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Objective@#To investigate the effect of sulfentanyl and tropisetron postoperative analgesia pump on perioperative interleukin 6(IL-6), tumor necrosis factor (TNF-α) and insulin resistance in patients undergoing abdominal general anesthesia.@*Methods@#From March 2016 to March 2017, 120 patients undergoing elective abdominal surgery in our hospital were selected, all patients were treated with general anesthesia.The patients were randomly divided into control group and observation group according to the digital table, with 60 cases in each group.The control group was treated with on-demand delivery analgesia.The observation group was treated with sulfentanyl and tropisetron postoperative analgesia pump for postoperative analgesia.The BCS score, VAS score, Ramsay score at the end of operation and after operation were compared.The TNF-α, ISI, IL-6, insulin levels and blood glucose levels of preoperation and postoperation were compared between the two groups.@*Results@#Compared with the control group, the BCS score and Ramsay score of postoperative 0.5d[(2.78±0.57)points, (2.27±0.39)points], postoperative 1d[(3.04±0.48)points, (2.36±0.50)points], postoperative 1.5d[(3.24±0.51)points, (2.43±0.49)points], postoperative 2d[(3.35±0.43)points, (2.51±0.42)points] in the observation group increased (t=-18.604, -8.65, -8.204, -3.967, t=-9.634, -4.864, -4.610, -2.604, all P<0.05), the VAS scores of postoperative 0.5d[(2.4±1.1)points], postoperative 1 d[(1.8±0.8)points], postoperative 1.5d[(1.7±0.5)points], postoperative 2d[(1.7±0.9)points] in the observation group were lower (t=2.082, 4.834, 7.934, 3.098, all P<0.05). Compared with the control group, the insulin, blood sugar, TNF-α, IL-6 of postoperative 0.5d[(7.26±2.17)mU/L, (5.63±0.58)mmol/L, (148.96±20.31)g/L, (120.54±22.27)pg/mL], postoperative 1d[(7.37±1.74)mU/L, (5.34±0.50)mmol/L, (121.35±21.07)μg/L, (116.35±21.01)pg/mL], postoperative 1.5d[(6.57±2.14)mU/L, (5.11±0.50)mmol/L, (114.36±23.99)μg/L, (113.14±18.05)pg/mL], postoperative 2d[(5.87±1.84)mU/L, (4.87±0.51)mmol/L, (100.02±18.13)μg/L, (91.37±14.88)pg/mL] in the observation group were lower (t=9.374, 11.698, 6.455, 10.161, t=8.557, 13.027, 9.990, 8.541, t=6.730, 7.917, 7.811, 2.326, t=8.003, 7.225, 3.839, -7.618, all P<0.05). Compared with the control group, the ISI of postoperative 0.5d[(24.77±0.26)×1 000], postoperative 1d[(25.03±0.21)×1 000], postoperative 1.5d[(29.65±0.17)×1 000], postoperative 2d[(34.54±0.19)×1 000] in the observation group were increased (t=-281.912, -442.121, -248.226, -431.857, all P<0.05).@*Conclusion@#The analgesic effect of sulfentanyl and tropisetron postoperative analgesia pump is good, it can reduce the postoperative stress response and the levels of IL-6 and TNF-α, and reduce the degree of insulin resistance, and can be widely used in clinical.
