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Objective:To investigate the clinical effect of non-intubation anesthesia with ketamine combined with dexmedetomidine for elective surgery after burns in children.Methods:From January 2018 to December 2019, 50 children with burns who underwent elective surgery and were admitted to the Hanchuan People′s Hospital were enrolled and they were divided into the control group and the observation group by random number table, with 25 cases in each group. Both groups were given ketamine 1-2 mg/kg for induction of anesthesia, the control group was given propofol 4 mg/(kg·h) constant-rate pump injection, and the observation group was given dexmedetomidine 1 μg/(kg·h) pump injection for 10 min and then 0.5 μg/(kg·h) to maintain pump injection. The number of basic anesthesia, operation time and intraoperative fluid infusion between the two groups were compared. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO 2) at enter the operating room (T 1), 1 min before operation (T 2), 3 min after operation (T 3), end of the operation (T 4), recovery (T 5) points in the two groups were recorded and compared. The occurrence of adverse anesthesia reactions in the two groups and postoperative recovery were compared. Results:There was no statistically significant difference in the number of basic anesthesia, operation time, and intraoperative fluid infusion between the two groups ( P>0.05). The levels of MAP and HR did not change significantly at different time points in the control group ( P>0.05); the level of SpO 2 at T 2 and T 3 was lower than that at T 1 and was lower than that in the observation group at the same time point ( P<0.05); the levels of MAP and HR in the observation group at T 2, T 3, T 4, and T 5 were significantly lower than that at T 1, and were lower than that in the control group at the same time point ( P<0.05). The incidence of adverse reactions in the control group was higher than that in the observation group: 24.0%(6/25) vs. 4.0%(1/25), and the difference was statistically significant ( P<0.05); the scores of sedation and restlessness scale in the control group was higher than that in the observation group: (3.14 ± 0.76) scores vs. (1.22 ± 0.41) scores, the scores of the Ramsay score in the control group was lower than that in the observation group: (1.53 ± 0.36) s cores vs.(3.27 ± 30.41) scores, and the differences were statistically significant ( P<0.05). Conclusions:It is safe and effective to use ketamine combined with dexmedetomidine for non-intubation anesthesia during elective surgery after burns in children. The clinical anesthesia effect is significantly better than that of ketamine combined with propofol.
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Objectives: To compare propofol and fentanyl to induceconscious sedation in children undergoing flexiblebronchoscopy.Study design: Randomized controlled trial.Setting: Pediatric Pulmonology division at a tertiary care centerin Delhi, India.Participants: Children aged 3-15 years who underwentflexible bronchoscopy.Intervention: Children received either intravenous propofol 1mg/kg administered as a slow bolus over 1 minute followed by 2mg/kg/hour infusion, or intravenous Fentanyl 2 μg/kgadministered as a slow bolus over one minute.Outcomes: Primary outcome was time to achieve conscioussedation (Ramsay score 3). Secondary outcomes were need foradjuvant midazolam, physician satisfaction, level of cough,recovery features, and side-effects in the groups.Results: 53 children (propofol 27, fentanyl 26) were enrolled inthe study. The mean (SD) time taken to achieve Ramsay score 03was lower in propofol than fentanyl [15.7 (4.4) s vs 206 (55) s,P<0.001]. Propofol arm had significantly higher physiciansatisfaction, less requirement of adjuvant midazolam, lesscoughing and faster regain of full consciousness. There was nodifference in drug side-effects between the groups.Conclusion: Propofol has a shorter sedation induction time, lesscoughing during procedure, less recovery time, and betterphysician satisfaction compared to fentanyl for flexiblebronchoscopy in children.
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Objective To analyze the effects of nabuprofen combined with sufentanil on Ramsay sedation score,visual analogue scale (VAS) and analgesic effect in patients undergoing total hip arthroplasty (THA) for patient-controlled intravenous analgesia (PCIA).Methods From January 2017 to December 2017,72 patients with THA in the Department of Orthopedics from the People's Hospital of Linfen were divided into three groups:A group was given nabuprofen,B group was given sufentanil,C group was given nabuprofen + sufentanil,with 24 cases in each group.Ramsay sedation score,VAS score and analgesic effect were compared among the three groups before and after operation.Results The Ramsay sedation scores of A group at 3,12 and 24 hours after operation were (2.78 ±0.32) points,(2.59 ± 0.40) points and (2.4 ± 0.26) points,respectively,and the Ramsay sedation scores of C group at 3,12 and 24 hours after operation were (2.37 ± 0.24) points,(2.0 ± 0.15) points,(1.89 ± 0.22) points,respectively,which were decreased significantly compared with those of B group at the same time point [(3.07 ± 0.58) points,(3.01 ±0.62)points and (2.73 ±0.47)points] (Fbetween group =6.83,Pbetween group =0.01;Ftime point =7.24,Ptime point ＜0.01;Fbeyween group· time point =0.69,Pbetween group.timepoint =0.40).The VAS scores of group B at 3,12 and 24 hours after operation were (2.40 ± 0.72) points,(1.98 ± 0.57) points and (1.24 ± 0.38) points,respectively,and the VAS scores of C group at 3,12 and 24 hours after operation were (2.35 ± 0.75) points,(1.74 ± 0.46) points and (1.18 ±0.26) points,respectively,which were decreased significantly compared with those of A group at the same time point [(3.35 ± 0.59) points,(3.18 ± 0.46) points and (3.01 ± 0.33) points] (Fbetween group =7.02,Pbetween group ＜ 0.01;Ftime point =5.42,Ptime point =0.02;Fbetween group· time point =0.39,Pbetween gronp· time point =0.68).There was statistically significant difference among the three groups (x2 =7.66,P ＜0.05).The analgesic satisfaction of C group (91.67％) was significantly higher than that of A group (58.33％) and B group (62.50％) (x2 =5.44,4.25,all P ＜ 0.05).Conclusion The sedative and analgesic effects of PCIA nabuprofen combined with sufentanil for patients with THA are definite and comfortable,which can effectively alleviate pain,so it has a definite clinical application value.
