目的:评价注射用兰地洛尔治疗手术期心动过速性心律失常的疗效与安全性.方法:采用随机、双盲、安慰剂平行对照、多中心的临床试验方法,将240例患者随机分为治疗组和对照组(1:1),治疗组采用注射用兰地洛尔治疗,对照组采用安慰剂治疗,治疗后比较疗效.结果:共有239例患者完成试验,其中治疗组120例,对照组119例.治疗组的心动过速控制率为87.5％,对照组的心动过速控制率为4.2％,治疗组优于对照组(P＜0.05).治疗组起效时间中位数为1 min,安慰剂组起效时间中位数为大于2 min,治疗组优于对照组(P＜0.05).治疗组在治疗期及访视期心率收缩压乘积与治疗前相比显著下降,差异有统计学意义(P＜0.05);安慰剂组在治疗2 min时心率收缩压乘积与治疗前相比未见显著下降,差异无统计学意义(P＞0.05).结论:注射用兰地洛尔治疗手术期心动过速性心律失常安全、有效.

Objective To evaluate the clinical effects of butorphanol preempitive analgesia on postoperative analgesia undergoing gynecological laparoscopic operation.Methods Sixty ASA Ⅰ-Ⅱ patients undergoing gynecological laparoscopic operation were randomly allocated to three groups with 20 cases.The patients in group Ⅰwere given 1 mg butorphanol during 10 minutes before operation and 4 mg PCI,group Ⅱwere given 1mg butorphanol during 10 minutes before the end of surgery and 4 mg PCI,group Ⅲ were given 8 mg butrphanol PCI.The analgesia effect were evaluated by VAS,BCS and Ramesy scores at 2,4,8,12,24 h and the side effects were reconded.Results VAS scores of groups Ⅰand Ⅲ were significantly lower than those of group Ⅱ(P<0.05),Ramesy scores of groups Ⅰand Ⅱ were significantly lower than those of group Ⅲ at 12 and 24 h(P<0.05) and BCS scores were no statistical difference among the groups(P>0.05).The incidence of side effects including nausea and vomiting,urinary retention and pruritus was higher in group Ⅲ than in groups Ⅰand Ⅱ,no evidence of serious respiratory depression was seen in any patient.Conclusion The using of Butorphanol effect on therapeutic efficacy of postoperative analgesia in different stage,preemptive analgesia with butorphanol decrease postoperative requirement of analgesia and is effective,covenient and safe with less side effect in the patients undergoing laparoscopy,it deserve clinical application.

AIM:To evaluate the prophylactic effect of azasetron in different juncture injection on postoperative nausea and vomiting(PONV)during patients controlled intravenous ananlgesia(PCIA).METHODS:One hundred and twenty patients,scheduled for selective abdominal operations,were randomly divided into four groups:patients received an preoperative intravenous injection of 10 mg azasetron(Group A,n=30),patients received an intravenous injection of 10 mg azasetron during abdominal cavity(Group B,n=30),patients received an intravenous injection of 10 mg azasetron when the operation were finished(Group C,n=30),patients with no azasetron as control(Group D,n=30).The incidence rate and score of PONV,the visual analogue scales(VAS)and Ramsay scores were recorded at 4,8,12,24,48 h postoperatively.RESULTS:There was significant difference between the postoperative VAS during 12 to 48 h and that of 4 h postoperatively(Ρ0.01 or Ρ0.05).There was no somnolence and deep calm happening.The incidence of PONV in Group A was significantly lower than that in Group D(Ρ0.01 or Ρ0.05).The incidences of PONV in Group C in postoperative 0 to 4 h and 4 to 24 h were significantly lower than that in Group D(Ρ0.05).There was no significant difference between Group B and D(Ρ0.05).CONCLUSION:A preoperative intravenous injection of 10 mg azasetron can be used effectively to prevent PONV during PCIA.

Objective:To study the clinical effectiveness and safety of 5% lidocaine used for the spinal anesthesia.Methods: In this randomized,double-blind study,32 ASAⅠ～Ⅱpatients were divided into two groups.Group L received 5% lidocaine 2 ml(heavy,n=16)and group B,0.5% bupivacaine 2 ml(heavy,n=16) followed by respective measurement of the interval affecting sensation block,the motor block and Bromage scales.Anesthesia effect was evaluated on a basis of MAP,HR at 1,3,5,10 or 15 min after the administration and the frequency of postoperative nausea and vomiting.Results: Both the interval of affecting sensation block and motor block in group L were much faster than group B(P0.01,P0.05).Bromage scales 2～3 in group L was higher than that in group B,but the anesthesia effect showed no significant difference between the two groups.The decrease of HR and MAP was greater in group L compared with administration after 2～3 min.Conclusion: Both of 5% lidocaine and 0.5% bupivacaine can produce the same effect on spinal anesthesia with safety.5% Lidocaine has quicker effect and satisfied block,but hemodynamics must be monitored.

目的:探讨胸段硬膜外麻醉对病人血浆神经肽Y(NPY)的影响.方法:采用放射免疫分析法测定了31例择期上腹部手术病人胸段硬膜外麻醉前后血浆NPY的含量.结果:麻醉后平均动脉压较麻醉前显著下降(P＜0.01),血浆NPY则无显著变化(P＞0.05).结论:病人处于硬膜外麻醉状态下体内NPY含量的变化与交感神经系统调节具有一定的关系.