BACKGROUND:Pain in the emergency department(ED)is common but undertreated.The objective of this study was to examine the efficacy and safety of intranasal(IN)ketamine used as an analgesic for patients with acute injur...BACKGROUND:Pain in the emergency department(ED)is common but undertreated.The objective of this study was to examine the efficacy and safety of intranasal(IN)ketamine used as an analgesic for patients with acute injury with moderate to severe pain.METHODS:This study was a cross sectional,observational study of patients more than 8 years old experiencing moderate to severe pain[visual analog score(VAS)>50 mm].The initial dose of IN ketamine was 0.7 mg/kg with an additional dose of 0.3 mg/kg if VAS was more than 50 mm after 15minutes.Pain scores and vital signs were recorded at 0,15,30 and 60 minutes.Side-effects,sedation level and patient's satisfaction were also recorded.The primary outcome was the number of patients achieving≥20 mm reductions in VAS at 15 minutes.Other secondary outcome measures were median reduction in VAS at 15,30 and 60 minutes,changes of vital signs,adverse events,satisfaction of patients,and need for additional ketamine.RESULTS:Thirty-four patients with a median age of 29.5 years(IQR 17.5–38)were enrolled,and they had an initial median VAS of 80 mm(IQR 67–90).The VAS decreased more than 20 mm at15 minutes in 27(80%)patients.The reduction of VAS from baseline to 40 mm(IQR 20–40),20 mm(IQR 14–20)and 20 mm(IQR 10–20)respectively at 15,30 and 60 minutes(P<0.001).No critical changes of vital signs were noted and adverse effects were mild and transient.CONCLUSION:This study showed that IN ketamine is an analgesic choice for patients with acute injury in moderate to severe pain in an overcrowded and resource limited ED.展开更多
目的:观察耳穴贴压对血透合并瘙痒患者白细胞介素水平的影响并探讨其可能机制。方法:筛选我院长期进行维持性血液透析并发皮肤瘙痒病例,将其分为对照组和治疗组,对照组采用基础治疗加耳穴贴治疗(不含王不留行籽),治疗组采用基础治疗加...目的:观察耳穴贴压对血透合并瘙痒患者白细胞介素水平的影响并探讨其可能机制。方法:筛选我院长期进行维持性血液透析并发皮肤瘙痒病例,将其分为对照组和治疗组,对照组采用基础治疗加耳穴贴治疗(不含王不留行籽),治疗组采用基础治疗加耳穴贴治疗(内含王不留行籽)。结果:耳穴贴压治疗组与对照组数据比较,瘙痒VAS评分(2.656±0.8654 vs 4.194±0.9202)、FIIQ量表评分(8.563±1.759 vs 10.08±1.842)、中医症候积分(29.38±4.470 vs 36.33±4.980)以及IL-6含量(5.798±0.6576 vs 6.239±0.8250)数据比较显著下降,差异有统计学意义(P<0.05),IL-2含量(999.7±226.8 vs 1076±237.2)、IL-8(56.41±8.420 vs 60.36±8.093)、IL-10(6.629±1.098 vs 6.263±1.134)数据比较差异无统计学意义(P>0.05)。结论:耳穴贴压可以改善维持性血液透析患者皮肤瘙痒,提高患者的整体生活质量。展开更多
目的探讨非特异性下腰痛(Low back pain,LBP)患者腰椎ModicⅠ(MC1)面积与Oswestry功能障碍指数(Oswestrydisability index,ODI)、疼痛视觉模拟评分(Pain visual analog scale,VAS)分级之间的相关性。方法选取我院因LBP且腰椎MRI有MC1表...目的探讨非特异性下腰痛(Low back pain,LBP)患者腰椎ModicⅠ(MC1)面积与Oswestry功能障碍指数(Oswestrydisability index,ODI)、疼痛视觉模拟评分(Pain visual analog scale,VAS)分级之间的相关性。方法选取我院因LBP且腰椎MRI有MC1表现患者47例。于扫描3日内采集患者ODI和VAS,以及性别、年龄、BMI等一般临床资料信息。并在MRI评价每位患者退行性变最重的椎间盘、小关节和肌肉分级;记录患者有无腰椎间盘纤维环高信号区(high-intensity zone,HIZ)、椎间盘膨/突出;测量MC1总面积、最窄处椎管面积等。通过SPSS软件分析ODI、VAS分级与上述变量间相关关系。结果ODI与VAS分级、MC1面积、椎管面积、椎间盘膨/突、椎小关节分级之间相关,相关系数分别为:r=0.684(P=0.000)、r=0.509(P=0.000)、r=-0.320(P=0.028)、r=0.305(P=0.037)、r=0.297(P=0.042)。VAS分级除ODI外仅与MC1面积相关,且相关系数为r=0.321,P=0.028。结论相对于其他影像学征象,MC1面积与ODI、VAS分级相关性更高。展开更多
