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OBJECTIVE：To investigate the effects of dexmedetomidine on regional cerebral oxygen saturation and cerebral function in patients undergoing intracranial aneurysm embolization. METHODS ：Totally 44 patients undergoing intracranial aneurysm embolization in the First Affiliated Hospital of Hunan University of TCM during Jun. 2017-Aug. 2019 were collected and randomly divided into group D （22 cases）and group C （22 cases）. Ten minutes before anesthesia induction ，group D was given intravenous injection of Dexmedetomidine hydrochloride injection 1 μg/kg；group C was given buffered normal saline 20 μL. Both groups were induced with Propofol emulsion injection+Midazolam injection+Fentanyl citrate injection+Cisatracurium besylate for injection. During the operation ，group D was given Dexmedetomidine hydrochloride injection 0.5 μg（/ kg·h）+Fentanyl citrate injection+Benzsulfosum atracurium for injection+Propofol emulsion injection to maintain anesthesia ；group C was continuously pumped with buffered normal saline 0.5 μg（/ kg·h）+Fentanyl citrate injection + Benzsulfosum aratracurium for injection Propofol emulsion injection to maintain anesthesia. Before anesthesia induction （T0）， immediately after anesthesia。induction （T1）， 1 min after tracheal intubation （T2）， immediately after operation finished （T3），immediately afte extubation（T4），the mean arterial pressure（MAP），heart rate 中国药房 2021年第32卷第7期 China Pharmacy 2021Vol. 32 No. 7 ·865· （HR），regional cerebral oxygen satur ation（rSO2）were observed in 2 groups. The levels of neuron specific enolase （NSE）and S100 β protein in serum were measured at T1，T3，6 h after operation （T6）. The recovery time ，intraoperative blood loss ， nitroglycerin amount and the occurrence of ADR were recorded. RESULTS ：MAP and HR of group D at T 2-T4 were significantly lower than those at T 0；MAP and HR of group C at T 2-T4 were significantly higher than those at T 0；the group D were significantly lower than the group C at the same period （P＜0.05）；there was no statistical significance in rSO 2 between 2 groups at T 0-T4（P＞ 0.05）. The levels of serum NSE and S 100β protein in 2 groups at T 3 were significantly higher than at T 1；those in 2 groups at T 6 were significantly lower than at T 3，but those of group D were significantly lower than the group C at T 3（P＜0.05）；there was no statistical significance in the levels of serum NSE or S 100β protein between 2 groups at T 1（P＞0.05）. The recovery time of anesthesia，the amount of nitroglycerin ，the incidence of tachycardia ，nausea and vomiting ，restlessness，shivering and cough in group D were significantly shorter or lower than group C （P＜0.05）；there was no statistical significance in the intraoperative blood loss between 2 groups（P＞0.05）. CONCLUSIONS ：Dexmedetomidine can maintain the hemodynamic stability of patients with intracranial aneurysm embolization during the perioperative period ，has little effect on rSO 2 and brain function ，and has good safety.
