ABSTRACT
Objective To evaluate the postoperative efficacy and safety of dexmedetomidine for cardiac surgery patients in intensive care unit. Methods A total of 90 cardiac surgery patients in the intensive care unit (ICU)were randomly assigned into dexmedetomidine group(D group,45 cases)and propofol group(P group,45 cases)to receive dexmedetomidine or propofol respectively for post-operative sedation. The ratio of sedation satisfac-tion was evaluated and calculated by Riker sedation-agitation scale(SAS),and the duration of mechanical ventila-tion,24-hour consumption of sufentanil,ICU staying time,and the incidences of side-effects(such as hypoten-sion,bradycardia,delirium etc)were recorded during the observation period. Results No significant differences were found in the ratio of sedation satisfaction and the incidences of bradycardia and delirium between the two groups (P > 0.05). The duration of mechanical ventilation and ICU staying time were significantly shorter in D group than that in P group(P<0.01),while the 24-hour consumption of sufentanil and the incidences of hypoten-sion and delirium were significantly lower than that in P group(P<0.05). Conclusion Using the dexmedetomi-dine as a postoperative sedation drug for post cardiac surgical patients in ICU is clinically effective and safe ,and the postoperative recovery of patients may be enhanced by the drug using.
ABSTRACT
Objective To investigate the relationships between septic shock and vascular endothelial cells (VECs)injury by measuring the plasma CEC,vWF,and NO in septic shock patients and to explore its potential clinical values. Methods 72 patients were divided into group A including 34 infection patients but without septic shock,and group B including 38 patients with septic shock. Circulating endothelial cell(CEC),von willebrand factor(vWF),and nitric oxide(NO)in plasma were measured in all patients at the time points of accessing ICU (T0)and 24 hours after staying in ICU(T1). And the blood pressures of studied patients were also recorded at the same time points. Results The levels of CEC and vWF at each observing time point were higher in group B than those in group A(P < 0.01),while the levels of NO were lower in group B than those in group A(P < 0.01). In group B,the levels of CEC and vWF at T1 were higher than those at T0(P<0.01),while the level of NO was low-er at T1 than that at T0(P<0.01). With contrary to those of group A,circulation conditions of group B were obvi-ously unstable and high doses of vasoactive agents were needed during the therapy period. MAP in group B at each time point was obviously lower than that in group A(P<0.05). There were 7 dead cases(18%)in group B but no death in group A during the whole therapy period. Conclusion Obvious injury of vascular endothelial cells exists in septic shock patients and the injury degree is related to the severity of the disease.
ABSTRACT
Objective To determine the median effective concentration (EC50) of amitriptyline for intravenous regional anesthesia (IVRA) in rats.Methods Ninety healthy male SD rata weighing 190-240 g were randomly divided into 3 groups (n=30 each) : amitripryline group,bupivncaine group and lidocaine group.The rat's tail was divided into 3 epual parts: the proximal,middle and distal part.A 24 gauge needle was inserted into vena caudalis in the distal part.Esmarch bandage was applied around the tail from distal to proximal to expel blood from the taft and was removed after a tourniquet was applied between the proximal and middle part of the tail to occlude artery.0.5 ml of amitriptyline,bupivncaine or lidocaine was injected into the taft vein immediately after the application of the tourniquet.Ten minutes after drug administration the tourniquet was released.The ECho was determined by the up-and-down sequence method.The initial concentration of amitriptyline was 0.05%,the consecutive concentration-ratio was 1.4i4; the initial concentration of bupivacaine was 0.03%,the consecutive concoatration-ratio was 1.667 and the initial concentration of lidncaine was 0.08%,the consecutive concentrationratio was 1.250.EC50 and 95% confidence interval were calculated.Tail-flick latency (TFL) was assessed at 1 h before (baseline) and at 3 min and 2 d after drug administration.Central nervous system toxicity (seizure,convulsion,death) and local tissue damage to the tail were also recorded.Results The EC50 for IVRA was 0.111% (95% CI,0.092%-0.133%) in amitripthline group; 0.058% (95% CI,0.048%-0.078%) in bupivacaine group and 0.129% (95% CI,0.103%-0.160%) in lidocaine group respectively.The EC50 was significantly lower in bupivacaine group than in amitriptyline and lidocaine group.There was no significant difference in EC50 between amitriptyline and lidocaine group.The TFL measured at the proximal part of the tail was not significantly different between different time points in each group.The TFL measured at the middle part at 3 rain after drug adminisuation was significantly increased as compared with the baseline in all 3 groups but was not significantly different between the baseline and that measured at 2 d after drug administration.No CNS toxicity and local tissue damage were found during the experiment in all 3 groups.Conclusion Amitriptyline can produce intravenous regional anesthesia.The potency of amitriptyline is significantly lower than that of bupivncaine but is not significantly different from that of lidocaine.