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Objective To observe the anesthesia effect of propofol combined with small dose of sufentanyl in the painless gastroscopy.Methods From January 2017 to June 2017,68 patients with painless gastroscopy in Lishui Central Hospital were selected in the research.According to the digital table,the patients were randomly divided into observation group (propofol and sufentanil ) and control group (propofol plus fentanyl ),with 34 cases in each group. The anesthesia effect , the intraoperative vital signs , directional recovery and consciousness recovery time were compared between the two groups.The adverse reactions were recorded.Results The effective rate of anesthesia in the observation group was 100.00%,which was significantly higher than 82.35%in the control group (χ2＝8.856, P＜0.05).After medication, the MAP, HR, RR, SpO2in the observation group were ( 73.15 ±6.15 ) mmHg, (67.52 ±9.15)times/min,(11.02 ±2.54)times/min,(91.54 ±1.02)%,respectively,compared with those before medication [(87.51 ±8.16)mmHg,(81.02 ±10.24)times/min,(18.24 ±1.52)times/min,(98.45 ±1.52)%], the differences were statistically significant (t＝8.194,5.732,14.305,5.732,all P＜0.05).After medication,the MAP,HR,RR,SpO2in the control group were (73.20 ±6.16) mmHg, (67.62 ±9.14) times/min, (11.03 ± 2.58)times/min,(91.58 ±1.05)%,respectively,compared with those before medication [(87.59 ±8.14)mmHg, (81.05 ±10.28) times/min,(18.25 ±1.56) times/min,(98.46 ±1.58)%],the differences were statistically significant (t＝8.219,5.692,13.963,21.146,all P＜0.05).The differences of MAP,HR,RR and SpO2between the two groups after medication were not statistically significant (t ＝0.033,0.045,0.019,0.159,all P＞0.05).The orientation force recovery time and consciousness recovery time in the observation group were (3.01 ±0.75) min, (2.02 ±1.05)min,respectively,which were shorter than those in the control group [(4.67 ±1.20)min,(3.71 ± 1.18)min],the differences were statistically significant (t＝6.840,6.238,all P＜0.05).The dosage of propofol of the observation group was (1.03 ±0.19)mg/kg,which was less than (1.77 ±1.58)mg/kg of the control group,the difference was statistically significant (t＝2.711,P＜0.05).The incidence rate of adverse reaction in the observation group (0.00%) was lower than that in the control group (20.59%) (χ2＝7.803,P ＜0.05).Conclusion Application of propofol combined with small dose of sufentanil in painless gastroscopy has satisfactory anesthetic effect,and with stable vital signs,redirected restore and consciousness recovery time ,small adverse reactions,drug safety,it is worthy of clinical promotion.
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Objective To compare the anesthetic effect of sufentanil combined with propofol and remifentanil combined with propofol in hysteroscopic surgery, and to provide a scientific basis for the selection of clinical anesthesia methods. Methods From November 2016 to March 2017, 94 patients in Lishui central hospital underwent hysteroscopic surgery were divided into the observation group and the control group according the anesthesia way, 47 cases in each group. The control group were given remifentanil(1 μg/kg) combined with propofol(2 mg/kg) by intravenous injection, the observation group were given sufentanil(0.2 μg/kg) combined with propofol(2 mg/kg). The mean arterial pressure(MAP), respiration (RR), pulse oxygen saturation (SpO2), heart rate (HR), the onset time of anesthesia, the postoperative recovery time, the recovery time of orientation and Ramsay sedation score in the two groups were recorded and compared before anesthesia, 2 min after anesthesia, 10 min after operation, 10min after operation finished. Results Compared with before anesthesia, MAP, RR, SpO2, HR index decreased significantly after anesthesia, the differences have statistical significance (P<0.05), the control group compared to the index value, the observation group and the control group of convergence and the decline of difference, group showed no statistically significant difference the observation group was more stable; comparison between the 10min group and MAP HR index after surgery, there was significant difference between two groups (P<0.05). The onset time of anesthesia, postoperative recovery time, orientation recovery time, Ramsay score difference between the groups was not statistically significant sedation score difference was statistically significant between group VAS, observation group than in the control group (P<0.05). Conclusion Sufentanil combined with propofol anesthesia were used in hysteroscopic surgery, which can better maintain the vital signs of patients, effectively reduce postoperative pain.
