ABSTRACT
<p><b>OBJECTIVE</b>To compare the safe duration of apnea and intubation time between face mask ventilation with air and 100% oxygen during induction of general anesthesia.</p><p><b>METHODS</b>Eighty adult patients with ASA class I or II without predicted difficult airways were scheduled for elective surgery under general anesthesia. The patients were randomized to receive anesthesia induction with preoxygenation [Group 1, n=40, fraction of inspired oxygen (FiO)=1] or without preoxygenation (Group2, n=40, FiO=0.21). Two experienced anesthesiologists performed the mask ventilation and tracheal intubation during induction, and the assistants adjusted the oxygen concentration and recorded the pulse oxygen saturation (SpO) and other variables. The cases where SpOdecreased to below 90% before accomplishment of intubation were considered unsuccessful, and mask ventilation with 100% oxygen was given. After tracheal intubation, mechanical ventilation was not initiated until the SpOdecreased to 90%. The number of unsuccessful cases, the safe duration of apnea and intubation time were recorded in the two groups.</p><p><b>RESULTS</b>There was no unsuccessful case in either groups. The safe duration of apnea was 469.5∓143.0 s in Group 1 and 63.6∓20.0 s in Group 2, and the intubation time was 34.4∓12.6 s and 32.8∓9.6 s, respectively. The safe duration of apnea was significantly longer than the intubation time in both groups (P<0.01). The intubation time and the number of cases with SpO≥90% before completion of tracheal intubation were similar between the two groups. The safe duration of apnea was significantly shorter in Group 2 than in Group 1 (P<0.01) and was correlated with the body mass index of the patients (P<0.05).</p><p><b>CONCLUSION</b>Anesthesia induction without preoxygenation can provide sufficient time for experienced anesthesiologists to complete tracheal intubation.</p>
ABSTRACT
Objective To investigate the clinical effect of imipenem and cilastatin sodium in the treatment of severe pneumonia.Methods Sixty patients with severe pneumonia were selected from May 2013 to August 2016 in Wuxi People's Hospital.The patients were divided into observation group and control group according to the treatment method,30 cases in each group.The patients in the control group were treated with cefoperazone and sulbactam injection,and the patients in the observation group were treated with imipenem and cilastatin sodium.The levels of serum procalcitonin (PCT) and C-reactive protein (CRP) were measured,and the cough score was performed in the two groups before and after treatment.The clinical effect was evaluated after treatment,and the adverse reactions of the patients were recorded in the two groups.Results There were no significant difference in the levels of serum PCT and CRP between the two groups before treatment (P ＞ 0.05).The levels of serum PCT and CRP after treatment were significantly lower than those before treatment in the two groups (P ＜ 0.05).The levels of serum PCT and CRP in the observation group were significantly lower than those in the control group after treatment (P ＜ 0.05).There was no significant difference in cough score between the two groups before treatment (P ＞ 0.05).The cough score after treatment was significantly lower than that before treatment in the two groups (P ＜ 0.05).The cough score in the observation group was significantly lower than that in the control group after treatment (P ＜ 0.05).The total effective rate in the observation group and the control group was 93.33％ (14/15) and 60.00％ (9/15) respectively,the total effective rate in the observation group was significantly higher than that in the control group (x2 =4.658,P ＜ 0.05).The incidence of adverse reactions in the two groups was 6.67％,there was no significant difference in the incidence of adverse reactions between the two groups (x2 =0.000,P ＞ 0.05).Conclusion Imipenem and cilastatin sodium can significantly reduce the inflammatory response and clinical symptoms in patients with severe pneumonia,and the curative effect is remarkable.