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Anesthetic management of a patient with COVID-19 under incubation period undergoing total hip arthroplasty 一例处于潜伏期的新冠肺炎患者行全髋关节置换术的麻醉管理
Q4 Medicine Pub Date : 2020-03-02 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.02.015
Jing-li Chen, Pu Ma, Chang Liu, Hong Yan
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引用次数: 0
Anesthesia management for cesarean section during novel coronavirous epidemic/ 中华麻醉学杂志 新型冠状病毒疫情期间剖宫产的麻醉管理中华麻醉学杂志
Q4 Medicine Pub Date : 2020-02-25 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.0006
Zhi-qiang Zhou, Xingxing Sun, Shiyong Li, L. Wan, A. Luo, Dongji Han
Thirty-six puerperas who underwent emergency cesarean section at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 24, 2020 to February 9, 2020, who all wore medical surgical masks, were retrospectively included in this study. Anesthesia management was performed under tertiary medical protection measures. A dedicated anesthesia equipment was separately sterilized. Narcotic drugs were used for one patient only, and disposable medical supplies were used for anesthetic supplies. Contact transmission should be avoided when a neonate required resuscitation, and early isolation and nucleic acid testing were provided for the neonates. The rate of suspected cases of novel coronavirus (2019-nCoV) was 11% , and the rate of clinically diagnosed cases was 17% before surgery. The rate of clinically diagnosed cases of 2019-nCoV was 22%, the rate of confirmed cases was 8%, and the total positive rate of diagnosis was 31% after surgery. The rate of neuraxial anesthesia was 86%, the rate of general anesthesia was 14%, the time of spinal puncture was (15±7) min, the time of tracheal intubation under general anesthesia was (2.1±1.3) min, the operation time was (95±36) min, and blood loss was (276±166) ml. The Apgar score of newborns was 8.8 ± 0.5. There was 1 neonate whose mother was diagnosed as having 2019 novel coronavirous disease after operation, an oropharyngeal swab specimen was obtained at 36 h of birth, and the swab was tested positive for 2019-nCoV by nucleic acid testing. As of February 10, 2020, an anesthesiologist involved in the operation was diagnosed to have infection by 2019-nCoV. In conclusion, diagnosis of 2019 novel coronavirous disease during pregnancy is more difficult, it is necessary to perform anesthesia management for cesarean section under tertiary medical protection. Although the difficulty in anesthesia operation is increased under tertiary medical protection, anesthesiologists can carry out standardized anesthesia management and guarantee the safety of maternal and infants and anesthesiologists themselves as long as they are rigorously trained and adhere to protective protocols. Key words: COVID-19; Cesarean section; Anesthesia
对2020年1月24日至2020年2月9日在华中科技大学同济医学院同济医院接受紧急剖宫产手术的36名产妇进行了回顾性研究,她们均佩戴医用外科口罩。麻醉管理是在三级医疗保护措施下进行的。专用麻醉设备单独消毒。麻醉药品仅用于一名患者,麻醉用品使用一次性医疗用品。当新生儿需要复苏时,应避免接触传播,并为新生儿提供早期隔离和核酸检测。新型冠状病毒(2019-nCoV)疑似病例率为11%,手术前临床诊断病例率为17%。2019-nCoV的临床诊断病例率为22%,确诊病例率为8%,术后诊断总阳性率为31%。神经轴麻醉率为86%,全身麻醉率为14%,脊髓穿刺时间为(15±7)min,全麻下气管插管时间为(2.1±1.3)min,手术时间为(95±36)min,失血量为(276±166)ml。新生儿Apgar评分为8.8±0.5。有1名新生儿的母亲在手术后被诊断为2019新型冠状病毒病,出生36小时时采集口咽拭子样本,核酸检测结果为2019-nCoV阳性。截至2020年2月10日,一名参与手术的麻醉师被诊断为2019-nCoV感染。总之,2019新型冠状病毒疾病在妊娠期的诊断更加困难,有必要在三级医疗保护下对剖宫产进行麻醉管理。尽管在三级医疗保护下,麻醉手术的难度增加了,但麻醉师只要经过严格的培训并遵守保护协议,就可以进行规范的麻醉管理,保障母婴和麻醉师自身的安全。关键词:新冠肺炎;剖宫产;麻醉
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引用次数: 6
