical reduction,but this operation is often affected by the patient’s level of agitation and the type of anesthesia used.The main treatment for lower-extremity fractures is operative reduction.However,operations can often be affected by both agitation and the degree of anesthesia.Therefore,it is of great importance to develop an effective anesthesia program to effectively ensure the progress of surgery.AIM To discuss the effect of ultrasound-guided nerve block combined with dexmedetomidine anesthesia in lower extremity fracture surgery.METHODS A total of 120 hospital patients with lower extremity fractures were selected for this retrospective study and divided into an observation group(n=60)and a control group(n=60)according to the anesthesia scheme;the control group received ultrasound-guided nerve block;the observation group was treated with dextromethomidine on the basis of the control group,and the mean arterial pressure,heart rate(HR),and blood oxygen saturation were observed in the two groups.RESULTS The mean arterial pressure of T1,T2 and T3 in the observation group were 94.40±7.10,90.84±7.21 and 91.03±6.84 mmHg,significantly higher than that of the control group(P<0.05).The observation group’s HR at T1 was 76.60±7.52 times/min,significantly lower than that of the control group(P<0.05);The observation group’s HR at T2 and T3 was 75.40±8.03 times/min and 76.64±7.11 times/min,significantly higher than that of the control group(P<0.05).The observation group’s visual analog score at 2 h,6 h and 12 h after operation was 3.55±0.87,2.84±0.65 and 2.05±0.40.the recovery time was 15.51±4.21 min,significantly lower than that of the control group(P<0.05).Six hours post-anesthesia,epinephrine and norepinephrine in the observation group were 81.10±21.19 pg/mL and 510.20±98.27 pg/mL,significantly lower than that of the control group(P<0.05),and the mini-mental state exam score of the observation group was 25.51±1.15,significantly higher than that in the control group(P<0.05).CONCLUSION Ultrasound-guided nerve block combined with dexmedetomidine has a good anesthetic effect in the operation of lower limb fractures and has little effect on the hemodynamics of patients. 展开更多
关键词 ULTRASOUND Nerve block DEXMEDETOMIDINE Lower extremity fracture anesthesia effect
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Evaluation of the Effect and Value of Low-flow Sevoflurane Anesthesia in Laparoscopic Surgery
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作者 ZHANGZidong 《外文科技期刊数据库(文摘版)医药卫生》 2022年第10期127-131,共5页
Objective to analyze the value of low-flow sevoflurane in anesthesia maintenance during laparoscopic surgery to maintain the stability of patients signs during operation and ensure the safety of patients after operati... Objective to analyze the value of low-flow sevoflurane in anesthesia maintenance during laparoscopic surgery to maintain the stability of patients signs during operation and ensure the safety of patients after operation. Methods: 60 patients who underwent laparoscopic surgery in our hospital from April 2020 to April 2022 were selected