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Objective To evaluate the surface anesthesia and antibacterial effect of compound lidocaine cream in indwelling urethral catheter in order to seek the optimal indwelling urethral catheter scheme in cardiac surgery.Methods A total of 198 patients undergoing elective cardiac surgery in this hospital from November 2016 to January 2017 were selected and divided into the two groups:the lidocaine cream group(L) and liquid paraffin control group(C).The visual analogue scale (VAS) and catheter-related bladder discomfort(CRBD) were used immediately after tracheal catheter extubation and at 2,4 h after extubation.The number of white blood cells and bacteria in urine were observed on postoperative 1,7 d.The urine culture results were observed on postoperative 7 d.Results The VAS and CRBD scores immediately after extubation in the group L was significantly lower than that in the group C(P＜0.05).The urine WBC count and bacterial count on postoperative 7 d in the group L were significantly lower than those in the group C(P＜0.05),the positive rate of urine culture on postoperative 7 d in the group L was significantly lower than that in the group C,the difference was statistically significant(5.05％ vs.13.13％,P＜0.05).Conclusion Compound lidocaine cream as lubrication indwelling urethral catheter can decrease the incidence rate of urinary tract infection on postoperative 7 d in the patients with cardiac operation,furthermore can prevent the wake agitation caused by indwelling urethral catheter.
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OBJECTIVE:To observe the effects of dexmedetomidine (Dex) on postoperative agitation of Wilson's disease patients with secondary hypersplenism after genernl anesthesia of splenectomy.METHODS:A total of 60 Wilson's disease patients with secondary hypersplenism underwent general anesthesia of splenectomy duning Jan.-Dec.2016 were divided into control group and observation group according to random number table,with 30 cases in each group.Observation group was given intravenous pump of Dex 0.4 μg/kg at constant speed 15 min before anesthesia induction,and then maintained at 0.4 tg/(kg·h)till splenectomy completed.Control group was given constant volume of normal saline.Other anesthesia plans were same in 2 groups.Mean arterial pressure (MAP),heart rate (HR) and pulse oxygen saturation (SpO2) of 2 groups were observed before pumping (T0),before intubation (T1),1 min after intubation (T2),before extubation (T3),3 min after extubation (T4).Riker sedation-agitation score (SAS) were recorded in 2 groups at T3 and T4.The duration of stay in postanesthesia intensive care unit (PACU) and the occurrence of bradycardia were compared between 2 groups.RESULTS:At T0,there was no statistical significance in MAP,HR or SpO2 levels between 2 groups (P＞0.05).At T1,T2,T3 and T4,MAP and HR levels of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).SpO2 were 100％ at each time point,there was no statistical significance between 2 groups (P＞0.05).Riker SAS scores of observation group was significantly lower than that of control group,with statistical significance (P＜0.05).The incidence of bradycardia in observation group was 26.67％,which was significantly higher than 3.33％ of control group,with statistical significance (P＜0.05).But this symptom was corrected after intravenous injection of atropine.The duration of stay in PACU in observation group was significantly shorter than control group,with statistical significance (P＜0.05).CONCLUSIONS:Dex can keep postoperative hemodynamics stable in Wilson's disease patients with secondary hypersplenism,reduce agitation and shorten the time of the patients transferring from PACU.
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Objective To study the effect of psychological counseling for patients with thoracic surgery recovery period.Methods Ono hundred patients with lobectomy were selected,they were divided into experimental group and control group with 50 cases each according to the treatment method.Two groups of patients were in the ward completed indwelling catheter,inserted into the right double lumen endotracheal tube by high seniority anesthesiologists,postoperative given perfect analgesia.Two group patients were treated with routine operation before the visit,assess the condition and signed the anesthesia informed consent,the test group were given psychological support therapy,explain in detail postoperative recovery period may be uncomfortable,eliminate the anxiety of patients,establish the confidence to overcome the disease,Two groups of patients after surgery by the recovery room nurse to give psychological counseling,complete extubation and record the restlessness,24 h after the patient satisfaction questionnaire.Results In test group patients were able to follow instructions and coordinate nurse smooth tube removal,15 cases of patients need to brake,additional sedatives and dehyed extubation,the difference between the two groups has statistical significance (P ＜ 0.05).The satisfaction questionnaire in test group was significantly higher than that in control group:100％ (50/50) vs.82％ (41/50),there was statistical difference (P ＜ 0.05).Conclusion Psychological counseling can effectively avoid agitation in recovery period of patients with postoperative chest tube removal,smooth.