How to conduct clinical research on anesthesiology during epidemic of the novel coronavirus pneumonia: recommendations from the epidemiological perspective/ 中华麻醉学杂志 新型冠状病毒肺炎疫情期间如何进行麻醉临床研究:流行病学角度的建议/中华麻醉学杂志
Q4 Medicine Pub Date : 2020-02-24 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.0004
Xiaoxia Peng, L. Nan
During the outbreak and epidemic of novel coronavirus pneumonia, anesthesiologists are not only the high-risk group of secondary infection, but also undertake tasks to initiate clinical research so that the regular pattern of disease could be summarized, which will product clinical evidences for clinical decision-making and optimization of anesthesia therapy as soon as possible. The clinical research evidences of anaesthesia are of great importance for improving the prevention and control strategy of infectious diseases and implementing relevant measures effectively. The recommendations from the epidemiological perspective are provided on how to conduct clinical research on anesthesiology during epidemic of the novel coronavirus pneumonia in the present paper: (1) The case report and case series research should be initiated promptly once the infectious cases treated in anesthesia department are diagnosed; (2) To focus on need of evidence of decision-making of diagnosis and treatment, to summarize general rules timely and to promote the rapidly production of evidence; (3) To establish a special cohort of novel coronavirus pneumonia so that more prognosis studies could be carried out; (4) To explore the risk factors which result in hospital infection among medical staffs so that hospital infection could be controlled. The purpose of this study is to provide clinicians with methodological suggestions on how to carry out high-quality clinical research in the epidemic period of infectious diseases, and to close the gap between clinical and public health. Key words: novel coronavirus pneumonia; case report; clinical research; special cohort; hospital infection
在新型冠状病毒肺炎疫情暴发流行期间,麻醉师不仅是二次感染的高危人群,而且承担着启动临床研究的任务,以总结疾病的规律,为临床决策和麻醉治疗的优化尽快提供临床依据。麻醉的临床研究证据对改进传染病预防控制策略和有效实施相关措施具有重要意义。本文从流行病学角度对新型冠状病毒肺炎疫情期间如何开展麻醉学临床研究提出建议:(1)一旦诊断出麻醉科治疗的感染性病例,应及时启动病例报告和病例系列研究;(2) 注重诊疗决策的证据需要,及时总结一般规律,促进证据的快速生成;(3) 建立新型冠状病毒肺炎的特殊队列,以便开展更多的预后研究;(4) 探讨医务人员医院感染的危险因素,以控制医院感染。本研究的目的是为临床医生在传染病流行期如何开展高质量的临床研究提供方法论建议,并缩小临床与公共卫生之间的差距。关键词:新型冠状病毒肺炎;病例报告;临床研究;特殊群体;医院感染
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引用次数: 0
Fighting Novel Coronavirus Pneumonia outbreak: improvement in anesthesia-related infection control 抗击新型冠状病毒肺炎疫情:改善麻醉相关感染控制
Q4 Medicine Pub Date : 2020-02-22 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.02.004
Guyan Wang, Xiang-yang Guo
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引用次数: 2
AIDS associated with pneumocystis cariniisevere pneumonia during the epidemic of novel conoraviruspneumonia: one case report 新型冠状病毒肺炎流行期间艾滋病合并卡氏肺囊虫重症肺炎1例
Q4 Medicine Pub Date : 2020-02-21 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.02.012
Yucui Shen, Yu Luo, Jiawei Ren, Jue Zhang, Lize Xiong
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引用次数: 0
Suggestions on infection control for performing endotracheal intubation in patients with coronavirus disease 2019: based on literature review of airway management in patients with SARS 2019冠状病毒病患者气管插管感染控制建议:基于SARS患者气道管理的文献综述
Q4 Medicine Pub Date : 2020-02-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.02.002
Lulong Bo, Xiaojian Wan, J. Bian, Xiaoming Deng
