Objective To investigate the related factors for postoperative urinary retention in patients with intrathecal anesthesia. Methods Collect 230 patients of orthopaedic surgery with intrathecal anesthesia in our hospital from June 2012 to June 2013. Prospective analysis the related factors of postoperative urinary retention in patients with intrathecal anesthesia. Results 48 cases have postoperative urinary retention from 230 patients of orthopaedic surgerywith intrathecal anesthesia. Difference of urinary retention group and unurinary retention group is statistically significant (P < 0.05)in age, urine excretion before anesthesia, operation time, intraoperative rehydration, dose to anesthesia, postoperative analgesia. Difference of urinary retention group and unurinary retention group hasn’t statistical significance (P > 0.05) in Sex, body mass index, smoking history, the mode of anesthesia Age, operation time, intraoperative rehydration, anesthetic dosage ≥11.25 mg and postoperative analgesia are the risk factors of postoperative urinary retention with multiariable Logistic regression analysis. The urine excretion before anesthesia are protective factors. Conclusion postoperative urinary retention with intrathecal anesthesia is many factors caused by a temporary performance of bladder dysfunction , Perioperative appropriate management (minimize anesthetic doses, shorten the operation time, control intraoperatie rehydration , preoperative try to drain urine ) can reduce the occurrence of postoperative urinary retention.

OBJECTIVETo explore the impacts on EC50 in the remifentanil inhibition of tracheal intubation response by the transcutaneous electrical acupoint stimulation (TEAS) at Hegu (LI 4) and Neiguan (PC 6).

METHODSForty patients with selective surgery undergoing endotracheal intubation with intravenous general anesthesia were divided into I to II degree by the American Society of Anesthesiologists (ASA) and were randomized into an observation group and a control group, 20 cases in each one. Before general anesthesia induction, in the observation group, the transcutaneous electric stimulation was applied to bilateral Hegu (LI 4) and Neiguan (PC 6) for 30 min, with dense-disperse wave, 2 Hz/100 Hz in frequency; in the control group, the sham-stimulation was applied to the acupoints, with the lamp on, but without electric current output. Afterwards, the general anesthesia induction started. When the target concentration of propofol and remifentanil was stabilized at the preset value, the endotracheal intubation was conducted. Dixon sequential method was applied for the determination of ECs in remifentanil inhibition of tracheal intubation response.

RESULTSThe level of EC50 in remifentanil inhibition of tracheal intubation response was 3. 46 ng/mL, 95% confidence interval was 2. 80 ng/ml to 4. 27ng/mL in the observation group; those were 4. 18 ng/mL and 3. 30 ng/mL to 5. 29 ng/mL in the control group separately. The differences were significant in comparison of the two groups (P<0. 01).

CONCLUSIONTEAS apparently reduces EChe in the remifentanil inhibition of tracheal intubation response by around 17%as.

Acupuncture Points ; Adult ; Aged ; Anesthetics, Intravenous ; administration & dosage ; Female ; Humans ; Intubation, Intratracheal ; adverse effects ; Male ; Middle Aged ; Pain ; etiology ; Pain Management ; Piperidines ; administration & dosage ; Transcutaneous Electric Nerve Stimulation

OBJECTIVETo observe the acupuncture effect on urinary retention after spinal anesthesia.

METHODSOne hundred and fifty-four patients with spinal anesthesia were randomized into an observation group (80 cases) and a control group (74 cases). In the observation group, the electroacupuncture was applied to bilateral Fushe (SP 13) and Shuidao (ST 28); 2 Hz/50 Hz, retaining for 30 min. One treatment was required. In the control group, no any intervention was applied after operation. The incidence of the postoperative urinary retention, the time of the first automatic micturition since 30 min after spinal anesthesia, the volume of the first micturition, the postoperative urine condition, the lower abdominal distention, incomplete urination and the others were observed.

