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Objective To compare the anesthetic effect of ropivacaine and bupivacaine in combined spinal-epidural anesthesia(CSEA)for cesarean section,and their influence on the incidence rate of supine hypotension syndrome(SHS).Methods 200 patients with cesarean section surgery in our hospital from February 2016 to July 2016 were randomly divided into observation group and control group,all of cases were given CSEA.100 patients in the observation group(the group L)were given ropivacaine in spinal anesthesia,the other 100 patients in the control group(the group B)were given bupivacane in spinal anesthesia.Recorded the relevant indicators,compared the incidence rate of SHS,the effect of anesthesia and neonatal score.Results The incidence rate of SHS of the group L was lower than the group B(χ2 =9.261,P0.05).Conclusion The application of ropivacaine in CSEA for cesarean section not only has exact anesthesia effect,but also can effectively prevent SHS without any side effects.
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Objective To investigate the effect of sufentanil midazolam intravenous anesthesia combined with epidural block on hemodynamics and postoperative consciousness after anesthesia.Methods 40 cases undergoing acute chest and abdominal surgery from January 2015 to December 2016 in Taizhou tumor hospital as the research objects, were randomly divided into the control group and the experimental group, 20 cases in each group.The control group were received sufentanil midazolam intravenous anesthesia, and the experimental group were received sufentanil midazolam intravenous anesthesia combined with epidural block.Hemodynamics and anesthesia consciousness in the two groups were compared.Results Compared with pre-induction, the diastolic and systolic blood pressure and the heart rate were significantly decreased at pre-intubation (P<0.05).There were no significant differences between the two groups at other observation time points.The intravenous anesthesia medication in the experimental group was significantly less than that in the control group, the difference was statistically significant (P<0.05).The recovery time in the experimental group was (31.5±4.2) min, the extubation time was (4.8±1.5) min, and the basic awake time was (8.2±2.4) min.The above data were significantly better than those in the control group (P<0.05).No complications such as postoperative agitation and respiratory depression occurred in the experimental group and the control group.Conclusion Sufentanil midazolam intravenous anesthesia combined with epidural block, hemodynamic stability, it can reduce the amount of anesthesia drugs and shorten the recovery time to some extent, and is worthy of clinical application.
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General anesthesia combined with epidural anesthesia and postoperative epidural analge-sia is capable of accelerating the recovery of gastrointestinal function,providing better postoperative pain re-lief,improving the patient's satisfaction as well as shortening hospitalization dates.The article summarized the mechanisms of epidural analgesia influencing the recovery of gastrointestinal function.
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Objective To evaluate the effectiveness and safety of the combination of dexmedetomidine and propofol for sedation in pediatrics undergoing regional anesthesia.Methods Forty-eight children aged 2 -6 years old,scheduled for elective surgery under regional anesthesia,were randomly divided into the two groups.The dexme-detomidine plus propofol group(group DP,n=24)received an infusion over 10 minutes of dexmedetomidine 0.7μg/kg and propofol 1.0 to 2.5 mg/kg bolus for induction,then an infusion of dexmedetomidine 0.5μg·kg-1·h-1 and propofol 100-300μg·kg-1·min-1 for maintenance.The propofol group(group P,n=24)received a propofol 1.0 to 2.5mg/kg bolus for induction,then an infusion of propofol 150 -300μg·kg-1 ·min-1 for maintenance.If body movement was detected during surgery,a bolus of propofol 1 .0mg/kg was administered in both groups,and if there was another body movement within three minutes of the propofol bolus,a bolus of ketamine 1 .0mg/kg was adminis-tered.Hemodynamic data,respiratory rate,and oxygen saturation were recorded by researchers blinded to the study drugs.Recovery time and the primary outcome were evaluated by a modified Aldrete score.The occurrence of adverse events and the amount of supplemental ketamine used were also recorded.Results The consumption of propofol in the group DP was (149.00 ±24.93)μg·kg-1·min-1,and in the group P was (217.00 ±17.90)μg·kg-1· min-1.The propofol consumption was significant lower that in group DP(t=117.94,P=0.00).The needs for sup-plemental ketamine bolus in the group DP was 0.50(1.00)/case,and it was 2.00(1.00)/case in group P.The need for supplemental ketamine was less in group DP(Z=-4.48,P=0.00).Hypopnea occurred in 5 cases in group P, and 0 in group DP.The incidence of hypopnea was more in group P(χ2 =5.58,P=0.03).In group DP,the mean arterial pressure and heart rate at discharge were respectively (74.96 ±5.69)mmHg and (101.17 ±9.65)bpm,and their baseline values were (81.13 ±7.23)mmHg and (112.00 ±13.65)bpm.Both mean arterial pressure and heart rate in the group DP remained decreased at discharge(t=10.78,P=0.00;t=10.08,P=0.00;respectively).The discharge time of the group DP was (40.91 ±10.90)min and it was(39.67 ±14.95)min in group P.There was no significant difference in the discharge time(t=0.11,P=0.74).Conclusion The combination of dexmedetomidine and propofol can provide appropriate depth of sedation in pediatric patients undergoing regional anesthesia.
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La miotonía de Thomsen es una enfermedad autosómica dominante que consiste en una marcada hipertrofia muscular a predominio en miembros superiores, que se encuentra asociada a una alteración en los canales de cloruro que intervienen en el potencial de acción del músculo esquelético, dicha enfermedad ha sido vinculada con complicaciones anestésicas como episodios de hipertermia maligna. Se presenta el caso de una paciente de 20 años, IIG, IC, con embarazo de 38 semanas, y diagnóstico de miopatía de Thomsen para resolución obstétrica electiva por vía alta. Se discuten los aspectos clínicos de la enfermedad y su manejo anestésico
Thomsen myotonia is a autosomal dominant disease which consists in marked muscular hypertrophy with dominance in the upper limbs associated with disturbance in the chloride channels involved in the skeletal muscle action potential. This disease has been linked with anesthetic complications such as malignant hyperthermia episodes. Is a patient of 20 years old, IIG, IC, with 38 weeks pregnancy, and diagnosis of myopathy of Thomsen for elective obstetrical resolution by cesarean section. The clinical aspects of the disease and its anaesthetic management are discussed