In order to effectively prevent infection or severe acute respiratory syndrome coronavirus 2 transmission among medical staff during tracheal intubation in patients with suspected or confirmed coronavirus disease 2019(COVID-19), and to ensure the safety of personnel who will perform the endotracheal intubation, we made a literature review to analyze the airway management for SARS patients from China and abroad in 2003 Relevant documents, consensus of diagnosis and therapy for patients with COVID-19 from the National Health Commission, and guidelines of relevant academic societies were also reviewed Thus, we provide suggestions on infection control for performing endotracheal intubation in patients with COVID-19 mainly as follows Medical staff should fully understand the infection risk of COVID-19 and strengthen the training before the procedure It is suggested that the indication of endotracheal intubation should be properly defined, and the need for intubation as emergent or elective should be evaluated early with preparation made in advance During the implementation of endotracheal intubation, the procedure should be completed by the most experienced personnel in airway management using the tools they master best, and a rapid sequential induction of endotracheal intubation is recommended © 2020 Chinese Medical Association
为有效预防疑似或确诊的2019冠状病毒病(COVID-19)患者气管插管过程中医务人员的感染或冠状病毒2型传播,确保气管插管人员的安全,我们对2003年国内外SARS患者气道管理的相关文献进行了文献回顾分析。回顾了国家卫生健康委新冠肺炎诊疗共识和相关学会指南,我们对COVID-19患者气管插管的感染控制建议主要有以下几点:医务人员应充分认识COVID-19感染风险,加强术前培训。建议正确界定气管插管指征;在气管插管实施过程中,应由最有经验的气道管理人员使用自己最熟悉的工具完成插管,并建议快速序贯气管插管©2020中华医学会
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引用次数: 1
Fighting the outbreak of novel coronavirus-infected pneumonia: suggestions to anesthesia practioners 应对新型冠状病毒感染的肺炎:对麻醉从业人员的建议
Q4 Medicine Pub Date : 2020-02-18 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.0001
Lize Xiong
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引用次数: 0
Effect of dexmedetomidine on acute lung injury induced by "double hit" in rats 右美托咪定对大鼠“双击”急性肺损伤的影响
Q4 Medicine Pub Date : 2019-11-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.027
Qing Fang, Xiao-jing Wu, Min Yuan, Qian Kong, Huan Luo, Q. Jin, Xuemin Song
Objective To evaluate the effect of dexmedetomidine on acute lung injury (ALI) induced by "double hit" in rats. Methods Forty SPF male Sprague-Dawley rats, aged 8 weeks, weighing 215-225 g, were divided into 4 groups(n=10 each) using a random number table method: sham operation group (Sham group), "double hit" -induced ALI group (ALI group), "double hit" -induced ALI plus dexmedetomidine group (ALI+ Dex group) and "double hit" -induced ALI plus dexmedetomidine plus yohimbine group (ALI+ Dex+ Y group). ALI was induced by blunt chest trauma and hemorrhagic shock-resuscitation in pentobarbital sodium-anesthetized rats in ALI, ALI+ Dex and ALI+ Dex+ Y groups.In group ALI+ Dex, dexmedetomidine was intravenously infused for 10 min in a loading dose of 1 μg·kg-1·h-1 starting from the time point immediately after blunt chest trauma, followed by continuous infusion of 5 μg·kg-1·h-1 until the end of operation.Yohimbine 0.1 mg/kg was injected after giving the loading dose of dexmedetomidine and at 3 h after blunt chest trauma in ALI+ Dex+ Y group.Rats were sacrificed at 6 h after successful establishment of the model, blood samples were obtained for determination of concentrations of TNF-α and IL-6 in serum (by enzyme-linked immunosorbent assay), and lung tissues were obtained for determination of wet/dry weight (W/D) ratio, expression