静脉低剂量氯胺酮超前镇痛对腹腔镜胆囊切除术后苏醒和疼痛的影响

目的 观察氯胺酮切皮前给药对腹腔镜胆囊切除术(LC)后苏醒和疼痛的影响.方法 全麻下行LC患者80例,随机均分为两组:对照组采用雷米芬太尼复合丙泊酚麻醉;研究组在切皮前加用小剂量氯胺酮0.3 mg/kg.采用SS和VRS评分评估对苏醒时间和苏醒期躁动情况.结果 两组呼吸恢复时间、睁眼时间、拔管时间差异无统计学意义.研究组苏醒期躁动、镇痛、镇静效果显著优于对照组(P<0.05).结论 静脉低剂量氯胺酮超前镇痛用于LC术后苏醒快,术后疼痛轻,苏醒期躁动少.     

头风宁镇痛机制的实验研究

目的：在已有实验的基础上，揭示头风宁胶囊的镇痛机制。方法：通过出凝血时间测定，ADP诱导小鼠血栓性死亡试验，耐缺氧实验，体外血栓形成，血小板聚集，脑组织5－HT含量测定等方法，观察头风宁和川芎茶调散（对照药）对上述指标的影响。结果：动物血液流变学各指标的异常得以纠正，缺氧动物死亡率降低，脑组织5－HT含量升高，各指标改善程度均具有统计学意义。治疗组疗效优于对照组，结论：头风宁的镇痛作用与其纠正高血黏状态，调节动物脑组织5－HT含量，提高动物耐的缺氧能力等机制相关。     

可乐定麻醉镇痛应用及机制

可乐定作为中枢性降压药早为人们所认识，但在临床麻醉镇痛的应用上则起步不久。本文就其在围手术期的应用和不良反应，特别是镇痛及其机制进行综述。     

Pain in fibrous dysplasia of bone: age-related changes and the anatomical distribution of skeletal lesions

Summary To determine the prevalence, distribution, age-related changes and treatment of pain in fibrous dysplasia, we studied 78 children and adults. Pain was common, more prevalent and intense in adults, sometimes requiring narcotic analgesia. It was often untreated, especially in children, and surprisingly severity did not correlate with skeletal disease burden. Introduction Pain is common in fibrous dysplasia (FD), but relatively unstudied. We studied a well-characterized population of patients with a spectrum of disease. Methods Thirty-five children (16 male, 19 female, mean age 11.4 (range 5–18)) and 43 adults (15 male, 28 female, 23–62 yrs, mean age 40.3 (range 23–62)) were studied. Bone scans were used to identify the location and extent of disease. The Brief Pain Inventory was used to determine severity. Results Pain at sites of FD was common, reported by 67% of the population, but more prevalent and severe in the adult group than the children (81% and 49%, respectively p < 0.005, severity 4.1/10, and 2.8/10, respectively, p < 0.01). Surprisingly, there was no correlation between pain severity and skeletal disease burden. Children were more likely than adults to be untreated for pain (44% vs. 26%). Conclusions Pain, which was sometimes severe, was common in subjects with FD. It was often un- or under-treated, especially in children. The prevalence and severity of pain was greater in the adult group, but unrelated to the burden of FD. Disclosures: none     

Medial forebrain stimulation enhances intracranial nociception and attenuates morphine analgesia suggesting the existence of an endogenous opioid antagonist

The purpose of this experiment was to test in the rat the hypotheses that activation of the brain reward system would attenuate the effects of intracranial nociceptive stimulation and would potentiate the antinociceptive effects of morphine. In this experiment pain (nociception) was generated by electrical stimulation of a brain pain pathway, the mesencephalic reticular formation (MRF) of the rat. Reward pathway stimulation was to the medial forebrain bundle at the level of the lateral hypothalamus (MFB-LH). Current thresholds for escape from MRF stimulation were determined using a modification of the psychophysical methods of limits. MRF stimulation was delivered concurrently with different intensities of non-contingent MFB-LH stimulation. The effects of morphine and saline were determined under all stimulation conditions. Contrary to expectation MFB-LH stimulation significantly lowered MRF stimulation escape thresholds. Morphine administration elevated MRF thresholds in the absence of MFB-LH stimulation. However, this effect was blocked by concurrent MFB-LH stimulation. These findings, which mimic the effects of the opiate antagonist naloxone, i.e., potentiating of pain and antagonism of morphine's analgesic effects, suggest the presence of an endogenous opiate receptor antagonist.     

