ABSTRACT
Objective To assess clinical results between proximal-first sequential anastomosis technique (POPCAB) and conventional technique off-pump coronary artery bypass grafting(COPCAB) in 72 patients over 65 years old.Methods Between Jan 2008 and Oct 2012,72 patients with multiple vessel coronary artery disease underwent off-pump coronary artery bypass grofting.They were divided into two groups,POPCAB and COPCAB groups.Preoperative and postoperative variables of two groups were compared.Results There were no significant difference in sex,age,history of acute myocardium infarction,hypertension,diabetes and number of bypass grafts between two groups.The ICU stay time in POPCAB group was less than in COPCAB group(P ＜0.05).There were lower creatine kinase MB and cardiac trop I after operation in POPCAB group compared with COPCAB group(P ＜ 0.05).Conclusion The results confirm that promixal-first sequential anastomosis technique remains a valuable option of surgical myocardial revascularization,and may optimize the outcome in the aged.
ABSTRACT
Objective To compare the gas and heat exchange performance of membrane oxygenator DDMO-100S and membrane oxygenator Terumo SX-10 in cardiopulmonary bypass(CPB)in children.Methods 39 children aged 3-12 yrs who suffered from congenital heart disease were selected,and the repair of ventricle septal defect or/and atrial septal defect was performed under cardiopulmonary bypass.The 39 children were randomly divided into Group DD(n =21)and Group SX(n = 18).Membrane oxygenator DDMO-100S(Made by Xi'an Daidai,China)was used in Group DD and Membrane oxygenator Terumo SX-10(Made by Terumo,Japan)in Group SX,respectively.The hypothermic cardiopulmonary bypass with high perfusion flow and the cool crystalloid cardioplegia were applied in all children.The artery blood samples were taken for measuring PO2 and PCO2 and the oxygenating index(OI)was calculated by the formulae(OI = PaO2/FiO2).The temperature at nasal pharynx was monitored and the rewarming time was recorded.Results The total priming volume in Group DD was bigger than in Group SX [(742.5 ± 107.3)ml vs(531.3 ± 84.3)ml,P ＜ 0.05].The PO2,OI and PCO2 at 15 min after CPB or at 5 min before cease of CPB had no differences in both group(P ＞0.05).The rewarming time had no difference in both group [(31.5 ± 10.2)min vs(30.61 ± 8.2)min,P ＞0.05].Conclusions Under our observation condition,the gas and heat exchange performance of membrane oxygenator DDMO-100S were the same as membrane oxygenator Terumo SX-10,when it was used in cardiopulmonary bypass in children,but it had a little bit more priming volume.
ABSTRACT
Objective To investigate the effect of pretreatment with parecoxib for postoperative analgesia in patients undergoing laparoscopic hernia repair. Methods Sixty patients undergoing laparoscopic hernia repair were assigned in two groups by random digits table with 30 cases each. The patients in pretreating group received parecoxib 40 mg intravenously before anesthesia, and in control group with the same capacity of normal saline. All patients were anesthetized with combined spinal epidural blockage and tranquilized with pethidine, droperidol and diazepam. Postoperative pain of the abdomen incision was assessed by visual analogue scale (VAS) and the pain of shoulder or back was judged by a 4 grade scale. Side-effects, supplement analgesic, passage of gas by anus 24 h after surgery were observed as well. Results The abdomen incision VAS at 4,8,12,24 h after surgery in pretreating group were lower than those in control group (P ＜ 0.05). And the incidence of pain of shoulder or back was lower in pretreating group (13.3% ,4/30) than that in control group (33.3% ,10/30)(P ＜0.05). While the cases needing supplement analgesic also decreased in pretreating group (13.3% ,4/30) compared with control group (40.0%, 12/30)(P ＜ 0.05). And the side effects and passage of gas by anus 24 h after surgery had no significant difference in two groups. Conclusion Pretreatment with parecoxib in patients undergoing laparoscopic hernia repair may relieve the postoperative incision pain and the pain of shoulder or back while reducing the analgesic supplement without side effects.