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@#Objective To explore the risk factors for postoperative agitation (PA) in patients with cerebral palsy (CP). Methods 199 patients with CP receiving selective posterior rhizotomy or lower limbs orthopedics under combined intravenous and inhalational anesthesia were reviewed. Results 30 patients suffered from PA (15%), who tended to be younger, less body mass, and administered less anesthetics.Conclusion It may prevent PA of sufficient intra-operative and postoperative analgesia, necessary psychological intervention and sedatives.
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Objective To investigate the preemptive analgesia therapy of dezocine on postoperative agitation in patients undergoing Esophagectomy under thoracoscopy.Methods Sixty cases of ASA Ⅰ,Ⅱ undergoing thoracoscopic resection of esophageal cancer patients were divided into two groups randomly:dezocine and control group,each group with 30 patients.Patients in dezocine group were intravenously injected with dezocine 0.1 mg/kg before intubation,and patients in control group just intubation as usual.The incidence of postoperative agitation in two groups were observed,and visual analog scale(VAS) score at 0 min,15 min,30 min and 45 min after extubation were registered.The time of wake up and extubatio,the change of hemodynamic were also recorded.Results The incidences of postoperative agitation in dezocine preemptive analgesia group were obviously lower than that in the control group (10％ (3/30) vs.60％ (19/30),P ＜0.01).The VAS score at 0 min,15 min,30 min and 45 min after extubation in dezocine preemptive analgesia group ((1.3 ± 1.2),(2.4 ± 1.7),(2.7 ± 1.3),(2.8 ± 1.2) points) were significantly lower than those in the control group ((3.4±1.5),(4.7±1.8),(5.0±1.6),(4.8±1.7) points) (F within group =18.6,P＜0.05; F between group =20.4,P ＜ 0.05 ; F interaction =20.0,P ＜ 0.05 ; compared different time between two groups,all P ＜ 0.01).Conclusion Preemptive analgesia with dezocine can obviously lessen postoperative agitation in patients undergoing Esophagectomy under thoracoscopy,and dezocine is also effective in postoperative analgesia.
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To evaluate the different anesthesia in elderly patients with gastric cancer surgery influence blood con-centrations of melatonin and its correlation with postoperative agitation. The agitation scroes were evaluated and re-corded,and the blood samples were taken twice:before induction as well as just at the end of surgery,then making correlation analysis. The agitation scroes were significantly lower in group ET than in group T(P<0.01);the level of postoperative blood concentrations of melatonin was higher in group ET than that in group T(P<0.01);the agi-tation scroes and the level of postoperative blood concentrations of melatonin were negatively correlated ( r =-0.429,P<0.05).
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PURPOSE: Sevoflurane is a well accepted anesthetic in children but results high incidence of undesirable emergence agitation (EA). We investigated the EA in burn injured children. METHODS: In 219 un-premedicated burn injured children aged 2~8 years, mask induction with sevoflurane was performed. On arriving operating room, modified Yale preoperative anxiety scale (m-YPAS) was checked. In the postanesthesia care unit, EA scale was recorded as follows; EA1 (no EA), EA2 (mild EA) and EA3 (marked EA). RESULTS: The incidence of EA was 50.2%. The m-YPAS was significantly higher in EA2 and EA3 compared to EA1 (P<0.001). Burn surface area was significantly wider in EA3 compared to EA1 (P<0.05). In deep second-degree burned children, the incidence of EA1 was greatest, whereas EA3 was the greatest in third-degree burned children. CONCLUSION: The incidence of EA after sevoflurane anesthesia in burn injured children was higher as the burn surface areas was greater. In addition, the symptoms of EA in third-degree burned children were more severe than in second-degree burned children.