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Objective To explore the clinical efficacy and safety of low dose fentanyl combined to ropivacaine in subarachnoid block for cesarean section.Methods Eighty patients with ASA physical status Ⅰ and Ⅱscheduled to undergo cesarean section for delivery were randomly allocated to receiving spinally mixture none fentanyl ( group R),5 μg fentanyl ( group F5 ), 10 μg fentanyl ( group F10 ), and 15μg fentanyl ( group F15 ), combined with 1%ropivacaine 1 ml and 10% glucose 1 ml respectively,after combined spinal-epidural anesthesia puncture was applied at the L2～3 interspace.Heart rate, blood pressure, the onset and recovery time of the sensory and motor block,time to the highest level and the highest level of sensory block, time to the maximal extent and the maximal extent of the motor block were recorded at regular intervals.The adverse effects were sought during and after surgery.Neonatal outcome was assessed using Apgar score.Results The recovery of sensory block was prolonged significantly in group F10 and group F15 than in group R and group F5.Conclusion Ropivacaine with 10μg fentanyl is safe and effective in subarachnoid block for cesarean section.
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0.05).Traction reactions,the use of sedative and centrally acting anesthesia drugs during the operation were significantly less in group AEA than those in group EA(P
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OBJECTIVE To estimate the value of video-assisted thoracoscopic surgery (VATS) in diagnosis and treatment of children with chest diseases. METHODS From May 1997 to October 2001, forty-one children (25 boys and 16 girls) with chest diseases received VATS under general anesthesia in our hospital. Their average age was 6.9 years (range 9 days to 16 years) and their median body weight was 22.5 kg (2.8-54.0 kg). Operative procedures included fibrinopurulent empyema with debridement and decortication in 15 children, biopsy and(or) resection of mediastinal tumor in 11, bullectomy and cystectomy of the lung in 6, lobectomy with huge cyst of the lung or sequestration in 5, clearance of hemothorax in 2, and exploration, and repair of diaphragmatic hernia in 2. RESULTS The mean operative time was 74 minutes (range 30 to 220 minutes). The lost blood volume was 33 ml (range 10 to 150 ml). The mean duration of chest drainage and hospital stay after surgery was 2.4 days and 7.0 days (range 4 to 15 days) respectively. One infant born after 9 days with congenital diaphragmatocele died of respiratory failure due to left pulmonary hypoplasia 10 days after operation. Postoperative morbidity was 7.3% (3 patients). Forty patients were followed up for an average of 15.6 months, 38 patients lived and developed normally, and 2 received chemotherapy. CONCLUSION Video-assisted thoracoscopy is a safe and effective diagnostic and therapeutic procedure for children with chest disease, and this approach has an important place in pediatric thoracic surgery.
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Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Postoperative Complications , Epidemiology , Thoracic Surgery, Video-Assisted , MethodsABSTRACT
AIM: To investigate the effect of premedication with clonid in e on the concentrations of catecholamine (CA), angiotention Ⅱ (AⅡ), cortisol a nd carbohydrate metabolism during tracheal extubation. METHODS: Twenty-two patients scheduled for general anesthesia with tracheal intubation were randomly divided into two groups: clonidine group and control group. Oral p remedication with clonidine 5 ?g?kg -1 was taken in clonidine group 6 0 min before anesthesia induction in addition to some common premedication in bo th groups. The change of hemodynamics,arterial plasma concentrations of CA, A Ⅱ, cortisol, blood sugar and lactic acid were measured before anesthesia, befor e intubation and 1,2,5, 10 min after tracheal extubation, respectively. RESULTS: The levels of CA, AⅡ, cotisol, blood sugar and lactic acid were significantly increased during tracheal extubation in both groups,but the levels in control group were higher than those in clonidine group. The change of hemodynamics was more stable in clonidine group than that in control group. CONCLUSION: Oral premedication with clonidine can alleviate stress response during tracheal extubation.
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Objective To evaluate Zeus robot-assisted laparoscopic cholecystectomy. Methods Forty patients were divided into two groups receiving respectively Zeus robot-assisted laparoscopic cholecystectomy (group A, 20 cases), and laparoscopic cholecystectomy (group B, 20 cases). A variety of clinical parameters were evaluated. Compared between these two groups. Results Camera clearing (1.1?1.0) times and time used for operation field adjustment in group A (2.2?0.7) min were significantly less than those in group B (4.5?1.5,7.5?1.2) min. Dissection actions(337?86)times and operative errors(10%) in group A were less than those in group B(389?94) times,25%. The operation time(104.9?20.5) min and setup time (29.5?9.8) min in group A were longer than those in group B (78.6?17.1) min,(12.6?2.5) min. The blood loss,and postoperative hospital stay were similar. There were no postoperative complications in either groups, and conversion to open surgery was done in one each patients. Conclusions Compared with laparoscopic technique, Zeus robotic surgical system offers greater ability of controlling operation field, precise and stable operative manipulations though it requires longer operation time.
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Objective To investigate the effect of hypertonic-hyperoncotic solution (HHS) on CD11b expression on the surface of human neutrophils which are stimulated by lipopolysaccharide (LPS) in vitro. Methods Neutrophils were isolated from fresh peripheral venous blood of healthy volunteers aged 20-4oyr find incubated with LPS 100 ng/ml al 37℃ in 5% CO2 incubator for 15, 30, 60min, 4, 12 or 24h. HHS was prepared with 10%NaCl and 10% hydroxyethyl starch. Neutrophils were incubated with 0.25% or 0.5%HHS for 10min, 1h or 4h. Some of the HHS treated neutrophils were further subjected to LPS stimulation for 30 mm. CDllb on the surface of neutrophils were measured by using immunofluorescence and flow cytometry. Results CD11b expression on neutrophils increased significantly after being exposed to LPS for 15min (P