as samples. After they were enrolled into the group, they were divided into standardized groups, and different anesthesia schemes were given to carry out the comparative analysis, namely the control group (Levantin anesthesia maintenance) and the observation group (low flow sevoflurane anesthesia maintenance). Statistic the differences of anesthesia indexes of different groups of samples, and the effects of different anesthesia schemes on the changes of patients signs and safety. Results: the time required for each stage of anesthesia in the two groups was measured. The results showed that the clinical indexes of the patients in the observation group were better, the time of onset of anesthesia, complete block, and the time required for patients to wake up after operation were shorter, and the dosage of anesthetic drugs was lower (P 0.05). Before anesthesia induction, there was no significant difference in baseline data (including heart rate, systolic blood pressure, diastolic blood pressure) among patient groups (P > 0.05). After anesthesia, the patients physical signs were monitored again before and 10 minutes after the establishment of pneumoperitoneum, all of which showed that the changes of the patients physical signs in the observation group were more stable, with significant difference compared with the control group (P 0.05). The indexes of heart rate, systolic blood pressure and diastolic blood pressure in the immediate observation group were better, P 0.05. The incidence of unsafe events during and after operation in the two groups was evaluated. The evaluation value of the observation group was 6.67%, which was significantly lower than that of the control group by 26.67%, P 0.05. Conclusion: low-flow sevoflurane is adopted in anesthesia maintenance scheme of laparoscopic surgery, which has significant value in maintaining the stability of patients signs during operation and ensuring the safety of patients after operation. 展开更多
关键词 LAPAROSCOPY low-flow sevoflurane anesthesia effect security
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Effects of Anesthesia on Effective Connectivity in the Brain
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作者 Xinyu Xu Guolin Wang Xin Tian 《World Journal of Neuroscience》 2015年第2期99-107,共9页
The brain constitutes a formidably complicated structural network. There are three main types of connectivity used to describe neuronal networks, which reflect three parallel levels of investigation: anatomical connec... The brain constitutes a formidably complicated structural network. There are three main types of connectivity used to describe neuronal networks, which reflect three parallel levels of investigation: anatomical connectivity, functional connectivity and effective connectivity. Effective connectivity indicates the direct influence that a node exerts on another, and in the context of neuronal?circuits, a causal relationship between the activities of two nodes. Since its definition, effective?connectivity analysis has been used to describe causal relationship across multiple spatial