ABSTRACT
Objective To determine the appropriate dosage of parexoxib sodium for postoperative analgesia in different age children with day surgery.Methods One hundred and eighty ASA Ⅰ children aged 1-12 yr scheduled for day surgery undergoing sevoflurane anesthesia combined with lateral inguinal regional blockade were divided into 3 groups according to age ( n =60 each):group 1-3 yr (group Ⅰ ),group 4-6 yr (group Ⅱ ) and group 7-12 yr (group Ⅲ).Eeach group was randomly divided into 2 sub-groups( n =30): parecoxib sodium 0.5 mg/kg (sub-group A) and parecoxib sodium 1.0 mg/kg (sub-group B).Sub-groups A and B received iv injection of paracoxib sodium 0.5 or 1.0 mg/kg respectively immediately at skin incision.Analgesic effect was evaluated by FLACC score (group Ⅰ ),CHEOPS score (group Ⅱ ) and VAS scroe (group Ⅲ) at 6(T1 ),12(T2 )and 24 h (T3)after operation.The effective analgesia was defined as FLACC score≤3,CHEOPS score≤7 or VAS score≤ 3.Side effects were also observed.Results Compared with sub-group B,FLACC score was significantly increased at T1 in sub-group Ⅰ -A ( P ＜ 0.01 ).There was no significant difference in CHEOPS score or VAS score between sub-groups Ⅱ -A and Ⅱ -B,and between sub-groups Ⅲ-A and Ⅲ-B (P ＞ 0.05).The incidence of effective analgesia was 97％ in group Ⅰ (93％ in group sub-group Ⅰ -A,100％ in sub-group Ⅰ -B),100％ in group Ⅱ and 93％ in group Ⅲ (97％ in sub-group Ⅲ-A,90％ in sub-group Ⅲ-B).There was no significant difference in the incidence of side effect between sub-groups Ⅰ -A and Ⅰ -B,between sub-groups Ⅱ -A and Ⅱ -B,and between sub-groups Ⅲ-A and Ⅲ-B ( P ＞ 0.05).Conclusion Parecoxib sodium 1.0 or 0.5 mg/kg can be used in postoperative analgesia in children aged 1-3 yr or 4-12 yr with day surgery respectively.
ABSTRACT
Objective To investigate the influence of continuous infusion of tramadol on target plasma propofol concentration during maintenance of anesthesia with target-controlled infusion (TCI) system. Methods Fifty ASA Ⅰ - Ⅱ patients (22 male, 28 female) aged between 20-70 yr and weighing 42-85 kg, were randomly divided into two groups of 25 patients each: in group Ⅰ anesthesia was maintained with propofol given by TCI; in group Ⅱ anesthesia was maintained with propofol given by TCI and continuous tramadol infusion (loading dose 3 mg?kg and 0.5 mg?kg ?h for maintenance). The patients were premedicated with intramuscular scopolamine 0.3 mg. Anesthesia was induced with midazoiam 0.035 mg?kg-1, fentanyl 0.1 mg, target plasma propofol concentration 2.5-3.5 ?g?ml-1 and vecuronium 0.1-0. 15mg?kg . After tracheal intubation the patients were mechanically ventilated. During maintenance of anesthesia BIS was maintained at 50 ? 10 by adjustment of target plasma propofol concentration. BIS, MAP, HR, HRV and LF/HF were continuously monitored. The total amount of propofol used during operation, the duration of surgery and time of recovery from anesthesia were recorded. Results There was no significant difference in BIS value between the two groups. Target plasma concentration of propofol was significantly higher at skin incision and extubation in group Ⅰ than that in group Ⅱ (P