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Safety of applying midazolam-ketamine-propofol sedation combination under the supervision of endoscopy nurse with patient-controlled analgesia pump in colonoscopy

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World Journal of Clinical Cases 2018年第16期6卷 1146-1154页

作者： Selda Kayaalt? mer Kayaalt? Division of Anaesthesiology and Reanimation Develi Public Hospital Computer Technology Kayseri University Develi Huseyin Sahin Vocational College

AIM To compare the results of midazolam-ketaminepropofol sedation performed by an endoscopy nurse and anaesthetist during colonoscopy in terms of patient satisfaction and safety.METHODS American Statistical Association(ASA) Ⅰ-Ⅱ 60 patients who underwent colonoscopy under sedation were randomly divided into two groups: sedation under the supervision of an anaesthetist(SSA) and sedation under the supervision of an endoscopy nurse(SSEN). Both groups were initially administered 1 mg midazolam, 50 mg ketamine and 30-50 mg propofol. Continuation of sedation was performed by the anaesthetist in the SSAgroup and the nurse with a patient-controlled analgesia(PCA) pump in the SSEN group. The total propofol consumption, procedure duration, recovery times, pain using the visual analogue scale(VAS) and satisfaction score of the patients, and side effects were recorded. In addition, the patients were asked whether they remembered the procedure and whether they would prefer the same method in the case of re-endoscopy.RESULTS Total propofol consumption in the SSEN group was significantly higher(P patient satisfaction, recall of the procedure, re-preference for the same method in case of re-endoscopy, and side effects, there were no significant differences(P > 0.05) between the two groups. No long-term required intervention side effects were observed in either group.CONCLUSION Colonoscopy sedation in ASA Ⅰ-Ⅱ patients can be safely performed by an endoscopy nurse using PCA pump with the incidence of side effects and patient satisfaction levels similar to sedation under anaesthetist supervision.

关键词： Midazolam-ketamine-propofol combination patient-controlled analgesia pump Nurse-administered sedation Colonoscopy

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A comparative study of three concentrations of intravenous nalbuphine combined with hydromorphone for post-cesarean delivery analgesia

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Chinese Medical Journal 2020年第5期133卷 523-529页

作者： Chun-Yun Huang Shu-Xi Li Mei-Juan Yang Li-Li Xu Xin-Zhong Chen Department of Anesthesia Women’s HospitalZhejiang University School of MedicineHangzhouZhejiang 310006China

Background:Nalbuphine has been suggested to be used for post-cesarean section(CS)intravenous analgesia.However,ideal concentration of nalbuphine for such analgesia remains unclear.The present study was conducted to explore an ideal concentration of nalbuphine for post-CS intravenous analgesia by evaluating the analgesic effects and side-effects of three different concentrations of nalbuphine combined with hydromorphone for post-CS intravenous analgesia in healthy parturients.Methods:One-hundred-and-fourteen parturients undergoing elective CS were randomly allocated to one of three groups(38 subjects per group)according to an Excel-generated random number sheet to receive hydromorphone 0.05 mg/mL+nalbuphine 0.5 mg/mL(group LN),hydromorphone 0.05 mg/mL+nalbuphine 0.7 mg/mL(group MN),and hydromorphone 0.05 mg/mL+nalbuphine 0.9 mg/mL(group HN)using patient-controlled analgesia(PCA)pump.Visual analog scale(VAS)for pain,PCA bolus demands,cumulative PCA dose,satisfaction score,Ramsay score,and side-effects such as urinary retention were recorded.Results:The number of PCA bolus demands and cumulative PCA dose during the first 48 h after CS were significantly higher in group LN(21±16 bolus,129±25 mL)than those in group MN(15±10 bolus,120±16 mL)(both P0.05).VAS scores were significantly lower in group HN than those in group MN and group LN for uterine cramping pain at rest and after breast-feeding within 12 h after CS(all P0.05).Ramsay sedation scale score in groupHNwas significantly higher than that in group MN at 8 and 12 h after CS(all P<0.01)and group LN at 4,8,12,24 h after CS(all P<0.05).Conclusions:Hydromorphone 0.05 mg/mL+nalbuphine 0.7 mg/mL f

关键词： Hydromorphone Nalbuphine Cesarean section Post-operative analgesia patient-controlled intravenous analgesia

