共查询到19条相似文献，搜索用时 359 毫秒
1.
目的探讨异丙酚在老年病人全麻诱导中对HR、SBP、DBP的影响.方法选择ASAⅠ～Ⅱ级老年手术病人,无电解质紊乱及低蛋白血症,比较诱导前与注射异丙酚后1min插管时及插管后5minHR、SBP、DBP变化.结果注药后1minHR稍增加,SBP、DBP略降低,插管时HR、SBP、DBP较注药后增加,插管后5minHR恢复正常.SBP、DBP较注药前略降低.结论异丙酚对心血管扰乱小,为老年病人全麻诱导时较为理想的药物. 相似文献
2.
30例全麻诱导气管插管病人,随机分为两组即组Ⅰ硫喷妥钠,琥珀胆硷诱导气管插管和组Ⅱ氟芬合剂,硫喷妥钠,琥珀胆硷诱导气管插管。两组病例均对麻醉诱导前和气管插管后1-2min所测的SBP、DBP、MAP、HR,等几项血流动力学参数和血浆肾素活性、血管紧张素、醛固酮及皮质醇的变化进行自身对照,结果显示两组气管插管后和诱导前自身对比,组Ⅰ SBP、DBP、MAP、均升高40％以上,HR,增加18％(P<0.01)有非常显著性差异。组ⅡSBP、DBP、MAP较诱导前增高20％,HR增加10％(P<0.05)但无显著性差异。血浆肾活性、血管紧张素Ⅱ、醛固酮及皮质醇的变化,两组气管插管后与诱导前对照,均在正常值范围(P>0.05)无显著性差异、结果表明组Ⅱ选用氟芬合剂诱导前用药,能减轻气管内插管过程中的应激反应。 相似文献
3.
目的：比较瑞芬太尼和芬太尼分别复合丙泊酚对患者全麻诱导期心血管反应的影响。方法：60例胆囊切除术患者随机分为F组（芬太尼复合丙泊酚麻醉）和R组（瑞芬太尼复合丙泊酚麻醉）。入室后常规监测心率（HR）、无创血压（SBP、DBP和MBP）、脉搏血氧饱和度（SPO2）。分别记录入室后（T0）、气管插管前即刻（T1）、气管插管后1min（T2）和5min（T3）时患者的HR、SBP、MBP、DBP数值。结果：两组患者基础值差异无统计学意义（P〉0．05）。患者诱导前后自身比较,在插管后1min时,F组患者的HR、SBP、MBP、DBP各数值均显著上升,同时R组各指标差异无统计学意义（P〉0．05）。组间比较,R组患者T1、T2、L时的HR、SBP、MBP、DBP均显著低于F组差异具有统计学意义（P〈0．05）。结论：相比芬太尼,瑞芬太尼可显著抑制患者全麻诱导期的心血管反应。 相似文献
4.
目的 观察静脉注射地佐辛预防全麻诱导期舒芬太尼诱发呛咳反应的效果。方法200例需行气管插管或喉罩全身麻醉的择期手术患者,年龄2065岁,ASAⅠⅡ级,随机分为地佐辛组（A组）和对照组（B组）,每组各100例常规连续监测心电图（ECG）、心率（HR）、无创血压（BP）、脉搏血氧饱和度（SPO2）、呼吸频率（RR）以及呼气末二氧化碳分压（PETCO2）。A组患者在全身麻醉诱导时最先缓慢静脉推注地佐辛5 mg,B组静推生理盐水2 ml。分别记录两组患者诱导期间发生呛咳反应的例数及严重程度以及给药前（T1）、插管前即刻（T2）、插管后即刻（T3）、插管后2 min（T4）各时间点的心率、收缩压、舒张压。结果 两组患者MAP、HR诱导前差异无统计学意义（P>0.05）。A组患者诱导期间5例出现呛咳发生率5%;B组诱导期间发生呛咳45例,发生率45%,差异有统计学意义（P<0.05）,出现呛咳前后患者部分生命体征如心率、血压出现显著改变（P<0.05）。两组T1、T2、T3、T4各点的心率及血压变化不明显（P>0.05）。结论 在麻醉进行前静脉注射地佐辛可有效预防全麻诱导期舒芬太尼所引起的呛咳现象效果明显。 相似文献
5.
