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Objective:To analyze the application of thinking visual guidance teaching model in anesthesia clinical practice teaching.Methods:Taking the implementation time (March 2019) of thinking visual guidance teaching model in our hospital as the limit, 56 interns who came to our hospital for anesthesia practice before the implementation were included as control group, and 61 interns enrolled after the implementation (from March 2019 to March 2020) were included in study group. The mastery status of professional skills (duration of anesthesia operation, success rate of one-time anesthesia puncture and success rate of one - time tracheal intubation), professional knowledge assessment results and professional attitude changes were compared between the two groups at 2 months and 6 months of training. Self-evaluation after 6 months of training was compared between the two groups. SPSS 18.0 was used for t test and chi-square test. Results:After 6 months of training, the mastery status of professional skills (duration of anesthesia operation, success rate of one-time anesthesia puncture, and success rate of one-time tracheal intubation) of the two groups of interns were significantly improved compared with those after 2 months of training, and the above indicators of study group were significantly better than those of control group (all P<0.05). After 6 months of training, the scores of assessment results of professional knowledge (basic knowledge, understanding and memory, case analysis, emergency handling) and professional attitude (behavior, language, initiative and adaptability) in the two groups of interns were significantly higher than those after 2 months of training, and the above indicators scores of study group were significantly higher than those of control group (all P<0.05). The scores of self-evaluation (learning efficiency, learning atmosphere, learning ability, self-confidence and satisfaction) of study group at 6 months of training were significantly higher than those of control group at the same period (all P<0.05). Conclusion:Thinking visual guidance teaching model can effectively improve the professional knowledge and operation skills of anesthesia clinical interns, and it has a good application effect.
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Objective To investigate the clinical application of caudal block combined anesthesia with sevoflurane in pediatric hernia.Methods 102 patients were randomly divided into three groups:caudal block combined with sevoflurane (A group),caudal block combined with isoflurane and sevoflurane combined with ketamine.HR,MAP,SpO2,anaesthetic effect,the recovery time,the awake time and the adverse reaction were observed.Results The HR,MAP,SpO2 in A and B group had no significant difference before and after anesthesia (P ＞ 0.05).The HR,MAP,SpO2 in C group had statistically significant difference before and after anesthesia(t =10.121,6.681,4.469,all P ＜ 0.05).Compared with A and B group,the recovery time and the awake time in C group were longer significantly(t =8.240,11.693,all P ＜0.05).Compared with B group,the recovery time and the awake time in A group had no statistically significant difference(P ＞ 0.05).Compared with C group,the adverse reaction in A group had no statistically significant difference (P ＞ 0.05).Compared with B group,the adverse reaction in A group had statistically significant difference (x2 =3.923,P ＜ 0.05).Conclusion The caudal block combined anesthesia with sevoflurane in pediatric hernia has a good effect and security.
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Objective To observe the safety and feasibility of low-dose dexmedetomidine combined with target controlled infusion propofol in hysteroscope electric resection of submucous myoma.Methods Eighty ASA Ⅰ-Ⅱ patients undergoing hysteroscope electric resection of submucous myoma were divided into four groups with 20 cases each by table of random digit:group A was 0.9％ sodium chloride combined with propofol,group B was dexmedetomidine 0.25 μ g/kg combined with propofol,group C was dexmedetomidine 0.50 μ g/kg combined with propofol and group D was dexmedetomidine 1.00 μ g/kg combined with propofol.The perioperative hemedynamic changes,total dose of propofol,recovery time,rate of adverse reaction and postoperative uterine contraction pain were observed and compared among the four groups.Results When expanding the palace and electric cutting,systolic blood pressure (SBP) and heart rate (HR) in group B,C and D were significantly lower than those in group A [(107.3 ± 8.8),(108.6 ± 9.3) and (105.7 ± 8.9)mm Hg (1 mm Hg =0.133 kPa) vs.(115.1 ± 8.2) mm Hg,(109.9 ±9.6),(109.2 ± 9.5) and (106.7 ±9.1)mm Hg vs.(121.3 ± 9.9) mm Hg,(83.9 ± 6.6),(81.2 ± 7.1) and (78.7 ± 6.9) times/min vs.(91.3 ± 6.5)times/min,(84.2 ± 7.6),(83.6 ± 7.3) and (80.7 ± 6.8) times/min vs.(97.3 ± 7.2) times/min,P ＜ 0.05].The recovery time in group D was significantly longer than that in group A [(13.2 ± 3.0) min vs.(11.2 ±3.3)min,P＜ 0.05].The total dose of propofol in group C and D were significantly lower than that in group A [(289.6 ± 57.7) and (278.5 ± 56.9) mg vs.(324.6 ± 67.9) mg,P ＜ 0.05],and analgesic effect were better than group A (P ＜ 0.05).The rates of respiratory depression and recovery period restlessness in group C and D were significantly lower than those in group A [10％(2/20) and 10％(2/20) vs.20％(4/20),15％(3/20)and 20％ (4/20) vs.65％ (13/20),P ＜ 0.05],while,the rate of drowsiness after operation in group D was significantly higher than that in group A [45％(9/20) vs.10％(2/20),P＜ 0.05].Conclusions Low-dose dexmedetomidine combined with target controlled infusion propofol can be safely applied in hysteroscope electric resection of submucous myoma,and has a good analgesic effect,less adverse reaction,postoperative analgesia perfect advantages.