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OBJECTIVE@#To evaluate the impact of a history of vaginal delivery on anesthesia management of patients undergoing hysteroscopic surgery under intravenous general anesthesia without tracheal intubation.@*METHODS@#Ninety-nine patients undergoing hysteroscopic surgery under intravenous general anesthesia were enrolled in this study, including 43 patients with (VD group) and 56 patients without a history of vaginal delivery (NVD group). For all the patients, blood pressure, heart rate (HR), blood oxygen saturation (SpO2) and bispectral index (BIS) were recorded before anesthesia (T1), after anesthesia (T2), after cervical dilation (T3), and at 3 min after cervical dilation (T4). Propofol and etomidate doses during anesthesia induction, the total dose of propofol administered, additional intraoperative bolus dose and times of propofol, intraoperative body movement, total operation time and surgeons' satisfaction feedback scores were compared between the two groups. The postoperative awake time, recovery time, VAS score at 30 min after operation, and postoperative nausea and vomiting (PONV) were also compared.@*RESULTS@#There was no significant differences in SBP, DBP, HR, SpO2, or BIS between the two groups at T1 and T2, but at T3 and T4, SBP and DBP were significantly higher in NVD group than in VD group (P < 0.01); HR was significantly higher in NVD group only at T3 (P < 0.01). The application of vasoactive drugs did not differ significantly between the two groups. The total dose of propofol, additional intraoperative dose and times of propofol were all greater in NVD group than in VD group (P < 0.01). More body movements of the patients were observed in NVD group (P < 0.01), which also had lower surgeons' satisfaction score for anesthesia (P < 0.01), higher postoperative VAS score (P < 0.05), and shorter postoperative awake time (P < 0.05) and recovery time (P < 0.01).@*CONCLUSION@#A history of vaginal delivery has a significant impact on anesthesia management of patients undergoing hysteroscopic surgery under intravenous general anesthesia without tracheal intubation in terms of hemodynamic changes, anesthetic medication, and postoperative recovery quality, suggesting the necessity of individualized anesthesia management for these patients.
Subject(s)
Female , Humans , Pregnancy , Anesthesia, General , Anesthesia, Intravenous , Anesthetics, Intravenous , Cohort Studies , Delivery, Obstetric , Hysteroscopy , PropofolABSTRACT
Objective To investigate the efficacy ofpoly (lactic acid co castor oil) microspheres containing ropivacaine for sciatic nerve block of mice.Methods A total of 150 Kunming male mice were randomly assigned into 3 groups,namely placebo microspheres (lactic acid co castor oil) group (group A,n=50),ropivacaine injection group (group B,n=50) and ropivacaine microspheres group (group C,n=50).After sevoflurane anesthesia,the mouse was fixed on the operating table and the bilateral sciatic nerve was exposed.The corresponding preparations were implanted or injected near the sciatic nerve.Five mice were randomly selected from each group for the next experiments.Paw withdrawal thermal latency,the ability to splay and flex of the hind paw and plasma ropivacaine concentration were measured 10min,30min,1h,3h,5h,7h,10h,15h,30h and 48h after drug administration.Results The anesthetic effect of group C began to work at 3h.Compared with group B,the duration of sciatic nerve sensory block of group C was significantly longer and the effect of motor block was weaker.No anesthetic effect was observed in group A.The sensory and motor block of group B reached the peak at 1h,and the pharmacodynamics subsided at 7h.Compared with group B,the concentration of ropivacaine in group C increased slowly,and the peak value at 10h after administration was gradually decreased.Conclusions Ropivacaine loading poly (lactic acid co castor oil) microspheres can significantly extend the effect of ropivacaine on sciatic nerve sensory block.Compared with ropivacaine injection,motor block effect of ropivacaine loading poly (lactic acid co castor oil) microspheres is reduced and its plasma ropivacaine concentration fluctuation range is small.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the anesthetic management for neurosurgery using intraoperative magnetic resonance imaging (iMRI).</p><p><b>METHODS</b>Thirty patients with intracranial tumor received MRI for preoperative safety screening and the operation was performed with general anesthesia and support by MRI-compatible machines. The operative time, frequency and duration of MRI, MRI-related time (from the preparation for MRI to the beginning of the surgery), time delay by MRI, body temperature at the initial iMRI and special issues related to the scanning and perioperative anesthesia were recorded.</p><p><b>RESULTS</b>Thirty patients successfully completed the operations without any incidents related to anesthesia or scanning. The mean frequency of MRI was 1.8, the mean duration of MRI was 29.24 ∓ 10.10 min, and the MRI-related time was 43.83 ∓ 10.23 min; the time delay MRI was 92.63 ∓ 28.31 min, and the body temperature was significantly higher at 2 h after MRI than that after induction.</p><p><b>CONCLUSION</b>In the anesthetic management for neurosurgery with iMRI, the anesthesiologists should focus on the safety precaution and anesthetic modulation according to the special environment and procedure of iMRI.</p>