of Fas, FasL and caspase-3 in lung tissues (by SABC assay), cell apoptosis (by TUNEL), content of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) and for examination of the pathological changes which were scored.The apoptosis index (AI) was calculated. Results Compared with Sham group, the lung injury score, AI, levels of Fas, FasL, caspase-3 and MDA, and concentrations of TNF-α and IL-6 in serum were significantly increased, and the SOD activity in lung tissues was decreased in ALI group (P<0.05). Compared with ALI group, the lung injury score, AI, levels of Fas, FasL, caspase-3 and MDA, and concentrations of TNF-α and IL-6 in serum were significantly decreased, and the SOD activity in lung tissues was increased in ALI+ Dex and ALI+ Dex+ Y groups (P<0.05). Compared with group ALI+ Dex, the lung injury score, AI, levels of Fas, FasL, caspase-3 and MDA, and concentrations of TNF-α and IL-6 in serum were significantly increased, and the SOD activity in lung tissues was decreased in group ALI+ Dex+ Y (P<0.05). Conclusion Dexmedetomidine reduces ALI induced by "double hit" in rats, and the mechanism may be partially related to activating alpha-2 adrenergic receptor and inhibiting inflammatory responses, lipid peroxidation and cell apoptosis. Key words: Dexmedetomidine; Thoracic injury; Shock, hemorrhagic; Acute lung injury
目的探讨右美托咪定对大鼠“双击”致急性肺损伤(ALI)的作用。方法选用SPF级8周龄雄性Sprague-Dawley大鼠40只,体重215 ~ 225 g,采用随机数字表法分为4组(n=10):假手术组(sham组)、“双打”诱导ALI组(ALI组)、“双打”诱导ALI+右美托咪定组(ALI+右美托咪定组)和“双打”诱导ALI+右美托咪定+育喜滨组(ALI+ Dex+ Y组)。戊巴比妥钠麻醉ALI、ALI+ Dex和ALI+ Dex+ Y组大鼠钝性胸外伤及失血性休克复苏诱导ALI。ALI+右美托咪定组,自钝性胸外伤后即刻开始,以1 μg·kg-1·h-1负荷剂量静脉滴注右美托咪定10 min,此后持续滴注5 μg·kg-1·h-1至手术结束。ALI+ Dex+ Y组在右美托咪定负荷剂量后及钝性胸外伤后3 h注射育亨宾0.1 mg/kg。模型建立成功后6 h处死大鼠,取血样测定血清中TNF-α和IL-6的浓度(酶联免疫吸附法),取肺组织测定干/湿重(W/D)比、肺组织中Fas、FasL和caspase-3的表达(SABC法)、细胞凋亡(TUNEL法)、丙二醛(MDA)含量和超氧化物歧化酶(SOD)活性,并对病理变化进行评分。计算细胞凋亡指数(AI)。结果与Sham组比较,ALI组大鼠肺损伤评分、AI、血清Fas、FasL、caspase-3、MDA水平及TNF-α、IL-6浓度显著升高(P<0.05),肺组织SOD活性降低(P<0.05)。与ALI组比较,ALI+ Dex组和ALI+ Dex+ Y组大鼠肺损伤评分、AI、血清Fas、FasL、caspase-3、MDA水平及TNF-α、IL-6浓度均显著降低,肺组织SOD活性升高(P<0.05)。与ALI+ Dex组比较,ALI+ Dex+ Y组大鼠肺损伤评分、AI、血清Fas、FasL、caspase-3、MDA水平及TNF-α、IL-6浓度显著升高,肺组织SOD活性降低(P<0.05)。结论右美托咪定减轻大鼠“双击”诱发的ALI,其机制可能与激活α -2肾上腺素能受体,抑制炎症反应、脂质过氧化和细胞凋亡有关。关键词:右美托咪定;胸受伤;休克、出血;急性肺损伤
{"title":"Effect of dexmedetomidine on acute lung injury induced by \"double hit\" in rats","authors":"Qing Fang, Xiao-jing Wu, Min Yuan, Qian Kong, Huan Luo, Q. Jin, Xuemin Song","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.027","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.027","url":null,"abstract":"Objective \u0000To evaluate the effect of dexmedetomidine on acute lung injury (ALI) induced by \"double hit\" in rats. \u0000 \u0000 \u0000Methods \u0000Forty SPF male Sprague-Dawley rats, aged 8 weeks, weighing 215-225 g, were divided into 4 groups(n=10 each) using a random number table method: sham operation group (Sham group), \"double hit\" -induced ALI group (ALI group), \"double hit\" -induced ALI plus dexmedetomidine group (ALI+ Dex group) and \"double hit\" -induced ALI plus dexmedetomidine plus yohimbine group (ALI+ Dex+ Y group). ALI was induced by blunt chest trauma and hemorrhagic shock-resuscitation in pentobarbital sodium-anesthetized rats in ALI, ALI+ Dex and ALI+ Dex+ Y groups.In group ALI+ Dex, dexmedetomidine was intravenously infused for 10 min in a loading dose of 1 μg·kg-1·h-1 starting from the time point immediately after blunt chest trauma, followed by continuous infusion of 5 μg·kg-1·h-1 