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Targeted to the junior nursing students in our university, we applied experiential teaching in the course of Obstetrics and Gynecology Nursing to carry out humanistic care infiltration education, which mainly included three parts: aesthetic activities in theoretical class, experiential activities in experimental class and enlightenment after class. After class, compared with the nursing students who were educated by traditional teaching methods, the quality of humanistic care of nursing students who accepted experiential teaching was improved more obviously. It is suggested that the application of experiential teaching is effective in infiltrating humanistic care education in nursing professional courses, which is also in line with the development of nursing discipline.
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Objective To evaluate the efficacy of dexmedetomidine mixed with ropivacaine for thoracic paravertebral nerve blocks by multiple injections for preemptive analgesia on postoperative analgesia of patients undergoing thoracotomy. Methods Ninety patients, all genders, ASA Ⅰ or Ⅱ, aged 35-64, BMI 18-24 kg/m2, undergoing radical operation for esophageal carcinoma were randomly divided into three groups (each group 30 patients): group C received general anesthesia, group R received ropivacaine for thoracic paravertebral nerve block and group RD received dexmedetomidine mixed with ropivacaine for thoracic paravertebral nerve block.Three groups all used intravenous infusion of propofol, refentanyl and inhalation sevoflurane for anesthesia maintenance, and PCIA pump started before the end of surgery in 3 groups.Meanwhile, group R and group RD received ultrasound-guided T4-T8thoracic paravertebral nerve blocks by multiple injections on operation side preoperatively.In group R, the mixture of 0.5% ropivacaine 19 ml and 1ml of normal saline was injected, and in group RD, the mixture of dexmedetomidine 1 μg/kg and 19 ml of 0.5% ropivacaine was injected.The analgesia process lasted 48 h after surgery of these 3 groups, and the VAS score was maintained<4 points.When the VAS score was 4 or more points, intravenous injection of morphine 5- 10 mg was delivered. Postoperative PCIA liquid and morphine consumption, somnolence, nausea, vomiting, respiratory depression, itching and urinary retention was recorded. Additionally, the occurrences of adverse events about thoracic paravertebral nerve blocks were recorded.Results The dosages of propofol, refentanyl in group R and group RD were lower than those in group G:(7.2 ± 0.6),(6.1 ± 0.5)mg/(kg·h)vs.(8.1 ± 0.5)mg/(kg·h), and there were significant differences(P<0.05).The dosage of propofol in group RD was lower than that in group R: (6.1 ± 0.5) mg/(kg·h) vs. (7.2 ± 0.6) mg/(kg·h), and there was significant difference (P <0.05). Compared with group G, the consumption of PCIA liqud and the usage rate of morphine was reduced in group R and group RD (P < 0.05); the consumption of PCIA liqud and the usage rate of morphine was lower in group RD than that in group R(P<0.05).The rate of nausea and vomiting and itch in group R and group RD was lower than that in group G,and there were significant differences(P<0.05). No significant difference in somnolence showed between three groups (P > 0.05). Conclusions Ropivacaine combined with dexmedetomidine for target thoracic paravertebral nerve blocks by multiple injections for preemptive analgesia can significantly improve the efficacy of postoperative analgesia after thoracotomy, meanwhile,it can also save the dosage of anesthetic drugs during the operation.
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Objective To evaluate the effects of dexmedetomidine on postoperative cognitive function in the aged patients undergoing carotid endarterectomy.Methods Forty patients,aged 65-80 yr,of ASA physical status Ⅱ or Ⅲ,scheduled for elective carotid endarterectomy,were randomly divided into 2 groups (n =20 each):control group (group C) and dexmedetomidine group (group DEX).Anesthesia was induced with midazolam,etomidate,fentanyl and rocuronium.The patients were tracheally intubated.In group DEX,a loading dose of dexmedetomidine 0.03 μg· kg-1 ·min-1 was infused intravenously for 10 min starting from the time point before induction,and dexmedetomidine 0.30μg· kg-1 ·min-1 was infused until 30 min before the end of operation starting from the end of intubation.The equal volume of normal saline was given instead of dexmedetomidine in group C.At 1 day before operation (To) and 6 and 24 h after operation (T1.2),venous blood samples were collected for determination of serum brain-derived neurotrophic factor (BDNF) concentrations.The cognitive function of the patients was assessed using Mini-Mental State Examination (MMSE) at To,T2,and 48 h,72 h,7days and 1 month after operation (T3-6).Results Compared with the baseline value at T0,the serum BDNFconcentrations were significantly increased at T1 in the two groups,MMSE scores were decreased at T2,3 in groupC,and MMSE scores were decreased,and the serum BDNF concentrations were increased at T2 in group DEX.Compared with group C,the MMSE scores were significantly increased at T3.4,the serum BDNF concentrations were increased at T2,and no significant change was found in MMSE scores at T5.6 in group DEX.Conclusion Dexmedetomidine is helpful in improving postoperative cognitive function and in promoting the recovery of postoperative cognitive function,and the mechanism may be related to enhanced production of endogenous BDNF in the aged patients undergoing carotid endarterectomy.
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To improve the anesthesia skills of younger anesthesiologists ,department of anes-thesiology of the Affiliated Hospital of Yangzhou University formed the tutorial system based on tutori-al team. Through enhancing the selection of tutors,establishing of tutorial team and conducting clini-cal skill guidance and scientific research ability training,department of anesthesiology aimed to devel-op personal quality,clinical and scientific research ability of younger anesthesiologists in the process of clinical completion and application of scientific research subject.