Objective To observe the clinical effect of low-dose dexmedetomidine plus tramadol hydrochloride for patient-controlled interscalene analgesia (PCIA) after laparoscopic hysterectomy.Methods Seventy ASA Ⅰ ～ Ⅱ female patients with elective laparoscopic hysterectomy were randomly divided into two groups:the tramadol hydrochloride PCIA group(group A),and the dexmedetomidine plus tramadol hydrochloride PCIA group(group B),35 cases in each group.Visual analog scale (VAS),Ramsay scores,Sleepiness scale and the tramadol consumption were recorded.And the adverse events such as nausea and vomiting,dizziness and respiratory depression were observed.Results All patients got good analgesia in both two groups,VAS scores ＜ 4.In group B,VAS scores of postoperative 24h and 48h were (3.2 ±0.3) (2.7 ±0.3),which were significantly lower than (3.8 ±0.4) and (3.2 ± 0.2) in group A (t24 =7.099,t48 =8.204,all P ＜ 0.05).Sleepiness scale (3.1 ± 0.7) in group B was lower than group A (4.2 ± 0.8) (t =6.122,P ＜ 0.05),while there was no difference of Ramsay scores between two groups (P ＞ 0.05).And in group B,the tramadol consumption [(625.2 ± 113.7) mg] and the intramuscular pethidine times (2.1 ±1.9) were fewer than group A[(782.9 ± 102.6)mg,(5.2 ±2.2) times] (t =6.092,6.309,all P ＜0.05).Conclusion Low-dose dexmedetomidine may improve the effect of tramadol hydrochloride PCIA after laparoscopic hysterectomy,and help to reduce the tramadol consumption and adverse effects.

Objective:To investigate the role of 5-HT5A receptors in rats with chemo the rapy-evoked hyperalgesia by intra the calinjection of adenovirus-mediated small-interference RNA.Methods:Adult male SD rats were randomly divided into 2 groups:model group(n=10,intraperitoneal injection of vincristine)and control group(n=10,intraperitoneal injection of normal saline).The mechanical hyperalgesia were measured as the paw withdrawal thresholds(PWT)and the expression of 5-HT5AR mRNA in L4、5 spinal cord were determined by RT-PCR.Thirty rats with chemotherapy-evoked hyperalgesia were randomly divided into 3 groups after the formation of chemotherapy pain model:experimental group,negative control group and blank control group,which respectively were treated with intrathecal injection of Ad-5-HT5AR-siRNA,Ad-X-HK and normal saline.Expressions of 5-HT5AR mRNA and PWT after intrathecal injection were assessed respectively.Results:Compared with control group,PWT of rats in model group were significantly decreased(P

Objective:To analyze the application of thinking visual guidance teaching model in anesthesia clinical practice teaching.Methods:Taking the implementation time (March 2019) of thinking visual guidance teaching model in our hospital as the limit, 56 interns who came to our hospital for anesthesia practice before the implementation were included as control group, and 61 interns enrolled after the implementation (from March 2019 to March 2020) were included in study group. The mastery status of professional skills (duration of anesthesia operation, success rate of one-time anesthesia puncture and success rate of one - time tracheal intubation), professional knowledge assessment results and professional attitude changes were compared between the two groups at 2 months and 6 months of training. Self-evaluation after 6 months of training was compared between the two groups. SPSS 18.0 was used for t test and chi-square test. Results:After 6 months of training, the mastery status of professional skills (duration of anesthesia operation, success rate of one-time anesthesia puncture, and success rate of one-time tracheal intubation) of the two groups of interns were significantly improved compared with those after 2 months of training, and the above indicators of study group were significantly better than those of control group (all P<0.05). After 6 months of training, the scores of assessment results of professional knowledge (basic knowledge, understanding and memory, case analysis, emergency handling) and professional attitude (behavior, language, initiative and adaptability) in the two groups of interns were significantly higher than those after 2 months of training, and the above indicators scores of study group were significantly higher than those of control group (all P<0.05). The scores of self-evaluation (learning efficiency, learning atmosphere, learning ability, self-confidence and satisfaction) of study group at 6 months of training were significantly higher than those of control group at the same period (all P<0.05). Conclusion:Thinking visual guidance teaching model can effectively improve the professional knowledge and operation skills of anesthesia clinical interns, and it has a good application effect.