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Objective To investigate the utility of anesthesia depth monitoring of BIS during general anesthesia without tracheal intubation.Methods Sixty patients underwent surgery with local anesthesia were randomly divided into three groups of Ⅰ ,Ⅱand Ⅲ,who were sedated with propofol by TCI propofol 1.0,1.5,2.0μg/ml,respectively.HR,MAP,SpO2 BIS and MOAA/S score were recorded at l0min before operation(T0) .during local anesthesia ( T1) , at 30min after incision (T2) , at 60min after incision (T3) , and the end of operation (T4).Results BIS values declined with the decrease of MOAA/S.MOAA/S score was lower in group Ⅲ than that in group Ⅰ (all P < 0.05).Respiratory depression was seen in 3 cases in group Ⅲ.The difference of MAP had statistical significance between level 3 and level 2 of MOAA/S in group Ⅱ and group Ⅲ (P < 0.05).Conclusion Propofol 1.0 ～ 1.5 μg/ml given by TCI could produce optimal depth of sedation with less side effects in surgery during local anesthesia.
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ObjectiveTo investigate the risk factors for airway management after tracheal extubation in old patients. Methods280 patients underwent general anesthesia were enrolled in the study. The procedure of anesthesia induction and maintenance were in the routine method. The patients were with tracheal extubation under clinical standards after operation. Dyspnea was recorded after tracheal extubation. They were divided into dyspnea group and general group. Twelve perioperative variables, ten variables in operation and six post-operative variables of two groups were compared respectively. ResultsThe incidence of dyspnea after tracheal extubation was 8.6％. Analysis identified that obesity( BMI ≥25kg/m2 ), preoperative lung disease and without postoperative neostigmine were the significant risk factors for dyspnea. ConclusionBMI≥25kg/m2 ,preoperative lung disease and without antagonist muscular relaxant were the main risk factors for dyspnea after tracheal extubation in old patients.
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Objective To evaluate the effects of deliberated hypotension combined with acute hypervolemic hemodilution (AHH) on safety,operation time, blood loss,postoperative hemoglobin (Hb) and hematocrit (Hct) of the patients undergoing endoscopic nose surgery.Methods Twenty ASA grade I to II patients undergoing selective endoscopic nose surgery were divided randomly into two groups: control group (n=10) and hypotensive group (n=10). All patients received general anesthesia. In the hypotensive group, AHH was accomplished with infusion of HAES and lactated Ringer's solution after endotracheal intubation and before operation. Deliberated hypotension was induced and maintained with nitroprusside 0 5～3 0?g?kg -1 ?min -1 iv. Operation time, intraoperative blood loss, postoperative hemoglobin (Hb) and hematocrit (Hct) and hemodynamics during operation were recorded and compared between the both groups.Results Operation time was about 44% shorter in the hypotensive group than that in the control group. Blood loss was significantly lower in the hypotensive group than that in the control group (P