静脉输液拔针后不同按压方法的效果观察

目的:了解患者对3种按压方法的认同程度,探讨拔针后合适有效的按压方法.方法:采用自身对照的方法,对168例病人,506次静脉输液拔针后,同一病人分别采用4指按压法、大鱼际按压法及大拇指按压法按压,按压时间平均为4 min,按压力度中等,观察皮肤出血和/或皮下淤血的发生情况.结果:4指按压法与大鱼际按压法及大拇指按压法比较有显著性差异(P＜0.01).结论:静脉输液拔针后采用4指按压法能有效减少出血的发生,病人依从度高.     

紫苏子油静脉注射乳剂的研制

根据《中国药典》中对静脉注射乳剂稳定性、药用辅料、乳剂粒径的要求,对紫苏子油静脉注射乳剂的各项指标进行了考察,通过L9（33）正交试验确定了紫苏子油静脉注射乳剂的最优处方,并优化出紫苏子油静脉注射乳剂的最佳制备工艺。     

Alfaxalone for total intravenous anaesthesia in dogs undergoing ovariohysterectomy: a comparison of premedication with acepromazine or dexmedetomidine

ObjectiveTo describe alfaxalone total intravenous anaesthesia (TIVA) following premedication with buprenorphine and either acepromazine (ACP) or dexmedetomidine (DEX) in bitches undergoing ovariohysterectomy.Study designProspective, randomised, clinical study.AnimalsThirty-eight healthy female dogs.MethodsFollowing intramuscular buprenorphine (20 μg kg^?1) and acepromazine (0.05 mg kg^?1) or dexmedetomidine (approximately 10 μg kg^?1, adjusted for body surface area), anaesthesia was induced and maintained with intravenous alfaxalone. Oxygen was administered via a suitable anaesthetic circuit. Alfaxalone infusion rate (initially 0.07 mg kg^?1 minute^?1) was adjusted to maintain adequate anaesthetic depth based on clinical assessment. Alfaxalone boluses were given if required. Ventilation was assisted if necessary. Alfaxalone dose and physiologic parameters were recorded every 5 minutes. Depth of sedation after premedication, induction quality and recovery duration and quality were scored. A Student's t-test, Mann–Whitney U and Chi-squared tests determined the significance of differences between groups. Data are presented as mean ± SD or median (range). Significance was defined as p < 0.05.ResultsThere were no differences between groups in demographics; induction quality; induction (1.5 ± 0.57 mg kg^?1) and total bolus doses [1.2 (0 – 6.3) mg kg^?1] of alfaxalone; anaesthesia duration (131 ± 18 minutes); or time to extubation [16.6 (3–50) minutes]. DEX dogs were more sedated than ACP dogs. Alfaxalone infusion rate was significantly lower in DEX [0.08 (0.06–0.19) mg kg^?1 minute^?1] than ACP dogs [0.11 (0.07–0.33) mg kg^?1 minute^?1]. Cardiovascular variables increased significantly during ovarian and cervical ligation and wound closure compared to baseline values in both groups. Apnoea and hypoventilation were common and not significantly different between groups. Arterial haemoglobin oxygen saturation remained above 95% in all animals. Recovery quality scores were significantly poorer for DEX than for ACP dogs.Conclusions and clinical relevanceAlfaxalone TIVA is an effective anaesthetic for surgical procedures but, in the protocol of this study, causes respiratory depression at infusion rates required for surgery.     

Pulmonary embolism as a complication after abdominal surgery and colitis in a foal

This report describes a fatal pulmonary embolism in a foal, as a sequela of septic thrombophlebitis of the right jugular vein and/or a generalised hypercoagulable state. The foal underwent abdominal surgery and suffered from severe and prolonged colitis. Despite intense supportive care, the colt developed venous thrombophlebitis and subsequently died suddenly 12 days after discharge from the hospital, following an initial improvement. On post‐mortem examination, a large pulmonary embolism was discovered. Pulmonary thromboembolism is a potentially fatal sequelae of thrombus formation. It is difficult to detect and therefore likely to be underdiagnosed.     

Cardiopulmonary effects of an infusion of remifentanil or morphine in horses anesthetized with isoflurane and dexmedetomidine

ObjectiveTo examine the cardiopulmonary effects of infusions of remifentanil or morphine, and their influence on recovery of horses anesthetized with isoflurane and dexmedetomidine.Study designRandomized crossover study with 7-day rest periods.AnimalsSix adult horses (507 ± 61 kg).MethodsAfter the horses were sedated with xylazine, anaesthesia was induced with ketamine and diazepam, and maintained with isoflurane. After approximately 60 minutes, a dexmedetomidine infusion was started (0.25 μg kg^?1 then 1.0 μg^?1 kg^?1 hour^?1) in combination with either saline (group S), morphine (0.15 mg kg^?1 then 0.1 mg kg^?1 hour^?1; group M), or remifentanil (6.0 μg kg^?1 hour^?1; group R) for 60 minutes. Mean arterial pressure, heart rate, end-tidal carbon dioxide tension, and end-tidal isoflurane concentration were recorded every 5 minutes. Core body temperature, cardiac output, right ventricular and arterial blood-gas values were measured every 15 minutes. Cardiac index, systemic vascular resistance (SVR), intrapulmonary shunt fraction, alveolar dead space, oxygen delivery and extraction ratio were calculated. Recoveries were videotaped and scored by two observers blinded to the treatment. Data were analyzed using repeated measures anova followed by Dunnett’s or Bonferroni’s significant difference test. Recovery scores were analyzed using a Kruskal–Wallis test.ResultsNo significant differences were found among groups. Compared to baseline, heart rate decreased and SVR increased significantly in all groups, and cardiac index significantly decreased in groups S and M. Hemoglobin concentration, oxygen content and oxygen delivery significantly decreased in all groups. The oxygen extraction ratio significantly increased in groups M and R. Lactate concentration significantly increased in group S. Recovery scores were similar among groups.Conclusions and clinical relevanceDexmedetomidine alone or in combination with remifentanil or morphine infusions was infused for 60 minutes without adverse effects in the 6 healthy isoflurane-anesthetized horses in this study.     