until the end of operation.Yohimbine 0.1 mg/kg was injected after giving the loading dose of dexmedetomidine and at 3 h after blunt chest trauma in ALI+ Dex+ Y group.Rats were sacrificed at 6 h after successful establishment of the model, blood samples were obtained for determination of concentrations of TNF-α and IL-6 in serum (by enzyme-linked immunosorbent assay), and lung tissues were obtained for determination of wet/dry weight (W/D) ratio, expression of Fas, FasL and caspase-3 in lung tissues (by SABC assay), cell apoptosis (by TUNEL), content of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) and for examination of the pathological changes which were scored.The apoptosis index (AI) was calculated. \u0000 \u0000 \u0000Results \u0000Compared with Sham group, the lung injury score, AI, levels of Fas, FasL, caspase-3 and MDA, and concentrations of TNF-α and IL-6 in serum were significantly increased, and the SOD activity in lung tissues was decreased in ALI group (P<0.05). Compared with ALI group, the lung injury score, AI, levels of Fas, FasL, caspase-3 and MDA, and concentrations of TNF-α and IL-6 in serum were significantly decreased, and the SOD activity in lung tissues was increased in ALI+ Dex and ALI+ Dex+ Y groups (P<0.05). Compared with group ALI+ Dex, the lung injury score, AI, levels of Fas, FasL, caspase-3 and MDA, and concentrations of TNF-α and IL-6 in serum were significantly increased, and the SOD activity in lung tissues was decreased in group ALI+ Dex+ Y (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Dexmedetomidine reduces ALI induced by \"double hit\" in rats, and the mechanism may be partially related to activating alpha-2 adrenergic receptor and inhibiting inflammatory responses, lipid peroxidation and cell apoptosis. \u0000 \u0000 \u0000Key words: \u0000Dexmedetomidine; Thoracic injury; Shock, hemorrhagic; Acute lung injury","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1379-1382"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42006521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of PCIA with nalbuphine on postoperative cellular immune function in patients undergoing liver cancer resection 那布芬PCIA对癌症切除术后细胞免疫功能的影响
Q4 Medicine Pub Date : 2019-11-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.021
Tao Li, Chen Gao, Xiao-qin Chai, S. Shu, Ling Zhou, Yanhu Xie
Objective To evaluate the effects of patient-controlled intravenous analgesia (PCIA) with nalbuphine on postoperative cellular immune function in the patients undergoing liver cancer resection. Methods Eighty hepatoma patients of both sexes, aged 40-64 yr, with body mass index 19-25 kg/m2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, undergoing elective liver cancer resection, were divided into 2 groups (n=40 each) using a random number table method: sufentanil PCIA group (S group) and nalbuphine PCIA group (N group). Transverse abdominal plane block was performed in two groups.In group S, sufentanil 0.1 μg/kg was intravenously injected at 30 min before the end of surgery, PCIA was performed with sufentanil 2 μg/kg plus ondansetron 16 mg (diluted to 100 ml in normal saline) at the end of surgery, and PCA pump was set up with a 1 ml bolus dose, a 10-min lockout interval and background infusion at a rate of 2 ml/h.In group N, nalbuphine 0.1 mg/kg was intravenously injected at 30 min before the end of surgery, PCA was performed with nalbuphine 2 mg/kg plus ondansetron 16 mg (diluted to 100 ml in normal saline) at the end of