关键词： Indian Journal of Anaesthesia   full-text   online   electronic   e-journal   free access   open access   online submission  

摘要： Background: Traditionally, midazolam has been used for providing conscious sedation in endoscopic retrograde cholangiopancreatography (ERCP). Recently, dexmedetomidine has been tried, but very little evidence exists to support its use. Objective: The primary objective was to compare haemodynamic, respiratory and recovery profile of both drugs. Secondary objective was to compare the degree of comfort experienced by patients and the usefulness of the drug to endoscopist. Study Design: Open-label Randomised Controlled Trial. Methods: Subjects between 18 and 60 years of age with American Society of Anaesthesiologist Grade I-II requiring ERCP were enrolled in two groups (30 each). Both groups received fentanyl 1 g/kg IV at the beginning of ERCP. Group M received IV midazolam (0.04 mg/kg) and additional 0.5 mg doses until Ramsay Sedation Scale (RSS) score reached 3-4. Group D received dexmedetomidine at loading dose of 1 g/kg over 10 min followed by 0.5 g/kg/h infusion until RSS reached 3-4. The vital parameters (heart rate (HR), blood pressure (BP), respiration rate, SpO ₂ ), time to achieve RSS 3-4 and facial pain score (FPS) were compared during and after the procedure. In the recovery room, time to reach modified Aldrete score (MAS) 9-10 and patient and surgeon's satisfaction scores was also recorded and compared. Any complication during or after the procedure were also noted. Results: In Group D, patients had lower HR and FPS at 5, 10 and 15 min following the initiation of sedation (P<0.05). There was no statistically significant difference in BP and respiratory rate. The procedure elicited a gag response in 29 (97%) and 7 (23%) subjects in Group M and Group D respectively (P<0.05). MAS of 9-10 at 5 min during recovery was achieved in 27 (90%) subjects in Group D in contrast to 5 (17%) in Group M (P<0.05). Dexmedetomidine showed higher patient and surgeon satisfaction scores (P<0.05). Conclusion: Dexmedetomidine can be a superior alternative to midazolam f

关键词： Spineboard   Tissue-interface pressure   Anaesthetized patients   Trauma  

摘要： Background: Immobilization of the spine of patients with trauma at risk of spinal damage is usually performed using a rigid long spineboard or vacuum mattress, both during prehospital and in-hospital care. However, disadvantages of these immobilization devices in terms of discomfort and tissue-interface pressures have guided the development of soft-layered long spineboards. We compared tissue-interface pressures between awake and anaesthetized (unconscious) patients during immobilization on a rigid spineboard and a soft-layered long spineboard. Methods: In this comparative study, 30 anaesthetized patients were randomized to immobilization on either the rigid spineboard or the soft-layered spineboard for the duration of their elective surgery. Tissue-interface pressures measured using an Xsensor pressure-mapping device were compared with those of 30 healthy volunteers who were immobilized sequentially on the rigid spineboard and the soft-layered spineboard. Redness of the sacrum was also recorded for the anaesthetized patients immediately after the surgery. Results: For both anaesthetized patients and awake volunteers, tissue-interface pressures were significantly lower on the soft-layered spineboard than on the rigid spineboard, both at start and after 15 min. On the soft-layered spineboard, tissue interface pressure and peak pressure index (PPI) for the sacrum were significantly lower for anaesthetized patients than for awake volunteers. Peak pressures and PPI on the rigid spineboard were equal for both groups. Tissue-interface pressures did not change significantly over time. Redness of the sacrum was significantly more pronounced on the rigid spineboard than on the soft-layered spineboard. Conclusions: This prospective randomized controlled trial shows that using a soft-layered spineboard compared to a rigid spineboard for spinal immobilization resulted in lower tissue-interface pressures in both awake volunteers and anaesthetized patients. Moreover, tissue-inter

关键词： 生物医学工程   美国FDA   美国国防部   批准上市   意识控制   肢体动作   信号转换   肌肉收缩  

摘要： 1 DEKA手臂系统 DEKA手臂系统（DEKA Arm System）于2014年5月9日获美国FDA批准上市。与以往的意识控制助残机械臂不同的是，DEKA手臂系统可以接收患者残肢处肌肉收缩的电信号．将肌电图（EMG）电极传输信号转换成多达10种的肢体动作，完成使用钥匙和锁、料理食物、吃饭、使用拉链和梳头等动作。美国国防部高级研究项目局（DARPA）曾指出，“为了接近人类手臂的自然状态，这个手臂系统具有与一个成年人相同的大小、质量、形状和握力”。