Determination of the Minimum Infusion Rate (MIR) of alfaxalone required to prevent purposeful movement of the extremities in response to a standardised noxious stimulus in goats

ObjectiveTo determine the minimum infusion rate (MIR) of alfaxalone required to prevent purposeful movement of the extremities in response to noxious stimulation.Study DesignProspective, experimental.AnimalsEight healthy goats; four does and four wethers.MethodsAnaesthesia was induced with alfaxalone 3 mg kg⁻¹ intravenously (IV). A continuous IV infusion of alfaxalone, initially at 0.2 mg kg⁻¹ minute⁻¹, was initiated. Following endotracheal intubation the goats breathed spontaneously via a circle breathing circuit delivering supplementary oxygen. The initial infusion rate was maintained for 30 minutes before testing for responses. The stimulus was clamping on the proximal (soft) part of one digit of the hoof with Vulsellum forceps for 60 seconds. In the absence or presence of purposeful movement of the extremities, the infusion rate was reduced or increased by 0.02 mg kg⁻¹ minute⁻¹ and held constant for 30 minutes before claw-clamping again. Alfaxalone MIR was calculated as the mean of the infusion rates that allowed and abolished movement. Cardio-respiratory parameters were measured. Recovery from general anaesthesia was timed and quality scored. Results are presented as median (range).ResultsThe MIR of alfaxalone was 0.16 (0.14–0.18) mg kg⁻¹ minute⁻¹ or 9.6 (8.4–10.8) mg kg⁻¹ hour⁻¹. Induction of and recovery from anaesthesia were excitement-free. Cardio-respiratory changes were minimal, although compared to baseline HR increased, and at 2 minutes post-induction, (prior to oxygen supplementation), PaO₂ decreased significantly from 84 (80–88) to 70 (51–72) mmHg [11.2 (10.7–11.7) to 9.3 (6.8–9.6) kPa]. Sporadic muscle twitches, unrelated to depth of anaesthesia, were observed during the period of general anaesthesia. Time (minutes) to sternal recumbency and standing were 4.0 (3.0–10.0) and 41.5 (25.0–57.0) respectively.Conclusions and Clinical RelevanceAlfaxalone can be used for total intravenous anaesthesia (TIVA) in goats and is associated with minimal adverse effects. Oxygen supplementation is advised, especially when working at higher altitudes.     

Effects of Different Melatonin Injection Ways on the Enrichment and Metabolism of Blood Melatonin in Holstein Cows

In order to exploring the change pattern of melatonin in blood under the normal conditions of the multiparous Holstein cows within 24 h,the change of melatonin in blood of Holstein cows after the intravenous injection,subcutaneous implantation in neck,neck subcutaneous injection and drench were studied and the melatonin secretion rule and its metabolic rate were analyzed. The results showed that melatonin secretion changes obviously in the blood within 24 h,the concentration peak appeared at 04:00 (8.30 ng/mL),lowest at 16:00 (2.08 ng/mL). After subcutaneous implantation and drench,the concentration of melatonin in the blood rose relatively flat compared to other groups. Subcutaneous injection of 46.4, 4.64 and 0.464 mg melatonin,the concentration in the blood rose rapidly, the peak appeared at 1 h after the injection,which were 561.94,487.03,92.89 ng/mL,respectively,extremely significantly higher than pre-injection (P<0.01).Intravenous injection of 46.4,4.64 and 0.464 mg melatonin,the concentration in the blood also rose rapidly,the peak appeared at 0.5 h after the injection,which were 767.68,639.19,110.56 ng/mL,respectively,extremely higher than pre-injection (P<0.01).This study proved that the secretion of melatonin in the Holstein cows had obvious circadian rhythm,intravenous or subcutaneous injection of melatonin could improve the concentration of melatonin rapidly and there was a high correlation between the melatonin metabolic rate and the melatonin concentration in the blood,with the increase of the concentration of melatonin,the metabolism velocity was accelerated obviously.     

Plasma cortisol concentrations in normal dogs given hydrocortisone sodium succinate

OBJECTIVE: To evaluate the effects on plasma cortisol concentration of a continuous infusion of a readily available steroid with equipotent glucocorticoid and mineralocorticoid effects. PROCEDURE: Plasma cortisol concentrations were measured before and regularly after hydrocortisone sodium succinate was administered as a continuous intravenous infusion over 6 h at 0.32 and 0.65 mg kg-1 h-1 to 12 healthy dogs weighing 12 to 22 kg. RESULTS: The infusion at both does rates produced significant and stable increases in plasma cortisol concentrations. The plateau concentrations produced by the large and small doeses were respectively above and below plasma cortisol concentrations likely to provide adequate glucocorticoid and mineralocorticoid activity in stressed dogs with significantly decreased adrenal function. CONCLUSION: This paper presents information regarding the changes in plasma cortisol concentrations in 12 normal dogs given an hydrocortisone sodium succinate infusion at two dose rates. The marked and continuous increase in plasma cortisol concentrations suggests a continuous HSS infusion may be a possible alternative to desoxycorticosterone acetate and dexamethasone in the treatment of acute adrenal dysfunction.