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Objective To investigate the effect of small dose of dexmedetornidine on venous continuous infusion combined with oxycodone or fentanyl during brachial plexus blockade.Methods Sixty thyroid patients (ASA Ⅰ or Ⅱ) undergone brachial plexus anesthesia for cutting or cutting thyroid tumor patients were randomly and double-blindly into three groups (n =20 in each group).Group A:single brachial plexus anesthesia;group B:dexmedetornidine combined with fentanyl;group C:dexmedetornidine combined with oxycodone.Blood pressure (Bp),heart rate (HR),the determination of plasma norepinephrine (NE),cortisol (Cor),the concentration of blood glucose (Glu),VAS,Ramsay calm score,local anesthetics dosage and side effect formation rate at the beginning operation (To),skin incision (T1),separation of the glands (T2),gland excision (T3),and the end of the surgery (T4) were recorded.Results Compared to group A,the mean arterial pressure (MAP),HR,NE,Cor,and Glu were much lower at each time point (P ＜ 0.05) in groups B and C;Ramsay calm score and VAS score were significantly better at each time point (P ＜ 0.05);the incidence of chills and lidocaine additional quantity were significantly lower (P ＜0.01).However,compared to groups A and C,choking cough response rates were much higher in group B (P ＜ 0.01).Conclusions Small dose of dexmedetornidine on venous continuous infusion combined with oxycodone during brachial plexus blockade for thyroid patients both can eliminate the preoperative patients nervous anxiety,and effectively restrain perioperative stress response,maintain hemodynamics stable,implementation of intraoperative awaken to reduce complications.It is the new choice of anesthetic adjuvant.
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Objective To evaluate the value of bispectral index(BIS)monitoring as an indicator for extubation sedation level after children's oper?ation by total intravenous anesthesia. Methods One hundred and eighty children(2?13 years old)were randomly divided into six groups with 30 cases in each. Group A kept BIS 56?60,and Group B 61?65,Group C 66?70,Group D 71?75,Group E 76?80,Group F 81?85 till extubation. All children were given fentanyl,propofol and cisatracurium besilate when induced,and maintained with propofol and remifentanil. All cases kept BIS 40?55 during the operation. Then the changes of electrocardiogram,mean arterial pressure,heart rate,SpO2,postoperative complications and recovery time were observed. Results Groups A and B were extubated at deep anesthesia,cycle stability,but with high incidence of adverse reactions and awaked with a long time. Groups E and F were extubated when awaked,but with greater stimulation and easier agitation. Groups C and D were lighter hemodynamic responses,less respiratory effects and less postoperative complications of anesthesia. Conclusion The BIS level of 66?75 is a good se?dation level for extubation,especially in the level of 71?75.
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Objective To monitor right heart hemodynamic changes of patients with lung cancer during and after the procedures of pneumonectomy and discuss the effect of pneumonectomy on right heart function and risk of postoperation morbidities. Method 16 patients with lung cancer were randomly selected and the clinical database was queried and Swan-Ganz catheter was applied awake from jugular vein to pulmonary artery ,measuring mean arterial pressure(MAP) ,heart rate(HR) ,central venous pressure(CVP) ,mean pulmonary artery pressure (MPAP),mean pulmonary capllary wedge pressure(MPCWP) ,and eardiaoc output(CO) and calculating cardiac index (CI),left ventricular-stroke work index (LVSWI), right ventricular stroke work index (RVSWI) , and stroke volume index(SVI) instantaneously before anaesthesia, after anaesthesia with single lung ventilation, after pulmonary artery and pulmonary vein occlusion and supine chest dosed during the procedure of pneumonectomy. Pre-and post-operative complications were recored. Results Cardiovascular complications occurred in 6 patients(37.5%) postoperatively. There were no operative or perioperative deaths. MPAP increased significantly after the procedure of pneumonectomy compared with that of preoperation, and MPAP > 26 mm Hg was in 4 patients who got cardiovascular complications postoperatively with morbidity of 100% ,which was "significantly higher than the morbidity of 16.7% (2/12) when MPAP < 25 mm Hg. Conclusion Pneumonectomy has significant effects on right heart hemodynemic changes and as MPAP increases postoperatively, the risk of cardiovascular complications becomes higher.
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Objective To investigate the preventive effects of midazolam and propofol on liver against hypoxia/reoxgenation(H/R) injury in rats.Methods Twenty-four Wistar rats of both sexes weighing 200-250g were randomized into four groups:control group(group A),hypoxia/reoxygenation(group B),H/R + midazolam(group C) and H/R + propofol(group D).The 8-iso-prostaglandin F2?(8-iso-PGF2?) levels in the hepatic tissue were determined by enzyme-linked immunosorbent assay(ELISA).The contents of nitric oxide(NO) and the activity of nitric-oxide synthase(NOS) in hepatic tissue were determined by biochemistry methods.Results After hypoxia and reoxgenation injury in rats,the 8-iso-PGF2? level of hepatic tissue in group B was significantly higher than that in group A(P
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Objective To determine the expression of inducible nitric oxide synthase (iNOS) in brain after cerebral hypoxia / reoxygenation and the effects of preoxygenation with different concentrations of oxygen in rats.Methods Seventy-two male Wistar rats weighing 250-300 g were randomly divided into 4 groups : group Ⅰ, Ⅱ ,Ⅲ ,and Ⅳ . Each group was further divided into 3 subgroups : a, b, c. Group Ⅰ a, Ⅱ a, Ⅲ a and Ⅳa were preoxygenated with 21 % O2 (Ⅰa), 50 % O2 (Ⅱ a) , 75 % O2 (Ⅲa) and 95 % O2 (Ⅳ a) for 30 min. GroupⅠ b-Ⅳb were subjected to hypoxia (5 % O2 ) for 20 min after preoxygenation. Group Ⅰc-Ⅳc were reoxygenation (98 % O2) for 20 min after preoxygenation and hypoxia. The animals were sacrificed 48 h after the experiment. Brains were immediately removed for microscopic examination and determination of iNOS expression in brain using immuno-histochemistry technique. Results The number of iNOS positive cells was significantly greater in hypoxia groups than that in preoxygenation groups ( P
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Objective To investigate the protective effects of propofol on liver against hypoxia/reoxgenation (H/R) injury in rats. Methods Twenty-four Wistar rats of both sexet weighing 200-250g were randomized into control group (group A), hypoxia/reoxygenation group (group B) and H/R + propofol group (group C). The 8-iso-prostaglandin F 2? (8-iso-PGF 2? ) level in the hepatic tissue was determined by enzyme-linked immunosorbent assay (ELISA). The content of NO and the activity of NOS were assessed by biochemical methods. Results In group B, the 8-iso-PGF 2? level in hepatic tissue was significantly higher than that in group A (P