ABSTRACT
Objective To compare the cerebral oxygenation in the patients undergoing gynecological laparoscopic surgery under sevoflurane-versus propofol-based anesthesia.Methods Fifty adult patients,aged 18-56 yr,weighing 55-72 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with hemoglobin≥ 110 g/L,undergoing elective gynecological laparoscopic surgery under general anesthesia,were equally and randomly divided into sevoflurane group (group S) and propofol group (group P) using a random number table.Anesthesia was induced with iv midazolam 0.04 mg/kg,sufentanil 1.5-2.0 μg/kg,rocuronium 0.9 mg/kg,and propofol 1.5-2.0 mg/kg.Anesthesia was maintained with inhalation of sevoflurane (2.0％-2.6％) in group S,or with target-controlled infusion of propofol (plasma concentration 2.5-4.0 μg/ml) in group P.The concentrations of sevoflurane and propofol were adjusted to maintain bispectral index value at 40-50.In both groups,remifentanil was given by targetcontrolled infusion (target plasma concentration 2 ng/ml),and vecuronium 0.06-0.08 mg/kg was injected intermittently to maintain muscle relaxation.The regional cerebral oxygen saturation (rSO2) was recorded after induction and at 10 min before pneumoperitoneum (T1),at 10 min of pneumoperitoneum in the Trendelenburg position (T2),and at 10 min after the end of pneumoperitoneum (T3).The occurrence of cerebral oxygen desaturation was recorded during surgery.Results The rSO2 was significantly higher at T2,3 in group S than in group P (P＜0.05).Compared with the value at T1,no significant change was found in rSO2 at T2,3 in group S (P＞0.05),and the rSO2 was significantly decreased at T2,3 in group P (P＜0.05).The incidence of cerebral oxygen desaturation was 12％ in group P,and cerebral oxygen desaturation was not detected in group S.Conclusion Sevoflurane-based anesthesia produces no effect on rSO2,however,propofol-based anesthesia can decrease rSO2 in the patients undergoing gynecological laparoscopic surgery,and sevoflurane-based anesthesia is more suitable for gynecological laparoscopic surgery.
ABSTRACT
Objective To evaluate the effect of edaravone on myocardial injury in patients undergoing offpump coronary artery bypass grafting (OPCABG).Methods Forty ASA physical status Ⅲ-Ⅳ patients,aged 45-64 yr,weighing 55-95 kg,with NYHA class Ⅱ-Ⅲ,scheduled for elective OPCABG,were randomly divided into 2 groups (n =20):edaravone group (group E) and control group (group C).After induction of anesthesia,edaravone 60 mg (in 100 ml of normal saline) was infused over 30 min in group E,while the equal volume of normal saline was given instead of edaravone in group C.Venous blood samples were taken before operation (T1),after skin incision (T2),at the end of operation (T3),and at 24 h after operation (T4) to measure the serum levels of myocardial enzymes and cardiac troponin Ⅰ (cTnI).The time for ventilator treatment,duration of stay in the intensive care unit and duration of stay in hospital were recorded.Results Compared with group C,the activities of serum creatine kinase,creatine kinase isoenzyme-MB,aspartate aminotransferase and lactate dehydrogenase and cTnI concentrations were significantly increased at T3 and T4 (P ＜ 0.05) and no significant changes were found at T1 in group E (P ＞ 0.05).The parameters mentioned above were significantly higher at T3 and T4 than at T1 in the two groups (P ＜ 0.05).The time for ventilator treatment,duration of stay in the intensive care unit and duration of stay in hospital were significantly shortened in group E as compared with group C (P ＜ 0.05 or 0.01).Conclusion Edaravone 60 mg infused before OPCABG can provide effective myocardial protection in patients.