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Objective To investigate the effect of sulfentanyl and tropisetron postoperative analgesia pump on perioperative interleukin 6(IL-6),tumor necrosis factor (TNF-α) and insulin resistance in patients undergoing abdominal general anesthesia.Methods From March 2016 to March 2017,120 patients undergoing elective abdominal surgery in our hospital were selected ,all patients were treated with general anesthesia.The patients were randomly divided into control group and observation group according to the digital table ,with 60 cases in each group.The control group was treated with on -demand delivery analgesia.The observation group was treated with sulfentanyl and tropisetron postoperative analgesia pump for postoperative analgesia.The BCS score,VAS score,Ramsay score at the end of operation and after operation were compared.The TNF-α,ISI,IL-6,insulin levels and blood glucose levels of preoperation and postoperation were compared between the two groups .Results Compared with the control group ,the BCS score and Ramsay score of postoperative 0.5d[(2.78 ±0.57) points,(2.27 ±0.39) points],postoperative 1d [(3.04 ±0.48)points,(2.36 ±0.50) points],postoperative 1.5d[(3.24 ±0.51) points,(2.43 ±0.49) points], postoperative 2d[(3.35 ±0.43) points,(2.51 ±0.42) points] in the observation group increased ( t＝-18.604,-8.65,-8.204,-3.967,t＝-9.634,-4.864,-4.610,-2.604,all P＜0.05),the VAS scores of postopera-tive 0.5d[(2.4 ±1.1) points],postoperative 1 d[(1.8 ±0.8) points],postoperative 1.5d[(1.7 ±0.5) points], postoperative 2d[(1.7 ±0.9)points] in the observation group were lower (t＝2.082,4.834,7.934,3.098,all P＜0.05).Compared with the control group ,the insulin,blood sugar,TNF-α,IL-6 of postoperative 0.5d[(7.26 ± 2.17)mU／L,( 5.63 ±0.58 ) mmol／L, ( 148.96 ±20.31 ) g／L, ( 120.54 ±22.27 ) pg／mL], postoperative 1d [(7.37 ±1.74)mU／L,(5.34 ±0.50)mmol／L,(121.35 ±21.07) μg／L,(116.35 ±21.01) pg／mL],postoperative 1.5d[(6.57 ±2.14)mU／L,(5.11 ±0.50)mmol／L,(114.36 ±23.99)μg／L,(113.14 ±18.05)pg／mL],postoper-ative 2d[(5.87 ±1.84)mU／L,(4.87 ±0.51) mmol／L,(100.02 ±18.13) μg／L,(91.37 ±14.88) pg／mL] in the observation group were lower ( t ＝9.374,11.698,6.455,10.161,t ＝8.557,13.027,9.990,8.541,t ＝6.730, 7.917,7.811,2.326,t＝8.003,7.225,3.839,-7.618,all P＜0.05).Compared with the control group ,the ISI of postoperative 0.5d[(24.77 ±0.26)×1 000],postoperative 1d[(25.03 ±0.21)×1 000], postoperative 1.5d [(29.65 ±0.17)×1 000],postoperative 2d[(34.54 ±0.19)×1 000] in the observation group were increased (t＝-281.912,-442.121,-248.226,-431.857,all P＜0.05).Conclusion The analgesic effect of sulfentanyl and tropisetron postoperative analgesia pump is good ,it can reduce the postoperative stress response and the levels of IL-6 and TNF-α,and reduce the degree of insulin resistance ,and can be widely used in clinical.
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Objective To study the influence of anesthetic effect,maternal and infant outcomes and safety of subarachnoid block used sulfentanyl combined with ropivacaine for patients with gestational hypertension in the cesarean section.Methods 180 cases of gestational hypertension ready to cesarean section were selected as study subjects,and they were randomly divided into A group,B group and C group by digital table method,60 cases in each group.A group used 10mg ropivacaine,B group used 13mg ropivacaine,C group used 5μg sulfentanyl combined with 10mg ropivacaine.The anesthetic effect,circulation function,duration of pain,operation time,neonatal Apgar score at 1 and 5 min after birth,neonatal weight,motor block evaluation after operation,adverse reaction and complication were compared in three groups.Results The anesthetic effect between B group and C group had no statistical difference (x2 =1.233,1.465,all P ＞ 0.05).The anesthetic effect of B group and C group was better than that of A group(F =5.633,7.299,all P ＜0.05).The HR and MAP of every time points between A group and C group had no statisticaldifferences (F =1.313,1.265,all P ＞ 0.05).Compared with T0,the HR and MAP of B group at T1,T2,T3,T4 had statistical differences compared with A group and C group(F =5.633,7.299,all P ＜0.05).The operation time of the three groups had no statistical difference(F =0.933,P ＞ 0.05).The duration of pain between B group and C group had no statistical difference(t =0.822,P ＞ 0.05).The duration of pain of A group was longer than that of B group and C group(F =8.316,P ＜0.05).The neonatal Apgar scores at 1 and 5 min after birth and neonatal weight of the three group had no statistical differences(F =0.822,0.929,all P ＞ 0.05).The improved Bromage score between A group and C group had no statistical difference (t =2.627,1.991,all P ＞ 0.05).The improved Bromage score between B group and A,C group had statistical differences(F =6.371,5.693,all P ＜ 0.05).The complete recovery time of motor nerve of B group was much longer than that of A group and C group (F =8.924,P ＜ 0.05).The incidence rates of vomit and nausea of A group and B group were much higher than that of C group(F =3.561,12.581,all P ＜ 0.05).The incidence rate of bradycardia and hypotension of B group was much higher than that of A group and C group (F =8.273,10.833,all P ＜ 0.05).Conclusion During subarachnoid block anaethesia using 5 μg sulfentanyl combined with l0mg ropivacaine can be applied to mild and moderate gestational hypertension,it has advantages such as less adverse reaction,good analgesic effect,less hemodynamic effect,and it is worthy of clinical promotion.
