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Objective:To explore the application and safety of visual endotracheal tube in tracheal intubation in patients with gen eral anesthesia operation.Methods:220 patients with general anesthesia operation in Department of Anesthesiology,Guangdong No.2 provincial people's hospital firom October 2014 to December 2016 were selected,110 patients were treated with visual endotracheal intubation as observation group,110 patients were treated with general endotracheal intubation as control group.The number of intubation,intubation times and complication rate in the two groups were contrasted,compared the heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP) and oxygen saturation (SpO2) in the two groups at before induction of anesthesia (T0),after induction of anesthesia (T1),airway intubation (T2),5 min after intubation (T3).Results:The number of intubation and intubation times in the observation group were significantly less than those in the control group,the differences were statistically significant (P＜0.05);At each time point,the HR,SBP,DBP and SpO2 in the two groups were no significant difference (P＞0.05);The HR,SBP,DBP and SpO2 in the two groups at T1 were significantly less than T0,T2,T3,the differences were statistically significant (P＜0.05);The incidence of throat pain in the observation group (0.91％) was significantly less than that in the control group (7.27％),the difference was statistically significant (P＜0.05).Conclusion:Use visual endotracheal tube in tracheal intubation in patients with general anesthesia operation is satisfactory,can effectively reduce the time of intubation and intubation times,and has good security,it is worthy of clinical application.
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Objective To determine whether concentrations of plasma homocysteine and status of folate and vitamin B12 were altered in patients with heroin dependence compared with control subjects. Methods We recruited 20 patients with heroin addiction. Twenty age-and sex-matched healthy volunteers as the control group were enrolled. Blood concentrations of homocysteine, folate and vitamin B12 were measured in a fasted status. Results Mean homocysteine level was higher in the heroindependence group than in the control group [18.3 ± 4.5 (Q1 = 14.7, Q2 = 17.6, Q3 = 19.2) vs. 8.4 ± 2.7 (Q1 = 5.9, Q2 = 8.5, Q3 = 10.5) μmol/L, P < 0.001]. Patients in heroinaddictiongroup had signi cantly lower folate levels compared with the control group [6.6 ± 2.6 (Q1=4.6, Q2=6.4, Q3=8.1) vs. 12.7 ± 2.5 (Q1 = 11.1, Q2 = 13.0, Q3 = 17.5) ng/mL, P < 0.001]. There was significant difference on plasma B12 concentrations between heroin users and controls [384.1 ± 228.8 (Q1=312.0, Q2=348.5, Q3=374.5) vs. 399.4 ± 45.1 (Q1=358.0, Q2=394.5, Q3=428.3) Pg/mL, P < 0.001]. Heroin users group demonstrated a negative correlation of homocysteine with folate , which was statistically significant in heroin users groups (r = - 0.614; P = 0.004), there was a trend towards a negative correlation of homocysteine with B12 in heroin users (r = -0.605; P = 0.005), respectively. Conclusions We conclude that patients with heroin dependence are prone to high concentration of plasma homocysteine.
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Objective To investigate the effect of nalmefene on sufentanil and propofol anesthesia for abortion and its impact on BIS. Methods One hundred and twenty patients undergoing abortion patients were randomly divided into group A, B, C, and D (n = 30 each). Patients in group A and B received 0.2 μg/kg or 0.3 μg/kg sufentanil, respectively, followed with 1.5 mg/kg propofol for induction of anesthesia post-pretreatment with 0.2 μg/kg nalmefene. Patients in group C and D received induction of anesthesia as patients in group A and B. According to the BIS and fluctuation of hemodynamic , the amount of propofol was adjusted. If necessary, additional single intravenous injection of 0.5 mg/kg propofol. The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2) and respiratory rate (RR) in patient before injection (T1), the eyelash reflex (T2), dilatation (T3), curettage (T4) and surgery awake (T5) were detected. The additional amount of propofol , operation time , recovery time of surgery , the steward score of orientation recovery after 1min of surgery , body movement reaction , cough , respiratory depression , postoperative visual analog digital score (VAS) 15 min later were also recorded in each group. Results Compared with group A, propofol could reduce the intraoperative body movement reaction rate , with lower postoperative VAS in group B and group D (P 0.05). The rapid recovery, surgery within 1 min orientation recovery were higher in group B, C, D compared with group A (P <0.05). However, orientation recovery score in group D was higher than that in group B (P < 0.05); The respiratory depression and choking were higher in group A and B than those in group C , D (P < 0.05, respectively). Conclusion The doses of 0.2 μg/kg nalmefene can effectively antagonize the respiratory depression , delay recovery and other adverse reactions in painless which induced by sufentanil , and the dose of nalmefene in this study failed to enhance the effect of analgesic and change the BIS values.
