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Objective To analyze the clinical effects of dexmedetomidine on postoperative agitation in children patients . Method Forty-four children undergoing surgeries in our hospital between March 2011 and March 2014 were treated with intravenous injection of 10 mL dexmedetomidine with a dose of 0.5μg/kg in 15 minutes after general anesthesia. Result The occurrence rate of postoperative restlessness was only 6.82%(3/44). Conclusion The use of dexmedetomidine combined with specific clinical nursing intervention for children undergoing surgery can effectively reduce the occurrence of postoperative restlessness , which ensures the clinical therapeutic effect and life safety.
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Objective To investigate the effects of isoflurane and sevoflurane at the same dose on expression of Caspase-3 of primary somatosensory cortex (SI) and expression of micmmbule associated protein 1B (MAP1B)in cortical neuronsin neonatal SD rats.Methods Fifty-five neonatal SD rats at postnatal day 7 (eleven rats each litter,altogether 5 litters)were assigned randomly into control group(C group),isoflurane group (I group)and sevoflursne group(S group)in average.The rats in I group,S group or C group were exposed to 1.1% isoflurane or 1.8% sevoflurane (equivalent to 0.5MAC)or air 4h.The brain of neonatal rats were perfused and embedded by paraffin,Caspase-3 positive expression in the SI cortex of brain was detected by immunohistochemistry staining.Besides,the fresh cortex was dissected at O h in C group and at 2h,4h in I group and S group,microtubule associated protein 1 B expression was detected by West blot staining.Results Caspase-3 positive cells in the SI cortex were increased by 561.23%in I group(t=4.45,P<0.01)and 194.46% in S group(t=5.17,P<0.01)when compared with C group,and increased by 124.45% in I group(P<0.05)when compared with S group.The MAP1B protein was increased by 557.15%at 2h(t=16.54 P<0.01)and 475.21% at 4h(t=32.97,P<0.01)in I group while increased by 693.11%at 2h(t=9.45,P<0.001)and 268.15% at 4h(t=2.79,P=0.049) in S group when compared with C group.In S group,MAP1B protein at 4h reduced by 53.65%(P<0.01) when compared with that at 2h.Conclusion 0.5 MAC isoflurane can induce more apoptosis in the cortex in the neonatal rats'brain at postnatal day 7 than sevoflurane.They can both significantly promote the expression of MAP1B in the cortex to start the self-reparation.
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BACKGROUND: Stellate ganglion block (SGB) has become a technique frequently used in the field of pain management for its wide indication spectrum. Its ameliorative effect on cephal-facial pain may be achieved by regulating the cerebrovascular diastolic and systolic functions and intensifying cerebral perfusion.OBJECTIVE: To observe the influence of SGB on the blood velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) and vertebral artery with three-dimensional transcranial Doppler (TCD) in patients with caphal-facial diseases caused by is chemia or vascular spasm.DESIGN: A before-after control observation.SETTINGS: Department of Pain Management, Guizhou Provincial Orthopaedic Hospital; Department of Anesthesiology, the First Affiliated Hospital of Guangzhou Medical College; Department of Anesthesiology, the Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Twenty patients of 18-50 years old were selected from the Department of Pain Management of Guizhou Provincial Orthopaedic Hospital from March 2004 to December 2005, including 6 cases of migraine,3 of cluster headache, 4 of muscle tension-type headache, 2 of nervous tinnitus and earache, and 5 of derangement of temporomandibular joint.METHODS: Unilateral SGB was performed by means of paratracheal anterior technique, with the following compound prescription: lidocaine (20 g/L)2.5 mL and dexamethasone 1 mg in normal saline with a total volume of 10 mL. SGB was performed once a day for 7 consecutive days as one course.MAIN OUTCOME MEASURES: The changes of blood velocity of ACA,MCA, PCA and vertebral artery were observed with three-dimensional TCD before SGB and at 30 minutes after SGB.RESULTS: All the 20 patients finished the treatment and entered the analysis of results. After treatment, the blood velocities of ACA, MCA and PCA of the blocked side were increased remarkably as compared with those before treatment [(76.20±3.83), (61.95±2.50) cm/s; (83.65±2.36),(77.55±2.69) em/s; (65.20±2.99), (58.70±2.2.35) cm/s; P ＜ 0.01], but that of vertebral artery had no significant change before and after treatment [(47.20±2.04), (45.55±2.23) cm/s, P ＞ 0.05]. CONCLUSION: The blood velocities of the blocked side are obviously increased after treatmeut, the increased blood velocities of ACA, MCA and PCA have important clinical significance for the blood supply of cerebral hemisphere, especially the anterior 2/3 part, but had little great influence on vertebral artery, indicating that SGB has great pertinence to the caphalfacial diseases caused by ischemia or vascular spasm, and can ameliorate the cerebral blood perfusion.