ABSTRACT
Objective To evaluate the effect of anti-microbia-l coated central venous catheter (CVC),compared with routine CVC,on catheter-associated deep venous thrombosis (CADVT). Methods A total of 1 359 patients,aged 26-82 years,ASA physical status Ⅰ-Ⅲ,undergoing internal jugular,axillary-subclavian,or femoral vein CVC catheterization during January to June of 2017,were retrospectively reviewed.The patients were divided into intoanti-microbial-coated CVC group (group A)and routine CVC group (group B).Gender,age,ASA class,pre-operative risk of thrombus (Caprini score),CVC site,surgical site,ultrasound-guided catheterization,and anticoagu-lation therapy,CADVT and the degree,as well as the other adverse events were recorded.Results A total of 938 patients were successfully matched.There were 323 (34.4%)articipants diagnosed with CADVT with bedside point-of-care ultrasound,in which 172 cases (36.7%)in group A and 151 (32.2%)in group B.There was no statistical significance of CADVT and the degree between the two groups.The subgroup analysis results indicated that the patients using anti-microbial-coated CVC with high risk of thrombus (Caprini score ≥ 5 points)(OR 1.34,95% C I 1.01-1.78),undergoing catheterization according to anatomical landmark (OR 1.69,95% C I 1.04-2.74),and not-receiving anticoagulation therapy (OR 1.39,95% C I 1.01-1.92)had an increased risk of CADVT compared with those using routine CVC.A significantly decreased incidence of catheter-associated infection in group A was observed compared with group B (0.9% vs 4.1%,P<0.05).Conclusion Anti-micro-bial-coated CVC does not increase the incidence of CADVT.
ABSTRACT
Objective To investigate the sedative effect of different doses of buccal dexmedeto-midine premedication during peri-anesthesia in pediatric patients undergoing tonsillectomy and/or ade-noidectomy.Methods Eighty pediatric patients undergoing tonsillectomy and/or adenoidectomy in department of otorhinolaryngology,54 males and 26 females,aged 4-12 years,ASA Ⅰ or Ⅱ,from June,2014 through May,201 6 were enrolled,n =20 in each group.Children were randomly assigned to receive buccal dexmedetomidine 0 μg/kg (group A),1 μg/kg (group B),2 μg/kg (group C)and 4μg/kg (group D)60 min before transporting to operating room.Sedation score (OAA/S scale)was monitored before and after administering buccal dexmedetomidine.Time of post-operative first spon-taneous respiration,opening eyes,extubation,anxiety score (SAS scale),as well as OAA/S scale, pain intensity (FLACC),and adverse events 60 min after surgery were recorded.Results Compared with group A and group B,markedly superior OAA/S within 60 min after administering buccal dexmedeto-midine in group C and group D were observed (P < 0.05 ).Compared with group A and group B,the OAA/S score 5 min after extubation was lower in group D.FLACC scores within 30 and 60 min after extu-bation in group D were lower than those in group A.Group D showed obviously prolonged time of post-op-erative first spontaneous respiration,opening eyes and extubation compared with the other groups (P <0.05).All the rates of adverse events were similar.Conclusion 2 or 4 μg/kg premedecation of buccal dexmedetomidine 60 min before transporting to operating room can effectively and safely sedate pediatric pa-tients when entered operating room,improve parental separation,mask and sevoflurane acceptance,as well as decrease the stress induced by intubation and post-operative pain.