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Objective To investigate the effect and function analysis by sulfentanyl in patients with tongue cancer postoperative analgesia.Methods A total of 74 patients with radical resection of tongue cancer in department of anesthesiology with general anesthesia from our hospital were collected, patients or their families signed consent, according to postoperative self-controlled intravenous analgesia drugs divided into experimental group and control group with 37 cases in each group.Patients in control group were treated by fentanyl self-controlled intravenous analgesia;patients in experimental group were treated by sulfentanyl self-controlled intravenous analgesia, determination of the analgesic effect, sedative effect and the changed of vital signs postoperative 2, 4, 8, 12, 24, 48 h,at the same time recorded complications.Results After operation, at different time points analgesic effect and sedative effect were changed in the two groups, the VAS scored of the experimental group was lower than the control group postoperative 2, 4, 8, 12, 24, 48 h time points, the Ramsay Sedation scored of the experimental group was lower than the control group postoperative 2 h, 4 h, 8 h, 12 h time points ( P 0.05 ) . Conclusion Sulfentanyl in the treatment of patients with radical resection of tongue cancer the analgesic effect and sedative effect are better than fentanyl, has no effect on the vital signs, and the role is security and exact.
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Objective To explore effects of sulfentanyl preconditioning on myocardial injury in scald in diabetic and non-diabetic rats.Methods Eighty SD rats (40 diabetic rats and 40 non-diabetic rats)were divided into eight groups (10 rats per each),including sham group(group NS,non-diabetic rats with sham burn),burned group(group NB,non-diabetic rats with third-degree burns over 30%total body surface area (TBSA)and lactated Ringer??s solution for resuscitation),sulfentanyl group (group NP,non-diabetic rats without given sulfentanyl before burning and lactated Ringer??s solution for resuscitation)and naloxone group(group NN,non-diabetic rats given naloxone before sulfentanyl group),Diabetes sham group(group DS,diabetic rats with sham burn),Diabetic rats burned group (group DB,diabetic rats given third-degree burns,over 30 percent of the total body surface area had been burned and given lactated Ringer??s solution for resuscitation),diabetic sulfentanyl group(group DP,diabetic rats given sulfentanyl before burning and given lactated Ringer??s solution for resuscita-tion)and diabetic naloxone group(group DN,diabetic rats given naloxone,after that treated as the sulfentanyl group).Results Compared to group NB,for the mice in group NP,the activity of plasma SOD increased significantly,TNF-α,cTnI and water content level in myocardium decreased signifi-cantly (P <0.05 );whereas TNF-α,cTnI and water content level in myocardium in group DB in-creased significantly (P <0.05);Compared to group DB,for the mice in group DP,the activity of plasma SOD increased significantly,MDA,TNF-α,cTnI and water content level in myocardium de-creased significantly (P <0.05).Conclusion Diabetes may deteriorate burn-induced myocardial injury in rats.Sulfentanyl pretreatment exhibits significant protective effects on burned-induced myocardial injury in severely burned diabetic rats via inhibiting lipid peroxidation and TNF-αexpression.
