ABSTRACT
Objective To compare the hypnotic effects of propofol administered by target-controlled infusion (TCI in daytime and nighttime,in order to explore the effect of circadian rhythm on the sedative effect of propofol.Methods Sixty-five male ASA Ⅰ or Ⅱ patients,aged 18-55 years,with the body mass index (BMI) of 18.5-24.9 kg/m2,undergoing emergency minor hand surgery were divided into two groups according to the time of the day when they received TCI of propofol:daytime group (from 07:01 to 19:00) and nighttime group (from 19:01 to 07:00).The pharmacokinetic parameters proposed by Schnider et al.which suggested the effect-site concentration (Ce) was used.Four Ces of propofol were set at 0.8,1.2,2.0 and 4.0 μg/ml,respectively.Ce was increased step by step and each Ce was maintained for 5 minutes.The level of sedation at each Ce was assessed by bispectral index (BIS) and observer's assessment of alertness/sedation (OAA/S) scores.BIS values and Ces of propofol were recorded and compared between the two groups when the patients lost consciousness (OAA/S score =2).Results There were 28 and 30 patients in daytime and nighttime groups,respectively.When Ces were 1.2 and 2.0 μg/ml,the BIS values were significantly lower in the nighttime group than in the daytime group.There was no significant difference in BIS values between the two groups when Ces were 0.8 and 4.0 μg/ml.When the patients lost consciousness (OAA/S =2),the BIS value was comparable between the two groups,but Ce was significantly lower in the nighttime group than in the daytime group.Conclusion The hypnotic effect of propofol is greater during night time than during day time.
ABSTRACT
Objective To compare the clinical efficacy and adverse reactions of different doses of tramadol in the treatment of patients with postoperative shivering after general anesthesia and to explore the appropriate dose of tramadol for the treatment of general anesthesia shivering.Methods 87 cases who required elective general anesthesia in patients with abdominal surgery were selected in our hospital.They were divided into five groups according to the wishes of patients.Among them,17 patients of the control group did not receive tramadol.17 patients of the observation group one were given intravenous tramadol 0.5mg/kg.17 patients of the observation group two were givenintravenous tramadol 1.0mg/kg.18 patients of the observation group three were given intravenous tramadol 1.5mg/kg and 18 patients of the observation group four were given intravenous tramadol 2.0mg/kg.After treatment,the degree of chills of the patients was evaluated.The difference of the chills score of five groups was observed before and after treatment.The clinical efficacy and adverse reactions of different doses of tramadol were compared.Results Tramadol could significantly reduce the shivering score and improve the efficacy.The incidence rate of adverse reactions was 0.00％,0.00％,0.00％,5.56％,61.11％,and the total effective rate was 11.76％,70.59％,100.00％,94.44％,77.78％ in five groups.The clinical efficacy of the observation group two were significantly better than the other groups,the difference was statistically significant (x2 =9.85,P ＜ 0.05).Conclusion Tramadol at the dose of 1.0mg/kg or 1.5mg/kg can not only significantly improve the clinical efficacy of postoperative shivering,but also can reduce the incidence rate of adverse reactions.It is the optimal dose for clinical treatment,which is worthy of clinical application.
ABSTRACT
Objective To compare the hypnotic effect of propofol administered by target-controlled infusion (TCI) during day-time and night-time,in order to explore the effect of circadian rhythms on the sedative effect of propofol.Methods Sixty-five male ASA Ⅰ or Ⅱ patients aged 18-55 yr undergoing emergency minor hand surgery were divided into 2 gorups according to the time of the day when they received propofol TCI:day-time group (from 7:01 to 19:00) and night-time group (from 19:01 to 7:00).The pharmacokinetic parameters proposed by Schnider which predict effect-site concentration (Ce) were used.Four effect-site concentrations of propofol were set:0.8,1.2,2.0 and 4.0 μg/ml.Ce was increased step by step and each Ce was maintained for 5 min.The level of sedation at each Ce was assessed by BIS and OAA/S scores.BIS value and Ce of propofol were recorded and compared between the 2 groups when the patients lost consciousness (OAA/S score =2).Results There was 28 and 30 patients in day-time and nighet-time groups respectively.When Ce =1.2 and 2.0 μg/ml,the BIS values were significantly lower in night-time group than in day-time group.There was no significant difference in BIS value between the 2 groups when Ce =0.8 and 4.0 μg/ml.When the patients lost consciousness (OAA/S =2),the BIS value was comparable between the 2 groups,but Ce was significantly lower in night-time group than that in daytime group.Conclusion The hypnotic effect of propofol is greater during night-time than during day-time.