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Objective:To investigate the effect of nerve block anesthesia on hemodynamics in elderly patients undergoing unilateral lower limb trauma surgery.Methods:From February 2017 to June 2019, 100 elderly patients with unilateral lower extremity trauma admitted in our hospital were selected in this study.According to different anesthesia methods, the patients were divided into two groups, with 50 cases in each group.Group B was given light specific gravity subarachnoid anesthesia, while group A received nerve block anesthesia.The anesthesia effect, hemodynamic parameter changes, complications and incidence of adverse reactions between the two groups were compared.Results:The total effective rate of group A was 98.00%(49/50), which was significantly higher than that of group B[86.00%(31/50)], the difference between the two groups was statistically significant(χ 2=16.973, P<0.05). Before anesthesia, there were no statistically significant differences in diastolic blood pressure, heart rate and blood oxygen saturation between the two groups(all P>0.05). At 15 minutes after anesthesia, the diastolic blood pressure, heart rate and blood oxygen saturation in group A were (70.32±3.42)mmHg, (86.28±2.42)times/min, (139.03±2.63)%, respectively, which in group B were (70.26±1.66)mmHg, (86.73±1.63)times/min, (140.97±1.84)%, respectively.At 30 minutes after anesthesia, the diastolic blood pressure, heart rate and blood oxygen saturation in group A were (68.73±2.11)mmHg, (85.26±0.52)times/min, (136.18±3.89)%, respectively, which in group B were (70.98±1.92)mmHg, (87.24±2.31)times/min, (140.39±0.77)%, respectively.At 60 minutes after anesthesia, the diastolic blood pressure, heart rate, blood oxygen saturation in group A were (67.34±3.25)mmHg, (86.26±1.31)times/min, (134.89±2.37)%, respectively, which in group B were (71.01±3.12)mmHg, (87.39±1.32)times/min, (140.99±1.64)%, respectively.The differences between the two groups were statistically significant( t=11.315, 10.924, 10.599, t=13.411, 8.226, 9.779, t=9.057, 8.497, 10.131, all P<0.05). The incidence of complications and adverse reactions in group A was 2.00%(2/50), which was significantly lower than that in group B[18.00%(9/50)], the difference between the two groups was statistically significant(χ 2=16.913, P<0.05). Conclusion:Nerve block anesthesia is effective in elderly patients with unilateral lower limb trauma surgery, which can effectively stabilize the hemodynamics and reduce the incidence of complications and adverse reactions.
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Objective To study the analepsia effect of high and low dose sevoflurane combined with propofol anesthesia in partial hepatectomy.Methods 64 patients with partial hepatectomy were selected as the subjects.They were randomly divided into low concentration group and high concentration group,32 patients in each group.The two groups were treated with sevoflurane combined with propofol anesthesia,low concentration group was given 0.5MAC sevoflurane,high concentration group was given 1.0MAC sevoflurane.The clinical results were compared between the two groups.Results The time of propofol use,postoperative recovery time,extubation time and improved Aldrete score of 9 min in the high concentration group were(765.83±342.86)mg,(21.39±8.23)min,(41.81±8.37)min and(30.24±9.63)min,respectively,which were significantly lower than those in the low concentration group [(1 143.64±374.64)mg,(25.46±7.98)min,(46.68±7.73)min and(35.94±8.89)min,respectively,t=4.208,0.008,2.418,2.460,all P<0.05].In addition,the OAA/S scores at T0,T1of the high concentration group were(3.83±0.64)points and(4.28±0.85)points,respectively,which were significantly higher than those of the control group[(3.36±0.76)points and(3.79±0.87)points],the differences between the two groups were statistically significant(t=2.676,2.279,all P<0.05).Conclusion The combination of sevoflurane and propofol in patients with partial hepatectomy can reduce the dosage of propofol and shorten the recovery time of postoperative spontaneous breathing in patients,and contribute to improve the quality of patients'' recovery.
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AIM:To investigate the effect of intravenous infusion of lidocaine on postoperative pain,return of bowel function and stress response after hysterectomia surgery. METHODS:Sixty patients scheduled to undergo hysterectomia surgery were randomly divided into two groups with thirty in each group. Group L received intravenous lidocaine bolus injection of 1.5 mg/kg at induction of anesthesia,then continuous infusion of 1 mg?kg-1?h-1 intraoperatively and infusion of 100 mg plus sulfentanyl 50 mg for 48 h postperatively. Group S received an equal volume saline and infusion of sulfentanyl 100 mg for 48 h postperatively. Postoperative pain score at rest and cough were recorded by VAS. The times of first flatus,enterocinesia were recorded and the levels of motilin,cortisol and serum glucose were measured. RESULTS:Lidocaine significantly reduced postoperative pain,nause and vomit scores. Times to first flatus,enterocinesia were significantly shorter in patients who received lidocaine. the levels of motilin were significantly higher,but the levels of cortisol and serum glucose were significantly lower in Group L than in Group S. CONCLUSION:Intravenous lidocaine relieves postoperative pain,improve bowel function through increasing plasma motilin levels and decreasing stress responses after hysterectomia surgery.