ABSTRACT
Objective To evaluate the effects of ultrasound-guided paravertebral nerve block(PVNB)and local infiltration anes-thesia on postoperative inflammation level and recovery quality of patients after robot-assisted radical nephrectomy.Methods A total of 100 patients who underwent elective robot-assisted laparoscopic radical nephrectomy in General Hospital of Central Theater Command from January 2022 to August 2022 were selected prospectively.They were randomly divided into observation group and control group by random number table method,with 50 cases in each group.The observation group chose general anesthesia combined with PVNB,while the control group chose general anesthesia combined with incision local infiltration anesthesia.All patients were connected with patient-controlled intravenous analgesia(PCIA)after operation.The pain visual analogue scale(VAS)of rest and cough,the systemic immune inflammatory index(SII),interleukin-6(IL-6),and the QoR-15 scores of the patients after operation in the two groups were recor-ded.The dosage of remifentanil,the times of effective compression of analgesia pump and remedial analgesia were recorded in the two groups.Adverse reactions and related complications were recorded.Results Compared with the control group,the pain VAS of rest and cough in the observation group were lower on first and second day after operation(P<0.05).SII and IL-6 were lower on the first and third day after operation(P<0.05).The QoR-15 scores on the first,second,and fifth day after operation were higher(P<0.05).The dosage of remifentanil was less during operation(P<0.01).The effective pressing times of intravenous analgesia pump were less af-ter operation(P<0.05).Lower incidence of remedial analgesia and adverse effects(P>0.05).Conclusion Compared with local in-filtration anesthesia,PVNB can provide better intraoperative and postoperative analgesia effect,reduce the early postoperative inflammato-ry reaction and accelerate the early recovery of patients for robot-assisted radical nephrectomy.
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Objective To study the antidepressant effect of subanesthestic dose ketamine in anesthesia after cesarean section. Methods One hundred and twenty-six parturients who had underwent cesarean section were divided into ketamine group and control group with 63 cases each, The parturients in control group were given intravenous 0.9%sodium chloride 20 ml after childbirth, and the parturients in ketamine group were given subanesthetic dose ketamine after childbirth (0.5 mg/kg + 20 ml 0.9%sodium chloride). The parturients were evaluated by hospital anxiety and depression scale (HADS) and postpartum depression screening scale (PDSS). Results The scores of HADS and PDSS 5 and 10 d after parturition in ketamine group were significantly lower than those in control group, HADS:(7.67 ± 2.53) scores vs. (10.48 ± 2.48) scores and (7.96 ± 2.61) scores vs. (11.24 ± 2.74) scores, PDSS:(52.58 ± 13.36) scores vs. (71.34 ± 15.19) scores and (53.73 ± 13.28) scores vs. (73.41 ± 15.37) scores, and there were statistical differences (P<0.01). The incidences of depression 5 and 10 d after parturition in ketamine group were significantly lower than those in control group:4.8%(3/63) vs. 15.9%(10/63) and 4.8%(3/63) vs. 17.5% (11/63), and there were statistical differences (P<0.05). There were no serious adverse reactions in the 2 groups. Only 2 cases had mild nausea in control group, and the symptoms disappeared after adjustment. Conclusions The use of subanesthestic dose ketamine can significantly reduce the incidence of postoperative depression in cesarean section, and it has a good antidepressant effect.
ABSTRACT
Objective To study the antidepressant effect of subanesthestic dose ketamine in anesthesia after cesarean section. Methods One hundred and twenty-six parturients who had underwent cesarean section were divided into ketamine group and control group with 63 cases each, The parturients in control group were given intravenous 0.9%sodium chloride 20 ml after childbirth, and the parturients in ketamine group were given subanesthetic dose ketamine after childbirth (0.5 mg/kg + 20 ml 0.9%sodium chloride). The parturients were evaluated by hospital anxiety and depression scale (HADS) and postpartum depression screening scale (PDSS). Results The scores of HADS and PDSS 5 and 10 d after parturition in ketamine group were significantly lower than those in control group, HADS:(7.67 ± 2.53) scores vs. (10.48 ± 2.48) scores and (7.96 ± 2.61) scores vs. (11.24 ± 2.74) scores, PDSS:(52.58 ± 13.36) scores vs. (71.34 ± 15.19) scores and (53.73 ± 13.28) scores vs. (73.41 ± 15.37) scores, and there were statistical differences (P<0.01). The incidences of depression 5 and 10 d after parturition in ketamine group were significantly lower than those in control group:4.8%(3/63) vs. 15.9%(10/63) and 4.8%(3/63) vs. 17.5% (11/63), and there were statistical differences (P<0.05). There were no serious adverse reactions in the 2 groups. Only 2 cases had mild nausea in control group, and the symptoms disappeared after adjustment. Conclusions The use of subanesthestic dose ketamine can significantly reduce the incidence of postoperative depression in cesarean section, and it has a good antidepressant effect.
ABSTRACT
Objective To observe the effects of target-controlled infusion ofpropofol on hemodynamics during anesthesia induction in intracranial aneurysms interventional treatment.Methods Ninety patients in intracranial aneurysms interventional treatment were divided into three groups by random digits table method with 30 cases each:control group (group C),plasma drug concentration in target controlled infusion group (group P) and effect of chamber drug concentration in target controlled infusion group (group E).The induction of anesthesia:patients in group C were single intravenous injected with propofol of 2 mg/kg; patients in group P were set target plasma concentration of propofol with 4 μ g/ml.Patients in group E were set the effect target concentration of propofol with 4 μ g/ml.Three groups were set the concentration of remifentanil 4 ng/ml with plasma controlled infusion,and cisatracurium was injected with 0.2 mg/kg.Electrocardiogram,mean arterial pressure (MAP),heart rate (HR),end-tidal pressure of carbon dioxide,bispectral index,pulse oxygen saturation were continuously monitored.Before the time of induction (T0),immediately before intubation (T1),after intubation 1 min (T2),3 min (T3),5 min (T4),10 min (T5),arterial pressure and HR were recorded and the number of using vasoactive drugs were recorded.Results The level of MAP and HR among three groups at T0 had no significant difference (P ＞ 0.05).The level ofMAP and HR in three groups at T1 was significantly lower than that at T0.(P ＜ 0.05).The level of MAP and HR in group P was lower than that in group E and group C,and there was significant difference (P ＜ 0.05).The incidence of using vasoactive agen in group P was significantly lower than that in group C [6.7％(2/30) vs.40.0％ (12/30)],and there was significant difference (P ＜0.01).Conclusion Hemodynamics is relatively stable during anesthesia induction using plasma target controlled infusion with propofol in patients undergoing interventional therapy for intracranial aneurysm.