Research on the emergency surgery risks of medical support and coping strategies for taikonauts of Shenzhou-12 astronauts / 中华急诊医学杂志

Objective:This study aims to analyze the characteristics and basic principles of emergency surgery risks and anesthesia care of medical support at the landing site for China’s taikonauts of the Shenzhou-12, and to summarize China’s experience in medical support at the landing site for manned spaceflight, and ensure supports in special environments such as an emergency return of manned spaceflight.Methods:This study was carried out through literature research on relevant reports on the emergency surgery risks and aids of domestic and foreign astronauts at the landing sites, and summaries of the experience in medical support for taikonauts of spacecrafts from Shenzhou-5 to Shenzhou-11 at the landing sites. At the same time, according to the characteristics of Shenzhou-12 such as the long on-orbit time, the adjustment in the landing area, the optimization of the mission mode, and new search and rescue power, a series of organization, pre-arranged planning, equipment allocation, and effective anesthesia treatment plan were proposed and inspected in practice.Results:Based on the original anesthesia care plan of medical support, the first-aid carrier was adjusted and modified, the first-aid procedure was optimized, a new generation of supraglottic airway opening tool, video laryngoscope, portable ultrasound, and other devices were added, and the anesthesia care plan at the landing site for manned spaceflight was formulated to provide strong support for the medical care of taikonauts that had stayed in the outer space for a long time.Conclusions:Upon the targeted improvement and process optimization, the anesthesia care plan of medical support for taikonauts of Shenzhen-12 in the landing area fully meets the anesthesia requirement of medical support in special environments such as the emergency return of the taikonauts that have stayed in the outer space for a long time under the new orbital altitude.

Comparison of effects of equivalent analgesic dose of sufentanil, fentanyl and dezocine on consciousness index and their adverse reactions / 实用医学杂志

Objective To compare the effects of the equivalent analgesic doses of sufentanil, fentanyl and dizosin on index of consciousness (IoC) and their adverse reactions. Methods Eighty patients undergoing painless gastroenteroscopy, aged 18～60 years, ASA grade Ⅰ to Ⅱ, were selected. The patients were randomly divided into control group (group C) , sufentanil group (group S) , fentanyl group (group F) , and dizosin group (group D) , with 20 cases in each group. Sufentanil 0.1～0.2 μg/kg, fentanyl 1～2μg/kg and dizocine 0.1～0.2 mg/kg were intravenously injected in group S, F and D respectively. Group C was given saline of equal volume, and then propofol 2～2.5 mg/kg was intravenously injected until consciousness disappeared.Intravenous infusion of propofol50～100 g/ (kg · min) maintained anesthesia. Heart rate, blood pressure, IoC and perioperative adverse events were recorded. Results There was no significant difference in operative time and recovery time among the 4 groups (P> 0.05). Compared with those in group C, the values of IoC at T2, TS, T4 and T5 in group S and F increased significantly (P < 0.05) , and the correlation coefficient between OAA/S and IoC was 0.872 (P < 0.05). Compared with that in group C, the incidence of nausea and vomiting was higher in group D, and the incidence of injection pain was significantly lower in group S, F and D (P < 0.05). Conclusion Compared with propofol alone, opioids used in painless gastrointestinal endoscopy anesthesia lead to loss of consciousness and increase of IoC value at recovery time, but have no significant effect on recovery time.

First aid cardiopulmonary resuscitation at the exit of capsule and strategy coping with the "Shenzhou 11"spacecraft / 中华急诊医学杂志

Objective To summarize the medical security experience in first-aid and resuscitation for astronauts at the exit of capsule after the spacecraft returns to the main landing site in the process of human spaceflight in China,and thus to provide a powerful security measures for Chinese aerospace medicine.Methods The medical support experiences were summarized in human spaceflight from "Shenzhou V" to "Shenzhou X",relevant reports on emergency rescue and resuscitation were consulted in in-orbit process and after emergency return and landing for domestic and foreign astronauts,astronauts' physiological changes in cardiopulmonary resuscitation were analyzed during emergency return,and then,corresponding strategies were proposed and tested in practice (actual combat) by combining with the flight characteristics of the spacecraft "Shenzhou XI".Results On the basis of the original emergency treatment,the countermeasures for the cardiopulmonary resuscitation were proposed after the spacecraft returned to the main landing site in human spaceflight,the emergency equipment was adjusted,the emergency procedures were optimized,and anti-fog glidescopes were added,laryngeal masks were introduced to perform supraglottic ventilation as the quickest and most effective airway opening measure on site.In addition,ultrasound examination was applied in practice as an important treatment and assessment method for basic life support and advanced life support.All these could ensure the rescuing ability on cardiopulmonary resuscitation during their stay in space for the medium-term and after their return to the main landing site.Conclusions During the return of the astronauts of the spacecraft "Shenzhou XI" to the main landing site,the first aid and support program had been improved specifically and the process had been optimized to ensure the successful completion of medical security mission of China's human spaceflight.