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Effect of direct current pulse stimulating acupoints of JiaJi (T10-L3) and Ciliao (BL 32) with Han's Acupoint Nerve Stimulator on labour pain in women: a randomized controlled clinical study

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Journal of Traditional Chinese Medicine 2015年第6期35卷 620-625页

作者： Liu Ye Xu Mingjun Che Xiangming He Junqin Guo Dandan Zhao Guosheng Zhang Guogang Zhang Shuo Kang Kai Zhang Chunlei Wang Yinan Li Shan Zhang Qinglin Xu Li Zhang Ming Han Bin Jing Yumiao Zhang Ning Department of Anesthesiology Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University Department of Traditional Chinese Medicine Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University

OBJECTIVE: To assess the clinical effect and safety of direct current(DC) pulse produced by Han's Acupoint Nerve Stimulator in reduction(HANS) of labor pain.METHODS: Totally 120 participants were enrolled in this clinical trial, and were randomly divided into4 groups including: HANS group, patient controlled intravenous analgesia(PCIA) group, patient-controlled epidural analgesia(PCEA) group and control group. The HANS group was treated by stimulating the acupoints of Jia Ji(T10-L3) and Ciliao(BL 32)with DC pulse of 100 Hz and 15-30 m A produced by a portable battery-powered Han's Acupoint Nerve Stimulator for 30 min. The PCIA group was intravenously infused Ondansetron(8 mg) for 5 min,then tramadol injection(1.5 mg/kg) was slowly dripped by using Baxter APⅡ electronic pump with50 m L tramadol(0.70%) + ondansetron(8 mg),background infusion 2 m L/h, PCA dose of 2 m L,lockout interval of 10 min. In PCEA group, women received intrathecal injection ropivacaine(3 mg) in L2-3, and epidural catheter was connected to Baxter APⅡ electronic pump, with 100 m L Ropivacaine(0.1%) and Sufentanil(50 ug), background infusion5 m L, patient controlled analgesia(PCA) dose of 5m L, lockout interval of 10 min. The control group was not received analgesia. The visual analogue scale(VAS), stage and manner of labor, Apgar score of newborn, neonatal weights, oxytocin dosage,postpartum hemorrhage and side effects were monitored in all groups.RESULTS: The vital signs were all stable in the four analgesic groups. After analgesia, there was statistical difference in VAS score between HANS group and control group, between PCEA group and the control group, between PCIA group and control group. The analgesic effect in the PCEA group was significantly better than that of other two groups.The second stage of labor in the PCEA group was longer than the other three groups, showing significant difference between them. The Apgar score of newborn 1min after birth in the PCIA group was slightly lower than that of the other two groups,showing significan

关键词： Analgesia, patient-controlled Analge-sia, epidural Anesthesia Combined spinal and epi-dural block The Han's Acupoint Nerve Stimulator Randomized controlled trial

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硬膜外自控镇痛在老年下肢手术患者中的应用价值研究

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中医临床研究 2014年第9期6卷 132-133页

作者：刘海超河北省徐水县医院河北徐水072550

目的：探讨硬膜外自控镇痛在老年下肢手术患者中的应用价值。方法：选取2011年10月～2013年10月于本院进行治疗的78例老年下肢手术患者为研究对象，将78例老年患者遵循随机分配的方式分为对照组（哌替啶肌内注射组）39例和观察组（硬膜... 详细信息

目的：探讨硬膜外自控镇痛在老年下肢手术患者中的应用价值。方法：选取2011年10月～2013年10月于本院进行治疗的78例老年下肢手术患者为研究对象，将78例老年患者遵循随机分配的方式分为对照组（哌替啶肌内注射组）39例和观察组（硬膜外自控镇痛组）39例，然后将两组患者术后12h及24h的疼痛程度及血清应激指标进行比较。结果：观察组术后12h及24h 的轻度疼痛率均高于对照组，血清皮质醇及肾上腺素则均低于对照组，P均＜0.05，均有显著性差异。结论：硬膜外自控镇痛在老年下肢手术患者中的应用价值较高，可有效缓解患者的疼痛及改善其应激状态。

关键词：硬膜外自控镇痛老年下肢手术应用价值 patient-controlled epidural analgesia (PCEA)

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