scales in?PET imaging, fMRI, electroencephalography (EEG) and magnetoencephalography (MEG), single-unit, and local field potential. There are diverse literatures which probe the anesthetized state?using effective connectivity analysis over the past two decades. The examination of effective connectivity in the anesthetized state is of relevance to both anesthesiologists and neuroscientists, as it has the potential to elucidate still unclear mechanisms of anesthesia while offering insight into intrinsic functional activity in the brain. The present review attempts to examine, elucidate, and integrate the insight that effective connectivity analysis of the anesthetized state has generated thus far. 展开更多
关键词 effective CONNECTIVITY anesthesia GRANGER CAUSALITY CONSCIOUSNESS
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Effect of continuous spinal anesthesia with ropivacaine on the ultrastructure of spinal cord and nerve roots in rats
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作者 孙志华 《外科研究与新技术》 2005年第3期157-157,共1页
To investigate the effects of continuous spinal anesthesia with different concentrations and doses of ropivacaine on the ultrastructure of the spinal cord and nerve roots.Methods Twenty-four male SD rats weighing 220... To investigate the effects of continuous spinal anesthesia with different concentrations and doses of ropivacaine on the ultrastructure of the spinal cord and nerve roots.Methods Twenty-four male SD rats weighing 220~280 g were anesthetized with intraperitoneal 10% chloral hydrate 300~350 mg/kg.A polyurethane microcatheter was inserted into the lumbar subarachnoid space according to the technique described by Yaksh.An 8 cm catheter segment was left in the subarachnoid space.The animals were randomized to receive normal saline,0.5%,0.75% or 1.0% ropivacaine 40 μl intrathecally 3 times at 1.5 h interval.Six hours after the first intrathecal administration the animals were decaptiated and L 1,2 segment of the spinal cord and nerve roots were immediately removed for electron microscopic examination.Results Electron microscopic examination revealed that in animals which received intrathecal (i.t.) normal saline,0.5% or 0.75% ropivacaine the neurolemma of the nerve roots and the mitochondria and endoplasmic reticulum of the neurons in the spinal cord were intact,while in animals which received i.t. 10.% ropivacaine the neurolemma was stratified and partly disrupted and there were swelling of endoplasmic reticulum and vacuole degeneration.Conclusion Six hours continuous spinal anesthesia with 10.% ropivacaine may be injurious to the spinal cord and nerve roots.12 refs,8 figs,1 tab. 展开更多
关键词 effect of continuous spinal anesthesia with ropivacaine on the ultrastructure of spinal cord and nerve roots in rats
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阿芬太尼与瑞芬太尼在甲状腺手术麻醉中的效果比较
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作者 颜莉丽 陈燕 袁峰 《河南医学研究》 2026年第2期250-253,共4页