surgery, and PCIA pump was set up with a 1 ml bolus dose, a 10-min lockout interval and background infusion at a rate of 2 ml/h, maintaining visual analog scale score <4 within 48 h after surgery.Blood samples were collected from the right internal jugular vein on admission to operating room (T1) and 24 and 72 h after surgery (T2, 3) for measurement of levels of T lymphocyte subsets CD3+ , CD4+ and CD8+ , B cells and NK cells.CD4+ /CD8+ ratio was calculated. Results Compared with S group, levels of CD3+ and CD4+ cells at T2 and levels of CD4+ and NK cells at T3 were significantly increased in N group (P<0.05). Compared with the baseline at T1, the levels of CD3+ , CD4+ , NK and B cells at T2 and NK cells at T3 were significantly decreased in two groups, and CD4+ /CD8+ ratio was decreased at T2 in group S (P<0.05). Conclusion PCIA with nabuphine can improve the postoperative cellular immune function in the patients undergoing liver cancer resection. Key words: Nalbuphine; Analgesia, patient-controlled; Immunity, cellular
目的评价纳布芬静脉自控镇痛(PCIA)对癌症切除术后细胞免疫功能的影响。方法采用随机数表法,将80例美国麻醉学会Ⅱ、Ⅲ级、年龄40~64岁、体重指数19~25kg/m2的肝癌患者随机分为2组(各40例):舒芬太尼PCIA组(S组)和那布芬PCIA组。两组均行腹部横平面阻滞。在S组中,术前30分钟静脉注射舒芬太尼0.1μg/kg,术后用舒芬太尼2μg/kg加昂丹司琼16 mg(在生理盐水中稀释至100 ml)进行PCIA,并设置PCA泵,单次剂量为1 ml,锁定间隔为10 min,背景输注速率为2 ml/h。在N组中,在手术结束前30分钟静脉注射0.1 mg/kg的那布芬,在手术结束时用2 mg/kg的那布芬加16 mg的昂丹司琼(在生理盐水中稀释至100 ml)进行PCA,并设置PCIA泵,以1 ml的推注剂量、10分钟的锁定间隔和2 ml/h的速率背景输注,在手术后48小时内保持视觉模拟量表评分<4。在进入手术室时(T1)以及手术后24和72小时(T2,3)从右颈内静脉采集血样,用于测量T淋巴细胞亚群CD3+、CD4+和CD8+、B细胞和NK细胞的水平。计算CD4+/CD8+比值。结果与S组相比,N组T2时CD3+、CD4+细胞水平及T3时CD4+、NK细胞水平均显著升高(P<0.05),S组T2时CD4+/CD8+比值下降(P<0.05)。关键词:纳布芬;镇痛,患者控制;免疫,细胞
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引用次数: 0
Effect of chronic alcohol intake on postoperative analgesia in cancer patients: a large sample, retrospective analysis 慢性酒精摄入对癌症患者术后镇痛的影响:大样本回顾性分析
Q4 Medicine Pub Date : 2019-11-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.004
Jianfeng Zhang, C. Xing, Ding-yi Wang, Xiaohong Chen, Yan Yu, Qian Yin, Huaiyue Diao, Ye Chen, Hanzhong Cao
Objective To evaluate the effect of chronic alcohol intake on postoperative analgesia in cancer patients. Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ male patients, aged ≥18 yr, underwent postoperative intelligentized patient-controlled analgesia management from January 1, 2016 to October 22, 2018, searched from wireless analgesia management system database, were selected.The patients were divided into control group and chronic alcoholic intake group according to the history of chronic alcoholic intake.Combined intravenous-inhalational anesthesia was used during surgery.Patient-controlled intravenous or subcutaneous analgesia was performed with sufentanil.When moderate pain occurred (4 points≤numeric rating scale score≤6 points), the parameters of analgesia pump was regulated for rescue analgesia.When severe pain occurred (numeric rating scale score at rest or during activity≥7 points), dezocine 0.5 mg was intravenously injected as rescue analgesic.The effective pressing times, the number of attempts, consumption of sufentanil and occurrence of moderate or severe pain were recorded.The adverse reactions such as nausea and vomiting, pruritus, dizziness and hypotension were also recorded. Results A total of 1 914 patients were enrolled in this study, with 1 508 cases in control group and 406 cases in chronic alcoholic intake group.Compared with control group, the effective pressing times, the number of attempts, consumption of sufentanil and incidence of moderate or severe pain were increased (P<0.05), and no significant change was found in the incidence of nausea and vomiting, pruritus, dizziness or hypotension in chronic alcoholic intake group (P<0.05). Conclusion Chronic alcohol intake can decrease the efficacy of postoperative analgesia in cancer patients. Key words: Alcohol drinking; Pain, postoperative; Analgesia, patient-controlled
