ABSTRACT
Objective To explore the impact of different hemoglobin on postoperative cognitive functions in female patients underwent laparoscopic surgery. Methods 215 female patients who were underwent laparoscopic total hysterectomy or laparoscopic myomectomy from January 2016 to December 2016 in our hospital were selected. The patients were divided into 3 groups according to their hemoglobin:Group N with normal hemoglobin ,Group A with hemoglobin concentration of 9 ~ 11 g/L ,and Group B with hemoglobin concentration of 6 ~ 9 g/L. Same anesthesia and recovery plan were performed in all patients. Basic and operative information were recorded. The score of MoCA on the day before surgry ,the day after surgry ,3 days after surgry and 30 days after surgry were recorded. Blood samples were collected on the day before surgry and the day after surgry for the determina-tion of serum S-100β protein and IL-6 concentrations. Results No significant difference was found in basic and operative information among three groups. The recovery time was much longer in Group B than that in Group N. No difference were found among three group in the score of MoCA on the day before surgry and 30 days after surgry ,while the score in the day after surgry and 3 days after surgry were lower in Group B com-pared with Group N. The incidence of POCD were higher in Group B compared with Group N. Compared with the day before surgry ,the concentration of serum S-100β protein and IL-6 were much higher. And compared with Group N ,the concentration of serum S-100β protein was higher in Group A and B in the day after surgry , while IL-6 was higher in Group B. The concentration of serum S-100βprotein and IL-6 were much higher in Group B compared with Group A in the day after surgry. Conclusion Female patients with hemoglobin concen-tration of 6 ~ 9 g/L are susceptible to POCD ,which might be contributed by operative central nerve system damage induced by excessive inflammation.
ABSTRACT
Objective The aim of this study was to investigate different dosages and effects of dexmedetomidine for prevention of postanesthetic shivering. Methods One-hundred twenty patients scheduled for laparoscopic surgery were randomly allocated in four groups: before the operation, slowly injected 0.9% normal saline (group S, dexmedetomidine 0.5 μg/kg (group D0.5), dexmedetomidine 0.75 μg/kg (group D0.75), dexmedetomidine 1.0 μg/kg(group D1.0). HR and rectal temperature[C2] were continually monitered during and after operation, time to extubation was measured. Grades of shivering were recorded. Pain evaluation was assessed by a visual analogue scale, sedation was evaluated by Modified Observer′s Assessment of Alertness/Sedation scale. Results The patients in group S showed a significantly higher HR and postoperative incidence of shivering than those in group D0.75 and group D1.0, (P < 0.05). but the extubation time in groupd D0.75 and group D1.0 were longer than patients in group S (P<0.05). Conclusion Slowly injected dexmedetomidine 0.75 μg/kg or 1.0 μg/kg can prevent postanesthetic shivering in laparoscopic surgery effectively.
ABSTRACT
Objective To investigate the effects of intrathecal (IT) dexmedetomidine on analgesia and neurotoxicity produced by ropivacaine spinal block .Methods Male SD rats weighing 250-300 g were used in this study. The animals were anesthetized with intraperitoneal 10% chloral hydrate 300 mg/kg. IT catheter was placed according to the technique described by Yaksh and Rudy. The tip of the IT catheter was positioned at lumbar region. Thirty-six SD rats in which IT catheter was successfully placed without complication were randomly allocated into 6 groups (n = 6 each): group Ⅰ received normal saline IT (group C); group Ⅱ received 0.5% ropivacaine 20 μl IT (group R); group Ⅲ received dexmedetomidine 3 μg/kg IT (group D ); group Ⅳ, Ⅴ , Ⅵ received 0.5% ropivacaine 20 μl + dexmedetomidine 1, 2 and 3 μg/kg IT respectively (group DR1, DR2, DR3). Tail-flick test, paw withdrawal threshold to yon frey stimuli and incline plate test were performed at 5, 30, 60, 120 and 240 min after IT drug administration. Two weeks later, the animals were sacrificed and the lumbar segment of the spinal cord was removed for microscopic examination. Results The duration of spinal block was significantly longer and the effect stronger in group DR1, DR2 and DR3 than in group R. Electron microscope showed that the injury to the myelin sheath of axon was the most severe in group DR3. Little or no damage to the axon was found in the other 5 groups (pathological score = 0). Conclusion Dexmedetomidine IT can enhance spinal block produced by 0.5 % ropivacaine, and there is celling effect.