目的:研究SLIPA喉罩用于全身麻醉手术中的有效性和安全性.方法:60例ASAⅠ～Ⅱ级、择期全麻下手术的成年患者,随机分为2组,T组:气管插管组;S组:SLIPA喉罩组,每组30例,比较诱导前(T1)、插管时(T2)、插管后5分钟(T3)、手术开始后30分钟(T4)、拔管时(T5)的心率、血压.结果:T组T2、T5时HR(心率)、SBP(收缩压)、DBP(舒张压)明显高于T1及S组(P＜0.05).结论:SLIPA喉罩能安全有效地应用于全身麻醉手术患者,且其心血管刺激反应较气管插管小. 相似文献
6.
不同静脉麻醉药对罗库溴胺快速诱导气管插管的影响 总被引：1，自引：0，他引：1
目的:观察硫贲妥钠、依托咪酯以及异丙酚麻醉诱导对罗库溴铵的插管条件和神经肌肉阻滞程度的影响。方法:选择39例全麻择期手术患者,ASAⅠ~Ⅱ级,随机分为三组,分别采用硫贲妥钠5.0mg.kg-1、依托咪酯0.3mg.kg-1及异丙酚1.5~2.0mg.kg-1静脉诱导,静注罗库溴铵60s后行气管插管。记录气管插管即刻的T1和T4/T1值、插管时间,记录血流动力学参数变化、脉搏血氧饱和度,根据气管插管评分标准进行插管评分。结果:各组病人气管插管即刻的T1和T4/T1及插管时间组间比较无明显差异(P>0.05),三组病人在静注罗库溴铵后60s气管插管条件综合评分均为优良(P>0.05),但是依托咪酯比硫贲妥钠和异丙酚气管插管反应略少。结论:依托咪酯伍用罗库溴铵在静注后60s行快速诱导插管略优于硫贲妥钠和异丙酚。如果患者禁忌使用琥珀胆碱可以改用依托咪酯与罗库溴铵来完成快速诱导和气管插管。 相似文献
7.
硬膜外阻滞复合Proseal喉罩通气在妇科腹腔镜手术中的应用 总被引：1，自引：0，他引：1
目的:评价Proseal喉罩在妇科腹腔镜手术中应用的安全性和可行性。方法:40例女性患者,ASAⅠ~Ⅱ级,年龄18~62岁,择期行腹腔镜下输卵管造口术,腹腔镜下行腹腔镜检查、卵巢囊肿剔除术和盆腔粘连松解术,随机分为两组,LMA组(A组)和气管插管组(B组),每组20人,两组患者均于T12-L1硬膜外腔穿刺置管给于局麻药镇痛,A组予以丙泊酚、芬太尼诱导,术中保留自主呼吸并吸入异氟醚维持麻醉,B组予以丙泊酚、咪唑安定、芬太尼、阿曲库胺诱导,术中以丙泊酚、阿曲库胺并吸入异氟醚维持麻醉。术中监测并记录两组喉罩或插管前1分钟、LMA置入或拔管后即刻、取出后1分钟的HR、SBP、DBP及两组气腹前、气腹后5min的Paw和PETCO2的变化。结果:A组三个时间段HR、DBP、SBP无显著性差异(P>0.05),B组后两个时间段HR、DBP、SBP波动明显,有极显著性差异(P<0.01);两组气腹后的Paw和PETCO2均显著高于气腹前(P<0.01),两组之间无显著性差异(P>0.05)。结论:妇科腹腔镜手术中使用Proseal喉罩具有操作简便,对呼吸、循环影响小,术后并发症少的优点,可以推广应用。 相似文献
8.
目的:探讨全麻诱导期经静脉输液管(墨菲氏管)给药能否减轻芬太尼诱发的呛咳。创新点:寻找一个简单易行、安全可靠的方法减轻全麻诱导期芬太尼诱发的呛咳。与既往芬成尼和呛咳相关的研究相比,本研究试验组操作不仅简便、快速,而且无需额外使用其它药物或设备,不增加人力成本或病人经济负担。方法:择期行全身麻醉手术1138例,所有患者均采用咪达唑仑-芬太尼-丙泊酚-顺式阿曲库铵-气管插管麻醉,随机分为静脉输液管缓慢滴注组(S组,573例)与经三通快速输注组(C组,565例),记录麻醉诱导期两组患者呛咳发生率及严重程度和其它不良反应发生情况。结论:静脉输液管缓慢滴注组呛咳发生率及严重程度较快速输注组明显降低,其它不良反应发生率比较差异无统计学意义。全麻诱导期经静脉输液管缓慢滴注芬太尼可明显降低该药所致呛咳的发生率,且该法简单易行、安全可靠,值得推广。 相似文献
9.
