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Objective To determine the optimal dose of dexmedetomidine required to prevent nausea and vomiting when used for postoperative analgesia after gynecological laparoscopic surgery.Methods A total of 135 patients,aged 18-60 yr,weighing 52-80 kg,of American Society of Anesthesiologists physical status I or Ⅱ,scheduled for elective gynecological laparoscopic surgery,were divided into 3 groups (n=45 each) using a random number table method:control group (group C),dexmedetomidine 1 μg/kg group (group D1) and dexmedetomidine 2 μg/kg group (group D2).Immediately after anesthesia induction,dexmedetomidine 0.4 μg · kg-1 · h-1 was injected intravenously until 30 min before the end of surgery in all the patients.When the patient was fully awake at the end of surgery,the tracheal tube was removed,and patients were sent to postanesthesia care unit and received patient-controlled intravenous analgesia (PCIA).The PCIA solution contained sufentanil 1.2 μg/kg and dezocine 20 mg in 100 ml of 0.9％ normal saline.The PCIA pump was set up with a 0.5 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 2 ml/h.Dexmedetomidine 1 and 2 μg/kg were added to PCIA solution in group D1 and group D2,respectively.The occurrence of nausea and vomiting was recorded in postanesthesia care unit stay period (P1) and in 0-12 h (P2),12-24 h (P3),24-36 h (P4) and 36-48 h (P5) periods after patients returned to the ward.Ramsay sedation score was recorded at 12,24,36 and 48 h after patients returned to the ward.When visual analogue scale score ＞3,patients were told to press PCIA.Patients were followed up for 48 h after surgery,and patients' satisfaction,pressing times of PCIA and occurrence of pruritus,respiratory depression,bradycardia and dizziness were recorded.Results Compared with group C,the incidence of nausea was significantly decreased in P2 period,and the pressing times of PCIA were reduced in P2,3 period in D1 and D2 groups (P＜0.05).There was no significant difference in Ramsay sedation score at each time point,patients' satisfaction and incidence of bradycardia among the three groups (P＞0.05).No patients developed pruritus,respiratory depression or dizziness in the three groups.Conclusion The optimal dose of dexmedetomidine required to prevent nausea and vomiting is 1 μg/kg when used for postoperative analgesia after gynecological laparoscopic surgery.
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Objective@#To determine the optimal dose of dexmedetomidine required to prevent nausea and vomiting when used for postoperative analgesia after gynecological laparoscopic surgery.@*Methods@#A total of 135 patients, aged 18-60 yr, weighing 52-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective gynecological laparoscopic surgery, were divided into 3 groups (n=45 each) using a random number table method: control group (group C), dexmedetomidine 1 μg/kg group (group D1) and dexmedetomidine 2 μg/kg group (group D2). Immediately after anesthesia induction, dexmedetomidine 0.4 μg·kg-1·h-1 was injected intravenously until 30 min before the end of surgery in all the patients.When the patient was fully awake at the end of surgery, the tracheal tube was removed, and patients were sent to postanesthesia care unit and received patient-controlled intravenous analgesia (PCIA). The PCIA solution contained sufentanil 1.2 μg/kg and dezocine 20 mg in 100 ml of 0.9% normal saline.The PCIA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml/h.Dexmedetomidine 1 and 2 μg/kg were added to PCIA solution in group D1 and group D2, respectively.The occurrence of nausea and vomiting was recorded in postanesthesia care unit stay period (P1) and in 0-12 h (P2), 12-24 h (P3), 24-36 h (P4) and 36-48 h (P5) periods after patients returned to the ward.Ramsay sedation score was recorded at 12, 24, 36 and 48 h after patients returned to the ward.When visual analogue scale score >3, patients were told to press PCIA.Patients were followed up for 48 h after surgery, and patients′ satisfaction, pressing times of PCIA and occurrence of pruritus, respiratory depression, bradycardia and dizziness were recorded.@*Results@#Compared with group C, the incidence of nausea was significantly decreased in P2 period, and the pressing times of PCIA were reduced in P2, 3 period in D1 and D2 groups (P<0.05). There was no significant difference in Ramsay sedation score at each time point, patients′ satisfaction and incidence of bradycardia among the three groups (P>0.05). No patients developed pruritus, respiratory depression or dizziness in the three groups.@*Conclusion@#The optimal dose of dexmedetomidine required to prevent nausea and vomiting is 1 μg/kg when used for postoperative analgesia after gynecological laparoscopic surgery.
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@#Objective To investigate the efficacy and safety of Escitalopram on panic disorder. Methods 40 patients were treated with Escitalopram. All patients were evaluated with Hamilton Anxiety Scale, Self-Rating Anxiety Scale and Adverse Drug Reactions Scale. Results All the patients released from panic since the second week after treatment, except one patient dropped because of side-effects. Other side-effects relieved during the course. Conclusion Escitalopram was effective and safe on panic disorder.
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Objective To investigate the efficacy of escitalopram combined with psychoanalysis in the treatment of refractory depression. Methods A total of 63 patients were randomly divided into escitalopram group ( n = 32) and escitalopram combined with psychoanalysis group( n = 31 ). All patients were evaluated with Hamilton depression Rating Scale(HAMD). Results After treatment,the scores of HAMD in two groups were both significantly lower than those before treatment. In the 8th ( ( HAMD ( 17.35 ± 2.98 ) ), 12th ( ( HAMD (9. 26 ±3.46) )weekend of treatment, the scores of HAMD in study group were significanlly lower than those in control group(8 th:21.97 ± 3.26; 12 th: 15.28 ± 3. 18 ). There were no significant differences in side effects between study group and control group. Conclusion Escitalopram angumented with psychoanalysis takes effects better than escitalopram single and doesn't increase side effects in the treatment of refractory depression.
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@#Objective To investigate the psychosocial factors in cancer patients with depression.Methods 81 cancer patients were surveyed with Hamilton Depression Scale(HAMD),Eysenck Personality Questionnaire(EPQ),Defense Style Questionnaire(DSQ),Social Support Rating Scale(SSRS),Life Events Scale(LES),Symptom Checklist 90(SCL-90).60 health persons as normal controls were surveyed with SCL-90,EPQ and DSQ.Results The score of HAMD was higher in cancer patients with more complication than that with less or no complication.There was significant difference in total score,somatization,obsessive-compulsive,anxiety,depression,other score of SCL-90 among groups of cancer patients with depression,caner patients without depression and normal controls,as well as the N factor of EPQ,negative life events and immature defense.Conclusion The severity of the complications,negative life events,personality,defense style may related with the occurring and persisting of the depression in cancer patients.