目的：本研究旨在比較一種新的腦電參數-腦電非線性指數（ENI）與BIS在丙泊酚靶控輸注時預測鎮靜深度的能力。方法:選擇30例18～60歲，ASA Ⅰ～Ⅱ級，擬行擇期普外科手術患者。每一患者同時監測ENI和BIS。麻醉誘導給予丙泊酚靶控輸注，直至患者意識消失后給予芬太尼和羅庫溴銨行氣管插管。麻醉誘導過程中每30秒進行一次鎮靜評分（采用改良OAA/S評分），并記錄ENI和BIS值以及平均動脈壓（MAP）和心率（HR）。結果:ENI和BIS與鎮靜評分的相關性比MAP和HR高（r=0.90、0.93 vs r=0.77、0.27）。鎮靜過程（改良OAA/S評分）中ENI和BIS有很好的相關性(R2=0.828)。ENI和BIS預測鎮靜深度的能力優于MAP和HR。結論：ENI可提供與BIS相似的反映鎮靜深度的信息，能準確預測不同的鎮靜深度。
Currently, monitoring system of awareness of the depth of anesthesia has been more and more widely used in clinical practices. The intelligent evaluation algorithm is the key technology of this type of equipment. On the basis of studies about changes of electroencephalography (EEG) features during anesthesia, a discussion about how to select reasonable EEG parameters and classification algorithm to monitor the depth of anesthesia has taken place. A scheme which combines time domain analysis, frequency domain analysis and the variability of EEG and decision tree as classifier and least squares to compute Depth of anesthesia Index (DOAI) is proposed in this paper. Using the EEG of 40 patients who underwent general anesthesia with propofol, and the classification and the score of the EEG annotated by anesthesiologist, we verified this scheme with experiments. Classification and scoring was based on a combination of modified observer assessment of alertness/sedation (MOAA/S), and the changes of EEG parameters of patients during anesthesia. Then we used the BIS index to testify the validation of the DOAI. Results showed that Pearson's correlation coefficient between the DOAI and the BIS over the test set was 0.89. It is demonstrated that the method is feasible and has good accuracy.
We reviewed the research progress of anesthesia management in hepatic echinococcosis surgery in recent years, including the key technologies, practical experience, and research progress of anesthesia management in hepatic echinococcosis surgery, so as to guide clinical practice. Firstly, in the selection of anesthesia, the general anesthesia combined with epidural block or regional nerve block is recommended to improve surgical safety and patients’ comfort. At the same time, the importance of intraoperative continuous monitoring, including key indicators such as hemodynamics and respiratory function, is emphasized, and transesophageal echocardiography and brain function monitoring techniques are introduced to optimize anesthesia management. Finally, the concept of enhanced recovery after surgery is promoted, and measures such as preoperative optimization, intraoperative heat preservation, refined fluid management, and postoperative analgesic management are implemented to promote the rapid recovery of patients. At the same time, some challenges and unsolved problems in the current research also are pointed out, such as complex case evaluation, complications prevention, and teamwork, etc., which need to be further studied in the future to optimize the anesthesia strategy.
【摘要】 目的 探討一次性麻醉穿刺包與普通腹腔穿刺包在腹腔化療中應用效果。 方法 將2008年6月-2009年4月住院的胃癌和卵巢癌行腹腔化療的患者53例，隨機分為兩組。實驗組29例，用一次性麻醉穿刺包行腹腔穿刺化療；對照組24例，用普通腹腔穿刺包行腹腔穿刺化療；比較兩組患者應用不同穿刺包行腹腔穿刺化療的并發癥比較。 結果 實驗組并發癥發生率明顯低于對照組(Plt;0.05)。 結論 一次性麻醉穿刺包應用于腹腔化療中操作簡便、創傷小、并發癥少，患者樂于接受等優點，值得在臨床上推廣使用。【Abstract】 Objective To explore the effects of one-off anesthesia paracentesis kit and ordinary peritoneal paracentesis kit in intraperitoneal chemotherapy. Methods A total of 53 patients with gastric cancer or ovarian cancer from June 2008 to April 2009 were randomly divided into two groups: 29 patients in trial group underwent intra-peritoneal chemotherapy with one-off anesthesia paracentesis kit, and 24 patients in the control group underwent intra-peritoneal chemotherapy with ordinary peritoneal paracentesis kit. The complications in two groups were compared. Results The incidence of complications in trial group was much lower than that in the control group (Plt;0.05). Conclusion One-off anesthesia paracentesis kit in intra-peritoneal chemotherapy has several advantages including simple manipulation, small injuries, and few complications, which is well accepted by the patients.
ObjectiveTo systematically evaluate the efficacy and safety of local anesthesia for venipuncture in children, and to provide evidence for related nursing practice.MethodsWeb of Science, PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Data, Chinese Biomedical Database and VIP databases were searched for randomized controlled trials (RCTs) about the application of local anesthesia in venipuncture in children till June 25th, 2021. Two reviewers independently reviewed the literature, extracted data, and assessed the risk of bias of included RCTs. RevMan 5.3 software was used for meta-analysis.ResultsA total of 19 RCTs were included, comprising 2 566 patients. All of them were high-quality English articles included in SCI or Medline. The results of meta-analysis showed that: the painless rate [odds ratio (OR)=3.80, 95% confidence interval (CI) (1.88, 7.66), P=0.000 2] and satisfaction rate of venipuncture [OR=2.12, 95%CI (1.27, 3.54), P=0.004] in the local anesthesia group were higher than those in the non-anesthesia group, and the pain score [mean difference=?0.62, 95%CI (?0.77, ?0.48), P<0.000 01] in the local anesthesia group was lower than that in the non-anesthesia group. There was no statistically significant difference between the two groups in the success rate of the first puncture [OR=1.14, 95%CI (0.77, 1.68), P=0.52], the incidence of transient skin reactions [OR=1.15, 95%CI (0.67, 1.95), P=0.62], the incidence of paleness [OR=1.11, 95%CI (0.57, 2.15), P=0.76], or the incidence of edema at the puncture site [OR=0.64, 95%CI (0.21, 1.96), P=0.44].ConclusionsLocal anesthesia can effectively reduce pain and improve the satisfaction of children with venipuncture, and has good clinical safety. It can be used by nursing staff in clinical practice.
