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Objective To evaluate the efficacy of caudal block with dexmedetomidine mixed with ropivacaine for the management of perioperative analgesia in children.Methods Sixty pediatric patients,aged 1-5 yr,of ASA physical status Ⅰ or Ⅱ,scheduled for elective hypospadias repair,were equally and randomly assigned into 2 groups using a random number table:ropivacaine group (group R) and dexmedetomidine mixed with ropivacaine group (group DR).Each patient received a single caudal dose of 0.25％ ropivacaine 1 ml/kg in group R.Each patient received a single caudal dose of 0.25％ ropivacaine 1 ml/kg mixed with dexmedetomidine 2 μg/kg in group DR.Postoperative analgesia was assessed using FLACC scale,and the degree of motor block was assessed using modified Bromage scale within 24 h after the end of operation.The duration of analgesia (the time from onset of caudal block to first requirement for the rescue analgesic) and development of side effects were recorded.Results Compared with group R,the duration of analgesia was significantly prolonged,and the incidence of bradycardia and oversedation was increased in group DR.Hypoxemia,hypotension and postoperative motor block were not found in either group.Conclusion Addition of dexmedetomidine 2 μg/kg to caudal ropivacaine can significantly optimize the efficacy of caudal block with ropivacaine alone for the management of perioperative analgesia in children.
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Objective To investigate the interactive effects between batroxobin and low molecular weight heparin(LMWH)in reducing peri-operative blood loss and coagulation function in patients who undergone the total hip replacement surgery. Methods 240 ASA Ⅰ-Ⅲ patients received 4 000 IU LMWH 12 hours preoperatively before undergoing the total hip replacement operation,were randomly divided into two groups:testing group (Group A,n=120) and control group(Group B,n=120)receiving 2 U batroxobin or 50 mg mannitol 10 minutes before incision respectively. Perioperative blood loss,postoperative 24 hours drainage and blood routine test, prothrombin time (PT),activated partial thromboplastin time(APTT) and fibrinogen(FIB) were measured respectively. Deep vein thrombosis (DVT) were measured through color Doppler B-ultrasound 3 days after the operation. Results The perioperative blood loss in Group A (422.64 ml)was less than that in Group B(667.67 ml)(P<0.01)while red blood cell,hemoglobin, red blood cell volume and platelet were decreasing after operation in both groups but no significant difference was found between the two groups(P>0.05). There were no drug-related adverse effects found in the two groups,neither the difference in hospitalization between the two groups(P>0.05). Conclusion Batroxobin (2 U) could reduce the perioperative blood loss in patients with LMWH who had undergone the total hip replacement operation but did not show adverse effect on DVT.
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Objective To investigate the interactive effects between batroxobin and low molecular weight heparin(LMWH)in reducing peri-operative blood loss and coagulation function in patients who undergone the total hip replacement surgery. Methods 240 ASA Ⅰ-Ⅲ patients received 4 000 IU LMWH 12 hours preoperatively before undergoing the total hip replacement operation,were randomly divided into two groups:testing group (Group A,n=120) and control group(Group B,n=120)receiving 2 U batroxobin or 50 mg mannitol 10 minutes before incision respectively. Perioperative blood loss,postoperative 24 hours drainage and blood routine test, prothrombin time (PT),activated partial thromboplastin time(APTT) and fibrinogen(FIB) were measured respectively. Deep vein thrombosis (DVT) were measured through color Doppler B-ultrasound 3 days after the operation. Results The perioperative blood loss in Group A (422.64 ml)was less than that in Group B(667.67 ml)(P<0.01)while red blood cell,hemoglobin, red blood cell volume and platelet were decreasing after operation in both groups but no significant difference was found between the two groups(P>0.05). There were no drug-related adverse effects found in the two groups,neither the difference in hospitalization between the two groups(P>0.05). Conclusion Batroxobin (2 U) could reduce the perioperative blood loss in patients with LMWH who had undergone the total hip replacement operation but did not show adverse effect on DVT.
