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重视对老年病人麻醉的研究 总被引:3,自引:0,他引:3
人口老龄化是当今世界的趋势。65岁以上人群中25%~50%有一次以上的手术治疗。老年人围术期并发症发生率和死亡率明显高于中青年,且所耗医疗费用也高。这是由于随着年龄增长,老年人各种器官、系统发生“衰老”,结构和功能随之退化;老年人的药代和药效与中青年比较有差别;常伴有与老年人相关的疾病如高血压、冠心病等。为此,必须重视对老年病人麻醉的研究。实际年龄不是手术的反指征及危险因素,麻醉方式也不是重要的危险因素。术前重要器官、系统的功能,有无并存病,手术大小,急诊手术,围术期血流动力学稳定性,术后并发症等均为重要因素。要加强围术期监测,及时进行术中、术后并发症防治及麻醉管理,重视术后护理。 相似文献
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术前手术/麻醉同意书对病人的影响及对策 总被引:3,自引:0,他引:3
目的评估术前手术同意书、麻醉同意书对手术病人的影响。方法对50例外科择期手术病人,在2份同意书签名前后,进行问卷调查及临床观察,了解病人对自身疾病的认知、焦虑、血压、心率等情况。结果2份同意书签字后病人对自身疾病、麻醉、手术方式的认知高于签字前;术前恐惧、焦虑紧张症状较签字前加重;签字后失眠人数多于签字前;血压、心率较签字前均有升高、加快,并有显著性差异,P<0.01。结论正确评估术前2份同意书对病人的影响,采取有效的护理干预,减轻病人术前焦虑、恐惧、紧张不安心理,是使病人积极配合手术,保证手术顺利进行的关键。 相似文献
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统计2010年1月-2010年4月76例全身麻醉手术的老年病人,分别记录他们在麻醉恢复室(PACU)的体温、血氧饱和度、心率、血压、苏醒时间及并发症的发生率,结果发生低氧血症11例,高血压7例,躁动6例,低体温4例,苏醒延迟2例.认为给予早期观察与护理,可避免病人在PACU期间出现并发症. 相似文献
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统计2010年1月—2010年4月76例全身麻醉手术的老年病人,分别记录他们在麻醉恢复室(PACU)的体温、血氧饱和度、心率、血压、苏醒时间及并发症的发生率,结果发生低氧血症11例,高血压7例,躁动6例,低体温4例,苏醒延迟2例。认为给予早期观察与护理,可避免病人在PACU期间出现并发症。 相似文献
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[目的]分析全身麻醉苏醒期病人躁动的原因,总结护理措施。[方法]分析54例开颅术后全身麻醉苏醒期躁动病人的原因,采取相应的护理。[结果]颅内因素、有害刺激、麻醉作用、术后并发症等是全身麻醉苏醒期病人躁动的主要原因;及时采取相应的护理措施,最终使术后病人安全返回病房。[结论]合理的护理能够帮助病人安全的度过全身麻醉苏醒期,是手术成功的重要保障。 相似文献
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向峰 《中国临床医药研究杂志》2008,(12)
麻醉是手术顺利实施与进展的必要前提、麻醉护理麻醉学的重要组成部分,手术室护士配合麻醉医师,从药品的管理,麻醉器械的准备,特殊液路的建立,病人体位安置,配合麻醉插管,各种麻醉穿刺到病人因麻醉状态的管理确保麻醉效果,手术顺利进行,促进麻醉清醒,术后无麻醉和护理并发症发生: 相似文献
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The review deals with the promising method of regional anesthesia--combined epidural anesthesia. It gives indications for anesthesia, the specific features of its technical performance, and possible complications. 相似文献
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The development of topical anesthetics has provided the family physician with multiple options in anesthetizing open and intact skin. The combination of tetracaine, adrenaline (epinephrine), and cocaine, better known as TAC, was the first topical agent available for analgesia of lacerations to the face and scalp. Cocaine has been replaced with lidocaine in a newer formulation called LET (lidocaine, epinephrine, and tetracaine). For analgesia to nonintact skin, LET gel is generally preferred over TAC because of its superior safety record and cost-effectiveness. EMLA (eutectic mixture of local anesthetics) is perhaps the most well-known topical anesthetic for use on intact skin. EMLA can be used to anesthetize the skin before intramuscular injections, venipuncture, and simple skin procedures such as curettage or biopsy. To be fully effective, EMLA should be applied at least 90 minutes before the procedure. ELA-Max is a new, rapidly acting topical agent for intact skin that works by way of a liposomal delivery system and is available over the counter. Other delivery vehicles for topical anesthesia currently in development, including iontophoresis and anesthetic patches, may one day give patients and physicians even more flexibility. 相似文献
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目的研究循证术前麻醉访视在局部麻醉患者中的应用效果。方法将240例局部麻醉患者采用随机数字表分为观察组和对照组,各120例,对照组采用常规术前访视,观察组采用循证麻醉访视,比较2组的手术应激情况以及功能恢复情况。结果观察组术中的恐惧评分低于对照组,收缩压、舒张压以及心率低于对照组,差异有统计学意义(P0.05)。观察组术后的躯体功能、认知功能、情感功能评分均高于对照组,差异有统计学意义(P0.05)。结论循证麻醉访视能够减轻局部麻醉患者的恐惧情绪,提高麻醉效果,有利于患者术后躯体功能的恢复。 相似文献
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The use of effective analgesia is vital for any office procedure in which pain may be inflicted. The ideal anesthetic achieves 100 percent analgesia in a short period of time, works on intact or nonintact skin without systemic side effects, and invokes neither pain nor toxicity. Because no single agent meets all of these criteria, the physician must choose from the available armamentarium based on the anesthetic properties that are most desired. Infiltrative anesthetics are frequently chosen because of their proven safety record, low cost, ease of storage, widespread availability, and rapid onset of action. Allergy to local injectable anesthetics is rare, and when it occurs it is often secondary to the preservative in multidose vials. Anesthesia can be prolonged with the addition of epinephrine or the use of longer-acting agents. Buffering the local anesthetic with bicarbonate, warming the solution, and injecting slowly can minimize the pain of anesthetic injection. Complications are rare but include central nervous system and cardiovascular toxicity, or extreme vasoconstriction in an end organ, if epinephrine is used. 相似文献
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