ABSTRACT
Objective To explore the effect of ProSeal laryngeal mask airway and endotracheal tube on analepsia stage of general anesthesia in geriatric patients undergoing radical mastectomy.Methods Thirty geriatric females with breast cancer of American Standards Association (ASA)Ⅰ-Ⅱscheduled for selective radical mastectomy under general anesthesia were randomly allocated to two groups: ProSeal laryngeal mask airway group(PLMA group, n=15) and endotracheal tube group (ET group, n=15). The patients were put on PLMA or were intubated with ET under general anesthesia in the two groups, respectively. The heart rate (HR), systolic blood pressure(SBP)and diastolic blood pressure (DBP) were recorded at the time points of 5 min after entering operation room (T0), end of surgery (T1), opening eyes (T2), after extubation (PLMA) immediately (T3) and 3 min after extubation (PLMA) (T4). The numbers of patients who were given antihypertensive agent,showed bucking, agitation or sore throat, nausea and vomiting after extubation were recorded during the analepsia stage of general anesthesia. Results The blood pressure (BP) and HR were mildly.increased in PLMA group at T2, and there was no significant difference compared with T0(P＞0.05). But the BP and HR were significantly higher at T3 than at T0 (P＜0.05). In ET group, the BP and HR were both significantly elevated at T2 and T3 than at T0 (P＜0.05), and reached the peak at T3. The increased levels of BP and HR were significantly lower in PLMA group than in ET group at T2 and T3 (P＜0.05). The quantities of patients who were given antihypertensive agent, showed bucking and sore throat were less in PLMA group than in ET group(P＜0.05). No differences in incidence rate of agitation, nausea and vomiting after extubation between the two groups were observed(P＞0.05). Conclusions PLMA can obviously reduce the occurrence of complications in analepsia stage of general anesthesia in geriatric patients scheduled for selective radical mastectomy,and is beneficial to provide much safer anesthesia.
ABSTRACT
Objective To assess the efficacy and safety of target-controlled infusion of propofol and remifentanil in geriatric patients with hepatocellular carcinoma undergoing percutaneous radiofrequency ablation. Methods Thirty geriatric patients with primary hepatocellular carcinoma of ASA Ⅱ-Ⅲ scheduled for percutaneous radiofrequency ablation under monitored anesthesia care (MAC) were randomly allocated to two groups: target-controlled infusion of propofol and remifentanil group (PR group, n= 15) and intravenous injection of midazolam and fentanyl group (MF group. n= 15). The mean arterial blood pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) of patients were recorded during the treatment. The Ramsay Score, Patient Cooperation Score, VAS Score and postoperative Patient Satisfaction Score were recorded as well. Results The Ramsay Score, Patient Cooperation Score, VAS Score and Patient Satisfaction Score were all higher in PR group than in MF group (all P<0.05). The maximum values of MAP and HR [( 108.7± 8.6) mm Hg, (83.8±7.1) times/min] were significantly higher than the baseline values [( 99.3 ± 8.5) mm Hg, (76.3±7.1) times/min] in MF group, and the degree of increment of MAP and HR were significantly greater in MF group than in PR group (both P<0.05). The minimum values of MAP and HR [(84.5±6.5) mm Hg, (66.6 ± 6.6) times/min] were significantly lower than the baseline values [(97.7±6.5) mm Hg, (75.4±7.3) times/min] in PR group, and the degree of decrement of MAP and HR were significantly greater in PR group than in MF group (both P<0.05). SpO2 of both groups decreased significantly (the minimum values of PR and MF groups were 95.1±2.0 and 95.5± 2.2, respectively), but there was no statistical difference between two groups (P>0.05) . Conclusions MAC with target-controlled infusion of propofol and remifentanil is more suitable for geriatric patients with hepatocellular carcinoma undergoing percutaneous radiofrequency ablation, as it can provide ideal analgesia and sedation, but the respiration and the change of hemodynamics of patients must be observed seriously.
ABSTRACT
Objective To evaluate the role of protein kinase C (PKC) in reduction of hypoxia-reoxygenation (H/R) injury by hypoxic preconditioning or norepinephrine preconditioning in cultured neonatal rat cardiomyocytes. Methods Primary cultured neonatal rat cardiomyocytes were randomly divided into 6 groups (n = 25 each): control group (group Ⅰ), H/R group (group Ⅱ), hypoxia preconditioning group (group Ⅲ), norepinephrine preconditioning group (group Ⅳ), H7 + hypoxia preconditioning group (group Ⅴ) and H7 + norepinephrine preconditioning group (group Ⅵ). In group Ⅱ , the cardiomyocytes were exposed to 3 h of hypoxia followed by 1 h of reoxygenation. In group Ⅲ, the cells were subjected to 20 min of hypoxia followed by 20 min of reoxygenation before H/R. Norepinephrine was added to the culture medium with a final concentration of 10- 7 mol/L,and then the cells were cultured for 30 min before H/R in group Ⅳ. H7 was added to the culture medium with a final concentration of 5 × 10-5 mol/L, the cells were then cultured for 10 min, and the following procedures before H/R were the same as thase described in group Ⅴ . H7 was added to the culture medium with a final concentration of 5 × 10-5 mol/L, the cells were then cultured for 10 min, and the following procedures were the same as those described in group Ⅵ. The cell survival rate, the activities of LDH and CK in the supernatant, and the content of MDA and activity of SOD in cardiomyocytes were determined. Results The cell survival rate and activity of SOD were significantly lower, while the LDH and CK activities and MDA content higher in group Ⅱ than in group Ⅰ ,in group Ⅴ than in group Ⅲ, and in group Ⅵ than in group Ⅳ (P ＜ 0.01). The cell survival rate and activity of SOD were significantly increased, while the LDH and CK activities and MDA content decreased in group Ⅲ and Ⅳ compared with group Ⅱ (P＜0.01).Conclusion The activiation of PKC is involved in the reduction of H/R injury by hypoxic preconditioning or norepinephrine preconditioning in cultured neonatal rat cardiomyocytes.