外科动物实验中猪的麻醉处理体会

我们从 1 998年以来 ,在开展腹腔镜、肾移植、原位肝移植、坏死胰腺炎模型等 50余例猪的外科实验中 ,就猪的麻醉方法取得了一些体会。1　猪的麻醉诱导和维持1 1　麻醉前　禁食 2 4小时 ,禁饮 8～ 1 2小时 ,不用术前药。在建立静脉通道后推注阿托品 0 0 1～0 1 5ｍｇ/ｋｇ以减少气道分泌物。1 2　麻醉诱导　 0 1 %安定 0 2～ 0 3ｍｇ/ｋｇ、 2 5%硫喷妥钠 8～ 1 0ｍｇ/ｋｇ (或 1 %氯胺酮 4～ 6ｍｇ/ｋｇ) ,慢诱插管。插管成功后 ,加用箭毒 0 1 5～ 0 2ｍｇ/ｋｇ ,机械通气控制呼吸。1 3　麻醉维持　吸入安氟醚或异氟醚 ,间断推注…     

术前心理行为干预对全麻患者苏醒期气管插管拔管时合作程度的影响

目的:探讨术前心理干预对全麻患者苏醒期气管导管拔管时合作程度的影响.方法:将160例气管内插管全麻下择期进行胆囊切除手术的成年患者随机分为观察组(心理指导组)80例,对照组(常规组)80例.对照组按常规进行麻醉前访视.观察组术前一天由麻醉医师和麻醉护士或手术室护士进行术前访视及心理指导,系统讲解麻醉的相关知识,重点解释气管内插管全身麻醉前后可能存在的咽喉部异物感或轻度疼痛、吞咽不适感等感觉,以及如何配合拔除气管插管;在手术当日麻醉前30分钟再次对观察组患者进行麻醉苏醒期相关知识宣教.重点观察患者在麻醉苏醒期及气管导管拔出前后是否合作及合作程度,手术后24小时随访.结果:两组患者一般情况、手术时间及麻醉时间差异无显著性(P>0.05).观察组中评分为1和2的百分比分别为20%与70%,对照组中评分为1和2的百分比分别为40%与20%.两组中评分为1和2的病例明显不同(P<0.05),说明观察组的心理指导与干预是有效的.患者对麻醉过程满意度,观察组为95%,明显高于对照组45%.结论:术前心理行为干预可明显减少气管内插管全麻患者苏醒期气管导管拔除时出现躁动或不合作的情况,提高其合作程度.     

外科动物实验中猪的麻醉问题

猪作为重要的实验动物,在外科实验中运用传统的麻醉方法时易引起呼吸道阻塞而死亡,我们使用全麻插管技术,并辅以术前术后各种对症处理,成功地解决了手术中猪因呼吸道阻塞而死亡的问题。     

可视气管导管在全麻手术患者气道插管中的应用及安全性评价

目的:探讨可视气管导管在全麻手术患者气道插管中的应用及安全性。方法:选取2014年10月-2016年12月在广东省第二人民医院麻醉科行全麻手术的患者220例,其中使用可视气管导管进行插管的110例记为观察组,使用普通气管导管进行插管的110例记为对照组。对比两组患者的插管次数、插管时间和并发症发生率,对比两组患者麻醉诱导前(T_0)、麻醉诱导后(T_1)、气道插管后(T_2)、气道插管后5 min(T_3)心率(HR)、收缩压(SBP)、舒张压(DBP)及血氧饱和度(SpO_2)的变化情况。结果:观察组的插管时间和插管次数较对照组降低(P0.05);T1时间点两组患者的HR、SBP、DBP均低于T_0、T_2、T_3时间点,差异有统计学意义(P0.05);T_0、T_1、T_2、T_3两组患者HR、SBP、DBP、SpO_2比较无统计学差异(P0.05);观察组的喉痛发生率为0.91%,显著低于对照组的7.27%,差异有统计学意义(P0.05)。结论:全麻手术患者气道插管时使用可视气管导管插管效果满意,可有效的减少插管时间和插管次数,安全性较高,值得临床推广应用。     