目的探讨慢性酒精摄入对肿瘤患者术后镇痛的影响。方法选取2016年1月1日至2018年10月22日在无线镇痛管理系统数据库中检索的美国麻醉医师学会物理状态Ⅰ或Ⅱ男性患者,年龄≥18岁,接受术后智能化患者自控镇痛管理。根据慢性酒精摄入史将患者分为对照组和慢性酒精摄入组。术中采用静脉-吸入联合麻醉。使用舒芬太尼进行患者控制的静脉或皮下镇痛。当出现中度疼痛(4分≤数字评定量表评分≤6分)时,调节镇痛泵参数进行抢救镇痛。当发生剧烈疼痛时(静止或活动时数值评定量表得分≥7分),静脉注射地佐辛0.5 mg作为救急镇痛药。记录有效按压次数、尝试次数、舒芬太尼用量及中重度疼痛发生情况。恶心呕吐、瘙痒、头晕、低血压等不良反应也有记录。结果共纳入1914例患者,其中对照组1 508例,慢性酒精摄入组406例。与对照组比较,慢性酒精摄入组有效按压次数、尝试次数、舒芬太尼用量、中重度疼痛发生率均增加(P<0.05),而恶心呕吐、瘙痒、头晕、低血压发生率无显著变化(P<0.05)。结论慢性酒精摄入可降低肿瘤患者术后镇痛效果。关键词:饮酒;疼痛,术后;病人自控镇痛,
{"title":"Effect of chronic alcohol intake on postoperative analgesia in cancer patients: a large sample, retrospective analysis","authors":"Jianfeng Zhang, C. Xing, Ding-yi Wang, Xiaohong Chen, Yan Yu, Qian Yin, Huaiyue Diao, Ye Chen, Hanzhong Cao","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.004","url":null,"abstract":"Objective \u0000To evaluate the effect of chronic alcohol intake on postoperative analgesia in cancer patients. \u0000 \u0000 \u0000Methods \u0000American Society of Anesthesiologists physical status Ⅰ or Ⅱ male patients, aged ≥18 yr, underwent postoperative intelligentized patient-controlled analgesia management from January 1, 2016 to October 22, 2018, searched from wireless analgesia management system database, were selected.The patients were divided into control group and chronic alcoholic intake group according to the history of chronic alcoholic intake.Combined intravenous-inhalational anesthesia was used during surgery.Patient-controlled intravenous or subcutaneous analgesia was performed with sufentanil.When moderate pain occurred (4 points≤numeric rating scale score≤6 points), the parameters of analgesia pump was regulated for rescue analgesia.When severe pain occurred (numeric rating scale score at rest or during activity≥7 points), dezocine 0.5 mg was intravenously injected as rescue analgesic.The effective pressing times, the number of attempts, consumption of sufentanil and occurrence of moderate or severe pain were recorded.The adverse reactions such as nausea and vomiting, pruritus, dizziness and hypotension were also recorded. \u0000 \u0000 \u0000Results \u0000A total of 1 914 patients were enrolled in this study, with 1 508 cases in control group and 406 cases in chronic alcoholic intake group.Compared with control group, the effective pressing times, the number of attempts, consumption of sufentanil and incidence of moderate or severe pain were increased (P<0.05), and no significant change was found in the incidence of nausea and vomiting, pruritus, dizziness or hypotension in chronic alcoholic intake group (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Chronic alcohol intake can decrease the efficacy of postoperative analgesia in cancer patients. \u0000 \u0000 \u0000Key words: \u0000Alcohol drinking; Pain, postoperative; Analgesia, patient-controlled","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1291-1293"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41852774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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中华麻醉学杂志
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