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Objective To assess the gastric contents before cesarean section using antral cross-sectional area (CSA) measured by ultrasonography.Methods One hundred and seventy-seven American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients,aged 20-44 yr,undergoing cesarean section,were enrolled in this study.The antral CSA in the semi-recumbent and right lateral decubitus positions was measured through the ultrasound images of the antrum in the sagittal plane below xiphoid before anesthesia and qualitatively graded.Qualitative grade 0 was considered as the gold standard,and the receiver operating characteristic (ROC) curve of CSA in assessing the preoperative gastric contents was plotted.Results The critical value of ROC curve of CSA in the semi-recumbent position was 6.025 cm2.The critical value of ROC curve of CSA in the right lateral decubitus position was 9.095 cm2.Conclusion CSA ＜ 6.025 cm2 measured by ultrasonography in the semi-recumbent position or CSA＜9.095 cm2 measured by ultrasonography in the right lateral decubitus position can confirm that the gastric emptying state is achieved before cesarean section.
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Objective:To investigate the effect of sufentanil in preventing the adverse effects of hamabate in the patients undergoing cesarean section.Methods:Forty patients who would have been injected with hamabate were selected,they were undergoing elective cesarean section with continuous epidural anesthesia and randomly divided into sufentanil group and 0.9％ sodium chloride injection group.When the fetus was removed and hamabate was injected,simultaneously patients in sufentanil group were injected sufentanil 0.1 μg/ kg,and patients in 0.9％ sodium chloride group were injected equal dose of normal saline.MAP,HR,SpO2 and RR were monitored in the two groups.Adverse reactions after hamabate injecting into the body of the uteru,such as nausea,vomiting,chest pain,dizziness and facial flushing were recorded,and Ramsay sedation score was recorded before anesthesia,at 30 min after hamabate was injected and at the ending of the operation.Results:After 30 min using hamabate,MAP,H R and RR of sufentanil group were more stable than 0.9％ sodium chloride group(P ＜ 0.05),Ramsay sedation score of sufentanil group was higher than 0.9％ sodium chloride group(P＜0.05).Adverse reactions such as nausea,chest pain,dizziness and facial flushing were lower in sufentanil group than those in 0.9％ sodium chloride group(P ＜0.05).Conclusions.Small doses of sufentanil can reduce the adverse effects of hamabate in cesarean section,and hemodynamic can be more stable,also it is a certain better sedation,and can be usesd safely.
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Objective:To investigate the postoperative analgesia effect of continuous femoral nerve block (CFNB) combined with parecoxib on the patients with Total knee arthroplasty (TKA).Methods:A total of 100 patients,who underwent unilateral TKA in Affiliated Hospital of Guizhou Medical University from January 2015 to December 2016,were selected and randomly divided into study group (n=50) and control group (n=50).After TKA,the patients of two groups were received CFNB,CFNB combined with parecoxib analgesia respectively,analgesic time was 2 days.The visual analogue pain scores (VAS) of the patients of two groups at rest and during exercise and the incidence of postoperative adverse reactions were observed at 6h,12 h,24 h,48 h after operation.The Hospital Special Surgery knee score (HSS) was used to evaluate the joint function of patients in the two groups 1 d before operation and 1 d,2 d,3 d after operation.Results:Resting state VAS and motion state VAS in the study group were significantly lower than those in the control group 6 h,12 h,24 h,and 48 h after operation (P＜0.05).There were no significant differences in the incidence of nausea / vomiting,respiratory depression,catheter related problems,and urinary retention between the two groups (P＞0.05).There was no significant difference in HSS score between the two groups 1 d before operation(P＞0.05).The HSS scores of the patients in the two groups 1 d,2 d,3 d after operation were significantly higher than those 1d before operation,and the HSS scores of the patients in the study group were significantly higher than those in the control group (P＜0.05).Conclusion:CFNB combined with parecoxib has the advantages of good analgesic effect and safety for postoperative analgesia of the patients undergoing TKA,which is good for the patients' early knee joint function exercise and is worthy of clinical promotion.
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Objective To evaluate the accuracy of thyromental height (TMH) in predicting difficult airway.Methods Three hundred and thirty patients of both sexes requiring endotracheal intubation,aged ＞18 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were selected.The modified Mallampati test (MMT) score,thyromental distance (THD),sternomental distance (SMD) and TMH were measured following admission to the operating room.Direct laryngoscope was placed after induction of anesthesia to expose the glottis,and the Cormack-Lehane grade was recorded.Difficult airway was defined as Cormack-Lehane grade Ⅲ or Ⅳ.The receiver-operating characteristics curve was used to evaluate the accuracy of MMT,THD,SMD and TMH in predicting difficult airway.Results The diagnostic threshold of TMH in predicting difficult airway was 39.04 mm,the sensitivity 88.24％,the specificity 90.42％,the area under the curve (95％ confidence interval) 0.897 (0.859-0.928),and the odds ratio 70.750.Compared with MMT,THD and SMD,the area under the curve of TMH in predicting difficult airway was significantly increased (P＜0.05).Conclusion TMH can accurately predict difficult airway,and the diagnostic threshold is 39.04 mm in patients.
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Objective To evaluate the relationship between melatonin and development of post-herpetic neuralgia (PHN) in rats.Methods Sixty adult Wistar rats of both sexes,aged 3 months,weighing 180-230 g,were randomly divided into A-F 6 groups (n =10 each) using a random number table.Group A served as sham operation group,and inactivated herpes simplex virus type-1 (HSV-1) was inoculated.Group B served as sham operation group,and HSV-1 was inoculated.In group C,pinealectomy was performed and inactivated HSV-1 was inoculated.In group D,pinealectomy was performed,and HSV-1 was inoculated.In group E,pinealectomy was performed,inactivated HSV-1 was inoculated,and melatonin was injected intraperitoneally everyday.In group F,pinealectomy was performed,HSV-1 was inoculated,and melatonin was injected intraperitoneally everyday.HSV-1 or inactivated HSV-1 was inoculated on the left hind paw of the rats at 1 h after pinealectomy,and the dosage of melatonin was 120 mg/kg once a day.The mechanical pain response score (MPRS) was determined before inoculation and on days 1,5,10,20 and 30 post-inoculation.The development of PHN was recorded on day 30 post-inoculation.Results MPRS was significantly higher in group B than in group A,and in group D than in group B (P ＜ 0.05).MPRS was significantly lower in group F than in group D (P ＜ 0.05).PHN was not found in A,C and E groups,and the incidence of PHN was 40％,90％ and 40％,respectively.Compared with group B,the incidence of PHN was significantly increased in group D (P ＜ 0.05),and no significant change was found in group F (P ＞ 0.05).Conclusion Reduction of melatonin secretion is related to the development of PHN in rats.