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Objective@#To analyze the effects of nabuprofen combined with sufentanil on Ramsay sedation score, visual analogue scale (VAS) and analgesic effect in patients undergoing total hip arthroplasty (THA) for patient-controlled intravenous analgesia (PCIA).@*Methods@#From January 2017 to December 2017, 72 patients with THA in the Department of Orthopedics from the People's Hospital of Linfen were divided into three groups: A group was given nabuprofen, B group was given sufentanil, C group was given nabuprofen + sufentanil, with 24 cases in each group.Ramsay sedation score, VAS score and analgesic effect were compared among the three groups before and after operation.@*Results@#The Ramsay sedation scores of A group at 3, 12 and 24 hours after operation were (2.78±0.32)points, (2.59±0.40)points and (2.4±0.26)points, respectively, and the Ramsay sedation scores of C group at 3, 12 and 24 hours after operation were (2.37±0.24)points, (2.0±0.15)points, (1.89±0.22)points, respectively, which were decreased significantly compared with those of B group at the same time point [(3.07±0.58)points, (3.01±0.62)points and (2.73±0.47)points] (Fbetween group=6.83, Pbetween group=0.01; Ftime point=7.24, Ptime point<0.01; Fbetween group·time point=0.69, Pbetween group·time point=0.40). The VAS scores of group B at 3, 12 and 24 hours after operation were (2.40±0.72)points, (1.98±0.57)points and (1.24±0.38)points, respectively, and the VAS scores of C group at 3, 12 and 24 hours after operation were (2.35±0.75)points, (1.74±0.46)points and (1.18±0.26)points, respectively, which were decreased significantly compared with those of A group at the same time point [(3.35±0.59)points, (3.18±0.46)points and (3.01±0.33)points] (Fbetween group=7.02, Pbetween group<0.01; Ftime point=5.42, Ptime point=0.02; Fbetween group·time point=0.39, Pbetween group·time point=0.68). There was statistically significant difference among the three groups (χ2=7.66, P<0.05). The analgesic satisfaction of C group (91.67%) was significantly higher than that of A group (58.33%) and B group (62.50%) (χ2=5.44, 4.25, all P<0.05).@*Conclusion@#The sedative and analgesic effects of PCIA nabuprofen combined with sufentanil for patients with THA are definite and comfortable, which can effectively alleviate pain, so it has a definite clinical application value.
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Objective:To explore influence of dexmedetomidine on Riker sedation -agitation scale (SAS) score and Ramsay sedation score in patients with hypertensive cerebral hemorrhage after borehole drainage . Methods :A total of 96 patients with hypertensive cerebral hemorrhage after borehole drainage treated in our hospital were selected . According to analgesic drugs taken after operation ,they were divided into dexmedetomidine group (n=48) and mid‐azolam group (n= 48) .Riker SAS score ,Ramsay sedation score and adverse reactions after operation were com‐pared between two groups . Results:Compared with midazolam group ,there were significant rise in Ramsay seda‐tion score [6h :(1.59 ± 0.52) scores vs .(2.13 ± 0.15) scores] and significant reduction in Riker SAS score [6h :(4.09 ± 0.82) scores vs .(3.73 ± 0.76) scores] on 6h ,12h and 24h after operation ,P<0.05 or <0.01 ;and signifi‐cant reduction in incidence rate of adverse reactions (37.5% vs .10.4% , P< 0.05 ) in dexmedetomidine group . Conclusion:Dexmedetomidine possesses definite analgesic and sedative effects on patients with hypertensive cerebral hemorrhage after borehole drainage ,it's safe andreliable ,which is worth extending .
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Objective To investigate the application value of BIS monitoring and Ramsay score in the prevention of unplanned tracheal extubation in ICU patients.Methods 93 patients were enrolled in this study,they were divided into the experimental group(47 cases)and the control group(46 cases) using random number method.They received sedation regimens with BIS monitoring and Ramsay score or Ramsay score respectively.Occurrence rate of unplanned extubation was compared between the two groups.Results The occurrence rate of unplanned extubation was significantly lower in the experimental group than that of the control group.Conclusions BIS monitoring and Ramsay score is a suitable ways for the management of sedation of intubated patients.