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BACKGROUND:Dexmedetomidine is an effective high-selectivityα2-adrenoceptor agonist that has sedative, analgesic, anxiolytic effects, but slightly affects respiration. OBJECTIVE:To observe the analgesic effect of dexmedetomidine on selective damage of sciatic nerve branch in a rat model by intrathecal injection. METHODS:A total of 36 male Sprague-Dawley rats were randomly divided into normal control group, physiological saline group and dexmedetomidine group. A rat model of selective damage of sciatic nerve branch was established by knotting off the common peroneal nerve and tibial nerve in the physiological saline group and dexmedetomidine group. Rats in the dexmedetomidine group were daily injected with dexmedetomidine 3μg/kg by intrathecal injection within 14 days after injury. Rats in the physiological saline group were injected with physiological saline. RESULTS AND CONCLUSION:Compared with the physiological saline group, the mechanical withdrawal threshold and the thermal withdrawal latency were significantly increased in the dexmedetomidine group (P<0.05). Neuronal nitric oxide synthase mRNA and protein expression levels were significantly decreased in the spinal dorsal horn (P<0.05). The injury to spinal dorsal horn neurons was obviously lessened. Moreover, neuronal nitric oxide synthase mRNA and protein expression levels and the injury to spinal dorsal horn neurons were similar between 14 days after administration and normal control group. Results indicated that intrathecal injection of dexmedetomidine could inhibit the expression of neuronal nitric oxide synthase in the spinal dorsal horn and relieve the pain induced by sciatic nerve injury.
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BACKGROUND:Dexmedetomidine is an efficient, highly selective alpha-2 adrenergic receptor agonist, with sedative, analgesia and anti-anxiety effects, it has little impact on the respiration. OBJECTIVE:To observe the analgesic effect induced by intrathecal injection of dexmedetomidine in rat model of spared nerve injury. METHODS:A total of 60 male Sprague-Dawley rats were randomly divided into three groups (n=12):normal control group, dexmedetomidine group and saline group. Except for the normal control group, spared nerve injury model was established in the rats of dexmedetomidine group and saline group. Dexmedetomidine group was treated with intrathecal injection of dexmedetomidine 3μg/kg every day within 14 days after injury. Saline group was given equal volume of saline for 14 days. The thermal withdrawal latency and mechanical withdrawal threshold were measured respectively before injury, after injury, before injection, and 2, 7, 14 days after intrathecal injection. Four rats were sacrificed in each group at day 2, 7 and 14 after injection, and the lumbar segments (L 4-6 Hematoxylin-eosin staining was performed to detect the morphology of the spinal dorsal horn neurons and ) of the spinal cord were removed. Real-time RT-PCR and western blot analysis were used to determine the expression of protein kinase C mRNA and protein in the spinal dorsal horn neurons. immunohistochemistry staining was carried out to assess the expression level and distribution of protein kinase C. RESULTS AND CONCLUSION:The thermal withdrawal latency and mechanical withdrawal threshold in dexmedetomidine group and saline group were significantly decreased compared with normal control group before or after injection (P<0.05). However, both the thermal withdrawal latency and mechanical withdrawal threshold in dexmedetomidine group after intrathecal injection were significantly higher than those in saline group (P<0.05). The protein kinase C expression in spinal dorsal horn neurons was significantly decreased in dexmedetomidine group compared with saline, and reached to the most lowest levels as normal control group on 14 days after injection. Moreover, the apoptosis of spinal dorsal horn neurons in dexmedetomidine group was lighter than that in saline group, and was similar to the morphology of neurons in normal control group on 14 days after injection. Intrathecal injection of dexmedetomidine could attenuate the hyperalgesia induced by spared nerve injury, which might be associated with the inhibition of protein kinase C expression in spinal dorsal horn.
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Expansion of services offered by the department of anaesthesiology in a hospital not only satisfies social needs but also conforms to the hospitals need for survival and development. Hence some hospitals have adopted the following methods to expand the services offered by their department of anaesthesiology: ①improvement of the anaesthesiologists skills; and ②delivery of such additional services as painless childbirth, deep vein tube placement, dressing change and pain easing for patients with extensive burn, fast extrication from drugs, painless endoscopy and treatment of pain. With the improvement of the expertise and the service quality of the department of anaesthesiology, sound social and economic benefits have been obtained.