异丙酚是快速,短效全麻药。小儿腺样体手术麻醉具有特殊性。我们随机观察异丙酚麻醉组(Ⅰ组)与普鲁卡因复合麻醉组(Ⅱ组)各20例,监测注药前,注药后2分钟,插管后1分钟,及手术后血压、心率及脉搏血氧饱和度的变化。结果:诱导后血压、心率Ⅰ组与注药前相比相差显著(*P<0.05,**P<0.01),麻醉清醒时间两组相比相差显著(*P<0.01)。提示:异丙酚麻醉在小儿腺样体手术麻醉中就清醒快速、完全而言优于普鲁卡因复合麻醉。 相似文献
10.
丙泊酚复合瑞芬太尼靶控静脉麻醉与静吸复合麻醉的临床观察 总被引：1，自引：0，他引：1
目的:比较丙泊酚复合瑞芬太尼靶控静脉麻醉与静吸复合麻醉的诱导和术后苏醒过程.方法:选腹腔镜胆囊切除术40例,ASA I—II级,15—66岁,随机分为静吸复合麻醉(C)组,丙泊酚瑞芬太尼靶控(R)组,每组20例,观察麻醉诱导,气管插管时的血压、心率,术毕停药后病人自主呼吸恢复时间,呼之睁眼时间,拔管时间,离开手术室时间,观察恶心、呕吐情况.结果:C组诱导时的收缩压低于R组,低血压者多于R组,插管反应发生率R组低于C组;二组病人术后自主呼吸恢复时间,呼之睁眼时间,拔管时间差异无显著性,恶心、呕吐发生率差异无显著性.结论:与静吸复合麻醉相比,异丙酚瑞芬太尼靶控输注麻醉诱导更平稳. 相似文献
11.
Objective： To compare the effects of epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine on propofol requirements, the time to loss of consciousness （LOC）, effect-site propofol concentrations, and the hemodynamic variables during induction of general anesthesia guided by bispectral index （BIS） were studied. Methods： Forty-five patients were divided into three groups to receive epidurally administered saline （Group S）, 1.5% （w/w） lidocaine （Group L）, or 0,5% （w/w） ropivacaine （Group R） Propofol infusion was started to produce blood concentration of 4 lag/ml. Once the BIS value reached 40-50, endotracheal intubation was facilitated by 0.1 mg/kg vecuronium. Measurements included the time to LOC, effect-site propofol concentrations, total propofol dose, mean arterial blood pressure （MABP）, and heart rate （HR） at different study time points. Results： During induction of anesthesia, both Groups L and R were similar for the time to LOC, effect-site propofol concentrations, total propofol dose, MABP, HR, and BIS. The total doses of propofol administered until 1 min post-intubation were significantly less in patients of Groups R and L compared with Group S. MABP and HR were significantly lower following propofol induction compared with baseline values in the three groups, or MABP was significantly increased following intubation as compared with that prior to intubation in Group S but not in Groups R and L while HR was significantly increased following intubation in the three groups. Conclusion： Epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine has similar effects on the time to LOC, effect-site propofol concentrations, total propofol dose, and the hemodynamic variables during induction of general anesthesia. 相似文献
12.
[目的]:观察丙泊酚用于老年心脏病病人行口腔颌面部手术时全麻诱导并经鼻气管插管情况.[方法]:选用65例老年心脏病病人行口腔颌面部手术用丙泊酚诱导并与硫贲妥钠相对比,观察插管前及插管后1、3、5 min不同时段血液动力学指标情况.[结果]:插管前两组平均动脉压(MAP),心率(HR)无显著性差异(P>0.05);插管后1、3、5 min不同时段丙泊酚组血液动力学波动明显低于硫贲妥钠组,二者有显著差异(P<0.01).[结论]:丙泊酚用于老年心脏病人行鼻腔插管优于硫贲妥钠等药物. 相似文献
13.
