ABSTRACT
Objective To investigate the influence of pure intercostal nerve block combined with hydromorphone hydrochlo-ride intravenous analgesia on the occurrence of postoperative cognitive function and analgesia in elder patients with thoracic surger-y.Methods Ninety-six ASA I?Ⅱ elder patients with elective thoracic operation were divided into intercostal nerve block group (A),intercostal nerve block combined with hydromorphone hydrochloride intravenous analgesia group (B)and hydromorphone hydrochloride intravenous analgesia group(C)according to the random number table method,32 cases in each group.The patient-controlled intravenous analgesia(PCIA)with sufentanyl was postoperatively performed in all cases.When analgesia effect was poor, dezocine 0.1mg/kg was intravenously injected.The mean artery pressure(MAP),heart rate(HR),respiratory rate(RR),visual ana-logue scale (VAS)score and mini mental state examination (MMSE)score were recorded at postoperative 2,6,24,48 h in 3 groups.Results The MMSE score in the group B was higher than that in the group A and C,the VAS score was lower than that in the group A and C,the difference was statistically significant(P <0.05).Postoperative MAP and HR in the group B were more sta-ble than those in the group A and C,the difference was statistically significant(P <0.05).RR in the group C was more fast and had smaller range than those in the group A and B,the difference was statistically significant(P <0.05).Conclusion Intercostal nerve block combined with hydromorphone hydrochloride intravenous analgesia can achieve better postoperative analgesic effect with sta-ble postoperative blood dynamics and low occurrence rate of early postoperative cognitive dysfunction.
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Objective To investigate the effects of preemptive analgesia with nalbuphine on inflammatory factors in elderly patients undergoing thoracotomy. Methods Eighty elderly patients with ASA I or Ⅱ undergoing thoracotomy were randomly allocated into control group (group C:n=40) and Nalbuphine group (group N:n=40). Each patient received 20 mg of Nalbuphine intravenously before induction of anesthesia in group N and same volume of normal saline in group C. Plasma levels of IL-10, TNF-α and IL-6 were measured at different time points. The VAS was recorded and the MAP, HR, SpO2 and PaCO2 were monitored. Results Compared with group C, the levels of TNF-α and IL-6 were lower, while IL-10 was higher at T2, T3, T4 in group N(P < 0.05). The VAS, MAP, HR and PaCO2 in group N were lower than those in group C at T2, T3 and T4 (P < 0.05). Conclusion Preemptive analgesia with Nalbuphine can improve the efficacy of postoperative analgesia and effectively reduce inflammatory reaction in the old patients undergoing thoracotomy.
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Objective To investigate the influence of preemptive analgesia with Hydr- omorphone Hy-drochloride on postoperative cognitive function and inflammation cytokines in the elderly patients. Methods Ninety ASA I orⅡ elder patients were randomly divided in control group (C)and Hydromorphone Hydrochloride group(H) with 45 cases each. Hydromorphone Hydrochloride 2 mg was injected iv before induction of anesthesia in group H. Observed plasma concentrations of the CRP、 TNF-α and IL-6 at different time. Cognitive function was assessed by minimental state examination. Results Plasma the CRP、 TNF-a and IL-6 concentrations were lower and MMSE scales were higher in group H than in group C. Conclusion Preemptive analgesia with Hy-dromorphone Hydrochloride 2 mg can reduce the incidence of postoperative cognitive dysfunction in the elderly patients.
ABSTRACT
Recent years, the development of medical devices kits is rapid. How to make the technical evaluation of medical devices kits more perfect bases on the two major principles of safe and effective, and to make kits in the market more normative and orderly, these issues for technical evaluation have to be considered. This article makes a study on current situation of production, classification of management and registration status, combined with existing regulations and related standards, and discusses technical evaluation related issues.