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Objective: To discuss the curative effect of gynecological postoperative patient-controlled intravenous analgesia ( PCIA) of parry celebrex sodium combined with sulfentanyl. Methods: Totally 66 cases with gynecological operation were randomly divided into the observation group and the control group. The patients in the two groups were both given PCIA of sulfentanyl after the tube withdrawal, and the patients in the observation group were given 40mg parry celebrex sodium respectively before skinning suture and 12 hours after the operation by intravenous injection, while the patients in the control group were given 5ml sodium chloride injec-tion (0. 9%) at the same time. The VAS and Ramsay scores of the patients at the stages of 1h (T1), 2h (T2), 6h (T3), 12h (T4) and 24h (T5) after the operation were observed. The press times of PCIA, effective press times, amount of sulfentanyl, VAS satisfac-tion rates and adverse drug reactions ( ADR) in 24 hours after the operation were recorded. Results:The VAS and Ramsay scores of the patients in the observation group at the different stages were much higher than those in the control group (P<0. 05). The total press times of PCIA, effective press times, amount of sulfentanyl of the patients in the observation group in 24 hours after the operation were much lower than those in the control group (P<0. 05). The VAS satisfaction rate in the observation group was much higher than that in the control group (P<0. 05), and the ADR occurrence rate in the observation group was much lower than that in the control group (P<0. 05). Conclusion:The application of parry celebrex sodium combined with sulfentanyl on PCIA after the operation can reduce the amount of sulfentanyl and enhance the VAS and Ramsay effect with fewer adverse drug reactions, which is a safe and effec-tive VAS method after the operation.
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Objective To assess the effects and side effects of ropivacaine combined with sulfentanyl in epidural anesthesia for caesarean section. Methods Two hundred ASA Ⅰ- Ⅱ patients scheduled for elective caesarean section were randomly divided into 2 groups (100 cases each):group S received 0.75% ropivacaine and 0.75 μg/ml sulfentanyl; and group R received 0.75 % ropivacaine. Epidural space L2-3 was punctured and the catheter was put upward 3 cm in all patients. Local anesthetic agents were administered until a complete sensory block was established extending upper T4-T6. In the operation, Bp, HR,SpO2, ECG were observed and the onset time, the upper spread and duration of sensory block were recorded.Assessed anesthetic efficacy and side-effects on newborn. Results The onset time [(4.5±1.2) min], the time needed to reach the highest sensory level [ ( 13±5) min ] were significantly shorter and the duration of sensory block [ (402±150 ) min ] was significantly longer in group S than those in group R (P < 0.05 ). There was no significant difference in the side effects such as tachycardia, nausea, vomiting, and shivering. Apgar score in newborn was not affected. Conclusion The anesthetic efficacy of epidural 0.75% ropivacaine is significantly enhanced which also has smaller local anesthetic requirements and low incidence of side-effects,in epidural anesthesia for caesarean section when sulfentanyl is added.
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Objective To investigate the effects of low-dose ketamine combined with fentanyl or sulfentanyl in postoperative patient-controlled intravenous analgesia.Methods Two hundred cases with ASA Ⅰ~Ⅱ undergoing elective orthopedic operations were randomly allocated into four groups(50 cases for each group): 0.4?g/(kg?h) fentanyl(group F);0.2?g/(kg?h) fentanyl+120?g/(kg?h) ketamine(group FK);0.04?g/(kg?h) sulfentanyl(group S);and 0.02?g/(kg?h) sulfentanyl+120 ?g/(kg?h) ketamine(group SK).8mg of ondansetron was added to each recipe,and then diluted into 100ml with normal saline.The loading doses of all the patient-controlled-analgesics were 2ml administered 30min before the end of the operation.The background infusion doses were 2ml/h,while the pressing doses were 2ml,with intervals of 30min.Heart rate(HR),blood pressure(BP),respiration rate(RR),pulse O2 saturation and visual analogue scales(VAS),sedation score(SS) with adverse effects and the total times of pressing PCA pump button were observed and recorded in all patients respectively for 48h after operations.Results No statistically significant differences were found in HR,BP and RR among the four groups.VAS and the total pressing times in group F were higher than that in the other groups significantly(P