ABSTRACT
Objective To determine the dose?response relationship of bupivacaine coadministered with sufentanil for subarachnoid block in severely preeclamptic patients undergoing cesarean delivery. Methods Two hundred patients with severe preeclampsia, of American Society of Anesthesiologists physi?cal statusⅠ?Ⅲ, scheduled for elective cesarean delivery, were divided into 4 groups ( n=50 each) using a random number table: bupivacaine 4 mg group ( group B4 ) , bupivacaine 6 mg group ( group B6 ) , bupivacaine 8 mg group ( group B8 ) , and bupivacaine 10 mg group ( group B10 ) . In B4 , B6 , B8 and B10 groups, bupivacaine 4, 6, 8 and 10 mg plus 2.5μg sufentanil in 2.5 ml of normal saline were injected into the subarachnoid space, respectively. Effective anesthesia was defined as bilateral sensory block of T6 achieved at 10 min after intrathecal administration when measured by pin?prick test, and with no need for epidural supplementation ( lidocaine ) . A probit analysis was used to estimate the 50% effective dose ( ED50 ) and 95% effective dose ( ED95 ) with 95% confidence intervals for bupivacaine, coadministered with sufentanil, when used for subarachnoid block in severely preeclamptic patients underwent cesarean de?livery. Results When coadministered with sufentanil, the ED50 and ED95 ( 95% confidence interval) of bupivacaine were 5.67 ( 5. 20-6. 10) mg and 8. 82 ( 8. 14-9.87) mg, respectively, for subarachnoid block in severely preeclamptic patients underwent cesarean delivery. Conclusion The ED50 and ED95 of bupivacaine for subarachnoid block, when coadministered with sufentanil 2.5 μg, are 5.67 and 8.82 mg, respectively, in severely preeclamptic patients undergoing cesarean delivery.
ABSTRACT
Objective To evaluate the reliability of Pain Vision method for assessment of labor pain.Methods Eighty-nine nulliparous parturients who were at full term and at the latent period of the first stage of labor,aged 19-31 yr,weighing 55-85 kg,were enrolled in this study.The degree of labor pain was assessed using Pain Vision method and VAS.Pain degree is calculated from two parameters,current perception threshold and pain compatible electrical current by using a somatosensory evoked potential stimulator.The former parameter was defined by the lowest electrical current detected; the latter parameter defined by the electrical current judged as being compatible with the intensity of ongoing pain.Linear correlation of VAS scores with pain degree was analyzed.Results There was no correlation between pain degree and VAS scores,and the correlation coefficient was 0.206 (P ＞ 0.05).Conclusion Pain Vision method can not be applied for objective assessment of labor pain.
ABSTRACT
Objective To compare the efficacy of laryngeal tube suction Ⅱ (LTS Ⅱ ) and ProSeal laryngeal mask airway (PLMA) for airway management during general anesthesia. Methods One hundred and twenty adult ASA Ⅰ or Ⅱ female patients, aged 30-50, with body mass index ＜ 30 kg/m2, undergoing general anesthesia for elective surgery were randomly divided into 2 groups ( n = 60 each) : PLMA group and LTS Ⅱ group. Each group was further divided into 2 subgroups: PLMA controlled ventilation group (group PC), PLMA spontaneous breathing group (group PS), LTS Ⅱ controlled ventilation group (group LC) and LTS Ⅱ spontaneous breathing group (group LS) . The rate of successful insertion was recorded. PetCO2 , peak airway pressure, lung compliance and incidence of gas leakage during controlled ventilation were recorded before operation, 10 min after the start of operation and at the end of operation. The tidal volume and PetCO2 were recorded in patients breathing spontaneously when the breathing was stable. The bucking and body movement were observed during removal of LTS Ⅱ or PLMA. The side effects in 24 h after surgery were recorded.Results Insertion was successful in all the patients. During either spontaneous breathing or controlled ventilation, the peak airway pressure was significantly higher in the patients with LTS Ⅱ than in the patients with PLMA ( P ＜ 0.05), and there wag no significant difference in the other ventilatory parameters between the two devices. There was no significant difference in the incidences of postoperative complications among the groups ( P ＞ 0.05) . Conclusion The efficacy of PLMA for airway manage ment is better than that of LTSⅡ during general anesthesia.