猪创伤皮肤缺损修复实验中的麻醉研究

目的探索一种适合猪创伤皮肤缺损修复实验的麻醉方法。方法实验分两部分,一是创伤皮肤缺损和修复动物模型制作手术中的麻醉,将14只仔猪随机分为3组,分别采用气管插管呼吸机辅助呼吸氯胺酮、安定、芬太尼复合麻醉、氯胺酮肌注加水合氯醛静滴麻醉、氯胺酮加戊巴比妥钠腹腔注射麻醉。二是换药中的麻醉,将64次麻醉分为3组,分别采用单纯氯胺酮麻醉、单纯戊巴比妥钠腹腔、氯胺酮加戊巴比妥组肌注。观察显效时间、维持时间、呼吸频率、心跳频牢、麻醉效果。结果皮肤创伤缺损和修复动物模型制作手术中,3组麻醉比较结果显示气管插管呼吸机辅助呼吸氯胺酮、安定、芬太尼复合麻醉显效时间快,维持时间可以控制,麻醉效果最好,安全可靠。在换药的麻醉中,氯胺酮加戊巴比显组肌注显效时间比较快,麻醉时间较短,效果好,动物容易苏醒。结论创伤皮肤缺损和修复动物模型制作手术中,采用气管插管呼吸机辅助呼吸氯胺酮、安定、芬太尼复合麻醉是有效安全的麻醉方法;在换药的麻醉中,氯胺酮加戊巴比妥组肌注是较好的麻醉方法。     

水合氯醛在猪外科实验中的麻醉效果

动物实验中麻醉占有重要内容。笔者于 1 999～2 0 0 1年 ,在我科猪的异种异位、同种异位、同种原位肾移植 ,睾丸移植 ,皮肤移植 ,异种组织包埋 ,同位素扫描和长时间检查等 50例 (次 )实验中 ,应用4 %水合氯醛静脉持续滴定麻醉 ,安全有效 ,而且操作方便 ,现报道如下。1　材料与方法1 1　动物选择　选择年轻、体健的猪 ,3月龄左右 ,不分雌雄 ,体重在 3 0～ 50ｋｇ为佳。1 2　药物配制　水合氯醛 ,化学纯 ,高压灭菌后用生理盐水配制成 4 %的溶液。氯胺酮注射液 ,每支2 0ｍｌ含盐酸氯胺酮 1 0 0ｍｇ。1 3　麻醉方法　(1 )实验前 2 4ｈ禁食、…     

大鼠气管插管方法学概述

由于大鼠呼吸频率较快、口腔狭小、声门较高,医学实验中气管内插管操作具有较多困难,多年来很多学者对大鼠气管内插管方法进行了大量研究。本文主要对大鼠气管内插管时动物和气管导管的选择、麻醉方式、插管的体位以及各种插管工具和方法等作一简要的综述。     

三种麻醉药在大鼠脑外科实验中麻醉效果的比较

动物实验中麻醉占有重要地位 ,神经外科动物实验需要维持稳定的颅内压、血压以及呼吸等重要指标 ,对麻醉药物提出更高要求。戊巴比妥钠、复方氯胺酮及乌拉坦是动物实验中常用麻醉剂 ,效果肯定。但目前尚无文献对这 3种药物在脑外科实验中的麻醉效果进行评价。我们在制备帕金森病大鼠模型时应用以上药物 ,对麻醉效果进行了初步比较 ,以期选择合适的麻醉剂 ,保证手术过程顺利 ,提高动物术后成活率。1　材料与方法1 1　实验动物及分组　雄性一级Ｗｉｓｔａｒ大鼠 4 5只 ,由军事医学科学院动物实验中心提供 ,体重 2 4 0～2 70 ｇ ,2 4小时人工…     

