ABSTRACT
ObjectiveThe correlation of intestinal flora diversity in infants undergoing cochlear implantation (CI) with different general anesthetics remains unclear. The aim of this study was to observe the effects of propofol and sevoflurane on intestinal flora diversity in infants undergoing cochlear implantation.MethodsFrom January 2018 to August 2018, twenty infants with hearing impairment who underwent CI in the Department of Anesthesiology, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine were randomly divided into propofol group (10 cases) and sevoflurane group (10 cases). The propofol group (group P) received intravenous injection while the sevoflurane group (group S) received inhalation. Genomic DNA was extracted for PCR and 16S rDNA sequencing technique was used to analyze the diversity of intestinal flora (intestinal flora taxonomic composition, flora alpha diversity index, and intestinal flora PICRUSt function prediction).ResultsThe analysis of intestinal flora taxonomic composition showed that the intestinal flora of infants in the two groups were mainly Firmicutes and Bacteroidetes after operation. There was no significant difference in species diversity of intestinal flora (Actinobacteria, Bacteriodetes, Firmicutes, etc.) between Group S and Group P（P＞0.05）. The analysis of flora alpha diversity index showed that there was no significant difference in metrics (species information index, chaol index, Shannon index, etc.) between Group S and Group P（P＞0.05）. The analysis of intestinal flora PICRUSt function prediction showed that there were significant differences in Peptidase metabolism (1.82±0.08, 1.91±0.07, P=0.02), Protein Kinase metabolism (0.32±0.03, 0.28±0.03, P=0.02) and Tuberculosis pathway (0.14±0.01,0.15±0.01,P=0.049) between Group S and Group P after operation.ConclusionSevoflurane and propofol can regulate the functional diversity of intestinal flora through affecting different metabolic pathways of KO function in the functional diversity of intestinal flora and provide new guidance for the use of clinical anesthetics in infants undergoing CI.
ABSTRACT
Objective·To explore the safety of elective therapeutic cardiac catheterization in congenital heart disease (CHD) children with recent upper respiratory tract infection (URI) (within two weeks),so as to provide guidance for clinical anesthesia management.Methods·A total of 140 CHD children of American Society of Anesthesiologist (ASA) Ⅱ～Ⅲ undergoing tracheal intubation general anesthesia for elective therapeutic cardiac catheterization,aged 3 months to 15 years,were divided into URI group and non-URI group according to history of recent URI.The incidence of perioperative respiratory adverse events (PRAEs) [i.e.laryngospasm,bronchospasm,breath holding ≥ 15 s,pulse blood oxygen saturation (SpO2)＜95％(≥ 10 s),cough,and glossoptosis] and postoperative dysphoria,fever,copious sputum,and vomiting within 24 h after operation were observed and compared.Results·Compared with non-URI group,recent URI increased significantly the overall incidence of PRAEs (any complications of PRAEs) (P=0.001),particularly the incidence of SPO2＜95％ (P=0.014) and cough (P=0.000).Compared with children aged from 4-15 in URIgroup,the overall incidence of PRAEs (P=0.003),SPO2＜95％ (P=0.018),and cough (P=0.027) of children younger than 3 years increased significantly.Besides,compared with non-URI group,recent URI increased significantly the incidence of postoperative copious sputum (P=0.002).Conclusion·Recent URI increases significantly the incidence of perioperative complications in CHD children undergoing elective therapeutic cardiac catheterization.These complications are short and easily managed,and no serious adverse events occurred in CHD children.