目的比较阿芬太尼与瑞芬太尼对甲状腺手术患者麻醉效果的影响。方法选取2022年3月至2023年12月在郑州大学第二附属医院接受择期甲状腺手术的92例患者为研究对象,随机分为阿芬太尼组和瑞芬太尼组,每组46例。阿芬太尼组在麻醉诱导和麻醉... 目的比较阿芬太尼与瑞芬太尼对甲状腺手术患者麻醉效果的影响。方法选取2022年3月至2023年12月在郑州大学第二附属医院接受择期甲状腺手术的92例患者为研究对象,随机分为阿芬太尼组和瑞芬太尼组,每组46例。阿芬太尼组在麻醉诱导和麻醉维持中使用阿芬太尼,瑞芬太尼组使用瑞芬太尼。比较两组患者术中血流动力学指标、术后视觉模拟法(VAS)评分、麻醉苏醒指标以及围手术期不良反应的差异。结果两组气管插管即刻(T_(1))时间点的平均动脉压(MAP)和心率(HR)均较麻醉诱导前(T_(0))升高,手术开始后30 min(T_(2))到手术结束时(T_(3))的MAP和HR逐渐降低,且阿芬太尼组T_(1)~T_(3)时间点均低于瑞芬太尼组(P<0.05),两组MAP和HR交互效应无统计学意义(P>0.05)。阿芬太尼组拔管后30 min、1 h和2 h的VAS评分均低于瑞芬太尼组(P<0.05),两组VAS评分交互效应无统计学意义(P>0.05)。阿芬太尼组患者呼吸恢复时间、意识恢复时间及拔管时间均长于瑞芬太尼组(P<0.05)。阿芬太尼组围手术期呼吸抑制、痛觉过敏的发生率低于瑞芬太尼组(P<0.05)。结论阿芬太尼应用于甲状腺手术患者的麻醉诱导和维持中,在稳定血流动力学、减轻术后疼痛以及降低不良反应风险等方面更具优势,而瑞芬太尼能使患者术后更快苏醒。 展开更多
关键词 甲状腺手术 麻醉 阿芬太尼 瑞芬太尼 效果
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Clinical Effect of Electroacupuncture Baihui and Neiguan Acupoint on Cognitive Function Recovery in Elderly Patients after General Anesthesia
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作者 Yuming Zhang Haiyan Huo +3 位作者 Zhu Zhu Qifan Huo Jing Zhao Jun Wang 《Journal of Clinical and Nursing Research》 2021年第3期99-102,共4页
Objective:To study and analyze the clinical effect of electroacupuncture at Baihui and Neiguan Points on cognitive function recovery of elderly patients after general anesthesia.Methods:The subjects were 80 elderly pa... Objective:To study and analyze the clinical effect of electroacupuncture at Baihui and Neiguan Points on cognitive function recovery of elderly patients after general anesthesia.Methods:The subjects were 80 elderly patients who received general anesthesia from January 2019 to February 2021.According to different anesthesia methods,they were divided into research group(electroacupuncture at Baihui and Neiguan combined with conventional drug anesthesia)and control group(simple drug anesthesia).The postoperative cognitive function recovery of the two groups was observed and compared.Results:Compared with the control group,the MMSE score and POCD incidence of research group were significantly better.There was significant difference between the two groups(P<0.05).Conclusion:Conclusion electroacupuncture at Baihui and Neiguan combined with conventional drug anesthesia can promote the recovery of cognitive function and prevent cognitive dysfunction in elderly patients under general anesthesia. 展开更多
关键词 E
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Effects of urethane on the response properties of visual cortical neurons in young adult and old cats 被引量:3
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作者 彭青松 周俊 +2 位作者 施夏明 化国鹏 华田苗 《Zoological Research》 CAS CSCD 北大核心 2011年第3期337-342,共6页
Previous studies have shown that visual cortical neurons in old mammals exhibit higher spontaneous activity,higher responsiveness to visual stimuli,and lower selectivity for stimulus orientations and motion directions... Previous studies have shown that visual cortical neurons in old mammals exhibit higher spontaneous activity,higher responsiveness to visual stimuli,and lower selectivity for stimulus orientations and motion directions than did neurons in young adult counterparts.However,whether the responsive difference in cortical neurons between young and old animals resulted from different