利多卡因三种方式用于预防老年患者全麻插管反应的临床效果观察

目的:比较利多卡因三种方式在预防老年患者全麻插管反应中的临床效果。方法:选择择期行全麻插管手术美国麻醉师协会(ASA)Ⅰ~Ⅱ级的老年患者(65~85岁)120例,随机分为环甲膜穿刺组(H组)、咽喉表面麻醉组(Y组)、静脉注射组(J组)及对照组(D组)。H组进行环甲膜穿刺注射利多卡因进行表面麻醉;Y组使用喉喷管对咽喉部喷洒利多卡因进行表面麻醉;J组在麻醉诱导时静脉注射利多卡因预防插管反应;D组为不给予利多卡因处置的对照组。监测各组患者诱导前(T0)、气管插管前(T1)和插管后1(T2)、3(T3)、5 min(T4)时收缩压(SBP)和心率(HR),比较四组血流动力学相关指标的变化。结果:同同组T0时刻比较,四组T1时刻SBP和HR均显著降低(P0.05);同同组T0时刻比较,D组T2、T3、T4时刻SBP和HR均显著升高(P0.05),另三组T2、T3时刻SBP显著升高(P0.05),T2时刻HR显著升高(P0.05);与D组比较,H、Y、J组SBP和HR在T2、T3、T4时刻差异有统计学意义(P0.05),而三组组间比较差异无统计学意义(P0.05)。结论:利多卡因三种方式的效果相当,均可用于预防老年患者的全麻插管反应;但环甲膜穿刺法增加了病人的痛苦,咽喉喷雾法增加了操作的繁琐性且提升了病人的费用,而静脉注射法操作简便。     

两种麻醉方法在妇科腹腔镜手术中的效果观察

目的比较硬膜外麻醉和气管内插管全身麻醉在妇科腹腔镜手术中的临床应用效果。方法选择妇科腹腔手术患者60例,ASAⅠ～Ⅱ级,随机分为硬膜外麻醉组(L组)和气管内插管全身麻醉组(M组),每组30例。L组选择T12～L1点硬膜外穿刺,M组采用气管内插管全身麻醉。两组患者麻醉后,持续监测平均动脉压(MAP)、心电图(ECG)、血氧饱和度(SpO2)、心率(HR)和呼气末二氧化碳分压(PETCO2)。记录两组患者CO2气腹前(T0),气腹后5 min(T1)1、5 min(T2)3、0 min(T3)及停气后10 min(T4)的MAP,HR,SpO2以及术后苏醒时间(TW),肛门排气恢复时间(TP)。结果 L组气腹后5 min(T1)、15 min(T2),HR明显降低(P0.05),30 min恢复到气腹前水平;M组气腹后HR无明显变化(P0.05),两组间比较,差异无显著性。气腹后M组MAP显著升高(P0.05),至停气后10 min尚未恢复到气腹前水平;而L组整个气腹期间MAP无明显变化或略低(P0.05),与M组比较差异有显著性(P0.05)。术后L组患者苏醒时间和肛门排气恢复时间均短于M组,L组与M组比较差异有显著性(P0.05)。结论气管内插管全身麻醉和硬膜外麻醉均可用于妇科腹腔镜手术,而硬膜外麻醉对于患者术后生理功能恢复具有一定的优势。     

Role for dopamine in malonate-induced damage in vivo in striatum and in vitro in mesencephalic cultures