YS-1型多系统电脑治疗仪在人工流产术中的镇痛效果分析

目的　探讨 Ｙ Ｓ－ １ 型电脑治疗仪在人工流产术中镇痛效果的作用。方法　对比分析了治疗组（３００ 例） 和对照组（１００ 例） 的疗效。结果　在治疗组中，疗效优的２４５ 例（８１ ．７ ％ ） ，良４５ 例（１５ ％ ） ，总有效率达９６ ．７ ％ 。两组比较有显著性差异（ Ｐ ＜ ０ ．０１） 。结论 应用 Ｙ Ｓ－ １ 型电脑治疗仪对人工流产是一种有效的镇痛方法，治疗适当，它的疗效令人满意。     

笑气吸入性镇痛在人工流产中应用100例分析

目的研究笑气吸入性镇痛在人工流产中的疗效和对患者的影响。方法将200例门诊早孕要求终止妊娠者随机分为观察组和对照组。对照组除不给笑气吸入外，其它与观察组相同。观察比较两组的疼痛程度、手术时间、阴道出血量等。结果观察组的疼痛强度明显低于对照组（P〈0．01）．手术时间较对照组短，观察组的阴道出血量于对照组无明显差异。结论笑气吸入性镇痛人工流产镇痛明显，手术时间短，对患者身体均无不良影响，是一种理想的镇痛方法，值得产科临床推广使用。     

国产盐酸左旋布比卡因用于开胸术后硬膜外镇痛

目的观察0．2％国产盐酸左旋布比卡因在开胸术后硬膜外持续泵注的镇痛效果,并与0．2％布比卡因进行比较。方法60例择期食管癌手术患者随机分为两组,每组30例:0．2％左旋布比卡因组(Lbup组)和0．2％布比卡因组(Bup组),镇痛液均含吗啡40μg／ml。全身麻醉诱导前行硬膜外置管,手术中间断注入1．6％利多卡因5 ml。术后采用患者自控镇痛。结果两组患者安静时镇痛效果均满意,咳嗽时伤口轻微疼痛,患者可以耐受,两组24 h内VAS评分在安静或咳嗽时差异均无统计学意义(P>0．05)。副作用少,未见严重并发症。结论0．2％国产盐酸左旋布比卡因复合吗啡用于胸科术后硬膜外镇痛同样有效,但较同浓度布比卡因更为安全、副作用少,其镇痛强度和同浓度的布比卡因相当。     

硫必利复合芬太尼在头颈部手术后患者自控镇痛的应用

目的对硫必利复合芬太尼用于头颈部手术后镇痛治疗的效果和安全性进行观察评价。方法选择ASAⅠ～Ⅱ级实施头颈部手术的患者50例随机分为2组,硫必利芬太尼复合(TF)组和芬太尼(F)组,每组各25例。TF组:硫必利600 mg 芬太尼0.6 mg;F组:芬太尼1.2 mg。两组均以生理盐水配制到100 ml。首次量5ml,背景输入量2 ml/h,单次PCA量0.5ml,锁定时间为15 min。记录术后4、8、24、48 h的患者疼痛评分、有效按压次数和不良反应。结果两组患者术后镇痛满意度和术后4、8、24、48 h的VAS评分、有效按压次数的差异无统计学意义(P>0.05),TF组的恶心呕吐、嗜睡和尿潴留等不良反应发生率分别为8%、4%和16%,低于F组的36%、24%和44%(P<0.05)。结论硫必利复合芬太尼应用于头颈部手术后镇痛治疗效果满意,与单纯芬太尼相当,但不良反应发生率低,是一种安全有效的镇痛方法。