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<p><b>OBJECTIVE</b>To investigate the interactive effects between batroxobin and low molecular weight heparin (LMWH) in reducing peri-operative blood loss and coagulation function in patients who undergone the total hip replacement surgery.</p><p><b>METHODS</b>240 ASA I - III patients received 4 000 IU LMWH 12 hours preoperatively before undergoing the total hip replacement operation, were randomly divided into two groups:testing group (Group A, n = 120) and control group (Group B, n = 120) receiving 2 U batroxobin or 50 mg mannitol 10 minutes before incision respectively. Perioperative blood loss, postoperative 24 hours drainage and blood routine test, prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) were measured respectively. Deep vein thrombosis (DVT) were measured through color Doppler B-ultrasound 3 days after the operation.</p><p><b>RESULTS</b>The perioperative blood loss in Group A (422.64 ml) was less than that in Group B (667.67 ml) (P < 0.01) while red blood cell, hemoglobin, red blood cell volume and platelet were decreasing after operation in both groups but no significant difference was found between the two groups (P > 0.05). There were no drug-related adverse effects found in the two groups, neither the difference in hospitalization between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Batroxobin (2 U) could reduce the perioperative blood loss in patients with LMWH who had undergone the total hip replacement operation but did not show adverse effect on DVT.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Middle Aged , Arthroplasty, Replacement, Hip , Batroxobin , Therapeutic Uses , Blood Coagulation , Hemorrhage , Heparin, Low-Molecular-Weight , Therapeutic UsesABSTRACT
Objective To investigate the effect of parecoxib pretreatment on the expression of aquaporin-4 (AQP4) during focal cerebral ischemia-reperfusion (I/R) in rats.Methods One hundred and twenty-eight adult male Sprague-Dawley rats,aged 6-8 weeks,weighing 230-280 g,were randomly divided into 4 groups (n =32 each):sham operation group (S group),I/R group,parecoxib 5 mg/kg group (group P5) and parecoxib 10 mg/kg group (group P10).The rats were anesthetized with 10％ chloral hydrate 3.5 ml/kg.Focal cerebral I/R was induced by 2 h middle cerebral artery occlusion followed by reperfusion.Parecoxib 5 and 10 mg/kg were injected via the right internal jugular vein at 30 min before middle cerebral artery occlusion in groups P5 and P10,respectively.The equal volume of normal saline was injected instead of parecoxib in groups S and I/R.Neurological deficit score (NDS) was assessed at 2 and 24 h of reperfusion.The rats were then sacrificed and brains were removed for determination of infract volume (by TTC staining).Brain water content was measured by wet/dry brain weight ratio.Their brains were cut into sections which were stained with haematoxylin and eosin and examined under microscope.The expression of AQP4 in brain tissues was measured.Results Compared with S group,NDS and brain water content were significandy increased,the infarct volume was enlarged,and the expression of AQP4 in brain tissues was up-regulated in I/R group (P ＜ 0.05 or 0.01).NDS and brain water content were significantly lower,the infarct volume was smaller,and the expression of AQP4 in brain tissues was lower in groups P5 and P10 than in I/R group (P ＜ 0.05 or 0.01).Microscopic examination showed that brain injury was significantly attenuated in groups P5 and P10 as compared with I/R group.Conclusion The mechanism by which parecoxib pretreatment alleviates the focal cerebral I/R injury in rats is related to down-regulation of the expression of AQP4.
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Objective To investigate the influence of sufentanial in postoperative patient controlled epidural analgesia(PCEA) in hemorheology after total hip replacement and its inhibitory effect on thrombosis.Methods Fifty patients,ASA Ⅰ-Ⅱ,undergone total hip replacement were randomly divided into PCEA group (n=25) and control group (n=25), and received continuous epidural anesthesia.After operation,5 mL 0.2% ropivacaine was administered in PCEA group,and then PCEA pump was used,analgesia liquid included 0.4 mg?L-1 sufentanial,0.2% ropivacaine and saline.Petidine was administered intramuscuarly according to pain in control group.VAS scores 1,12,24 and 48 h after operation and changes of various parameters of hemorheology at diffenent time after anesthesia were observed.Results ①The VAS scores 1,12,24,48 h after operation were lower than those in control group (P