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Objective To study dexmedetomidine on the adverse impact of ketamine based anesthesia and sedative effects in indirect inguinal hemia.Methods Eighty children underwent indirect inguinal hemia surgery were randomily divided into two groups after injected muscle with midazolam and ketamine,Group B was injectded with 0.5 μg/kg DEX,but Group A with normal saline,analgesia was with caudal block (lidocaine).The with hemodynamic,level of sedation,recovery time and CHW score were observed.The adverse reactions were recorded.Results Two groups of children have hemodynamically stable,and recovery time had no statistical significance.The two groups of CHW score in Group A (1.6 ± 0.5) points higher than in group B (0.9 ± 0.3) points (P ＜ 0.05).The restlessness rated group (1.52 ± 0.54) points was higher than in group B (0.51 ± 0.48) points (P ＜ 0.05).Compared with Group B,Group A had 12 cases of psychiatric symptoms,10 cases of involuntary movement of limbs,6 cases of severe postoperative agitation nausea,and 8 cases of vomiting (P ＜ 0.05).Conclusion 0.5μg/kg DEX can be safely and effectively used in the pediatric anesthesia,and reduce the adverse reactions caused by ketamine.
ABSTRACT
Objective To investigate the effect of propofol or sevoflurane on the quality of neuromuscular blockade with cisatracurium during comparable depth of anesthesia in elderly patients.Methods A total of 60 patients aged over 60 years [classified as American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅱ] were selected.Patients were randomized into 2 groups:propofol group (induction of anesthesia with propofol) and sevoflurane group (induction of anesthesia with sevoflurane) (n=35,each).Neuromuscular blocking effect was monitored by muscle response to ulnar nerve stimulation.The rates of cisatracurium injection at different time points,time of loss of consciousness and the onset time of cisatracurium neuromuscular block were compared between the two groups.Results The rate of cisatracurium injection was significantly decreased at 60 minutes,90 min,120 min in sevoflurane group(29.82％,42.28％,37.15％),and the onset time of cisatracurium neuromuscular block was significantly shorter in sevoflurane group than in propofol group [(148.62±28.54)s vs (96.53±23.69)s,P＜0.05].Conclusions Compared with propofol,sevoflurane can greatly shorten the onset time of cisatracurium and enhance the effect of cisatracurium neuromuscular block with stable hemodynamics.