ABSTRACT
Objective To evaluate the suppressive effect of dezocine ,lidocaine and ephedrine on fentanyl-induced cough . Methods A total of 120 patients ASA I-II ,scheduled for elective surgery under general anesthesia ,were randomly allocated into four groups (n= 30 ,each group) .Group Ⅰ ,Ⅱ ,Ⅲ ,Ⅳ were given saline (2 ml) ,dezocine (0 .1 mg/kg) ,lidocaine (1 mg/kg) or ephedrine(5 mg) ,respectively .One minute later all patients were injected with 4μg/kg of fentanyl ,after anoth-er one minute ,all patients were given midazolam (0 .1 mg/kg)+ propofol(2 mg/kg ,0 .4 ml/s)+cisatracurium (0 .2 mg/kg) . The incidence rate and severity of cough were recorded and hemodynamic parameters were also observed .Results The inci-dence rate of cough was 50% ,16 .7% ,13 .3% and 20% for group Ⅰ ,Ⅱ ,Ⅲ and Ⅳ ,respectively .Comparing to group I ,the incidence rate of cough was significantly lower (P<0 .05) in other groups ,but among the three experimental groups there was no significant difference in cough incidence rate and intensity .The hemodynamic changed of each group before and after the in-duction was consistent .Conclusion A priming dose of dezocine(0 .1 mg/kg) ,lidocaine (1 mg/kg) or ephedrine (5 mg) could effectively reduce the Fentanyl-induced cough response .
ABSTRACT
Objective To compare clinical effects of continuous spinal, epidural and combined spinal-epidural anesthesia for arthroplasty in the elderly over 70 years. Methods Sixty geriatric patients, ASA status Ⅱ~Ⅲ degree, aged 71~98 yr, undergoing arthroplasty operation on hip or knee joint, were randomly assigned to group of continuous spinal anesthesia, group of combined spinal-epidural anesthesia, or group of continuous epidural anesthesia, with twenty patients of per group. T_ 10 anesthesia level was aimed by 0.5% bupivacaine titrated carefully. Results All anesthesia were clinically satisfied with average anesthesia level T_ 10(T_ 7~11). Bromage's motor blockade scale in group of continuous spinal anesthesia was higher than that in group of continuous epidural anesthesia. Amount of bupivacaine consumptions were (8.0?1.8)mg, (13.7?9.7)mg, (39.4?16.6)mg in groups of continuous spinal anesthesia, combined spinal-epidural anesthesia, and continuous epidural anesthesia respectively (P0.05). Conclusions With 0.5% bupivacaine titrated carefully, all kinds of continuous spinal, epidural and combined spinal-epidural anesthesia are clinical efficient in the elderly over 70 years for arthroplasty, of which continuous spinal anesthesia is recommended due to the most stable hemodynamics.