ABSTRACT
Objective To investigate the anesthetic efficacy of topical dyclonine hydrochloride mucilage for preputial encircling in children. Methods Sixty children under preputial encircling, 13 patients with redundant prepuce, 47 patients with phimosis, aged 4-12 years, weighing 14-38 kg, falling into ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups with 30 cases each: dyclonine group (group D) and control group (group C). Children with redundant prepuce in group D were smeared evenly 1％ dyclonine hydrochloride mucilage on the anterior 2/3 foreskins, glans and coronary sulcus by anesthesiologists who were assisted by the their parents 30 min before entering the operating room. Children with phimosis in group D were smeared evenly 1％ dyclonine hydrochloride mucilage on the anterior 2/3 foreskins, and then the tube was inserted near the coronary sulcus with the 18# straight indwelling needle. The syringe was injected into the 1％ dyclonine hydrochloride mucilage, and the glans and the coronary sulcus were squeezed repeatedly several times by anesthesiologists who were assisted by the their parents 30 min before entering the operating room. The dosage of dyclonine hydrochloride mucilage for each child was 0.2-0.3 ml/kg. Children in group C were smeared evenly isodose normal saline at the same time. All the children were treated with ketamine and propofol anesthesia after entering. The occurrence of intraoperative body reaction were observed and recorded, HR and MAP were recorded before anaesthesia induction (T0), at the beginning of surgery (T1), at the time of the coronary sulcus was exposed (T2), at the time of ligating (T3), at the time of the excess foreskin was cut (T4), the dosage of ketamine and propofol were recorded, and the occurrence of postoperative recovery time and emergence agitation during recovery period were observed. Results Body dynamic reaction rate in group D was significantly lower than that in group C (P ＜ 0.05), HR and MAP was significantly lower than that in group C at T3-T4 (P ＜ 0.05), the dosage of ketamine and propofol was significantly smaller than that in group C (P ＜ 0.05), the recovery time was significantly shorter than that in group C (P ＜ 0.05), the incidence of emergence agitation was significantly decreased compared with group C (P ＜ 0.05). Conclusion Topical dyclonine hydrochloride mucilage can effectively decrease body movement, lessen cyclic fluctuation, economize general anesthetics, shorten recovery time, reduce emergence agitation in children undergoing preputial encircling.
ABSTRACT
Objective To study the anesthetic effect of oral dyclonine hydrochloride mucilage combined with laryngopharyngeal spray of lidocaine in infant esophagus dilatation.Methods Eighty infants with anastomotic stenosis after surgical correction of esophageal atresia under esophagus dila-tation assisted with gastroscope,51 males and 29 females,age 6 months to 3 years,weighing 5-12 kg,ASA physical status Ⅰ or Ⅱ,were randomly divided into four groups with 20 cases each:general anesthesia group (group A),general anesthesia combined with dyclonine surface anesthesia group (group B),general anesthesia combined with lidocaine surface anesthesia (group C),general anesthesia combined with dyclonine and lidocaine surface anesthesia group (group D).Infants in group B and group D were given 1 % dyclonine hydrochloride mucilage 0.2-0.3 ml/kg by their parents who were guided by the anesthesiologist at 10-15 min before entering the operating room,followed by slow intravenous injection of penehyclidine hydrochloride 0.01-0.02 mg/kg, propofol 2-2.5 mg/kg, remifentanil 1 μg/kg.After the induction,the children of group C and group D were exposed to 2% lidocaine 0.1 5-0.2 ml/kg through laryngoscope under laryngoscope to spray the laryngeal mucosa surface.All the children were converted to oxygen supply (6 L/min)asing double nasal high flow af-ter the mask was added to the stable breathing.Anesthesia was maintained by propofol 6 mg·kg-1·h-1,remifentanil 0.1 μg·kg-1·h-1infusion.In the case of somatic or choking during the operation,propofol and (or)remifentanil were inj ected into the pump to deepen the anesthesia. The occurrence of intraoperative oxygen saturation (SpO2<94%),cough and body reaction were ob-served and recorded,and the occurrence of postoperative recovery time and emergence agitation during recovery period were observed.Results The patients with oxygen saturation in group D de-creased,the incidence of cough was significantly lower than that of groups A and B (P<0.05 ), without significant difference in group C, body dynamic reaction rate was significantly lower compared with the other three groups (P<0.05),the recovery time was significantly shorter com-pared with the other three groups (P<0.05),the incidence of emergence agitation significantly de-creased (P<0.05).Conclusion Oral dyclonine hydrochloride mucilage combined with laryngopha-ryngeal spray of lidocaine can effectively decrease hypoxemia,cough,body movement,shorten recov-ery time,reduce emergence agitation in infants undergoing the esophageal dilatation.
ABSTRACT
Objective To evaluate the effect of I-gel laryngeal mask airway in general anesthesia for lapa-roscopic surgery in neonates. Methods 40 neonates to undergo neonatal laparoscopic surgery were divided into I-gel laryngeal mask group(group I)and tracheal intubation group(group E)randomly,20 in each group. After the induction of anesthesia,I-gel laryngeal mask(size 4 each)was used for ventilation in Group I,and tracheal intu-bation with ID(3.0 or 3.5 mm)was performed for ventilation in group E. The two groups were compared in terms of intubation duration,success rate,the hemodynamic parameters like mean arterial pressure (MAP),heart rate (HR)and plus oxygen saturation(SpO2)at each time point.,the end-tidal carbon dioxide pressure(PETCO2), peak airway pressure (Ppeak),the airway sealing pressure (Pleak),and the postoperative complications. Results There was no significant difference between the two groups in the success rate of intubation (laryngeal mask). However,the duration required for laryngeal mask insertion in I group was significantly shorter than that in E group(P<0.01). MAP and HR were significantly lower than group E at the time point of T1(P<0.05). Pleak in group I was significantly lower than E group at the time points of T1 ~ T3(P < 0.01). The adverse reactions was significantly lower than that in the E group (P < 0.05). There was no reflux aspiration in both groups. Conclusion I-gel laryngeal mask airway can achieve the same effect as tracheal intubation does for general anes-thesia during laparoscopic surgery. It is easy to operate ,with high success rate and few complications.
ABSTRACT
Objective To evaluate the effect of I-gel laryngeal mask airway in general anesthesia for lapa-roscopic surgery in neonates. Methods 40 neonates to undergo neonatal laparoscopic surgery were divided into I-gel laryngeal mask group(group I)and tracheal intubation group(group E)randomly,20 in each group. After the induction of anesthesia,I-gel laryngeal mask(size 4 each)was used for ventilation in Group I,and tracheal intu-bation with ID(3.0 or 3.5 mm)was performed for ventilation in group E. The two groups were compared in terms of intubation duration,success rate,the hemodynamic parameters like mean arterial pressure (MAP),heart rate (HR)and plus oxygen saturation(SpO2)at each time point.,the end-tidal carbon dioxide pressure(PETCO2), peak airway pressure (Ppeak),the airway sealing pressure (Pleak),and the postoperative complications. Results There was no significant difference between the two groups in the success rate of intubation (laryngeal mask). However,the duration required for laryngeal mask insertion in I group was significantly shorter than that in E group(P<0.01). MAP and HR were significantly lower than group E at the time point of T1(P<0.05). Pleak in group I was significantly lower than E group at the time points of T1 ~ T3(P < 0.01). The adverse reactions was significantly lower than that in the E group (P < 0.05). There was no reflux aspiration in both groups. Conclusion I-gel laryngeal mask airway can achieve the same effect as tracheal intubation does for general anes-thesia during laparoscopic surgery. It is easy to operate ,with high success rate and few complications.