【摘要】 目的 分析宜宾市第二人民医院2009年门、急诊麻醉药品的使用情况，促进麻醉药品使用的合理化和规范化。 方法 对2009年门急诊1 420张麻醉药品处方进行统计，统计处方总数，麻醉药品临床使用分布情况，根据药品分类分别统计麻醉药品的用药总量，各种麻醉药品的处方所占的比例，实际用药总天数等。对非癌症处方以用药频率及药物利用指数（DUI）为指标，癌症处方以用药天数及平均日用药量为指标进行进行统计、分析、评价。 结果 门急诊的麻醉药品有8种，盐酸吗啡缓释片的总用量居首位，盐酸哌替啶针在急诊处方中出现频率较高，芬太尼透皮贴剂的用药频度较小，药物利用指数均≤1。 结论 宜宾市第二人民医院的急诊麻醉药品使用基本合理。A total of 1 420 pieces of narcotic drugs prescriptions for the outpatient in our hospital in 2009 were extracted. The total number of prescriptions, the distribution of the clinical use of narcotic drugs, the total amount of narcotic drugs according to different types, the proportion of each kind of narcotic drug prescription and the actual number of medication durations were counted and analyzed. Defined daily dose (DDD) and drug use index (DUI) of the non-cancer drugs prescription; meanwhile, the number of drug-using days and average daily amount of cancer drug prescription were statistically analyzed. Results There were eight kinds of narcotic drugs for the outpatients. The most total amount of narcotic drugs was morphine hydrochloride sustained release tablets; the medication frequency of pethidine injection in the emergency prescription was high and the medication frequency of transdermal fentanyl was low. The narcotic drugs utilization index was lower than one. Conclusion The use of narcotic drugs in our hospital is rational.
ObjectiveTo evaluate the association of anesthesia regime (volatile or intravenous anesthetics) with the occurrence of postoperative pulmonary complications (PPCs) in adult patients undergoing elective cardiac surgery under cardiopulmonary bypass (CPB).MethodsThe electronic medical records of 194 patients undergoing elective cardiac surgery under CPB at West China Hospital, Sichuan University between September 2018 and February 2019 were reviewed, including 92 males and 102 females with an average age of 53 years. The patients were classified into a volatile group (n=94) or a total intravenous anesthesia (TIVA) group (n=100) according to anesthesia regimen during surgery (including CPB). The primary outcome was the incidence of PPCs within first 7 d after surgery. Secondary outcomes included incidence of reintubation, duration of mechanical ventilation, ICU stay and hospital stay.ResultsThere was no significant difference in the incidence of PPCs between the two groups (RR=1.020, 95%CI 0.763-1.363, P=0.896), with an incidence of 48.9% in the volatile group and 48.0% in the TIVA group. Secondary outcomes were also found no significant difference between the two groups (P>0.05).ConclusionNo association of anesthesia regimen with the incidence of PPCs is found in adult patients undergoing elective cardiac surgery under CPB.
Objective To observe the systemic inhalation anesthetic effects of preterm children with different gestational ages under ocular fundus examination, and to assess its safety. Methods Fifty-one preterm children with retinopathy of prematurity (ROP) were included in the study. These kids were divided into 2 groups, group Ⅰ included 24 kids with a corrected gestational age of 33 to ＜44 weeks, and group Ⅱ included 27 kids with a corrected gestational age of 44 to 64 weeks. The preterm months were same (t=-1.3.P＞0.05), but the body weights were different (t=-10.5.P＜0.05) between these two groups. Anesthesia was induced by inhalation of 6% sevoflurane, and the period from the beginning of inhalation to disappearance of body movement was the induction time. 6% sevoflurane was inhaled continuously for another period of the induction time, and then the concentration of sevoflurane was adjusted to a maintenance concentration. The initial maintenance concentration was 3%, and was adjusted by 0.5% each time. Sequential method was used to determine the subsequent maintenance concentration. If the preceding patient had not moved during the maintenance period, the sevoflurane concentration was decreased by 0.5% for the next patient. If the preceding patient had moved during the maintenance period, the sevoflurane concentration was increased by 0.5% for the next patient. Respiratory depression and cough during the induction and maintenance period, duration of anesthesia and recovery time were recorded. Choking and vomiting during drinking or milk-feeding in one hour after the ocular fundus examination were also recorded. Results The effective inhale concentration in 50% patient of sevoflurane was 2.5% in group Ⅰ, 2.9% in group Ⅱ. The average maintenance concentration was (2.5plusmn;0.5)% in group Ⅰ, (3.0plusmn;0.5)% in group Ⅱ. The difference was statistically significant (t=-3.3.P＜0.05). The average duration of anesthesia and the average awake time were the same (t=0.04 and -1.0 respectively.P＞0.05) between these two groups. The average induction time was significantly shorter in group Ⅰ than in group Ⅱ, the difference was statistically significant (t=-4.9.P＜0.05). All patients were successfully completed the ocular examination. No respiratory depression or cough occurred during and after the examination. No choking and vomiting during drinking or milkfeeding in one hour after the ocular fundus examination. Conclusion Anesthesia with inhaled sevoflurane by a face mask is safe for preterm outpatients undergoing fundus examination.
目的:分析本院住院部麻醉药品应用的现状及趋势,并作客观评价。方法:对2005~2008年本院麻醉药品的种类、用量、金额、DDDs等进行归类统计、比较和分析。结果:统计结果表明,本院住院部使用麻醉药品的用量及金额呈上升趋势。临床应用以芬太尼类居首。新型麻醉药品的应用也有上升趋势。结论:本院住院部麻醉药品应用基本合理,但仍存在一些不合理的习惯用法,需进一步提高合理用药水平。
Objective To examine the feasibility and efficacy of narcotic drugs and the first psychotropic drugs of category handover procedures, which based on CA certification electronic signature technology in the anesthesia information management system. Methods The handover of narcotic drugs and the first class psychotropic drugs in 30 operating rooms of the Department of Anesthesiology at West China Tianfu Hospital of Sichuan University between June and July 2023 was selected as the research object. According to the handover of narcotic drugs and the first class psychotropic drugs, the 30 operating rooms that were handed over using paper-based system in June 2023 were designated as the traditional handover group, the 30 operating rooms that were handed over using CA certification electronic signature technology in July 2023 were designated as the paperless handover group. The time spent on quality control of management of narcotic and psychoactive drugs, the time spent on the handover of narcotic and psychiatric drugs, and the users’ effort degree and satisfaction by anesthesiologists and nurses were compared between the two groups. Results The traditional handover group completed 3027 surgeries, while the paperless handover group completed 3022 surgeries. There were no statistically significant difference in the daily average number of surgeries completed in the operating rooms [(137.59±10.81) vs.(137.36±11.98) cases] and usage of narcotics drugs and the first class psychotropic drugs [(713.91 ± 7.24) vs. (716.64 ± 6.53) pills] between the TPH and paperless handover groups. The time of checking drug handover records [(35.80±3.07) vs. (3.89±0.43）min] and the cost time of drugs handover [(6.07±0.55) vs. (3.57±0.39）min] in the traditional handover group were higher than those in the paperless handover group (P<0.001). The average laborious degres [(3.17±1.17) vs. (4.34±0.70)] and the satisfaction [(3.75±1.09) vs. (4.64±0.52)] of the traditional handover group are lower than those of the paperless handover group (P<0.001). Conclusions CA certification electronic signature technology significantly enhances management efficiency, reduces non-technical workload, optimizes the healthcare experience, and enables permanent storage and real-time retrieval of electronic records. It complies with data security and ecological healthcare requirements, making it highly worthy of application.