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Objective To investigate the effect of small dose of dexmedetornidine on venous continuous infusion combined with oxycodone or fentanyl during brachial plexus blockade.Methods Sixty thyroid patients (ASA Ⅰ or Ⅱ) undergone brachial plexus anesthesia for cutting or cutting thyroid tumor patients were randomly and double-blindly into three groups (n =20 in each group).Group A:single brachial plexus anesthesia;group B:dexmedetornidine combined with fentanyl;group C:dexmedetornidine combined with oxycodone.Blood pressure (Bp),heart rate (HR),the determination of plasma norepinephrine (NE),cortisol (Cor),the concentration of blood glucose (Glu),VAS,Ramsay calm score,local anesthetics dosage and side effect formation rate at the beginning operation (To),skin incision (T1),separation of the glands (T2),gland excision (T3),and the end of the surgery (T4) were recorded.Results Compared to group A,the mean arterial pressure (MAP),HR,NE,Cor,and Glu were much lower at each time point (P ＜ 0.05) in groups B and C;Ramsay calm score and VAS score were significantly better at each time point (P ＜ 0.05);the incidence of chills and lidocaine additional quantity were significantly lower (P ＜0.01).However,compared to groups A and C,choking cough response rates were much higher in group B (P ＜ 0.01).Conclusions Small dose of dexmedetornidine on venous continuous infusion combined with oxycodone during brachial plexus blockade for thyroid patients both can eliminate the preoperative patients nervous anxiety,and effectively restrain perioperative stress response,maintain hemodynamics stable,implementation of intraoperative awaken to reduce complications.It is the new choice of anesthetic adjuvant.
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To observe the effect of PCEA on the serum endotheline and the renal function after operation in kidney transplantation patients. Forty patients with chronic renal failure were randomly divided into two groups: group P( n =20) and group N ( n =20) .Venous blood samples were drawn before anesthesia at the end of operation and 24, 48, 72h after operation. Mean arterial pressure (MAP), serum endothelin,creatinine, urea nitrogen, uric acid were measured with radioimmunoassay. The results showed that the MAP, serum endothelin, creatinine, urea nitrogen and uric acid were decreased significantly at 24h after operation.All of them reached the nadir at 72h after operation. But those of group N were significantly higher than group P ( P
ABSTRACT
Objective:Coherence analysis of the EEG is used to study the synchrony or coupling between cortical areas underlying the electrodes. However,the effects of intravenous anesthetics on EEG coherence have not been defined. Method: Forty patients were administered with intravenous thiopental (5mg/kg),propofol (2.5mg/kg ), ketamine(4mg/kg)or fentanyl(10?g/kg). The changes of coherences in total and in a given frequency band of the EEG(?.?.?.?) were measured with an AXON Systems Sentinel-4 Neurological monitor between two pair electrodes(Cz-F_7 vs Cz-F_8 and Cz-A_1 vs Cz-F_2). Result: The anesthetics had significantly different effects on the coherence by either increase or decrease. The variability of the coherences had no regular pattern,and no relationship to excitement or depression of the anesthetics and to potency of them. Conclusion:Each anesthetic above selectively depresses and excites generators of the EEG in quite different ways.