目的:探讨肝胆外科手术患者术后疼痛及不良反应的影响因素。方法:回顾性分析2018年3月至5月我院肝胆外科就诊并实施手术患者的临床资料。记录患者术后6 h、12 h的视觉模拟评分(VAS)及不良反应发生情况。分析患者性别、年龄、体质量指数...目的:探讨肝胆外科手术患者术后疼痛及不良反应的影响因素。方法:回顾性分析2018年3月至5月我院肝胆外科就诊并实施手术患者的临床资料。记录患者术后6 h、12 h的视觉模拟评分(VAS)及不良反应发生情况。分析患者性别、年龄、体质量指数、手术方式、手术时长、住院天数、麻醉方式、自控镇痛泵配方与术后疼痛、不良反应的关系。结果:共纳入患者410例,术后6 h VAS≥4分的患者占12.2%(50/410),术后12 h VAS≥4分的患者占7.8%(32/410),差异有统计学意义(χ~2=4.390,P<0.05)。手术时长、手术方式与术后6 h中重度疼痛有关,术后恶心呕吐与患者性别有关(均P<0.05)。Logistic回归显示手术时长与手术方式是肝胆外科手术患者术后中重度疼痛的危险因素(均P<0.05)。结论:手术时长与手术方式是肝胆外科手术患者术后中重度疼痛的危险因素,女性患者更容易发生术后恶心呕吐。展开更多
文摘BACKGROUND:Pain in the emergency department(ED)is common but undertreated.The objective of this study was to examine the efficacy and safety of intranasal(IN)ketamine used as an analgesic for patients with acute injury with moderate to severe pain.METHODS:This study was a cross sectional,observational study of patients more than 8 years old experiencing moderate to severe pain[visual analog score(VAS)>50 mm].The initial dose of IN ketamine was 0.7 mg/kg with an additional dose of 0.3 mg/kg if VAS was more than 50 mm after 15minutes.Pain scores and vital signs were recorded at 0,15,30 and 60 minutes.Side-effects,sedation level and patient's satisfaction were also recorded.The primary outcome was the number of patients achieving≥20 mm reductions in VAS at 15 minutes.Other secondary outcome measures were median reduction in VAS at 15,30 and 60 minutes,changes of vital signs,adverse events,satisfaction of patients,and need for additional ketamine.RESULTS:Thirty-four patients with a median age of 29.5 years(IQR 17.5–38)were enrolled,and they had an initial median VAS of 80 mm(IQR 67–90).The VAS decreased more than 20 mm at15 minutes in 27(80%)patients.The reduction of VAS from baseline to 40 mm(IQR 20–40),20 mm(IQR 14–20)and 20 mm(IQR 10–20)respectively at 15,30 and 60 minutes(P<0.001).No critical changes of vital signs were noted and adverse effects were mild and transient.CONCLUSION:This study showed that IN ketamine is an analgesic choice for patients with acute injury in moderate to severe pain in an overcrowded and resource limited ED.
文摘目的:观察耳穴贴压对血透合并瘙痒患者白细胞介素水平的影响并探讨其可能机制。方法:筛选我院长期进行维持性血液透析并发皮肤瘙痒病例,将其分为对照组和治疗组,对照组采用基础治疗加耳穴贴治疗(不含王不留行籽),治疗组采用基础治疗加耳穴贴治疗(内含王不留行籽)。结果:耳穴贴压治疗组与对照组数据比较,瘙痒VAS评分(2.656±0.8654 vs 4.194±0.9202)、FIIQ量表评分(8.563±1.759 vs 10.08±1.842)、中医症候积分(29.38±4.470 vs 36.33±4.980)以及IL-6含量(5.798±0.6576 vs 6.239±0.8250)数据比较显著下降,差异有统计学意义(P<0.05),IL-2含量(999.7±226.8 vs 1076±237.2)、IL-8(56.41±8.420 vs 60.36±8.093)、IL-10(6.629±1.098 vs 6.263±1.134)数据比较差异无统计学意义(P>0.05)。结论:耳穴贴压可以改善维持性血液透析患者皮肤瘙痒,提高患者的整体生活质量。
文摘目的探讨非特异性下腰痛(Low back pain,LBP)患者腰椎ModicⅠ(MC1)面积与Oswestry功能障碍指数(Oswestrydisability index,ODI)、疼痛视觉模拟评分(Pain visual analog scale,VAS)分级之间的相关性。方法选取我院因LBP且腰椎MRI有MC1表现患者47例。于扫描3日内采集患者ODI和VAS,以及性别、年龄、BMI等一般临床资料信息。并在MRI评价每位患者退行性变最重的椎间盘、小关节和肌肉分级;记录患者有无腰椎间盘纤维环高信号区(high-intensity zone,HIZ)、椎间盘膨/突出;测量MC1总面积、最窄处椎管面积等。通过SPSS软件分析ODI、VAS分级与上述变量间相关关系。结果ODI与VAS分级、MC1面积、椎管面积、椎间盘膨/突、椎小关节分级之间相关,相关系数分别为:r=0.684(P=0.000)、r=0.509(P=0.000)、r=-0.320(P=0.028)、r=0.305(P=0.037)、r=0.297(P=0.042)。VAS分级除ODI外仅与MC1面积相关,且相关系数为r=0.321,P=0.028。结论相对于其他影像学征象,MC1面积与ODI、VAS分级相关性更高。
文摘目的:探讨肝胆外科手术患者术后疼痛及不良反应的影响因素。方法:回顾性分析2018年3月至5月我院肝胆外科就诊并实施手术患者的临床资料。记录患者术后6 h、12 h的视觉模拟评分(VAS)及不良反应发生情况。分析患者性别、年龄、体质量指数、手术方式、手术时长、住院天数、麻醉方式、自控镇痛泵配方与术后疼痛、不良反应的关系。结果:共纳入患者410例,术后6 h VAS≥4分的患者占12.2%(50/410),术后12 h VAS≥4分的患者占7.8%(32/410),差异有统计学意义(χ~2=4.390,P<0.05)。手术时长、手术方式与术后6 h中重度疼痛有关,术后恶心呕吐与患者性别有关(均P<0.05)。Logistic回归显示手术时长与手术方式是肝胆外科手术患者术后中重度疼痛的危险因素(均P<0.05)。结论:手术时长与手术方式是肝胆外科手术患者术后中重度疼痛的危险因素,女性患者更容易发生术后恶心呕吐。
