ABSTRACT
Objective To study the effect of transcutaneous electrical acupoint stimulation (TEAS) on emergence agitation in children undergoing cochlear implantation.Methods Sixty patients (age range,1-4 years) scheduled to undergo pediatric cochlear implantation were enrolled and randomized into the TEAS group (group T,n =30) that received continuous TEAS and the control group (group C,n =30) that did not receive TEAS.Anesthesia time,operation time,change in blood flow dynamics during the perioperative period,extubation time,and PACU stay time were recorded.The incidence of emergence agitation and postoperative nausea and vomiting (PONV) was monitored.Results No significant intergroup differences were observed in age,sex,weight,operation time,and PACU stay time (P ＞ 0.05).The MAP and HR in group T were lower than those in group C at different time points such as 30 min after the start of surgery,the end of the surgery,the extubation and 5 min after extubation,and the difference was statistically significant (P ＜ 0.05).The FPS-R,FLACC,and PAED scores in group T were lower than those in group C at different time points within 30 min after exmbation (including the time of extubation),and the difference was statistically significant (P ＜ 0.05).Extubation time,anesthesia time,and incidence of PONV were lower in group T than in group C,and the difference was statistically significant (P ＜ 0.05).Conclusion TEAS combined with general anesthesia significantly reduces the incidence of emergence agitation in children undergoing surgery for congenital hearing loss;it also helps control hypotension,reheve dramatic hemodynamic changes during the waking period,and reduce the incidence of PONV.
ABSTRACT
Objective To evaluate the effects of dexmedetomidine on perioperative pulmonary compliance and the expression of Toll?like recep?tor(TLR)?2 and TLR?4 in the peripheral blood during perioperative period in patients undergoing open colorectal cancer radical surgery. Meth?ods Twenty patients with colorectal cancer underwent elective general anesthesia,with ASA gradeⅠ?Ⅱand body mass index(BMI)<30 kg/m2, aged 30 to 68 years old,were enrolled for the study. They were randomly divided into control group(group C,n=10)and dexmedetomidine group (group D,n=10). In group D,dexmedetomidine was infused at a rate of 0.4μg·kg-1·h-1 from the beginning of surgery till 30 min before the end of surgery. The patients in group C received same manipulation as in group D except dexmedetomidine was replaced by normal saline. The mean ar?terial pressure(MAP)and heart rate(HR)were recorded before anesthesia induction(T0),30 min(T2),60 min(T3),and 90 min(T4)after the beginning of surgery,extubation(T6),and 3 min after extubation(T7). Airway pressure and lung dynamic compliance were recorded at T1?T7 time points,respectively. Vein blood samples were drawn to analyze the TLR?2,TLR?4 and tumor necrosis factorα(TNF?α)concentration at T0,T4,T7 and the day after operation(T8),respectively. Results Compared with group C,MAP and HR increased in group D at T6(P<0.05);lung dynamic compliance increased in group D at T4(P<0.05);TLR?2 and TLR?4 concentration in serum decreased in group D at T4, T7 and T8(P<0.05);TNF?αconcentration in serum decreased in group D at T4,T7 and T8(P<0.05). Conclusion Continuous infusion of 0.4μg·kg-1·h-1 dexmedetomidine can help to stabilize hemodynamics,relieve inflammatory stress response,maintain the relative stability of intra?operative hemodynamic parameters,and also can improve the pulmonary dynamic compliance of patients.