ABSTRACT
AIM: To investigate the effect of remifentanil in the management of sedation and analgesia after severe traumatic brain injury and its influence on the incidence of inflammatory stress. METHODS: From January 2017 to April 2020, 92 patients with severe head trauma surgery in our hospital were selected as the research objects, randomly divided into groups, each with 46 cases. Both groups received postoperative sedation and analgesia management, the control group received dexmedetomidine + 0.9% sodium chloride injection, and the observation group received dexmedetomidine combined with remifentanil. The effects of sedation and analgesia, vital signs, and inflammatory stimuli C reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10)related indicators, serum cortisol, β-endorphin, and the incidence of adverse reactions in the two groups were observed and counted. RESULTS: The scores of sedation and analgesia in the observation group were lower than control group at 2 h, 4 h, and 12 h after administration (P 0.05). CONCLUSION: Remifentanil is used in the management of sedation and analgesia after severe traumatic brain injury, which can effectively improve the effect of sedation and analgesia, reduce inflammatory stimulation, regulate the levels of cortisol, and β-endorphin It is worthy of clinical application.
ABSTRACT
Objective To explore the effect of analgesia management on the analgesic effect and the quality of delivery of labor analgesia. Methods The 80 cases were divided into two groups according to the odd number of labor analgesia, the control group without anesthesia nurse labor analgesia, only the anesthesiologist operation, given routine obstetric care. Anesthesia nursing group for labor analgesia by anesthesiologists and nurse by anesthesia on maternal perinatal period health education and pain management, pain score was compared between the two groups (at full dilatation), mode of delivery, postpartum hemorrhage, neonatal asphyxia. Results The total score of pain in the nursing group was 3.9±0.2, while that of the control group was 8.4±0.8, and the difference was statistically significant (t=-38.5872,P=0.000); anesthesia nursing group cesarean delivery, delivery, were 1 cases, 27 cases, 12 cases; the control group were 9 cases, 21 cases, 10 cases, the difference was statistically significant (χ2=7.31, P0.05). Conclusions During the perinatal period, the labor management and nursing intervention of the parturient women with labor analgesia are significantly reduced, the cesarean section rate is significantly reduced, and the complication rate is reduced.
ABSTRACT
Objective To describe the patients′satisfaction with multimodal analgesia management after total knee arthroplasty. Methods 110 patients with total knee arthroplasty selected from February 2013 to February 2014 were recruited to complete a questionnaire, which was composed of the Visual Analogue Scale (VAS) , the Houston Pain Outcome Instrument (HPOI), and the Scale of Perceptions of Patients′Pain. Results VAS scores at different times were ranged from (2.14±1.21) points to (1.19±0.62) points, mean rating for general satisfaction with pain management was 80.04% (136.06/170.00), satisfaction with education on pain control was only 63.20% (37.92/60.00). Patients with different age and educational level of satisfaction with pain control had significant differences (P<0.05). Patients who thought relieving pain was harmful was 56.4% (62/110), the patients who did not understand the impact of pain on the body was 62.7% (69/110), the patients who did not understand the common methods of analgesia was 59.1%(65/110), the patients who did not understand the adverse reactions of pain measures was 63.6% (70/110). Conclusions Patients′satisfaction with the analgesic effect of multimodal analgesia is higher after total knee arthroplasty, while satisfaction with education on pain control was lower. Nurses should strengthen health education to patients with total knee arthroplasty about knowledgement of multimodal analgesia.