effects induced by anesthetics has remained unclear.To clarify this issue,we recorded the response properties of individual neurons in the primary visual cortex of old and young adult cats while systematically varying the anesthesia level of urethane,a widely used anesthetic in physiology experiments.Our results showed that cumulatively administrating 50 mg and 100 mg of urethane upon the minimal level of urethane required to anesthetize an old or young adult cat did not significantly alter the degree of neuronal response selectivity for stimulus orientations and motion directions nor significantly change the visually-driven response and spontaneous activity of neurons in old and young adult cats.Cumulatively administrating 150 mg of urethane decreased neuronal responsiveness similarly in both age groups.Therefore,urethane appears to exert similar effects on neuronal response properties of old and young adult animals. 展开更多
关键词 URETHANE anesthesia effects Neuronal response properties Primary visual cortex Young adult cats Old cats
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导航护士主导的时间点位管理对静脉麻醉人工流产患者负性情绪及护理成效的影响
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作者 徐丽丽 徐洁 +2 位作者 钱芳波 沈晔 司雯淼 《河北医药》 2026年第3期525-528,共4页
目的探讨以导航护士为主导的时间点位管理对静脉麻醉人工流产患者负性情绪及护理成效的影响。方法选取无锡市妇幼保健院行静脉麻醉下人工流产患者415例为观察对象分为对照组210例,偶数观察组205例。对照组采用计划生育门诊手术一般护理... 目的探讨以导航护士为主导的时间点位管理对静脉麻醉人工流产患者负性情绪及护理成效的影响。方法选取无锡市妇幼保健院行静脉麻醉下人工流产患者415例为观察对象分为对照组210例,偶数观察组205例。对照组采用计划生育门诊手术一般护理常规。观察组采用时间点位护理管理策略,比较观察2组患者负性情绪、护理成效(未按照要求禁饮食、未按时来院、意外拔针、跌倒、术后中重度腹痛、不良反应)、护患关系信任度及随访应答率、按时复诊率等。结果观察组患者的负性情绪显著低于对照组(P<0.05);观察组患者在未按时要求禁饮食、未按时来院、术后中重度腹痛发生率、不良反应发生率等护理成效指标,均低于对照组(P<0.05)。2组护患关系信任度、随访应答率及复诊率比较,差异均有统计学意义(P<0.05)。结论静脉麻醉下人工流产患者实施以导航护士为主导的时间位点管理可以减轻患者的负性情绪、提高护理成效及护患关系的信任度,减少术后不良反应的发生,降低患者的手术风险。 展开更多
关键词 时间点位管理 静脉麻醉 人工流产 负性情绪 护理成效
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阿芬太尼复合瑞马唑仑在肿瘤射频消融术中的应用效果研究
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作者 关志荣 区锦辉 +3 位作者 黄晓媚 梁凌 农兰依 钟爱群 《首都食品与医药》 2026年第8期61-63,共3页
目的探讨阿芬太尼复合瑞马唑仑在肿瘤射频消融术(RFA)中的麻醉效果和安全性。方法选取2024年1月-2025年5月需行肿瘤射频消融术的患者66例,随机分为阿芬太尼复合瑞马唑仑组(AR组)和芬太尼复合瑞马唑仑组(FR组),每组各33例,均行静脉全麻... 目的探讨阿芬太尼复合瑞马唑仑在肿瘤射频消融术(RFA)中的麻醉效果和安全性。方法选取2024年1月-2025年5月需行肿瘤射频消融术的患者66例,随机分为阿芬太尼复合瑞马唑仑组(AR组)和芬太尼复合瑞马唑仑组(FR组),每组各33例,均行静脉全麻。比较两组的麻醉效果及安全性。结果与FR组比较,AR组麻醉起效、苏醒时间更短,术中肢体扭动发生率及T3时VAS评分更高;T1-T5时MAP、HR、SpO2、BIS值更高,术后6h、24h VAS评分及不良反应总发生率更低(均P<0.05)。结论阿芬太尼复合瑞马唑仑用于肿瘤射频消融术,虽然术中镇痛效果稍差,但起效快、苏醒时间短、血流动力学稳定、不良反应少。 展开更多
关键词 射频消融手术 阿芬太尼 瑞马唑仑 静脉复合全麻 麻醉效果
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Impact of dexmedetomidine-assisted anesthesia in elderly patients undergoing radical resection of colon cancer 被引量:2
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作者 Xiao-Peng Tian Hui-Min Bu +1 位作者 Hong-Yan Ma Min Zhao 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第9期2925-2933,共9页