Total intravenous anesthesia of propofol-remifentanil for patients of cosmetic surgery / 中华医学美学美容杂志

Objective To explore the effect of propofol-remifentanil total intravenous anesthesia in cosmetic surgery and the controllability of anesthesia.Methods According to the American Society of Anesthesiologists (ASA),levels Ⅰ-Ⅱ hospitalized patients for elective cosmetic surgery (100 cases) were randomly divided into two groups,namely propofol-remifentanil total intravenous anesthesia group (Group T) and combined intravenous inhalational anesthesia group (Group C),50 cases each.Observatory items of patients included intraoperative cardiovascular drug use,body movement,waking-up time,extubation time,leaving time from operation theatre,postoperative adverse reaction,hypoxemia (SpO2＜95％) and anesthesia satisfaction.Results In Group C,waking-up time,extubation time and leaving time from operation theatre were (12.2 ± 3.6),(13.8± 4.6) and (4.6 ±5.8) min,respectively,which were longer than those (6.7±2.6),(7.8±3.3) and (3.3±3.8) min in Group T (P＜0.05).In Group T,intraoperative ephedrine usage (6/50,12.0％) and body moving rates (4/50,8.0％) were higher than those (1/50,2.0％) and (1/50,2.0％) in the Group C (P＜0.05).The Group T had lower incidence of postoperative adverse reactions,including lethargy (2/50,4.0％),irritability (1/50,2.0％),nausea and vomiting (8/50,16.0％),which were lower than those (8/50,16.0％),(7/50,14.0％) and (17/50,34.0％) in the Group C (P＜0.05).The incidence of postoperative chill was similar between the two groups with no statistical significance (P＞0.05).Satisfactory rate with anesthesia was 84.0％ (42/50) in Group T that was higher than 52.0％ (26/50) in Group C (P＜0.05).Conclusions Propofol-remifentanil intravenous anesthesia has definite effects with faster postoperative recovery,less adverse reaction and complications,safety and operablity.

Experience in first-aid and rescue for the ‘SHENJIU' astronauts in the landing site / 中华急诊医学杂志

Objective To discuss the experience of medical treatment and rescue of the ‘SHENZHOU' astronauts in the landing place in the past 10 years,and to establish more effective mobile ICU in medical helicopters to ensure ‘SHENJIU' astronauts safety.Methods The data collected from foreign nations and our country was reviewed.Formerly experience in first-aid and rescue astronauts of our team was summerized.The important reasons of accidental injuries of astronaut during aerospace flight were listed.More effective and reasonable prophylactic measurements and clinical treatments of the accidental injuries of astronauts were brought forward.Results we established three effective mobile ICU that could ensure the safety of the astronauts.The carriers of the ICU were helicopters,and damage control surgery can be performed there.Fine armature made us more effective.Conclusions Reasonable and effective prophylactic measurements and clinical treatments were the important aspect of the successful manned aerospace flight.The first-aid system in helicopters could realize the destination of swift response and first-aid.

Experience of first-aid and rescue for the"Shenzhou Ⅶ"astronauts at the landing site / 中华急诊医学杂志

Objective To discuss the experience of medical care for the assurance of security of the'Shenzhou Ⅶ'astronauts at the landing venue in order to innovate a high efficient mobile ICU in medical helicopters.Method The data collected from over.as and domestics were reviewed and analyzed to find out the possible causes of accidental injuries to astronauts during acmspaec flight,and to pmpose a practicably and effectively prophylactic strategy and reasonable treatments for the astronauts with accidental injuries.Results Three,high efficient mobile ICU innovated could elqsure the safety ofthe astronauts.The ICUs with high efficiency were set up in the helicopters where the surgery Call he peormed for controlling the danlage.Fine armature made our work mole effective.Conclusions Practicably and effectively Plephylactic measurements and reasonable treatments are the essential aspect of the successfulness for the security of astronauts of manned aemspacecraft flights.The innovated medical care system in helicopters could realized the obligation of swift response and the duty offirst-md.