ABSTRACT
Objective To investigate the effect of intravenous anesthesia with sufentanil combined with propofol on hemodynamics and oxygen metabolism in patients with esophageal cancer under high altitude.Methods 60 patients with esophageal cancer radical surgery was selected from March 2015 to March 2017 in our hospital and were divided into two groups according to the random number table,30 patients in each group.Patients in the control group were given with fentanyl and propofol intravenous anesthesia,and patients in the observation group were given sufentanil combined with propofol anesthesia.The occurrence of restlessness during the recovery of anesthesia in the two groups were observed,the spontaneous breathing recovery time,extubation time and postoperative Mini-mental State Examination (MMSE) score were recorded,and the indexes of hemodynamics and oxygen metabolism were measured at the time of before induction of anesthesia (T0),tracheal intubation (T1),skin incision (T2),thoracotomy (T3),free esophagus (T4),esophageal catheter removal time (T5).Results The spontaneous respiration recovery time and extubation time of the observation group were significantly shorter than those of the control group (P ＜ 0.05).The degree of restlessness in the observation group was weaker than that in the control group (P ＜ 0.05).Mean arterial pressure (MAP) in the control group at T2-T4 were significantly higher than those in T0 (P ＜ 0.05),but MAP and heart rate (HR) in the observation group at T1-T5 were significantly lower than those of T0 (P ＜ 0.05).Compared with T0 group,oxygen saturation (SpO2),oxygen saturation of mixed venose blood (SvO2) and oxygen delivery (DO2) at T1-T5 were significantly decreased (P ＜ 0.05),oxygen consumption (VO2) at T2-T4 was significantly increased (P ＜ 0.05),especially in the control group (P ＜ 0.05).The MMSE scores of the two groups were significantly lower than those before the operation (P ＜ 0.05),and the scores in observation group was significantly higher than the control group (P ＜ 0.05).Conclusions The intravenous anesthesia with sufentanil combined with propofol is more helpful in maintaining hemodynamic stability and oxygen metabolism balance than intravenous anesthesia with fentanyl combined with propofol and has little effect on postoperative anesthesia recovery and cognitive function.
ABSTRACT
Objective To investigate the appropriate ratio of propofol and remifentanil in total in travenous anesthesia for adult fiberoptic bronchoscopy.Methods 122 cases of adult patients who were examined under total intravenous anesthesia (TIVA) with fiberoptic bronchoscopy in Xiangya hospital were randomly divided into three groups regarding the mixed proportion of propofol and remifentanil:group Ⅰ including 42 cases,group Ⅱ 41 cases,group Ⅲ 39 cases;the mixed proportion of propofol and remifentanil in group Ⅰ was 400 mg∶ 1 mg,in group Ⅱ was 1 000 mg∶ 1 mg,and in group Ⅲ was 2 000 mg∶ 1 mg,were given during TIVA.In the surgery,the bispectral index (BIS) values were sustained between 45 and 60 and we compared the changes of vital signs,airway resistance,the incidence of bucking and airway spasm before and after anesthesia.Results Compared with group Ⅱ,the airway resistance and the incidence of bucking and airway spasm in group Ⅰ both significantly increased and the blood pressure fluctuation in group Ⅲ was greater significantly (P ＜ 0.05).Conclusions The appropriate ratio of propofol and remifentanil is 1 000 mg∶ 1 mg with total intravenous anesthesia in fiberoptic bronchoscopy,which results a stable hemodynamics,lower airway resistance,and lower incidence of bucking and airway spasm.
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Objective To investigate the effect of preoperative anxiety on propofol EC50 for nomovement during Painless gastroscopy.Methods Thirty-one patients (without anxiety) and twenty-seven patients (with anxiety) undergoing gastroscopy under general anesthesia were enrolled on the study.Anesthesia was conducted with a target-controlled infusion (TCI) of propofol.The initial target effect-site propo fol concentration (Ceprop) was 5.0 μg/ml and was adjusted stepwise by 0.5 μg/ml by an up-down sequential method to reach no-movement.Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety (5.32 μg/ml,95％ CI:4.75-5.88 μg/ml vs 4.75 μg/ml,95％ CI:4.48-5.01 μg/ml,P ＜ 0.05).Conclusions During painless gastroscopy,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety when intravenous injected of fentanyl 0.1 μg/kg.
ABSTRACT
Objective To evaluate the effects of preoperative sleep disturbance on the consumption of propofol during the period of general anesthesia and postoperative sleep quality.Methods Sixty-five patients scheduled for elective thyroidectomy surgery under general anesthesia were enrolled in the study.According to the preoperative Pittsburgh Sleep Quality Index (PSQI) score,the patients were divided into sleep normal group (n =33) and sleep disorder group (n =32).Anesthesia was induced and maintained with propofol given by closed-loop target-controlled infusion (CLTCI).The consumption of propofol during the period of general anesthesia,postoperative sleep quality in the evening of surgery and at 24 h after operation,and the painful levels of the patients at 1 d and 2 d after operation were compared between two groups.Results The totalconsumption of propofol in sleep disorder group [(1 024.33 ±213.02)mg] was more than that in sleep normal group [(892.25 ± 242.30) mg] (P ＜ 0.05),and the dosage of unit surface area per minute of propofol in sleep disorder group [(4.94 ± 0.80) mg/(min · m2)] was also more than that in sleep normal group [(4.45 ± 0.96) mg/(min · m2)] (P ＜ 0.05).Each group suffered from bad sleep quality in the evening of operation,and got improvement one day later (P ＜ 0.05).The sleep quality in sleep disorder group was improved after general anesthesia (P ＜ 0.05).Conclusions Preoperative sleep disturbance increased the consumption of propofol in the general anesthesia.General anesthesia can improve the sleep quality of the patients who suffered from sleep disorder.