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Objective To observe the effectiveness of dexmedetomidine on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy.Methods Seventy patients (17 males,53 females,aged 20-65 years,ASA grade Ⅰ or Ⅱ) undergoing laparoscopic cholecystectomy were randomized to receive either dexmedetomidine (group R,n=35) or dexamethasone (group D,n=35).The patients in the group R received 0.5 μg/kg bolus dose and maintenance dose at the rate of 0.5 μg·kg-1·h-1 of dexmedetomidine before intubation.The patients in the group D received 8 mg dexamethasone before intubation.The BP and HR were recorded at the following points: on arrival in the operating room (T1),before intubation (T2),5 minutes after intubation (T3),5 minutes after the beginning of the operation (T4),30 minutes after the beginning of the operation (T5),at the end of operation (T6) and 5 minutes after extubation (T7).The inhaling concentration of sevoflurane,extubation time,operation time and anesthesia time were recorded.The incidence of nausea and vomiting were recorded at 8,24,48 hours after operation.Results The incidence of nausea and vomiting at each point were similar between two groups.The HR at T2-T7 in group D was significantly lower.But MAP was similar between two groups.Conclusion 0.5 μg/kg bolus dose and maintenance dose at the rate of 0.5 μg·kg-1·h-1 of dexmedetomidine reduced the incidence of PONV in patients undergoing laparoscopic cholecystectomy,similar to dexamethasone.
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Objective To evaluate the efficacy of parecoxib sodium for preemptive analgesia.Methods PubMed,EMBASE,Cochrane Library,and CNKI database were searched for randomized placebo-controlled trials involving the efficacy of parecoxib sodium for preemptive analgesia.The modified Jadad scale was used for quality assessment.Evaluation indexes included VAS scores at 1,6,12 and 24 h after operation,consumption of morphine within 24 h after operation,and incidences of nausea and vomiting after operation.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0.2 software.Results Fourteen randomized placebo-controlled trials involving 1086 patients were included in our meta-analysis.The modified Jadad scale scores for the 14 studies were ≥ 4.The patients were divided into 2 groups:placebo group and parecoxib sodium 40 mg injected before operation group.The results of meta-analysis showed that VAS scores at 1,6,12 and 24 h after operation were significantly decreased,the consumption of morphine within 24 h after operation was reduced,and the incidences of nausea and vomiting after operation were decreased in parecoxib sodium 40 mg injected before operation group as compared with placebo group (P ＜ 0.05).Conclusion Intravenous injection of parecoxib sodium 40 mg before operation can produce significant preemptive analgesic efficacy and is helpful in decreasing the adverse effect of postoperative analgesia.
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Objective To investigate the incidence of postoperative intubation-related complications and the need for measurement and adjustment of cuff-pressure of endotracheal tube. Methods Five hundred and nine patients of either sex undergoing elective surgery under general anesthesia with tracheal intubation were divided into 2 groups: control group (group C)and cuff-pressure measured group (group CPM). Operation time and duration of endotracheal tube were recorded. Twenty patients with the duration of endotracheal tube 120-180 min in each group were selected. Their tracheal mucous membrane was examined by fiberoptic bronchoscopy at the time of withdrawal of endotracheal tube. Postoperative complications including cough and bloody sputum were also recorded at 24 h after extubation. Results The two groups were comparable with respect to age, sex, operation time and the duration of endotracheal tube. The incidence of sore throat and bloody sputum was significantly higher in group C than in CPM group. The incidence of sore throat and bloody sputum was significantly increased as the duration of endotracheal tube was prolonged in control group while in CPM group only the incidence of sore throat was increased. Varying degrees of injuries to tracheal mucous membrane were observed with fiberoptic bronchoscope.The injuries were more serious in group C than in CPM group. Conclusion Measurement of intracuff pressure is helpful for reducing the tracheal intubation-related complications.
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Objective To investigate the effect of gabapentin on the activation of glial cells in the spinal cord after chronic constrictive injury (CCI) to sciatic nerve in rats.Methods Twenty-four male SD rats weighing 180-220 g were randomly divided into 3 groups (n = 8 each): group Ⅰ sham operation (group S), group Ⅱ CCI and group Ⅲ gabapentin + CCI. Right sciatic nerve was exposed and 4 loose ligatures were placed with 6-0chromic catgut. Seven days after operation gabapentin 50 mg/kg in 5 ml was given by intragastric gavage twice a day for 5 days in group Ⅲ. Paw withdrawal threshold to mechanical stimulation with von Frey filaments was measured one day before (baseline) and at 7, 15 d after operation. The animals were killed at 15 d after operation. The lumbar segment L4-5 of the spinal cord was removed. Immunohistochemical double mark technique was used to detect the activation of astrocytes and microglias in the spinal cord. Results Paw withdrawal threshold to mechanical stimulation was significantly decreased on the 7th and 15th day after CCI operation in group CCI as compared with group S. After 5 day treatment with gabapentin, the withdrawal threshold to von Frey hair stimulation was significantly higher in group Ⅲ than in group Ⅱ . The activation of astrocytes and microglias in the spinal cord was significantly enhanced in group CCI as compared with group S. Treatment with gabapentin significantly inhibited CCI-induced activation of astrocytes and microglias in the spinal cord. ConclusionGabapentin reduces neuropathic pain by inhibiting activation of glial cells in the spinal cord.