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相关概念视频

Peripheral Artery Disease V: Postoperative Nursing Management01:23

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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General Anesthesia: Overview01:24

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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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外围神经阻塞的使用降低了骨科手术后术后认知功能障碍的发生率:系统性审查和元分析.

Liyun Deng1,2, Bo Jiao1,2, Jingjing Cai1,2

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概括

周围神经阻断 (PNB) 与全身麻醉 (GA) 结合,可以减少骨科手术后的术后认知功能障碍 (POCD). 然而,这种麻醉组合并没有显著改变术后痴呆症 (POD) 的发生率.

关键词:
综合麻醉是一种麻醉.整形外科手术 整形外科手术周围神经的阻断.术后神经认知障碍 术后神经认知障碍

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科学领域:

  • 麻醉学 麻醉学
  • 神经科学是一个神经科学.
  • 外科手术的结果

背景情况:

  • 手术后的神经认知障碍 (PND),包括手术后认知功能障碍 (POCD) 和手术后妄 (POD),在骨科手术后很常见.
  • 结合外围神经阻塞 (PNB) 与全身麻醉 (GA) 对PND发病率的影响尚不清楚.

研究的目的:

  • 为了研究PNB加GA对骨科手术后POCD和/或POD发病率的影响,与GA单独相比.

主要方法:

  • 进行了对12项随机对照试验 (RCT) 的元分析,涉及1488名患者.
  • 主要结局是POD和POCD的发病率.
  • 用二分结果的风险比率 (RR) 分析数据.

主要成果:

  • 与GA单独相比,PNB加GA显著降低了POCD的发生率 (RR:0.58,95%CI:0.35至0.95).
  • 在POD发生率上没有显著差异 (RR:0.87,95%CI:0.54至1.40).
  • 联合麻醉还导致了手术前和手术后的阿片类药物消费减少,以及手术后恶心和吐的发病率降低.

结论:

  • 将PNB与GA结合使用,可以有效地降低骨科手术后POCD的发生率.
  • 这种麻醉方法不会显著影响POD的发生率,但在疼痛和恶心管理方面有好处.