BACKGROUND Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy.However,due to the physiological charac-teristics of elderly patients,the safety of periop... BACKGROUND Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy.However,due to the physiological charac-teristics of elderly patients,the safety of perioperative anesthesia needs special attention.As anα2-adrenergic receptor agonist,dexmedetomidine(Dex)has attracted much attention from anesthesiologists due to its stabilizing effect on heart rate and blood pressure,inhibitory effect on inflammation,and sedative and analgesic effects.Its application in general anesthesia may have a positive impact on the quality of anesthesia and postoperative recovery in elderly patients undergoing radical resection of colon cancer.METHODS A total of 165 colon cancer patients who underwent radical surgery for colon cancer under general anesthesia at Qingdao University Affiliated Haici Hospital,Qingdao,China were recruited and divided into two groups:A and B.In group A,Dex was administered 30 min before surgery,while group B received an equivalent amount of normal saline.The hemodynamic changes,pulmonary compliance,airway pressure,inflammatory factors,confusion assessment method scores,Ramsay Sedation-Agitation Scale scores,and cellular immune function indicators were compared between the two groups.RESULTS Group A showed less intraoperative hemodynamic fluctuations,better pulmonary compliance,and lower airway resistance compared with group B.Twelve hours after the surgery,the serum levels of TLR-2,TLR-4,IL-6,and TNF-αin group A were significantly lower than those of group B(P<0.05).After extubation,the Ramsay Sedation-Agitation Scale score of group A patients was significantly higher than that of group B patients,indicating a higher level of sedation.The incidence of delirium was significantly lower in group A than in group B(P<0.05).CONCLUSION The use of Dex as an adjunct to general anesthesia for radical surgery in elderly patients with colon cancer results in better effectiveness of anesthesia. 展开更多
关键词 DEXMEDETOMIDINE General anesthesia ELDERLY Colon cancer radical surgery anesthesia effectiveness DELIRIUM Cellular immunity
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不同剂量罗哌卡因对老年股骨颈骨折内固定术患者麻醉效果的影响
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作者 田志红 杨军 郜思远 《海南医学》 2026年第6期856-861,共6页
目的比较不同剂量罗哌卡因对老年股骨颈骨折内固定术患者麻醉效果的影响。方法选取2022年8月至2024年7月河南中医药大学第三附属医院收治的120例择期拟行股骨颈骨折内固定术的老年患者,按随机数表法分为低剂量组和高剂量组各60例,低剂... 目的比较不同剂量罗哌卡因对老年股骨颈骨折内固定术患者麻醉效果的影响。方法选取2022年8月至2024年7月河南中医药大学第三附属医院收治的120例择期拟行股骨颈骨折内固定术的老年患者,按随机数表法分为低剂量组和高剂量组各60例,低剂量组患者罗哌卡因剂量为1.5 mL:7.5 mg,高剂量组患者罗哌卡因剂量为1.8 mL:9.0 mg。比较两组患者的运动阻滞起效时间、感觉阻滞起效时间、感觉阻滞持续时间、运动阻滞持续时间,以及给药前(T0)、给药后5 min(T1)、给药后10 min(T2)、给药后30 min(T3)、手术结束时(T4)的血流动力学指标[心率(HR)、平均动脉压(MAP)];比较两组患者术前及术后1 d、3 d、1周的认知功能[简易精神状态量表(MMSE)评分和蒙特利尔认知量表(MoCA)评分];比较两组患者术后麻醉恢复效果、术后谵妄及麻醉相关不良反应。结果两组患者的阻滞起效时间(感觉、运动)比较差异均无统计学意义(P>0.05);低剂量组患者的阻滞持续时间(感觉、运动)明显短于高剂量组,差异均有统计学意义(P<0.05)。T1~T4时,两组患者的HR、MAP均较T0时明显降低,差异均有统计学意义(P<0.05),但T0~T4时两组患者的HR、MAP比较差异均无统计学意义(P>0.05)。术前,两组患者的MMSE评分、MoCA评分比较差异均无统计学意义(P>0.05);术后1 d、3 d和1周,两组患者的MMSE评分、MoCA评分均呈先降低后升高趋势,且术后1 d、3 d,低剂量组患者的MMSE评分、MoCA评分明显高于高剂量组,差异均有统计学意义(P<0.05);术后1周,两组患者的MMSE评分、MoCA评分均恢复至术前水平,差异均无统计学意义(P>0.05);低剂量组患者术后麻醉苏醒、下肢运动阻滞恢复、首次排尿等时间分别为(12.36±2.14)min、(36.44±4.58)min、(3.36±0.67)h,明显短于高剂量组的(14.31±2.27)min、(49.37±5.65)min、(4.52±0.87)h,差异均有统计学意义(P<0.05)。低剂量组患者术后7 d内谵妄发生率为6.67%,略低于高剂量组的11.67%,但差异无统计学意义(P>0.05);术后住院期间,低剂量组患者术后麻醉相关不良反应发生率为8.33%,明显低于高剂量组的21.67%,差异有统计学意义(P<0.05)。结论老年股骨颈骨折内固定术蛛网膜下腔阻滞中采用不同剂量罗哌卡因均可确保感觉、运动阻滞迅速起效,且均对呼吸循环系统干扰小,可稳定术中血流动力学,但低剂量罗哌卡因更有利于提升术后麻醉苏醒质量,促进术后认知功能快速恢复,麻醉安全性更高。 展开更多