关键词： 大众文化   意识形态控制   途径  

摘要： 大众文化是承载意识形态的重要载体,现代社会大众文化表现出的意识形态功能吸引政界和理论界的关注与思考。厘清大众文化与意识形态控制的关系,研究大众文化的意识形态控制功能对现代社会的影响,探讨大众文化实现其意识形态控制功能的基本途径,具有重要的现实意义。

关键词： 意识形态   话语权   全媒体时代   制信息权   国家利益  

摘要： 凭借经济与科技优势,西方国家始终固化其对全球意识形态话语权的控制与操纵,初步形成了对非西方世界的战略围堵。在全媒体时代,由于制信息权的缺失,西方国家在意识形态话语权的绝对优势地位得到进一步加强与固化,对中国的和平发展带来重大的障碍。当下中国主流意识形态话语权,包括对内"言说的权力"和对外"言说的自由"两个方面,均受到西方所谓的"普世价值"的强力挑战。为此,应从固本——创新发展马克思主义意识形态话语、转型——实现主流意识形态话语表达的全媒体方式变换、突围——拓展中国意识形态话语国际影响力等三方面,探讨破局之策。

关键词： 《企业内部控制基本规范》   风险管理意识   内部控制规范   财务会计信息   2010年   2008年   高级管理层   中国企业  

摘要： 财政部同国资委、审计署、银监会、证监会、保监会五大部门于2010年4月26日在北京召开了联合发布会，发布了《企业内部控制配套指引》，该指引连同2008年5月发布的《企业内部控制基本规范》共同组成了中国企业内部控制规范体系。内部控制是企业为了实现经营目标、保护资产安全完整、保证经营活动的经济性、高效性、保证财务信息真实可靠而在企业内部采取的规划自我、约束自我、评价自我和控制自我的一系列办法、措施的总和。

关键词： 英语听力   意识控制   注意焦点  

摘要： 文章从音乐的相关训练和意识研究领域的相关理论提出一种新的听力训练方法，从听者心理，注意角度探讨稳定的听力感觉，从而在听力训练中突破传统方法的局限性，具有实际的指导意义，以期对英语听力教学起到积极的促进作用。

关键词： 孝道   基层社会   明清时期  

摘要： 文章以乾隆十一年《沈丘县志》记载为中心,来观察作为国家权力象征的《县志》在记述孝道行为当中,如何的塑造地方典型从而达到意识形态控制的。基层县志把国家认同的孝道观念渗透到基层社会生活的每一个角落,政治意识形态和道德伦理观念通过对孝道的旌表实现了世俗化和制度化,同时也由之进入了民众的实际生活。

关键词： Anxiety   oral surgery   phytotherapy  

摘要： Introduction: Anxiety is one of the components of patient stress in the dental office and is recognized as one of the main factors that negatively affect treatment. The control of anxiety can be performed through conscious sedation, for which benzodiazepine is the drug of choice in dental practice, however present side-effects. Objective: The objective of the following study is to evaluate the efficacy of Valeriana officinalis L. (Valerian) for control of anxiety during the third molar surgery. Materials and Methods: A single oral dose of either Valerian (100 mg) or placebo was randomly administered 1 h before each surgical procedure to 20 volunteers between 17 and 31 years of age. Anxiety level was assessed by physiological parameters (blood pressure and heart rate [HR]) and the observation of signs. Descriptive analysis, Chi-square test, Friedman test, Wilcoxon test and effect size test were performed (P < 0.05). Results: According to the researcher's (80%) and surgeon's (75%) evaluations, the patients treated with Valerian were calmer and more relaxed during surgery. Valerian had a greater effect on the maintenance of systolic blood pressure and HR after surgery. Conclusion: Valerian was more effective at controlling anxiety than a placebo when used for the conscious sedation of adult patients submitted to impacted lower third molar surgery.