ABSTRACT
Objective To observe the effect of ultrasound-guided transversus abdominis plane blockon median effective dose of sufentanil in pediatric postoperative analgesia. Methods Forty-fivepediatric patients under-going elective hernia repairsurgery were randomly divided into two groups:group Rop and group Sal. Ultrasound-guided transversus abdominis plane blocks were performed on both groups after general anesthesia induction before the start of surgery. Group Rop received 0.3 mL/kg of 0.25%ropivacaine,and group Sal received 0.3 mL/kg of 0.9%saline. Patient controlled intravenous analgesia pump within sufentanil was used in both groups after operation. Used the sequential method to determine the median effective dose of sufentanil ,recorded the times of the pressing self-control analgesia within 6h after operation,the use of sufentanil,postoperative pediatric pain(FLACC)score and adverse reactions. Results 1. The median effective dose of sufentanil in group Rop was lower than group Sal (0.0259 μg/(kg · h)vs 0.0379 μg/(kg · h)). 2.The times of the pressing self-control analgesia within 6 h after operation and the use of sufentanil in group Rop were less than in group Sal. 3.The postoperative FLACC score at different points in group Rop was lower than in group Sal(P < 0.05). 4.There were no significant difference(P >0.05)in incidence of adverse reactions in both groups. Conclusion The ultrasound-guided transversus abdominis plane block in pediatric lower abdominal surgery can effectively reduce the median effective dose of sufentanil.
ABSTRACT
Objective To observe the effects of dexmedetomidine hydrochloride on the cisatracurium-induced neuromuscular blockade in geriatric, young and middle-aged patients. Methods Forty elderly patients and forty young and middle-aged patients undergoing elective abdominal surgery under general anesthesia were randomly divided into 4 groups ( n=20 each):elderly dexmedetomidine hydrochloride group (group DE),elderly control group (group CE),young and middle-aged dexmedetomidine group (group DY) and young and middle-aged control group (group CY).In groups DE and DY,a loading dose of 0.5 μg?kg-1 dexmedetomidine was intravenously infused over 10 min before induction of anesthesia,respectively,followed by infusion at a rate of 0.4μg?kg-1?h-1 until the end of surgery.Equal volume of 0.9% sodium chloride was given in groups CE and CY.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium 0.15 mg?kg-1.Four groups were maintained with infusion of propofol and remifentanil. Neuromuscular blockade was maintained with continuous cisatracurium infusion in the four groups and was monitored with TOF-Watch SX acceleromyography at the adductor pollicis.The onset time,TOF no reaction period,duration of action,the amount of cisatracurium consumption,and the spontaneous recovery index ( T1 25% to 75%) were recorded. Results The four groups were comparable in the demographic data.Intubation conditions,the onset time and recovery index were not significantly different among the four groups. The duration of blockade action in groups DE and DY was ( 61. 1 ± 8.9) min and (53.6±9.3) min,which was significantly longer than that in group CE [(49.9±5.8) min] and group CY [(44.8± 6.4) min] (P<0.01).The duration of blockade action was significantly longer in groups DE and CE than in groups DY and CY (P<0.05).The amount of cisatracurium consumption in groups CE and CY was significantly higher than that in groups DE and DY (P<0.05). Conclusion The neuromuscular blockade is longer and the requirement of cisatracurium is less in elderly patients than in young and middle-aged patients.Continuous infusion of dexmedetomidine hydrochloride can't accelerate the onset time of cisatracurium.But duration of action is prolonged and the amount of cisatracurium consumption is lower in patients with infusion of dexmedetomidine hydrochloride.