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OBJECTIVE To explore the factors and effective preventive method of nosocomial lower respiratory(infection) after general anesthesia through trachea intubation.METHODS Using bacterial culture and identification technique to detect the samples collected from pipe and the sides of anesthetic machine,from disposable virus/(bacteri)a respiratory filter and buccal and bronchial secretion of patients with general anesthesia through trachea(intubation.) RESULTS Eight of 15 anesthetic machines without disinfection were with positive bacterial culture.All sides of virus/bacteria respiratory filter,and buccal and bronchial secretion of patients during operation had same(bacteria.) No bacteria growth was found in anesthetic machine and disposable virus/bacteria respiratory filter used after operation.The same bacteria as from buccal secretion were isolated from anesthetic machine in patients(without) using virus/bacteris respiratory filter.CONCLUSIONS The(results) showed the anesthetic machine is more easy to be contaminated by patients,and the reuse of anesthetic machine is an important factor for nosocomial(lower) respiratory infection after general anesthesia through trachea intubation.Intensifying periodic disinfection of(anesthetic) machine and using virus/bacteria respiratory filter can prevent contamination between anesthetic(machine) and patients and decrease nosocomial lower respiratory(infection) after operation.
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Objective To observe the therapeutic effect of tramadol combined with fentanyl in patient controlled intravenous analgesia after nucleotomy of intervertebral disc.Methods 60 patients under general anesthesia,scheduled for nucleotomy of intervertebral disc,were randomly divided into three group(n=20):group tramadol(group T),group fentanyl(group F) and group tramadol+fentanyl(group TF).All patients were received patient controlled intravenous analgesia by loading dose+background dose+PCA bolus dose.The BP,HR,RR,VAS at 6,12,24,48h of postoperation were observed.The sedation score in 24h,average effective-press times and drug dose in 48h of postoperation were recorded.The incidence of nausea and vomiting during 24h of postoperation were observed.Results It had no significantly difference of BP,HR,RR,VAS among three groups.The average effective-press times of group TF (8?2) were significantly less than those of group T (14?3) and group F (12?3).The drug dose of 48h was tramadol (17.9?1.5)mg/kg(group T),fentanyl (16.8?1.5)?g/kg(group F) and tramadol (11.5?0.7)mg/kg+fentanyl (9.1?0.7)?g/kg(group TF).The drug dose of group TF showed significant difference compared with others.The sedation score in group F was the highest,it had significant difference compared with the other two group.The frequency of nausea and vomiting in group T was significantly more than that in others.Conclusion Tramadol or fentanyl gived alone can afford the same satisfied analgesic effect on nucleotomy of intervertebral disc.But there is high nausea-vomiting frequency in tramadol and strong sedation frequency in fentanyl.Tramadol combined with a little opioid fentanyl can afford more satisfying analgesic effect,and is provided with advantage in less drug and side-effect.
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Objective To observe the treatment effect of nicardipine for the presence of hypertension responses during thyroidectomy under cervical plexus nerve block.Methods Patient without hypertension before the operation was brought into if he received thyroidectomy under cervical plexus nerve block,and with the presence of hypertension responses during the operation,and without effect after injected innovar one dose or dolantin 50mg by vein when the blood pressure was over 160/90mmHg.20 patients according to the criterion mention above were dripped nicardipine 20?g/kg by vein.The SBP,DBP,MAP,HR,SpO_2 and ECG were recorded at 3min,5min,15min,30min,45min after injection and the side effects were also recorded.Results The SBP,DBP,MAP of all patients were fallen distinctly at 3min after injection,and reached lowest at 5min.The blood pressures were steady at other points.There was significantly difference between the point before and after injection(P