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Objective To evaluate the effects of dexmedetomidine on the hemodynamics and the heart rate variability(HRV)in patients under-going lower limbs operations with application of tourniquet. Methods Forty patients undergoing lower limbs operations with application of tourni-quet were randomized assigned to dexmedetomidine group(group D,n=20)or control group(group C,n=20). After combined spinal-epidural anesthesia,group D received a continuous infusion of dexmedetomidine(0.5μg/kg for 10 min for loading dose and followed by 0.2μg·kg-1·h-1) until tourniquet deflation. The control group received normal saline instead. Mean arterial pressure(MAP),heart rate(HR),saturation of pulse ox-imetry(SpO2),low frequency power(LF),high frequency power(HF)and LF to HF ratio(LF/HF)were recorded at regular time points:imme-diately before loading dose(T0),before tourniquet inflation(T1),15 min after tourniquet inflation(T2),30 min after tourniquet inflation(T3),45 min after tourniquet inflation(T4),60 min after tourniquet inflation(T5),1 min after tourniquet deflation(T6),5 min after tourniquet deflation (T7)and 10 min after tourniquet deflation(T8). Results Compared with T0,the MAP of group D significantly decreased at T6-T8(P0.05). Compared with T2-T5,the MAP of group C significantly decreased at T6(P0.05). Compared with T0,the HF of group D significantly increased and the LF/HF of group D significantly decreased at T1-T4(P<0.05). Compared with group C,the HF of group D significantly increased and the LF/HF of group D significantly decreased at T1-T4(P<0.05). Conclusion The appropriate dose of dexmedetomidine(loading dose 0.5μg/kg and maintenance dose 0.2μg · kg-1 · h-1)can significantly increase vagal tone and improve cardiac sympathetic and parasympathetic balance during tourniquet appli-cation.
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Objective To assess the effect of opiod pretreatment on etomidate induced myoclonus. Methods The pertinent literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,and CHKD. Then the meta?analysis was performed by using RevMan 5.2 and STATA 12.0 software. Results A total of 24 RCTs involving 2 396 pa?tients were included for the study. Pretreatment ofμorκ?receptor agonists reduced myoclonus with RR=0.19(95%CI 0.14 to 0.27)and RR=0.22 (95%CI 0.12 to 0.40),respectively. Conclusion Pretreatment of opiods can reduce the incidence of etomidate induced myoclonus.
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Objective To evaluate the effects of various head and neck postures and phonation on oropharyngeal view(Mallampati score),and ex-plore the correlation with laryngoscopic view tested by the improved Cormach-Lehane score(MCLS). Methods Following the local ethics commit-tee approval and patients′informed consent to anesthesia,124 patients were enrolled for this study. Prior to anesthesia,these patients were placed in supine position with various head and neck positions for oropharyngeal structures visualization and evaluation,including two head positions(neu-tral and full extension),two tongue positions(in and out),and with and without phonation,according to the modified Mallampati test score(MMT). Following induction,laryngoscopic view scores according to MCLS were recorded,then the sensitivity,specificity,positive and negative predictive value and accuracy of the various MMT scores were calculated. Correlation coefficient(r)of MMT scores with MCLS were also studied. Results Mallampati score was decreased in all the postures of head full extension,tongue outside and phonation,which makes oropharyngeal structures to be better visualized. There is no correlation between MMT scores and MCLS. The sensitivity,specificity,positive and negative predictive value and accu-racy of the various MMT scores is most satisfied in the posture of head full extension,tongue outside and phonation. Conclusion During airway as-sessment in supine position,the best posture is head full extension,tongue outside and phonation.
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PURPOSE: The aim of this study was to evaluate the effects of perioperative psychological and music interventions in elderly patients undergoing elective surgery on anxiety, post-operative pain, and changes in heart rate variability (HRV) to ascertain if perioperative psychological and music interventions can affect overall anxiety levels. MATERIALS AND METHODS: Fourty elderly patients undergoing elective surgery were randomized to two groups; one group received psychological and music intervention, and the other was the control. The intervention group underwent psychological intervention and listening to music for 30 min before surgery. RESULTS: The mean change in HRV as determined by low frequency (LF) power measurements. After the intervention, the ratio of mean LF to high frequency (HF) power decreased significantly in the intervention group compared to before the intervention (p<0.05). In the control group, mean LF measurements and the ratio of LF:HF did not change significantly. In the intervention group, mean HF power was significantly higher after the procedure than before (p<0.01). Moreover, the mean self-rating anxiety score of the intervention group decreased after the procedure compared to before (p<0.05). The mean visual analogue score of the intervention group 6 hours after surgery was significantly lower than that of the control group (p<0.01). CONCLUSION: Perioperative psychological and music interventions can reduce anxiety and postoperative pain in elderly patients.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Anesthesia, Spinal/methods , Anxiety/therapy , Heart Rate/physiology , Music Therapy/methods , Pain, Postoperative/therapy , Relaxation Therapy/methodsABSTRACT
Objective To investigate the cerebral protective effects of propofol and ketamine against ischemia-reperfusion injury induced by cardiac arrest in rats. Methods One hundred and twenty male SD rats weighing 180-250 g were randomly divided into four equal groups of 30 animals : group A served as control without cardiac arrest;group B was subjected to 10 minutes of cardiac arrest followed by resuscitation ( C-R); group C received propofol 10 mg 100 ?g-1 ip 10 min before C-R; group D received ketamine 10 mg-100? g-1 ip 10 min before C-R. The animals were anesthetized with isoflurane inhalation by mask, intubated and mechanically ventilated. Anesthesia was maintained with isoflurane inhalation. Cardiac arrest was induced by asphyxiation (vecuronium 0.01 mg - 100 g -1, disconnection of ventilator, tracheal tube clamping) and maintained for 10 min, then resuscitated. Seven animals in each group were killed at 30 min (T, ) , 120 min (T,) and 180 min (T3 ) after successful resuscitation respectively for determination of serum TNF-a and IL-Ip and cerebra) SOD activity and MDA content. Results Cerebral SOD activity in group C and D was significantly lower than that in group A but higher than that in group B, while cerebral MDA content in group C and D was significantly higher than that in group A but lower than that in group B ( P
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Objective To observe the effects of subarachnoid block on plasma nitric oxide level of the pregnancy induced hypertension patients Methods Twenty female patients ASA class I ,scheduled for elective gynecological surgery served as non pregnancy group, 20 normal late stage gravidas as pregnancy group,and 20 severe pregnancy induced hypertension(PIH) gravidas as PIH group The intravenohs blood samples were taken immediately before subarachnoid block and 10 min following subarachnoid block(before incision),to quantify the plasma concentration of nitric oxide by measuring the metabolic production of nitric oxide:nitrite and nitrate Results Immediately before subarachnoid block,the plasma nitric oxide level decreased significantly in non pregnancy group and PIH group compared with that in pregnancy group (P