RESULTSThe incidence of urinary retention in the observation group was lower than that in the control group; the first automatic micturition in 30 min after spinal anesthesia was earlier than that in the control group; the comfortable urination rate was higher than that in the control group; the incidence of incomplete urination and lower abdominal distention were lower than those in the control group. The differences were significant in comparison of the two groups (all P<0.05).

CONCLUSIONAcupuncture apparently shortens the time of first automatic micturition after spinal anesthesia and promotes the recovery of bladder urinary reflection. This therapy acts on promoting urination and reducing postoperative urinary retention.

Acupuncture Points ; Adult ; Aged ; Anesthesia, Spinal ; adverse effects ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; physiopathology ; therapy ; Urinary Retention ; etiology ; physiopathology ; therapy ; Urination ; Young Adult

Objective To study the characteristics of respiratory impedance in patients with chronic obstructive pulmonary disease (COPD),obstructive sleep apnea hypopnea syndrome (OSAHS).Methods The respiratory impedance were measured by Impulse Oscillometry(IOS) technique and polysomnography(PSG) were done synchronously in 11 COPD patients,15 OSAHS patients,4 overlap syndrome patients(COPD+OSAHS) and 10 control group. Results Zrs、R5、Rc and RP in COPD group,OSAHS group and COPD+OSAHS group were higer than those in contml group.Zrs、R5、R5-20、Fres.Rc and Rp in COPD group and COPD+OSAHS group were significantly higerthan those in OSAHS group.R20 and Rc in OSAHS group were higher than those in COPD group and control group (P<0.05).Rc in OSAHS group was still significantly higher than that in COPD group (P<0.05). The level of sleep efficiency was positive correlated with FEVl/pre% of COPD(r=0.632),while the levels of rouse frequence (r=-0.672),time of SaO2 <90% (-0.868) and ODI (-0.846) were negative correlated with FEVl/pre% of COPD.Condusion For OSAHS patients, there is some dysfunction in peripheral airway tract;For COPD patients,ODI and time of SaO2<90% are good index for the severity of disease.

Objective:To explore the surgical technique and clinical effect of pressure boost in repairing soft tissue defects of limbs with thinned anterolateral thigh perforator flap (ALTP) .Methods:From January, 2015 to December, 2018, 18 cases with soft tissue defects of limbs with various damages of blood vessels and nerves with explosure of tendon and bone. There were 13 males and 5 females aged between 18 to 56 (averaged of 36.3) years, which were 6 defects in shank, 4 in foot and ankle, 5 in forearm, and 3 in hand. The soft tissue defect area was 7 cm ×12 cm to 13 cm ×30 cm. Thinned ALTP was used to repair the wound surface. The perforating vessels of the distal flap were anastomosed with one branch of the internal vessel pedicle flap to increase the pressure hence the blood supply of the distal region. The donor sites were sutured directly or covered by skin graft. Followed-up was conducted by 1-2 monthly clinic visits and telephone or on-line review to check the flap survival and recovery of functions.Results:All flaps survived without arterial or venous crisis. One flap had partial necrosis at the distal end, and healed after dressing change. One case had a swelling flap due to a congestion beneath the flap. The wound achieved primary healing after removal of sutures, ligation of subcutaneous vessels and drainage of hematoma. All patients were followed-up for 6 to 18 (average, 9.5) months. All flaps had good appearance and texture. After rehabilitation treatment, most of the joint activity had been recovered: extension and flexion of wrists joints ranged 60°-80°, 70°-80° for metacarpophalangeal joints and 40°-60° for ankle joints. One patient underwent ankle joint dorsiflexion function reconstruction and flap thinning at 6 months after operation due to the defects of most of the extensor tendon.Conclusion:During the use of free ALTP to repair soft tissue defect of limbs, application of the technique of pressure boost is able to increase blood supply to the distal region of flap. It helps to reduce the incidence of infection and necrosis at the edge of the flap.