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Objective:To evaluate the efficacy of target-controlled infusion (TCI) of sufentanil at different target effect-site concentrations combined with propofol for anesthesia in laparoscopic surgery.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of either gender, aged 18-68 yr, with body mass index of 17.0-29.5 kg/m 2, scheduled for elective laparoscopic surgery under general anesthesia, were included in this study.Anesthesia was induced with sufentanil combined with propofol given by TCI.The patients were divided into 3 groups ( n=20 each) using the sealed envelope method: target effect-site concentration 0.08 ng/ml group (Ⅰ group), 0.10 ng/ml group (Ⅱ group) and 0.12 ng/ml group (Ⅲ group). Anesthesia was maintained as follows: the target effect-site concentrations of sufentanil given by TCI were 0.08, 0.10, and 0.12 ng/ml in Ⅰ, Ⅱ, and Ⅲ groups, respectively, the target plasma concentration of propofol was adjusted, and the bispectral index value was maintained at 40-60, the fluctuation range of mean arterial pressure and heart rate was maintained not exceeding 20% of the baseline value, intermittent intravenous boluses of rocuronium was given when needed, and propofol and sufentanil TCI was stopped at the end of operation.The operation time, time for TCI, consumption of sufentanil and propofol, the number of cases used ephedrine and atropine during the period of anesthesia maintenance, time to eye opening at the end of operation and time of tracheal extubation, nausea and vomiting, muscle stiffness, shivering, agitation, respiratory depression and intraoperative awareness were recorded, and the number of cases used analgesics within 30 min and 30 min-24 h after operation was recorded. Results:Compared with group Ⅰ, the consumption of sufentanil was significantly increased in group Ⅲ, and the time to eye opening and extubation time were prolonged in Ⅱ and Ⅲ groups ( P<0.05). The consumption of sufentanil was significantly higher in group Ⅲ than in group Ⅱ( P<0.05). There was no significant difference in the other parameters among the three groups ( P>0.05). Conclusion:When combined with propofol for anesthesia in laparoscopic surgery, the recommended target effect-site concentration of sufentanil given by TCI is 0.08 ng/ml.
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Objective To evaluate the accuracy of target-controlled infusion (TCI) of sufentanil at low concentration.Methods Sixty patients with American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-68 yr,scheduled for elective surgery under general anesthesia,were included in this study.Anesthesia was induced and maintained with sufentanil TCI combined with propofol TCI,and muscle relaxation was maintained by intermittent injection of rocuronium as needed.The patients were divided into 3 groups (n=20 each) using the sealed envelope method:0.08 ng/ml group (group Ⅰ),0.10 ng/ml group (group Ⅱ) and 0.12 ng/ml group (group Ⅲ).Arterial blood samples were collected in 10 patients randomly selected from each group for measurement of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry.The accuracy of sufentanil TCI was evaluated by calculating bias (median performance error),precision (median absolute performance error) and wobble.Results In Ⅰ,Ⅱ and Ⅲ groups,the bias of sufentanil TCI was-6.1％,-10.2％ and-5.0％,respectively,the precision was 19.4％,15.8％ and 14.2％,respectively,and the wobble was 20.9％,11.0％ and 10.8％,respectively.The pooled bias,precision and wobble were-7.1％,16.8％ and 13.5％ in Ⅰ,Ⅱ and Ⅲ groups,respectively.Conclusion The accuracy of sufentanil TCI at low concentration is considered acceptable in clinical anesthesia,and the measured plasma sufentanil concentration is approximately 7％ lower than the target plasma sufentanil concentration in surgical patients.
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Stress response is an organism's defense mechanism against various stimulations, and involves nervous, endocrine, cardiovascular and immune systems.This review summarized the clinical research progress of adjuvant anesthetics and methods for reducing stress response and future trends of investigation.
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Objective To assess the feasibility of secondary check by LinaTech TiGRT treatment planning systems.Methods Choosing the Linatech TiGRT treatment planning system,researched and developed by Linatech company,as the third-party check tools.First,using Linatech TPS for recomputing treatment plans for geometrical phantoms designed in TG-119 and patients.after computation,compared the point dose with the measured data of phantoms (Using chameber No.2571 to measure point dose) and original plans.Using PTW verisoft with a criteria of 3% dose difference and 5 mm distance to agreement to assess the dose distribution on center level.After then,you can assess the accuracy of treatment plans.Results Tiny volume changes were found in ROI,especially in small size phantoms orcuspidal regions.For comparing measured data with recomputed plans and original plans,the dose data were found basically identical in TG-119 phantoms.And for patients,the differences between recomputed plans and AAA original plans or AXB original plans were smaller in breast cancer,but they were even bigger innasopharynx cancer,all patient cases showed a gamma passing rate more than 90%.The gamma passing rate of AAA original plans and AXB original plans were 95.6% and 97.53% for breast cancer,and 94.67% and 96.83% for nasopharynx cancer.Conclusions The method of utilizing the LinaTech TiGRT treatment planning system as a third-party check tools to assess the accuracy of plans is feasible,and the validation process is convenient,but some functions still need to improve and the scope of differences still need more patient cases to determine.
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Objective To investigate the relationship between negative acute phase proteins and chronic urticaria (CU).Methods Fifty patients with CU were enrolled into this study,and divided into three grades,i.e.,mild (grade 1),moderate (grade 2) and severe (grade 3) according to symptoms.Twenty-eight health checkup examinees served as the control group.Immunoturbidimetry was performed to determine serum levels of prealbumin (PA) and transferrin (TRF).Enzyme-linked immunosorbent assay was conducted to measure serum levels of insulinlike growth factor-1 (IGF-1) and tumor necrosis factor-α (TNF-α).Statistical analysis was carried out to assess differences in these indices between these two groups,the relationship among these indices and between these indices and disease severity.Results Compared with the control group,the patients with CU showed reduced serum levels of PA ((229.99 ± 54.16) vs.(272.06 ± 36.42) mg/L,t =3.667,P ＜ 0.05) and IGF-1 ((177.23 ± 46.48) vs.(239.88 ± 45.16) μg/L,t =5.748,P＜ 0.05),but higher serum levels of TNF-α ((25.39 ± 11.01) vs.(14.13 ± 6.12) ng/L,t =4.989,P＜ 0.05),and similar serum levels of TRF ((2.48 ± 0.49) vs.(2.48 ± 0.25) g/L,P＞ 0.05).The serum level of PA showed a significant negative correlation with that of TNF-α (r =-0.312,P ＜ 0.05),as well as with disease severity (r =-0.635,P ＜ 0.01),whereas the serum level of TNF-α showed a significant positive correlation with disease severity (r =0.409,P ＜ 0.01),and no statistical correlation was found between the remaining indices (all P ＞ 0.05) in the patients with CU.Conclusions Serum levels of some negative acute phase proteins decrease and negatively correlate with disease severity in patients with CU.Acute phase response may be involved in the occurrence of CU.