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Objective To evaluate the effects of doxofyline on intraoperative pulmonary function in patients receiving double lumen endotracheal intubation for one-lung ventilation. Methods Fifty patients who underwent elective pulmonary lo-bectomy under general anesthesia using double lumen endotracheal intubation were randomly divided into two groups ( n=25 each):control group (group C) and doxofyline group (group D).Doxofyline (4 mg?kg-1) was injected intravenously after double lumen endotracheal intubation in group D,while equal volume of 0.9% sodium chloride was intravenously given in group C.Total intravenous anesthesia with target controlled infusion was performed during the operation.Two milliliter blood samples were taken from the radial artery for blood gas analysis immediately before administration ( t0 ) ,at 30 min ( t1 ) ,60 min ( t2 ) after one-lung ventilation and at the moment of two-lung ventilation after chest closing ( t3 ) . The PaCO2 , PaO2 , peak airway pressure (Ppeak),airway plateau pressure (Pplat),airway resistance (Raw) and lung compliance (Compl) were recorded at t0-3. Results The Ppeak,Pplat and Raw were significantly decreased and the Compl and PaO2 significantly increased at t1-t3 in group D when com-pared with those in group C (P<0.05).The Ppeak,Pplat and Raw were significantly increased and Compl and PaO2 significantly de-creased at t3 as compared with those at t0 in group C ( P<0.05) . Conclusion Doxofyline can improve intraoperative pulmonary function in patients who undergo double lumen endotracheal intubation for one-lung ventilation.
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Objective:To investigate the clinical efficacy of gabapentin capsules( GBP)combined with amitriptyline and tramadol in the treatment of patients with postherpetic neuralgia( PHü)and anxiety. Methods:Totally 106 PHü patients with anxiety symptoms at different degree were selected and divided into group A(n=53)and group B(n=53). Group A was given GBP,amitriptyline and tramadol,while group was given GBP only. The anxiety,depression,quality of life and pain-relieving intensity( by VAS)of the pa-tients were determined before the medication( T1 )and in the first week( T2 )and the fourth week( T3 )after the medication. Follow-up was carried out regularly according to the requirements to evaluate the clinical efficacy. Results:The anxiety,depression and VAS scores in the two groups on T2 were statistically significant lower than the corresponding results on T1(P<0.05). On T3,however, there were statistically significant differences between the two groups(P<0. 05). The total adverse reaction rate of group A was signif-icantly lower than that of group B(P<0. 05). The total effective rate of group A was significantly higher than that of group B(P<0. 05). Conclusion:GBP combined with tramadol and amitriptyline in the treatment of PHü patients with anxiety can effectively con-trol the pain of the patients,significantly reduce the scores of VAS and improve the quality of life of the patients.
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Objective To evaluate the feasibility of using lumbar plexus block for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.Methods Forty ASA physical status Ⅱ or Ⅲ patients,aged 67-81 yr,weighing 47-65 kg,scheduled for extremity artificial vascular graft between femoral artery and deep femoral artery,were randomly divided into 2 groups (n =20 each) using a random number table:spinal anesthesia group (group S) and lumbar plexus block group (group L).In group S,0.5 ％ hyperbaric ropivacaine 3 ml was injected into the subarachnoid space.In group L,lumbar plexus block was performed with 30 ml of 0.5 ％ ropivacaine under the guidance of a nerve stimulator.The onset time and duration of sensory block,anesthetic efficacy,and requirement for ephedrine and volume of fluid infused during operation,and development of lumbar plexus block-related adverse events were recorded.Results Compared with group S,the onset time and duration of sensory block were significantly prolonged,the requirement for ephedrine and volume of fluid infused during operation were decreased,and no significant change was found in anesthetic efficacy in group L.No lumbar plexus block-related adverse events developed in group L.Conclusion Lumbar plexus block can be used for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.
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Objective To evaluate the efficacy of midazolam premedication for prevention of emergence agitation (EA) after sevoflurane anesthesia in children undergoing minor surgery.Methods One hundred and twenty ASA physical status Ⅰ or Ⅱ paediatric patients,aged 3-9 yr,weighing 15-35 kg,scheduled for elective tonsillectomy and adenoidectomy,were randomly divided into 4 groups (n =30 each):control group (group C) and midazolam 0.25,0.50 and 0.75 mg/kg groups (groups M1-3).The 10 ml mixture of midazolam 0.25,0.50 and 0.75 mg/kg and 10％ glucose was taken orally at 30 min before anesthesia in M1-3 groups,respectively,while 10 ml of 10％ glucose was taken orally in group C.Anesthesia was induced with inhalation of sevoflurane and maintained with iv infusion of remifentanil and inhalation of sevoflurane.EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.Results Compared with group C,the PAED scores and incidence of EA were significantly decreased in groups M2 and M3 (P ＜ 0.05),and no significant change was found in group M1 (P ＞ 0.05).Compared with group M1,the PAED scores and incidence of EA were significantly decreased in groups M2 and M3 (P ＜ 0.05).There was no significant difference in the PAED scores and incidence of EA between groups M3 and M2 (P ＞ 0.05).Conclusion Premedication with oral midazolam can prevent EA following sevoflurane anesthesia in children undergoing minor surgery and the optimum dose is 0.50 mg/kg.