RESUMO
Objective To observe the preemptive analgesia effects of katamine and elonidine, and to find out the influence of preemptive on stress responses. Methods 36 patients with hysteromyoma undergone hysteromyomec-tomy were randomly assigned to three groups (n = 12 each group) :group Ⅰ , control group, without preemptive analge-sia,the patients in control group were given continous epidural analgesia with 2% lidoeaine 12 - 14ml. Group Ⅱ ,the patients were injected 0. 6mg/kg katamine into epidural analgesia 30 minutes before operation. Group Ⅲ,the patients were injected 0. 6mg/kg katamine and 1.5μg/kg clonidine into epidural analgesia 30 minutes before operation. The patients in three groups were recorded VAS score on 2h ,4h ,6h, 12h ,24h after operation, also recorded the change of epinephrine(E) and norepinephrine(NE) and sensation and movement recovery time after operation. The side effects such as dizziness nausea,vomit,and exited talking were observed during the operation. Results The VAS score were significantly different between group Ⅰ ,Ⅱ and Ⅲ. The levels of E and NE in plasma in group Ⅰ were increased more than group Ⅱ and Ⅲ within 24 hours after operation, also there is significant difference in group Ⅱ compared with group Ⅲ in T1 ,T2 ,T3. The time of sensation and movement recovery were remarkably longer in group Ⅲ com-pared with group Ⅰ and Ⅱ, showing significant difference. There were no significant difference in side effects after operation in three groups. Conclusion The preemptive analgesia of kutamine and colnidine can relieve the pain of lower abdominal surgery and stress response after operation,and it do not increase the side effects.
RESUMO
BACKGROUND: It has been explained in many big sample experiments that community comprehensive prevention from the risks of cardiocerebrovascular disease can reduce its morbidity and mortality. But, it is required more samples to verify the evaluations of the process and effect of intervention.OBJECTIVE: To understand the effect of community comprehensive prevention on cardiocerebrovascular disease and hygienic costs demanded and summarizes the suitable patterns of comprehensive prevention on cardiocerebrovascular disease in countryside.DESIGN: Healthy people in community were taken as the objects and community intervention was designed.SETTING: Department of Community Hygienic Service of People's Hospital in Guzheng Town, Zhongshan City, Guangdong Province and Neurological Institute of Guangzhou Medical College.PARTICIPANTS: Totally 32 000 inhabitants were collected from 8 villages in Guzheng Town, Zhongshan City, Guangdong Province from March 1992 to March 2002, aged varied from 20 to 74 years, of which, 14 600inhabitants were male and 17 400 inhabitants were female.METHODS: The intervention of community-based prevention was applied on cardiocerebrovascular disease, including managementof hypertension,smoking control, rational nutrient, nationwide body building and diabetic management.MAIN OUTCOME MEASURES: [1] Awareness, attitude and behavior related to cardiocerebrovascular disease. [2] Management rate and control rate of hypertension. [3] Morbidity and mortality of cerebral apoplexy.RESULTS: [1] By 10-year intervention, awareness rate of hypertension in whole group was 70.29%. [2] Management rate and control rate of hypertension were increased yearly, in which, the management rate was increased from 25.66% in 1997 to 80.50% in 2002, the total control rate was increased from 4.43% in 1997 to 45.80% in 2002, the control rate of blood pressure ＜160/95 mm HG (1 mm Hg=0.133 kPa) was 58.80%and that ＜140/90 mm Hg was 32.80%. [3] The systolic and diastolic pressures in intervention community were decreased averagely, in which the D-values are 7.23 mm Hg and 3.92 mm Hg respectively. [4] The awareness, attitude and behavior related to cardiocerebrovascular disease were enhanced remarkably. [5] Morbidity and mortality of cerebral apoplexy were in tendency of decreasing yearly, from 146.90/100 000 and 108.63/100 000 in 1997 to 105.83/100 000 and 69.90/100 000 in 2002 respectively, by 41.07/100 000 and 38.73/100 000 respectively in 6 years and the age of incidence was postponed. [6] It was indicated in economic analysis that the average ratio of profit to cost between 1997 and 2001 was 2.32.CONCLUSION: Community-based comprehensive prevention on cardiocerebrovascular disease improves the awareness, attitude and behavior in community group and reduces morbidity and mortality of cerebral apoplexy.