关键词 股骨颈骨折 老年 罗哌卡因 蛛网膜下腔阻滞 麻醉效果 不良反应
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Ⅱ型胸神经阻滞对心脏瓣膜手术患者镇痛效果及麻醉安全性的影响研究
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作者 雷宁 许周茵 王地 《黑龙江医学》 2026年第4期408-411,共4页
目的:观察Ⅱ型胸神经阻滞(PECSⅡ)对心脏瓣膜手术患者镇痛效果麻醉安全性的影响。方法:研究为随机对照试验,共纳入2022年1月—2024年2月于郑州市第七人民医院就诊并接受心脏瓣膜手术的105例患者。采用计算机生成随机序列,并结合分配隐藏... 目的:观察Ⅱ型胸神经阻滞(PECSⅡ)对心脏瓣膜手术患者镇痛效果麻醉安全性的影响。方法:研究为随机对照试验,共纳入2022年1月—2024年2月于郑州市第七人民医院就诊并接受心脏瓣膜手术的105例患者。采用计算机生成随机序列,并结合分配隐藏,将合格患者随机分为常规麻醉组(52例)与联合麻醉组(53例)。常规组患者实施常规全身麻醉,联合组患者采用PECSⅡ辅助全身麻醉,比较两组患者的围术期血流动力学,术后疼痛、应激情况,镇痛补救情况、麻醉恢复情况及安全性。结果:联合组患者切皮时(T1)、锯胸骨时(T2)的心率(HR)以及平均动脉压(MAP)均低于常规组患者,差异均有统计学意义(t=2.435、2.467、2.977、3.360,P<0.05);联合组患者关胸时(T3)、出室时(T4)的HR及MAP比较,差异无统计学意义(t=0.511、0.100、0.499、1.317,P>0.05)。联合组患者术后30 min、术后2 h、术后4 h静息及活动时的视觉模拟疼痛量表(VAS)评分均低于常规组,差异均有统计学意义(t=2.341、6.193、6.789、3.668、2.521、6.249,P<0.05)。联合组患者术中舒芬太尼用药量、术后舒芬太尼用药量、拔管时间、ICU停留时间、术后恢复排气时间均低于常规组,差异均有统计学意义(t=3.245、2.494、2.785、3.189、2.942,P<0.05)。联合组患者的麻醉相关副反应发生率低于常规组,差异有统计学意义(χ^(2)=6.502,P<0.05)。结论:PECSⅡ阻滞联合全身麻醉有助于稳定心脏瓣膜手术患者的围术期血流动力学,并能有效减轻术后疼痛与应激反应,减少补救镇痛需求,缩短麻醉恢复时间,从而降低整体麻醉风险。 展开更多
关键词 心脏瓣膜病 全身麻醉 Ⅱ型胸神经阻滞 镇痛效果 麻醉安全性
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基于失效模式与影响分析的麻醉机风险管理研究
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作者 李艳春 李庚 +4 位作者 王宇坤 齐得州 张楷 董硕 白玫 《中国医学装备》 2026年第3期119-122,133,共5页
目的:运用失效模式与影响分析(FMEA)方法识别麻醉机潜在失效风险,评估风险等级并制定针对性管控措施,提升麻醉机临床应用的安全性与可靠性。方法:选取2022年至2024年首都医科大学宣武医院临床在用的14台Avance CS2型麻醉机的维修记录及... 目的:运用失效模式与影响分析(FMEA)方法识别麻醉机潜在失效风险,评估风险等级并制定针对性管控措施,提升麻醉机临床应用的安全性与可靠性。方法:选取2022年至2024年首都医科大学宣武医院临床在用的14台Avance CS2型麻醉机的维修记录及相关运行数据,组建麻醉机风险管理评价专家小组,从严重度、发生度和可探测度3个维度对麻醉机运行中的15类失效模式进行风险量化评估,计算风险优先数(RPN)并确定措施优先度(AP),重点分析高风险失效模式的原因与影响,制定针对性的风险控制策略。结果:麻醉机15类失效模式中风箱皮囊风险最高(RPN=240),电池、气体测量板、钠石灰罐密封盖等部件AP等级为中等。主要失效模式包括电池、氧电池、顺磁氧单元、气体测量板、手控机控转换开关、风箱皮囊、钠石灰罐密封盖和钠石灰罐密封垫8项,失效原因主要源于部件老化、机械磨损和密封失效,可通过人员培训、建立部件储备、优化预防性维护等措施降低设备故障风险。结论:FMEA方法能够有效识别麻醉机高风险失效部件并评估其风险程度,通过风险优先排序合理分配资源,需重点关注高风险的失效模式,提高风险管理的效率和效果,为医疗设备风险管理提供依据。 展开更多
关键词 失效模式与影响分析(FMEA) 麻醉机 风险管理 预防性维护
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舒芬太尼复合咪达唑仑与丙泊酚在无痛肠镜检查中的临床价值探析
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作者 杨琳 《中国实用医药》 2026年第2期119-122,共4页
目的探析接受无痛肠镜检查患者实施舒芬太尼复合咪达唑仑、丙泊酚的临床价值。方法纳入接受无痛肠镜检查患者100例,遵循随机数字表原则分组,将实施舒芬太尼联合丙泊酚麻醉方案的50例患者设为对照组,将实施舒芬太尼复合咪达唑仑、丙泊酚... 目的探析接受无痛肠镜检查患者实施舒芬太尼复合咪达唑仑、丙泊酚的临床价值。方法纳入接受无痛肠镜检查患者100例,遵循随机数字表原则分组,将实施舒芬太尼联合丙泊酚麻醉方案的50例患者设为对照组,将实施舒芬太尼复合咪达唑仑、丙泊酚麻醉方案的50例患者设为观察组。比较两组麻醉效果、麻醉指标、麻醉不良事件发生情况。结果观察组患者麻醉优良率96.00%高于对照组的72.00%,差异有统计学意义(P<0.05)。观察组麻醉起效时间(2.26±0.63)min、术后苏醒时间(5.34±1.45)min、定向力恢复时间(6.35±1.10)min短于对照组的(4.70±1.16)、(7.79±2.35)、(8.82±2.33)min差异有统计学意义(P<0.05)。无痛胃肠镜检查期间,观察组麻醉不良事件呼吸抑制、低血压、注射痛发生率分别为4.00%、4.00%、4.00%,低于对照组的24.00%、32.00%、32.00%,差异有统计学意义(P<0.05);两组恶心呕吐发生率比较,差异无统计学意义(P>0.05)。结论对接受无痛肠镜检查患者,在制定麻醉方案时,选择舒芬太尼复合咪达唑仑、丙泊酚药物更有利于患者平稳地完成检查,降低不良风险威胁。 展开更多
