[ effect of aminophylline on hemodynamic parameters and recovery time after propofol infusion]

This study is aimed to assess the effect of aminophylline [1mg/kg] on reversal of the sedative effects of propofol and the recovery time in patients under propofol anesthesia. Due to the known effects of aminophylline on myocardial contractility and the increase in cardiac output, its effects on hemodynamic changes of propofol are also assessed. In a double blinded randomized clinical trial on 154 patients, intubation was done after induction of anesthesia with sufentanil [0.2 mcg/kg], propofol [2.5 mg/kg] and atracurium [0.5 mg/kg]. Anesthesia was maintained with 200 mcg/kg/min of propofol infusion. After discontinuing propofol at the end of the surgery patients were randomly allocated to receive either aminophylline 1 mg/kg or normal. Heart rate, blood pressure and oxygen saturation were recorded before and after injection, and every 2 minutes until extubation was performed, and thereafter every 5 minutes till the patients' discharge from recovery. The time interval between injection and extubation plus the duration of recovery stay were also recorded. The mean arterial pressure 2,6, and 8 minutes post-extubation ; the heart rate 2,4,6, and 8 minutes just after extubation; and oxygen saturation 2,4,5, and 10 minutes post-extubation; were higher in the aminophylline group. The discharge time was on the contrary, shorter in this group. Aminophylline [1mg/kg] will result in a shorter recovery time following propofol anesthesia and can control propofol-induced blood pressure decrease and bradycardia

Results of surgically treated talar fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Talar fractures present a great challenge to surgeons due to poor treatment outcome and high incidence of sequelae. The purpose of this study was to report the surgical treatment outcome of displaced talar fractures treated by internal fixation.</p><p><b>METHODS</b>A total of 30 patients with a mean age of 38 years presenting with talar body or neck fractures were studied retrospectively to assess postoperative outcome based on American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale.</p><p><b>RESULTS</b>Postoperatively, malunion was found in 18 cases, infection in 5 cases and avascular necrosis in 12 cases. There were 12 cases with subtalar arthritis and 18 cases with both subtalar and malleolar arthritis. The average score of questionnaire was 64+/-12. Functional score was 53+/-15 and pain score was 65+/-13. Range of motion failure was detected as 15+/-4.</p><p><b>CONCLUSION</b>Talar injuries can compromise motion of the foot and ankle and result in poor prognosis on long-term evaluation. Late complications subsequent to surgically treated talar body fractures are inevitable, and patients are supposed to be counseled about the adverse outcome.</p>

[Comparison of Propofol with Thiopental in hemodynamic changes and apnea duration in intensive care units for intubation of trachea]

Use of drugs with short apnea duration and less hemodynamic changes for intubation of trachea in intensive care units is necessary. This study compares the effects of propofol and sodium thiopental on hemodynamic changes and apnea duration after tracheal intubation in patients admitted to intensive care units. In this double blind clinical trial, 25 ICU-admitted patients were evaluated. They were intubated two times with 72 hours interval, once received 1.5mg/kg sodium thiopental, and the other time 0.75 mg/kg propofol, while the drug used for intubation in the first time was randomly selected. Hemodynamic variables include systolic and diastolic BP, heart rate, MAP, RPP, MAP/HR and apnea duration in two times, during pre intubation, intubation and after intubation were measured. Data were analyzed with statistical tests of independent's t and ANOVA repeated test. In comparison with pre-intubation, hemodynamic variables such as systolic and diastolic BP, MAP and MAP/HR were decreased during tracheal intubation in both groups, but range of changes in propofol group is less than those of thiopental group and the difference is statistically significant [P<0.0001]. In comparison with thiopental, Propofol has fewer changes in hemodynamics in patients who needed tracheal intubation, and also has shorter apnea period. Accordingly use of propofol over thiopental is recommended for tracheal intubation in ICU patients