目的：探讨三通喉罩在无痛纤维支气管镜检查中的安全性和可行性。方法：选择年龄65岁以下,ASAⅠ～Ⅱ级患者,按照自愿的原则分为静脉全麻组（IA）和局麻组（LA）。局麻组术前30min肌注鲁米那100mg＋阿托品0．5mg,检查前经环甲膜穿刺注射2％利多卡因3mL做表麻。静脉全麻组静脉快速诱导后插入TLMA,插入成功后,TLMA标准端口连接麻醉机,纤支镜从直管带密封口置入进行检查、活检。记录麻醉前（T0）、纤支镜过声门即刻（T1）、纤支镜探查／活检时（T2）、术毕5min（T3）各时间点的SBP、DBP、HR和SPO2;记录检查中发生低氧事件的情况、检查时间、苏醒时间。结果：19例无痛纤支镜顺利完成,患者术中循环平稳,SPO：变化于正常范围内,无呛咳、体动、低氧等不良事件,与局麻组比较差异有统计学意义（P〈0．05）,静脉全麻组患者和内镜医师满意度高。结论：TLMA应用于无痛纤支镜检查安全可靠、效果满意,能同时满足麻醉医师和内镜医师对气道的管理需要,具有临床应用价值。 相似文献
14.
目的观察布托啡诺复合丙泊酚麻醉在无痛人工流产手术中的应用。方法选择60例无痛人工流产手术的患者随机分为三组,布托啡诺＋丙泊酚组（A组）、舒芬太尼＋丙泊酚组（B组）、单纯丙泊酚组（C组）,每组20例。观察记录各组术前、术中、术后3min的SBP、DBP、HR、Sp02,同时记录苏醒时间及丙泊酚用量。结果与术前比较,三组患者术中SBP、DBP下降、HR．减慢（P〈0．05）,与C组比较,A、B组患者术后3minSBP、DBP下降、HR减慢明显（P〈0．05）,且A组与B组比较,各时间点的SBP、DBP、HR的差异无统计学意义（P〉0．05）。A组的唤醒时间短于B、C组（P〈0．05）,丙泊酚用量A、B组明显少于C组（P〈0．05）。结论布托啡诺复合丙泊酚应用于无痛人工流产手术麻醉,可明显减少丙泊酚的用量,麻醉效果确切,术毕苏醒迅速而安全。 相似文献
15.
目的：比较SOS与直接喉镜在合并有门齿状况的老年患者气管插管中的安全性与成功率。方法：选择全麻插管下行择期手术的老年患者80例,其中门齿松动者27例,门齿残缺者32例,门齿孤立牙者21例,随机均分为SOS组（S组）和直接喉镜组（Z组）。记录并对比两组插管次数、插管时间和插管并发症情况。结果：S组患者均能一次性快速经口气管插管成功（100%）,明显高于Z组（45%）,而且Z组12例（25%）患者3次插管不成功改用SOS一次插管成功。S组没有一例患者因插管操作不当造成门齿损伤或脱落,而Z组有4例直接导致门齿脱落,9例导致门齿松动。S组插管时间为21（9~58）s,明显短于Z组的44（15~65）s（P〈0.05）。结论：SOS对于门齿有松动、残缺、甚至孤立牙的老年患者,插管成功率高,用时短,插管并发症少,是一种安全有效的插管方法。 相似文献
16.
湖南瓦乡人红细胞血型研究 总被引：1，自引：0，他引：1
调查了湖南怀化市沅陵县230名父母均系瓦乡人而彼此无血缘关系学生的ABO、Rhesus、P、MNSs四种红细胞血型系统的血型.结果表明,ABO系统中的基因频率r(0.6325)>p(0.2221)>q(0.1464);MNSs系统中的基因频率m(0.5196)>n(0.4804)、s(0.9848)>S(0.0152)、Ms(0.4902)>Ns(0.4576)>MS(0.0272)>NS(0.0228);Rhesus系统中CCDee表型最常见(57.83%),CDe单倍型频率较高(0.7588),而cDe频率(0.0207)较低;P系统中P1基因频率为0.1391.湖南瓦乡人的红细胞血型分布具有我国南方民族的特点.与云贵高原周边其他8个民族之间的遗传距离比较表明,湖南瓦乡人与湖南土家族的遗传距离最近而和贵州的仡佬族最远. 相似文献
17.
