ABSTRACT
Objective To investigate the effects of different duration of sevoflurane anesthesia in the neonatal period on the long?term cognitive function and hippocampal synaptic plasticity in rats. Methods Twenty?four pathogen?free healthy Sprague?Dawley rats of both sexes, aged 7 days, weighing 12-16 g, were divided into 3 groups ( n=8 each) using a random number table: control group ( group C) , sevoflu?rane anesthesia for 2 h group ( group S1 ) , and sevoflurane anesthesia for 6 h group ( group S2 ) . Group S1 and group S2 inhaled 2% sevoflurane for 2 and 6 h, respectively. Morris water maze test was performed at 30 days after the end of anesthesia ( postnatal day 37) to assess the cognitive function. After the end of the test, the rats were sacrificed, and hippocampi were isolated for determination of the expression of brain?de?rived neurotrophic factor ( BDNF) , postsynaptic density?95 ( PSD?95) and synapsin 1 in hippocampal tis?sues by Western blot. Results Compared with group C, the escape latency on 4th and 5th days of the test in group S1 and on 2nd-5th days of the test in group S2 was significantly prolonged, and the frequency of crossing the original platform was significantly decreased, and the time of staying at the platform quadrant was significantly shortened in S1 and S2 groups, the expression of BDNF, PSD?95 and synapsin 1 in hipp?ocampal tissues was significantly down?regulated in group S2 (P0?05) . Compared with group S1 , no significant change was found in the escape latency and frequency of crossing the original platform (P>0?05), the time of staying at the platform quadrant was significantly shortened, and the expression of BDNF, PSD?95 and synapsin 1 in hippocampal tissues was significantly down?regula?ted in group S2 ( P<0?05) . Conclusion Short?time and long?time sevoflurane anesthesia both can induce long?term cognitive dysfunction in the neonatal period, and the severity is aggravated with prolonged anes?thesia; the partial mechanism is related to inhibition of the synaptic plasticity of hippocampal neurons of rats.
ABSTRACT
Objective To compare the effects of dexmedetomidine (DEX) and remifentainil (REM) combined with sevoflurane (SEV) for general anesthesia on recovery quality in patients undergoing laparoscopic cholecystectomy (LC).Methods Sixty patients (ASA grade Ⅰ-Ⅱ) who underwent LC were divided into DEX combined with SEV for general anesthesia group (DEX group) and REM combined with SEV for general anesthesia group (REM group) by table of random digit,with 30 cases each.Time of first inspiration,eye opening,extubation,orientation recovery and passage of gas by anus were recorded.Vital sign,numeric rating score (NRS),Ramsay score and untoward reaction were recorded.Degree of satisfaction of patients,post-anesthesia care unit (PACU) nurse and surgeon were evaluated.Results The time of extubation and passage of gas by anus in DEX group were significantly shorter than those in REM group [(12.0 ±3.9) min vs.(15.9 ±5.6) min,t =-3.130,P =0.003; (18.5 ±3.4) h vs.(23.6 ±5.8) h,t =-5.455,P =0.000].However,the time of eye opening and orientation recovery in DEX group were significantly longer than those in REM group [(15.5 ± 4.2) min vs.(11.7 ± 2.9) min,t =4.078,P =0.000;(19.5 ± 4.5) min vs.(14.8 ± 3.6) min,t =4.315,P =0.000].During the first 2 h after operation,Ramsay score in DEX group was significantly higher than that in REM group (P ＜ 0.05),but NRS in DEX group was significanty lower than that in REM group (P ＜ 0.05),the patients with additional analgesics was minor than REM group (2 cases vs.9 cases,P ＜ 0.05).The percentages of patients suffering shivering and postoperative nausea and vomiting in DEX group were significantly lower than those in REM group [3.3％(1/30) vs.33.3％(10/30),6.7％(2/30) vs.30.0％ (9/30),P ＜0.05].Degree of satisfaction of patients and PACU nurse in DEX group were higher than those in REM group [89.0(72.0-100.0) scores vs.80.0(70.0-95.0) scores,Z =-4.066,P =0.000; 92.0 (80.0-99.0) scores vs.90.0 (80.0-95.0) scores,Z =-2.906,P =0.004],but degree of satisfaction of surgeon in REM group was higher than that in DEX group [(91.8 ± 5.8) scores vs.(81.7 ±6.1) scores,t =-6.568,P =0.004].Conclusion Compared with REM combined with SEV for general anesthesia,DEX combined with SEV for general anesthesia has a faster recovery for respiration and passing of gas by anus,lower NRS and incidence rates of shivering,nausea and vomiting,improves the quality of recovery for patients undergoing LC.