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Objective To determine the dose?response relationship of bupivacaine coadministered with sufentanil for subarachnoid block in severely preeclamptic patients undergoing cesarean delivery. Methods Two hundred patients with severe preeclampsia, of American Society of Anesthesiologists physi?cal statusⅠ?Ⅲ, scheduled for elective cesarean delivery, were divided into 4 groups ( n=50 each) using a random number table: bupivacaine 4 mg group ( group B4 ) , bupivacaine 6 mg group ( group B6 ) , bupivacaine 8 mg group ( group B8 ) , and bupivacaine 10 mg group ( group B10 ) . In B4 , B6 , B8 and B10 groups, bupivacaine 4, 6, 8 and 10 mg plus 2.5μg sufentanil in 2.5 ml of normal saline were injected into the subarachnoid space, respectively. Effective anesthesia was defined as bilateral sensory block of T6 achieved at 10 min after intrathecal administration when measured by pin?prick test, and with no need for epidural supplementation ( lidocaine ) . A probit analysis was used to estimate the 50% effective dose ( ED50 ) and 95% effective dose ( ED95 ) with 95% confidence intervals for bupivacaine, coadministered with sufentanil, when used for subarachnoid block in severely preeclamptic patients underwent cesarean de?livery. Results When coadministered with sufentanil, the ED50 and ED95 ( 95% confidence interval) of bupivacaine were 5.67 ( 5. 20-6. 10) mg and 8. 82 ( 8. 14-9.87) mg, respectively, for subarachnoid block in severely preeclamptic patients underwent cesarean delivery. Conclusion The ED50 and ED95 of bupivacaine for subarachnoid block, when coadministered with sufentanil 2.5 μg, are 5.67 and 8.82 mg, respectively, in severely preeclamptic patients undergoing cesarean delivery.
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To explore the feasibility and effects of Cook balloon cervical dilator on full-term nulliparous parturients under epidural analgesia.The observation group (n =40) received Cook balloon cervical dilation under epidural analgesia.However, the control group (n =40) had no epidural analgesia.Latent phase of labor was shorter in observation group than that in control group [(198.7 ± 65.7) vs.(242.9 ± 78.9) min, P ＜0.05].And the incidence of cesarean section and perineal laceration was lower under epidural analgesia(8％ vs.15％, 45％ vs.50％ respectively).There were no effects on success rate of induced labor in neither group.Cook balloon could shorten latent phase of labor, relieve the pain of parturients and increase no infection rate [leukocyte count : (8.82 ± 2.74) × 109/L vs.(9.10 ± 3.06) × 109/L, C-reactive protein: (4.73 ±0.87) mg/L vs.(4.82 ±0.90) mg/L respectively].It is worth wider clinical popularization.
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Objective To evaluate the reliability of Pain Vision method for assessment of labor pain.Methods Eighty-nine nulliparous parturients who were at full term and at the latent period of the first stage of labor,aged 19-31 yr,weighing 55-85 kg,were enrolled in this study.The degree of labor pain was assessed using Pain Vision method and VAS.Pain degree is calculated from two parameters,current perception threshold and pain compatible electrical current by using a somatosensory evoked potential stimulator.The former parameter was defined by the lowest electrical current detected; the latter parameter defined by the electrical current judged as being compatible with the intensity of ongoing pain.Linear correlation of VAS scores with pain degree was analyzed.Results There was no correlation between pain degree and VAS scores,and the correlation coefficient was 0.206 (P ＞ 0.05).Conclusion Pain Vision method can not be applied for objective assessment of labor pain.
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BACKGROUND: Glycemic index (GI) is a physiological index of carbohydrate food. It has been found out in epidemiological studies that GI is useful in controlling and preventing some chronic diseases such as diabetes,cardiovascular disease,obesity.OBJECTIVE:To investigate the acceptance and practical significance of GI knowledge in diabetic patients by comparing with the traditional education with food exchange list (FEL)as the main material.DESIGN:A comparative observational test.SETTING:Institute of Nutrition and Food Safety,Chinese Center for Disease Control and Prevention.PARTICIPANTS: Seventy-two diabetic patients volunteered to join in the study were selected from the Department Endocrinology of Beijiog No.6 Hospital from October 2000 to February 2002,including 36 males and 36 female of 10-70 years old with an average age of 58 years.METHODS:The 72 diabetic patients were randomly assigned to two groups:① GI group which received GI-based nutrition education;② FEL group receiving FEL-based nutrition education.They were educated for 5 months by means of classes,personal education and consultation by telephone.The changes of knowledge,food selection and blood glucose in the diabetic patients were observed before and after education.MAIN OUTCOME MEASURES:Changes of the awareness of nutrition education,fasting blood glucose (FBG) and 2-hour postprandial blood glucose (2hPBG) before and after education.RESULTS: All the 72 diabetic patients were involved in the analysis of results.①The correct answering rates after education were obviously higher than that before education (P<0.01).Before education,the correct rates of answers to GI questions in the Gl group were lower than the correct rates of answers to FEL questions in the FEL group (0 vs.6.5%,P<0.01).After education,the correct rates in the Gl group were higher than those in the FEL group (92.2%VS.79.4%,P<0.01): whereas there were no significant differences in the average correct rate of answer to the same question between the two groups (P>0.05).The Gl group was better than the FEL group in selecting cereal,fruit,bean and its.products (P<0.01).② The FBG and 2hPBG after education were lower than those before education in both groups(P<0.01),whereas there was no significant difference between the two groups (P>0.05).CONCLUSION:The knowledge of GI was better accepted than that of FEL by the diabetic patients in dietary treatment.
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Objective: To examine the effects of the education with glycemic index(GI)on dietary knowledge,attitude and practice of diabetic patients,and on their blood glucose and lipid.Methods: Seventy-two subjects with type 2 diabetes were randomly assingned into two groups. The test group (group GI) mainly learned the knowledge about GI of food. The controlled group (group FEL) mainly learned the knowledge about food exchange list(FEL). Outcomes were assessed by the change of dietary knowledge, attitude and practice, fasting blood glucose (FBG), 2 h postprandial blood glucose ( 2 hPBG), glycosylated hemoglobin (HbA 1c), and blood lipids which include total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG) and lipid comprehensive index (LCI). The period lasted five months. Results: The percent of correct answer for GI questions was increased significantly from 0 % before education to 92.2% after education (P