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Objective:To investigate the analgesic efficacy of dexmedetomidine combined with fentanyl citrate injection in patients undergoing laparoscopic appendectomy and its effects on inflammatory factor level.Methods:200 patients with appendicitis who underwent laparoscopic appendectomy in Hangzhou Dajiangdong Hospital from April 2017 to March 2019 were included in this study. They were randomly assigned to receive postoperative anesthesia either with fentanyl citrate injection alone (control group, n = 100) or fentanyl citrate injection combined with dexmedetomidine (observation group, n = 100). At different time points after surgery, Visual Analogue Scale (VAS) score was compared between the two groups. Inflammatory factors C-reactive protein, interleukin-6, and tumor necrosis factor-α levels before and after surgery, and the incidence of adverse reactions were compared between the two groups. Results:At 6, 12, 24 and 48 hours after surgery, VAS score in the observation group was significantly lower than that in the control group ( t = 4.671, 9.594, 10.877 and 12.358, all P < 0.001). Before surgery, there were significant differences in C-reactive protein, interleukin-6, and tumor necrosis factor-α levels between the two groups ( t = 0.224, 0.188, 0.421, all P > 0.05). At 24 hours after surgery, C-reactive protein, interleukin-6, and tumor necrosis factor-α levels in each group were significantly increased compared with before surgery, and C-reactive protein, interleukin-6, and tumor necrosis factor-α levels in the observation group were significantly lower than those in the control group ( t = 2.496, 2.209, 3.165, all P < 0.05). There was no significant difference in the incidence of adverse reactions between the control and observation groups [8.00% (8/100) vs. 10.00% (10/100), χ2 = 0.244, P > 0.05]. Conclusion:Dexmedetomidine combined with fentanyl citrate injection exhibits good and anesthesic and analgesic effects during laparoscopic appendectomy, helps inhibit the expression of inflammatory factors, reduces the level of inflammatory factors, leads to less adverse reactions, and is highly safe.
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Objective: Among the opioids used for treating dyspnea in cancer patients, the evidence for clinical use of fentanyl is not adequate. We report a case that suggested that fentanyl citrate patch improved dyspnea caused by lung metastasis of ureteral cancer.Case: An 86-year-old female was scheduled to start opioids for dyspnea caused by exacerbation of lung metastasis from ureteral cancer. Morphine hydrochloride was not chosen due to renal dysfunction, and oxycodone hydrochloride extended-release tablet was initiated. However, one day after starting medication, the patient refused to take the tablet because of vomiting. Given the difficulties in using morphine hydrochloride and oxycodone hydrochloride extended-release tablet, fentanyl citrate patch 0.5 mg/day was started for the purpose of improving dyspnea. The dose was eventually increased to 1.0 mg/day. Dyspnea improved and she was discharged.Conclusion: This case suggested the possibility that use of fentanyl citrate patch may be effective for dyspnea. Fentanyl citrate patch may provide one option when other drugs such as morphine hydrochloride and oxycodone hydrochloride cannot be used. However, since this is a report of a single case, further verification is required to clarify the effectiveness of fentanyl citrate patch for dyspnea.
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Objective To investigate the effect of fentanyl citrate combined with psychological intervention on the treatment of elderly patients with inguinal hernia tension-free repair. Methods From May 2015 to May 2017, 110 elderly cases with inguinal hernia tension-free repair were divided into two groups, the control group and the observation group according to the different nursing intervention mode . The control group were received routine nursing intervention combined with midazolam. The observation group were given fentanyl citrate and routine nursing care combined with psychological intervention. The effect and safety in the two groups were recorded and compared. Results The curative effect in the observation group was remarkable, and the indexes during the operation were better than those in the control group. The incidence of adverse reactions was lower than that in the control group, and the nursing satisfaction was higher than that in the control group, the difference was statistically significant (P<0.05). Conclusion The effect is remarkable which Fentanyl citrate combined with routine nursing and psychological intervention were used on the treatment of elderly patients with inguinal hernia tension-free repair, the body indexes are stable, has less adverse reaction and high nursing satisfaction, is worthy of clinical application.
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OBJECTIVE:To determine the contents of citric acid in fentanyl citrate raw materials and its injection by ion chro-matography. METHODS:The determination was performed on Thermo Dionex IonPacTM AS11-HC column with mobile phase con-sisted of potassium hydroxide (gradient elution) at the flow rate of 1.0 mL/min. The column temperature was 35 ℃,and sample size was 20 μL. The detector was suppressed conductivity detector. RESULTS:The linear range of citric acid were 0.1157-74.05 μg/mL(r=0.9995). The limit of quantitation was 0.1150 μg/mL,and the limit of detection was 0.0400 μg/mL;RSDs of preci-sion,stability and reproducibility tests were all lower than 2.0%;the average recoveries were 99.6%-101.5%(RSD=0.68%,n=9). CONCLUSIONS:The method is environmentally-friendly and simple with good accuracy and precision,and suitable for the contents determination of citric acid in fentanyl citrate raw materials and injection.
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OBJECTIVE: To explore the feasibility and safety of analgesia fiber bronchoscopy assisted by midazolam and fentanyl citrate. METHODS: A contrastive study was performed between analgesia bronchoscopy group(group A,n=58) and conventional bronchoscopy group (group B,n=57). RESULTS: 100% of patients in group A completed the examinations safely; 3.5% of patients in group B had to stop the check due to excessive pain. Group A was better than group B in the following aspects: better anaesthetic effects that made physicians perform better targeted examination(P