PURPOSE:The physiologic transition from a fetus to a neonate is composed of a series of complex processes that include changes in cerebral tissue oxygenation saturation (cSO2). Monitoring this process is of great importance. This study aimed to define the cSO2 reference interval in neonates without medical support, extending the measurements until 1 hour after birth, and to determine the incidence of abnormally low or high regional cerebral oxygenation during the neonatal transition.PATIENTS AND METHODS:A total of 418 neonates delivered by cesarean section were enrolled. Near-infrared spectroscopy was used to monitor cerebral oxygenation.RESULTS:We found that cSO2 of the non-oxygen-inhaled intrathecal anesthesia in neonates without medical support increased from about 49.0% in the second minute. Most of them reached cSO2 relative stabilization at 55.7-81.0% between 7 and 8 minutes after birth. One hour after birth, newborn cSO2 was maintained at 78.0-87.0%. The low cSO2 rate among babies born under intrathecal anesthesia with and without maternal oxygen inhalation during cesarean sections was approximately 4.5% and 9.0%, respectively.CONCLUSION:We reported the trend in cSO2 from 2 minutes after birth to 1 hour in the neonatal nursing room and determined the incidence of abnormal regional cSO2 during this neonatal transition period. Anesthesiologists should pay special attention to the risk of cSO2 abnormalities in newborns when managing pregnant women with comorbidities.

Objective To verify the effects of critical-care pain observation tool ( CPOT) on pain assessment after lung transplantation. Methods 2 critical care nurses applied CPOT scale for pain assessment of 42 cases hospitalized in ICU after lung transplantation who would have pain assessment. The whole investigation were divided into 3 stages and 2 points of each stage ( rest before turning over and the simulation of turning over) with total 6 measuring point (T1-T6). The first stage was patients with general anesthesia ( no awareness) , the second stage ( patients with sanity and applied artificial respirator through oral trachea cannula, the third stage ( patients got off oral trachea cannula and ventilator paused ) . The measurement point was 1 min, recording patient′s value of CPOT from T1 to T6. The second stage was used digital scoring method. Results For 3 stages, the measurement points of turning over for CPOT value was higher than that of rest measurement point before turning over; 2 critical patients had high uniformity for CPOT score;in stage 2, patient′s CPOT score had high uniformity with NRS score. Conclusions CPOT is a effective way to assess pain for mechanically ventilated patients after lung transplantation.

Objective To explore the application effects of 3M circular opening self-adhesive wound dressing on changing tracheostoma dressing.Methods A total of 56 tracheotomized patients from January to December 2014 were randomly admited to either observation group or control group.Different tracheostoma dressings were chosen by the two groups,the patients of observation group adopted 3M circular opening selfadhesive wound dressing and the patients of control group received sterile gauze.Skin situation after tracheotomy,incision infection,dressing frequency,cost and patient's satisfaction were evaluated.Results Three cases suffered from adverse skin reaction in observation group and 13 cases in the control group,with a statistically significant difference(x2 =8.750,P ＜ 0.05);the frequency of changing dressing was no significant difference between two groups (P ＞ 0.05),the observation group was once a day,while the control group was three times a day;the hospitalization costs were (59 242.16 ± 3 276) (￥) in the observation group,while it was (50 369.22 ±2 892) (￥) in the control group (t =6.420,P ＜ 0.05);patient's satisfaction in observation group was 96.43％,but 71.43％ in the control group (x2 =4.766,P ＜ 0.05).Conclusions 3M circular opening self-adhesive wound dressing for neurosurgery patients after tracheotomy can reduce complications,the rate of incisional infection,the hospitalization costs and improve patients' satisfaction and comfort,which also reduce the working load of clinical nurse.

Objective To study the effect of the 10％ of chloral hydrate delivery in different time on the children before they receive the pulmonary function test so as to discuss clinical effects.Methods Totals of two hundred children with asthma or asthmatic bronchitis needed the pulmonary function test were recruited,and randomly divided into experience group and control group with each group one hundred cases.Experience group received the chloral hydrate to hypnosis in ten to thirty minutes before they fall asleep,while control group received in doctor' s advice or appointment time.Then,the time of falling asleep,sleep level,the situation of test finishing in two group were observed and compared.Results The effective rate of chloral hydrate in experience group was 98％ which was significantly higher than 70％ in control group( P ＜ 0.01 )and there was significant differenee between two groups in the time of falling asleep and the sedation effect among the different ages (P＜0.01).Conclusions Personal medicine delivery can get the better effect,which is chloral hydrate delivery according to the sleep cycles of children before they receive the pulmonary function test.

Objective To estimate nursing effection of comfeel non adhesive foam dressing in the dressing tracheotomy.Methods 60 patients with tracheotomy were randomly divided into control and experimental group,each group had 30 cases respectively.The experimental group used the comfeel non-adhesive foam dressing for tracheotomy,The control group used ordinary sterile gauze dressing for tracheotomy.The skin condition after tracheotomy,incision infection,the average time between dressing changes and patient comfort were observed.Results 6 patients got skin lesion in experimental group and 12 in the control group,there was obviously different between the two groups(x2 =2.86,P ＜ 0.05).Dressing changing time were(3.63 ± 1.30)days and(1.28 ± 0.50)days in experimental and control group,respectively.there was statistically difference(t--9.24,P＜0.01); Extubation time in experimental group was less than the control group,it was(15.98 ±2.54)days and(21.05 ±3.15)days(t =6.86,P＜0.01).Conclusions Foam dressing is effective in reducing the incidence of skin reactions and wound infection.It can reduce the frequency of dressing change and increase the patient' s comfortable.

OBJECTIVE To compare the advantages and disadvantages between laryngeal mask airway anaesthesia combined with sacral canal block and single tracheal tube anaesthesia in pediatric surgery. METHODS Sixty 2-12-year-old children for lower limb or lower abdominal surgery were randomly assigned into two groups: a group that was given laryngeal mask airway anaesthesia combined with sacral canal block and a group was given single tracheal tube anaesthesia (n=30 each). Mean arterial pressure (MAP), SpO₂ and heart rate (HR) were recorded before induction of anaesthesia, before and after insertion of laryngeal mask airway (LMA) or tracheal tube (TT) and after removal of LMA or TT. The waking-up time, VAS pain scores and the frequency of mania were recorded after surgery. RESULTS There were no significant differences in MAP, SpO₂ and HR between the combined and single anaesthesia groups before anaesthesia and insertion of LMA or TT, while the MAP and HR in the combined anaesthesia group were significantly lower than those in the single anaesthesia group after insertion and removal of LMA or TT (P<0.05). The VAS pain scores were significantly lower and the waking-up time was significantly shorter in the combined anaesthesia group than those in the single anaesthesia group (P<0.05) after surgery. The frequency of mania after surgery in the combined anaesthesia group was significantly lower than that in the single anaesthesia group (P<0.05). CONCLUSIONS The hemodynamics is more stable in children during the induction and the waking-time of laryngeal mask anesthesia combined with sacral canal block. The anesthesia may relieve postoperative pain, shorten the waking-up time and decrease the frequency of mania.