Min-qiang Liu Feng-xian Li Ya-kun Han Jun-yong He Hao-wen Shi Li Liu Ren-liang He 《Journal of Zhejiang University. Science. B》2017,18(11):955-962
Objective
Fentanyl-induced cough (FIC) is a common complication with a reported incidence from 18.0% to 74.4% during general anesthesia induction. FIC increases the intrathoracic pressure and risks of postoperative nausea and vomiting, yet available treatments are limited. This study was designed to investigate whether administering fentanyl via a slow intravenous fluid line can effectively alleviate FIC during induction of total intravenous general anesthesia.Methods
A total number of 1200 patients, aged 18–64 years, were enrolled, all of whom were American Society of Anesthesiologists (ASA) grade I or II undergoing scheduled surgeries. All patients received total intravenous general anesthesia, which was induced sequentially by midazolam, fentanyl, propofol, and cisatracurium injection. Patients were randomly assigned to receive fentanyl 3.5 μg/kg via direct injection (control group) or via a slow intravenous fluid line. FIC incidence and the severity grades were analyzed with the Mann-Whitney test. Other adverse reactions, such as hypotension, hypertension, bradycardia, tachycardia, hypoxemia, vomiting, and aspiration, during induction were also observed. The online clinical registration number of this study was ChiCTR-IOR-16009025.Results
Compared with the control group, the incidence of FIC was significantly lower in the slow intravenous fluid line group during induction (9.1%, 95% confidence interval (CI): 6.7%–11.4% vs. 55.9%, 95% CI: 51.8%–60.0%, P=0.000), as were the severity grades (P=0.000). There were no statistical differences between the two groups with regard to other adverse reactions (P>0.05).Conclusions
The administration of fentanyl via a slow intravenous fluid line can alleviate FIC and its severity during induction for total intravenous general anesthesia. This method is simple, safe, and reliable, and deserves clinical expansion.18.
Sylvie Mrug Jan L. Wallander 《International Journal of Disability, Development & Education》2002,49(3):267-280
Different countries have approached the education of students with a disability in different ways. Some have advocated for maximum integration, while others have maintained separate schools for those with special needs. The impact of the different educational settings on the self-concept of young people with a physical disability so far has received very little empirical attention. This study compared four groups of students with a physical disability who differed in their level of school integration: (a) US integrated students ( n = 53), (b) Czech integrated students ( n = 14), (c) Czech students educated at special schools on a daily basis ( n = 51), and (d) Czech students attending special schools on a residential basis ( n = 66). In addition, these young people with a disability were compared to a normative sample of Czech students without a disability. The comparisons were made on self-reported self-perceptions, aggression/emotional instability, view of the world, and dependency using the Personality Assessment Questionnaire (Rohner, 1991). Significant between group differences favouring integration were found. More integrated students reported lower levels of aggression, more positive views of themselves, and more positive views of the world. Discussion addressed implications for educational policies for children with special needs. 相似文献
19.
Objective: To evaluate the predictive performance of ‘Diprifusor‘ TCI (target-controlled infusion) system for its better application in clinical anesthesia. Methods: The predictive performance of a ‘Diprifusor‘ TCI system was investigated in 27 Chinese patients (16 males and 11 females) during upper abdominal surgery under total intravenous anesthesia (TIVA) with propofol/fentanyl. Measured arterial propofol concentrations were compared with the values predicted by the TCI infusion system.Performance was determined by the median performance error (MDPE), the median absolute performance error (MDAPE), the divergence (the percentage change of the absolute PE with time), and the wobble (the median absolute deviation of each PE from the MDPE). Results: The median (range) values of 14.9% (-21.6%～42.9%) for MDPE, 23.3% (6.9%～62.5%) for MDAPE, -1.9% h^-1(-32.7%～23.0% h^-1) for divergence, and 18.9% (4.2%～59.6%) for wobble were obtained from 227 samples from all patients.For the studied population, the PE did not increase with time but with increasing target propofol concentration, particularly following induction. Conclusions: The control of depth of anaesthesia was good in all patients undergoing upper abdominal surgical operation and the predictive performance of the ‘Diprifusor‘ target controlled infusion system was considered acceptable for clinical purposes. But the relatively bigger wobble showed that the pharmacokinetic model is not so suitable and requires improvement. 相似文献