Measuring the intensive care experience of intensive care unit patients: A cross-sectional study in western China.

BACKGROUND: The negative experiences of intensive care unit (ICU) patients seriously affect their quality of life and survival outcomes. Thus, it is of great significance to evaluate the monitoring experience of ICU patients for the clinical improvement of their experiences and promote interventions. OBJECTIVES: The objective of this study was to investigate patients' experiences of ICU and to understand the sources of patient experience and influencing factors. METHODS: From November 2021 to September 2022, a cross-sectional survey was conducted with 600 inpatients from four grade A-III hospitals in western China. Data were collected using the Chinese version of the Intensive Care Experience Questionnaire. RESULTS: 585 valid questionnaires were collected, the response rate was 97.5%. ICU patients in western China scored below-the-average for their intensive care experience. Family monthly income, occupation types, medical payment method, type of ICU, ICU admission plan, ICU admission times, mechanical ventilation use, fertility status, analgesia, sedation, and Acute Physiology and Chronic Health Evaluation II scores are important factors influencing ICU patients' intensive care experience. CONCLUSIONS: Medical staff need to pay attention to patient experience, improve the awareness of patient stressors and influencing factors, design nursing programs conducive to patient-positive experience, and promote interventions to further improve the long-term prognosis of patients. The results of this study can also be used as a set of nursing-sensitive indicators for evaluating nursing structure, process, and outcomes.

[Effect of temperature on the partition coefficient of isoflurane and sevoflurane in perflurocarbon emulsion (Oxygent(TM))].

OBJECTIVE: To investigate the effect of temperature on the partition coefficient of isoflurane and sevoflurane in perflurocarbonate emulsion (Oxygent(TM)). METHODS: The partition coefficients of isoflurane and sevoflurane in perflurocarbonate emulsion (Oxygent(TM)) were measured at different temperatures (4, 22, 27, 32 and 37 degrees celsius;) using syringe-flask double headspace equilibration technique with gas chromatography, and the relationship between the partition coefficients and the temperature was analyzed. RESULTS: At 4, 22, 27, 32 and 37 degrees celsius;, the partition coefficients of isoflurane in Oxygent(TM) were 85.30∓5.60, 40.48∓1.09, 37.14∓3.64, 27.38∓2.28 and 24.66∓1.03, and those of sevoflurane were 91.54∓5.40, 42.50∓0.91, 37.21∓2.76, 25.43∓1.03 and 28.05∓1.74, respectively. The partition coefficients of sevoflurane at 4, 22 and 37 degrees celsius; were significantly higher than those of isoflurane (P<0.05). The regression equations between the partition coefficient and temperature for isoflurane and sevoflurane were Y=-1.893X+89.20 (R(2)=0.942) and Y=-2.075X+95.58 (R(2)=0.951), respectively. An inverse linear relationship was found between temperature and the partition coefficient. CONCLUSION: Within a specified range of temperatures, the partition coefficients isoflurane and sevoflurane decrease as the temperature increases. Sevoflurane shows a high solubility in Oxygent(TM) as compared to isoflurane.

[Comparison of single intubating dose and continuous infusion of rocuronium in prolonged gynecologic laparoscopic surgery].

OBJECTIVE: To compare the cardiorespiratory factors and surgical conditions during total intravenous anesthesia for prolonged laparoscopic pelvic surgery with or without supplemental muscle relaxants. METHODS: Forty female ASA I or II patients undergoing laparoscopic pelvic surgeries were randomized into two groups A and B, both with standardized anesthesia via a intravenous bolus injection of rocuronium (0.6 mg/kg). The patients in group B received continuous rocuronium infusion upon observation of one TOF twitch response with the T1 value maintained within 0-10% and rocuronium withdrawal at 20 to 30 min before the completion of the surgery. The patients in group A received no supplemental muscle relaxants. The cardiorespiratory parameters were measured during the operation. The respiratory system compliance (Ceff rs) was calculated as the quotient of the tidal volume (VT) and peak inspiratory pressure (PIP), and the operative conditions were graded by the operating gynecologist. RESULTS: The cardiorespiratory parameters significant increased and Ceff rs decreased after pneumoperitoneum, but no significant differences were found between the two groups. The surgical conditions were also comparable between the two groups, but the duration of intubation and the operating time were significantly shorter in the group A. CONCLUSION: Pneumoperitoneum severely affects the cardiorespiratory parameters during laparoscopy, which can not be lessened by neuromuscular block agents. A single intubating dose of rocuronium can suffice the requirement of prolonged gynecologic laparoscopic surgery.

[Epidural butorphanol analgesia in elderly patients undergoing hip replacement].

OBJECTIVE: To evaluate the efficacy and safety of continuous epidural analgesia (CEA) with butorphanol in elderly patients undergoing hip replacement. METHODS: Sixty patients scheduled for selective hip replacement were randomized into group B (n=30) to receive patient-controlled epidural analgesia (PCEA) with butorphanol and group M (n=30) to receive PCEA with morphine. Their pain distribution at 5 time points, postoperative global score and the adverse effects in 48 h were observed. RESULTS: The pain distribution at the 5 time points or the global score for postoperative PCEA in 48 h showed no statistically significant difference between the two groups (P<0.05). Analgesia with butorphanol caused less adverse effects (respiratory depression, nausea and vomiting, itching and abdominal distension) than that with morphine (P<0.05). CONCLUSION: CEA with butorphanol is safe and effective for the treatment of postoperative pain in elderly patients and causes less adverse effects than morphine.