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Wysłany: Pią 23:14, 18 Mar 2011
Temat postu: He Chongqing Normal children McNamara cephalometri
He Chongqing Normal children McNamara cephalometric analysis and Craniofacial line from the normal correlation
. Amethodofcepha [omerticanalysis. In: ClinicalAlterationoftheGrowingFace, Monograghl2, CraniofacialgrowthSeries [M]. AnnAbor. MichiganU-niversityofMichigan, CenterforHumanGrowthandDe-velopment, 1983.81. [7] Long Crescent. DENTAL PREVENTION Chen Yuanping, et al. Children's Craniofacial structure of the normal relationship between soft and hard tissue assessment [J]. STOMATOLOGY Journal, 2001,17 (4): 293. * Primary Corner ketamine epidural anesthesia supplemented with midazolam in pediatric surgery clinical Liu Yuemin, high to Lee (Chongqing Jiangbei District, First People's Hospital 400020) CLC number: R726.14 Document code: B Article ID :1671-8348 (2003) 03-0324 O1 statistics of a hospital in January 2001 ~ September 2002 anesthetic information on the operation of non-cooperation were treated under epidural anesthesia supplemented with midazolam and ketamine under implementation 86 cases of abdominal and lower limb surgery, anesthesia,
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, safe, are reported below. 1, 86 cases of children with clinical data, male 61 cases, 25 females; aged 2 to 12 years of age; weight 1O ~ 34kg; surgical categories: 45 cases appendectomy, hernia sac ligation in 25 cases, 8 cases of ligation of processus vaginalis,
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, lower extremity surgery in 8 cases. All patients 4h preoperative fasting for more than one operating room 30min before the intramuscular injection of atropine 0.01rng/kg, one operating room after the slow intravenous injection of ketamine liquid 1 1 ~ 2mg/kg as a foundation anesthesia, after the children sleep epidural again, after the epidural catheter are used 1.2oA ~ l_6 lidocaine dose of 8 ~ 10mg/kg, the emergence of anesthesia by slow intravenous drip Venturi Could midazolam 0. O8 ~ O. 1mg/kg, all patients were to maintain spontaneous breathing and oxygen by nasal cannula or mask, continuous monitoring of children with BP, HR, ECG and SPO2, and observe body movement,
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, drum intestine, recovery time of surgery, and postoperative nausea vomiting, restlessness and other complications. 2 Results 2.1 Intraoperative monitoring Intraoperative SPO All patients maintained at 96 ~ 100, BP, HR, ECG stable. Operation time: shortest 10min, up to 90min, 30min to complete the operation in which 61 patients, accounting for 71,30 ~ 60min to complete the surgery in 18 cases, accounting for 21,6 O ~ 90min to complete the operation in 8 cases, or about 8. 2.2 In addition to surgical anesthesia in children for more than 45min additional lidocaine epidural, the surgery does not make any anesthetic adjuvant drugs to complete the operation, 75 cases, accounting for 88, intraoperative body movement, encourage children ll cases of intestinal, about 12%, of which 9 cases appendectomy, hernia sac ligation in 2 cases. The slow intravenous injection of ketamine 0.05 ~ 1mg/kg quiet sleep after all. All patients improved intraoperative analgesia, muscle relaxation were satisfactory, no respiratory depression. 2.3 The shortest technical Bi Zhiqing wake 5min, up to 85min, which accounts for about 63 of 54 patients, surgery completed within 30min awakening. Emergence of adverse reactions: agitation in 6 cases, 1 case of psychiatric symptoms, nausea and vomiting in 1 case. 3 Discussion epidural anesthesia in the lower abdomen and lower limb surgery has been widely applied,
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, it has the exact effect of anesthesia, muscle relaxation, and security features. However, d, JL of anesthetic with a fear of surgery often do not match, such as intraoperative pain, usually manifested physically as well as anesthesia can not be tamper with, so the basis of rational use of anesthesia, can receive the desired effect. Therefore, use of ketamine and midazolam as / bJL adjunct to epidural anesthesia. First, ketamine can produce good analgesia and amnesia, induced by rapid intravenous injection, recovery period is short, slight effect on respiration and circulation,
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, etc., but often hallucinations, nightmares, delirium and other symptoms of awakening of the spirit. And midazolam have significant sedative, hypnotic, muscle relaxant, anticonvulsant and so on, and has rapid onset, fast metabolism, the role of time is short and so on. Application of ketamine and midazolam combined with the advantages from complementary pharmacological characteristics, and ammonia can reduce the adverse effects of ketamine awake, so quiet and smooth recovery from anesthesia to improve anesthetic safety. Therefore, epidural anesthesia to ketamine midazolam for 4, Jh lower abdominal pain and lower limb surgery with complete muscle relaxation and satisfaction, respiration and circulation stability, fewer complications, is an ideal method of anesthesia.
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