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Objective To research of acupuncture for the perioperative analgesia and immune function of the breast cancer patients.Methods A total of 40 breast cancer patients who were carried out the radical operation was randomly (random number table method) divided into acupuncture combined drugs group and control group in our hospital during from 2015.1 to 2016.12. The patients in acupuncture combined drugs group was carried out acupuncture combined TCI anesthesia,and the patients in control group was carried out TCI anesthesia. The analgesic effect was evaluated by Visual analogue scales(VAS) in 2h, 6h, 12h, 24h and 48h after operation. The percentage of peripheral blood subgroups of T-lymphocytes (CD3+, CD4+, CD8+), natural killer cell (CD16+CD56+) and the ratio of CD4+/CD8+ was detected in 30 min before anesthesia,2h after beginning of operation,1d , 2d and 5d after operation.Results he VAS scores at 2 h (2.30 ± 1.12vs. 3.75 ± 1.06,t=2.378), 6 h (2.64 ± 1.23vs. 5.56 ± 1.41,t=3.289) and 12 h (3.49 ± 1.46vs. 4.99 ± 1.27,t=2.040) after operation of acupuncture combined drugs group wwere significantly lower than those of control group (P<0.05). The CD3+ (52.35％ ± 4.20％vs. 48.01％ ± 4.42％,t=2.127), CD4+ (27.81％ ± 2.72％vs. 24.96％ ± 2.60％,t=2.250), CD4+/CD8+ (1.12 ± 0.15vs. 1.01 ± 0.13,t=2.136) in acupuncture combined drugs group were significantly higher than those of the control group in 1d after operation (P<0.05). The CD16+ CD56+ 2 h (14.79％ ± 2.04％vs. 13.58％ ± 1.50％,t=2.852), 1 d (14.43％ ± 2.27％vs. 13.11％ ± 1.82％,t=2.933) in acupuncture combined drugs group were significantly higher han those of control group in 2h after beginning of operation and 1d after operation (P<0.05).Conclusions The analgesic effect of acupuncture could be applied to radical operation of breast cancer under general anesthesia. This method could protect the subgroups of T-lymphocytes and natural killer cell, and improve the immune function of breast cancer patients.
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Objective To investigate the effect of cardiopulmonary bypass cardiac surgery on postoperative cognitive function of patients who wre undergoing selective cardiac surgery.Methods Fifty children patients who were scheduled for cardiac surgery were investigated with C-WISC (Chinese revised Wechsler Intelligence Scales for children) preoperative.The children patients were tested at the 7th day and 1 month postoperative by C-WISC and digital span.It could be defined postoperative cognitive dysfunction (POCD) if the C-WISC score decreased 1 SD (standard deviation).Results The incidence of POCD at the 7th day and in the first month postoperative was 40％,and 20％ in pediatric patients who underwent cardiopulmonary bypass surgery.It shows that ascending aorta clip time and cardiopulmonary bypass (CBP)time had negative correlation with intelligence quotient (IQ) (P ＜0.05),but age and education had not any correlation with intelligence quotient in pediatric patients who underwent cardiopulmonary bypass surgery (IQ) (P ＞ 0.05).Conclusions The occurrence of POCD in cardiac surgery children underwent CPB tend to be high,with long time CPB and aortic clip were more likely to have postoperative dysfunction.It shows a close relationship between CPB and aortic clip with POCD.Age and education had no significant influence on postoperative cognitive dysfunction in CPB cardiac surgery children.
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Objective To investigate the relationship between C-reactive protein (CRP) and postoperative cognitive function of female patients underwent cardiopulmonary bypass (CPB) cardiac surgery.Methods Sixty female patients were scheduled for CPB surgery from January 2012 to May 2013,aged form 35 to 60 years,mean aged (47.5 ± 12.5) years,and in state of ASAⅡ ～ Ⅲ.All patients had general anesthesia and CPB cardiac surgery.Blood samples were taken from peripheral vein before induction and 6 days after surgery.The neuropsychology assessment was measured with Wechsler Adult Intelligence Scale RC 2 + 1 (WAIS-RC) and digital span the first day preoperative,the 7th day,and the first month postoperative.The postoperative cognitive dysfunction (POCD) was judged with Newman style.Results (1) The rate of POCD of the 7th day and first month postoperatively was 50％ and 25％,respectively.(2) The Pearsong correlation showed negative correlation between CRP preoperative at the 6th day and the 7th day,and the first month postoperative WAIS-RC score(P ＜ 0.05).(3) The Pearson's figure showed negative correlation between CRP at the 6th day postoperative with digital span (P ＜ 0.05).Conclusions The ratio of POCD after CPB surgery was higher.It is instructively significant to monitor the variations of concentration of serum CRP for the selection of cognitive impairment in patients with cardiac-pulmonary bypass surgery.