关键词 丙泊酚 舒芬太尼 咪达唑仑 无痛肠镜 麻醉效果 风险事件
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环泊酚用于不同年龄椎管内麻醉患者程序性镇静的有效剂量
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作者 黄慧 蒋鹏 马鹏 《江苏大学学报(医学版)》 2026年第1期75-79,85,共6页
目的:探讨不同年龄患者椎管内麻醉期间复合环泊酚程序性镇静的半数有效剂量(ED_(50))和95%有效剂量(ED_(95))。方法:选择2023年12月至2024年3月拟在蛛网膜下腔阻滞下行下肢骨科手术的患者67例,按年龄分为青年组(18~40岁、22例),中年组(4... 目的:探讨不同年龄患者椎管内麻醉期间复合环泊酚程序性镇静的半数有效剂量(ED_(50))和95%有效剂量(ED_(95))。方法:选择2023年12月至2024年3月拟在蛛网膜下腔阻滞下行下肢骨科手术的患者67例,按年龄分为青年组(18~40岁、22例),中年组(41~64岁、24例)和老年组(65~80岁、21例)。椎管内麻醉完成后采用Dixon序贯法给予环泊酚程序性镇静,初始剂量0.2 mg/kg,相邻患者剂量梯度0.05 mg/kg。给药2 min后,以改良警觉/镇静量表(MOAA/S)评分≤3分且脑电双频谱指数(BIS)<85为镇静满意标准,调整后续患者剂量,出现≥7个交叉拐点后终止研究。采用Probit回归分析法计算各组ED_(50)、ED_(95),记录生命体征、MOAA/S评分、BIS值及不良反应发生情况。结果:青年组ED_(50)为0.263 mg/kg(95%CI:0.232~0.300 mg/kg),ED_(95)为0.318 mg/kg(95%CI:0.288~0._(50)9 mg/kg);中年组ED_(50)为0.208 mg/kg(95%CI:0.178~0.238 mg/kg),ED_(95)为0.264 mg/kg(95%CI:0.235~0.417 mg/kg);老年组ED_(50)为0.178 mg/kg(95%CI:0.130~0.217 mg/kg),ED_(95)为0.244 mg/kg(95%CI:0.209~0.526 mg/kg)。三组患者程序性镇静期间生命体征、MOAA/S评分、BIS值及不良反应发生率比较,差异均无统计学意义(P均>0.05)。结论:不同年龄段患者椎管内麻醉期间复合环泊酚程序性镇静的有效剂量存在差异,ED_(50)和ED_(95)随年龄增长而降低。 展开更多
关键词 环泊酚 程序性镇静 麻醉 序贯法 半数有效剂量 年龄依赖性剂量
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罗哌卡因局部浸润辅助全身麻醉对脊柱手术患者术后疼痛与快速康复的影响
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作者 张利强 冉丽 +1 位作者 叶和 熊洋 《中国药业》 2026年第3期116-120,共5页
目的探讨罗哌卡因局部浸润辅助全身麻醉(简称全麻)对脊柱手术患者术后疼痛与快速康复的影响。方法选取医院2023年8月至2024年6月收治的拟行脊柱手术的患者100例,采用随机抽签法分为对照组和观察组,各50例。两组患者均行全麻,对照组患者... 目的探讨罗哌卡因局部浸润辅助全身麻醉(简称全麻)对脊柱手术患者术后疼痛与快速康复的影响。方法选取医院2023年8月至2024年6月收治的拟行脊柱手术的患者100例,采用随机抽签法分为对照组和观察组,各50例。两组患者均行全麻,对照组患者术毕即刻连接静脉自控镇痛泵(PCIA),予舒芬太尼镇痛;观察组患者术毕即刻在切口周围局部浸润盐酸罗哌卡因注射液,待切口缝合完毕,采用与对照组相同的PCIA方案行术后镇痛。结果与对照组比较,观察组患者术后4,8,12,24,48 h的运动状态与静息状态下切口疼痛程度均显著降低(P<0.05);术后24,48 h的疼痛因子(神经肽Y、5-羟色胺、组胺、P物质)和炎性因子(肿瘤坏死因子-α、白细胞介素1β、白细胞介素6)水平均显著降低(P<0.05);术后引流管的拔除时间、首次排气时间、辅助下床时间、住院时间均显著缩短(P<0.05);术后24,48 h的凝血功能(凝血酶原时间、活化部分凝血酶时间、纤维蛋白原)无显著差异(P>0.05)。观察组患者术后的不良反应、并发症发生率分别为4.00%和2.00%,显著低于对照组的18.00%和14.00%(P<0.05)。结论罗哌卡因局部浸润辅助全麻,能显著减轻脊柱手术患者的术后疼痛与炎性反应,减少并发症,促进快速康复,且安全性良好。 展开更多
关键词 罗哌卡因 局部浸润 辅助全身麻醉 脊柱手术 镇痛效果 快速康复 并发症
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授权赋能在麻醉科专科护士工作嵌入与职业倦怠之间的作用分析
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作者 吴文燕 谭嘉裕 +4 位作者 朱琼芳 陈慕瑶 李芳 欧阳秋怡 龚凤球 《护理实践与研究》 2026年第3期382-389,共8页
目的探讨授权赋能在麻醉科专科护士工作嵌入与职业倦怠之间的中介作用。方法选取2023年8月—2024年10月全国三级甲等医院50名麻醉科专科护士为调查对象,采用一般资料调查问卷、工作嵌入量表、授权赋能量表和职业倦怠量表收集数据,通过SP... 目的探讨授权赋能在麻醉科专科护士工作嵌入与职业倦怠之间的中介作用。方法选取2023年8月—2024年10月全国三级甲等医院50名麻醉科专科护士为调查对象,采用一般资料调查问卷、工作嵌入量表、授权赋能量表和职业倦怠量表收集数据,通过SPSS 27.0进行描述性分析和Pearson相关性分析,运用AMOS 24.0软件构建结构方程模型分析授权赋能的中介效应。结果调查问卷有效回收率为90.91%。麻醉科专科护士授权赋能、工作嵌入、职业倦怠得分分别为43.32±5.82分、118.24±10.58分、74.04±6.36分。相关分析显示授权赋能各维度与工作嵌入各维度均呈正相关,相关系数范围0.334~0.848。授权赋能与职业倦怠中的个人成就感维度呈正相关,自主性维度对组织匹配的相关系数最高(0.848),自我效能与情绪耗竭的负相关性最强(-0.745)。中介效应结果显示,工作嵌入对职业倦怠的直接效应95%CI(-0.280~-0.032),授权赋能中介效应95%CI(-0.557~-0.302),差异有统计学意义(P<0.05)。中介效应(-0.323)占总效应(-0.479)的67.46%,授权赋能在工作嵌入与职业倦怠之间起到部分中介作用。结论授权赋能在工作嵌入影响职业倦怠的过程中发挥重要的中介作用,提升麻醉科专科护士的授权赋能水平有助于增强工作嵌入度,增强工作积极性和职业满足感,促进麻醉护理人员的专业发展和整体工作绩效。 展开更多
关键词 授权赋能 麻醉科专科护士 工作嵌入 职业倦怠 中介作用
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