Defects in mitochondrial energy metabolism have been implicated in the pathology of several neurodegenerative disorders. In addition, the reactive metabolites generated from the metabolism and oxidation of the neurotransmitter dopamine (DA) are thought to contribute to the damage to neurons of the basal ganglia. We have previously demonstrated that infusions of the metabolic inhibitor malonate into the striata of mice or rats produce degeneration of DA nerve terminals. In the present studies, we demonstrate that an intrastriatal infusion of malonate induces a substantial increase in DA efflux in awake, behaving mice as measured by in vivo microdialysis. Furthermore, pretreatment of mice with tetrabenazine (TBZ) or the TBZ analogue Ro 4-1284 (Ro-4), compounds that reversibly inhibit the vesicular storage of DA, attenuates the malonate-induced DA efflux as well as the damage to DA nerve terminals. Consistent with these findings, the damage to both DA and GABA neurons in mesencephalic cultures by malonate exposure was attenuated by pretreatment with TBZ or Ro-4. Treatment with these compounds did not affect the formation of free radicals or the inhibition of oxidative phosphorylation resulting from malonate exposure alone. Our data suggest that DA plays an important role in the neurotoxicity produced by malonate. These findings provide direct evidence that inhibition of succinate dehydrogenase causes an increase in extracellular DA levels and indicate that bioenergetic defects may contribute to the pathogenesis of chronic neurodegenerative diseases through a mechanism involving DA.     

Scurvy in capybaras bred in captivity in Argentine

In order to determine if the absence of vitamin C in the diet of capybaras (Hydrochoerus hydrochaeris) causes scurvy, a group of seven young individuals were fed food pellets without ascorbic acid, while another group of eight individuals received the same food with 1 g of ascorbic acid per animal per day. Animals in the first group developed signs of scurvy-like gingivitis, breaking of the incisors and death of one animal. Clinical signs appeared between 25 and 104 days from the beginning of the trial in all individuals. Growth rates of individuals deprived of vitamin C was considerably less than those observed in the control group. Deficiency of ascorbic acid had a severe effect on reproduction of another population of captive capybaras. We found that the decrease in ascorbic acid content in the diet affected pregnancy, especially during the first stages. The results obtained suggest that it is necessary to supply a suitable quantity of vitamin C in the diet of this species in captivity.     

Changes in lactate dehydrogenase activity in chicken tissues in hyperthyreosis in ontogenesis

The lactate dehydrogenase activity in reactions of lactate oxidation and synthesis was studied in subfractions of the chicken brain, heart and liver at the embryonal, early postembryonal and adult stages of development after thyroxine administration. It has been shown that during embryogenesis thyroxine predominantly enhanced the rate of lactate oxidation in the mitochondrial tissues. A marked increase in the lactate synthesis was found in cytoplasm of the adult chicken tissues. Specificity of enzyme activity alterations was detected in the chicken brain during ontogenesis after thyroxine administration.     

SSTR5 ablation in islet results in alterations in glucose homeostasis in mice

Somatostatin (SST) peptide is a potent inhibitor of insulin secretion and its effect is mediated via somatostatin receptor 5 (SSTR5) in the endocrine pancreas. To investigate the consequences of gene ablation of SSTR5 in the mouse pancreas, we have generated a mouse model in which the SSTR5 gene was specifically knocked down in the pancreatic beta cells (betaSSTR5Kd) using the Cre-lox system. Immunohistochemistry analysis showed that SSTR5 gene expression was absent in beta cells at three months of age. At the time of gene ablation, betaSSTR5Kd mice demonstrated glucose intolerance with lack of insulin response and significantly reduced serum insulin levels. Insulin tolerance test demonstrated a significant increase of insulin clearance in vivo at the same age. In vitro studies demonstrated an absence of response to SST-28 stimulation in the betaSSTR5Kd mouse islet, which was associated with a significantly reduced SST expression level in betaSSTR5Kd mice pancreata. In addition, betaSSTR5Kd mice had significantly reduced serum glucose levels and increased serum insulin levels at 12 months of age. Glucose tolerance test at an older age also indicated a persistently higher insulin level in betaSSTR5Kd mice. Further studies of betaSSTR5Kd mice had revealed elevated serum C-peptide levels at both 3 and 12 months of age, suggesting that these mice are capable of producing and releasing insulin to the periphery. These results support the hypothesis that SSTR5 plays a pivotal role in the regulation of insulin secretion in the mouse pancreas.