Hábito deportivo: efecto en la aptitud físico-motora y cardiorespiratoria en escolares / Sport habits: effect on physical-motor fitness, and cardiorespiratory of school children

Objetivo: Comparar el efecto del hábito deportivo sobre la aptitud físico-motora y cardiorrespiratoria en escolares. Métodos: Se estudiaron 58 escolares varones (33 hábito deportivo y 25 controles), con edades entre 7,5 y 9,5 años. Se evaluaron: antecedentes familiares, personales, hábitos psicobiológicos, antropometría y química sanguínea. Se llevó a cabo una prueba de resistencia de 1000 m para registrar la aptitud físico-motora clasificándolos en deficiente, regular, promedio, bueno y excelente. Se calculó el volumen máximo de oxigeno (VO2máx) que los clasifica en capacidad aeróbica: baja, regular, media, buena y excelente. Se realizó prueba de esfuerzo para el cálculo del índice cronotrópico y evaluación de la recuperación parasimpática. Resultados: El tiempo promedio en la prueba de resistencia en el grupo con hábito deportivo habitual (366,27±38,20 seg) fue significativamente menor (p<0,001) con respecto al grupo control (416,40±55,79 seg). En la aptitud físico-motora se encontró un desempeño significativamente mejor en los niños con hábito deportivo habitual que en los controles (p<0,005). Este mismo grupo presentó un consumo máximo de oxígeno mayor con un 45,19 ± 5,50 mL/kg/min que los controles con un 37,82 ± 8,20 mL/kg/min (p<0,001). Al categorizar el VO2máx, se encontró una significativa mayor frecuencia de capacidad aeróbica buena y excelente en el grupo con hábito deportivo habitual (p<0,002). En la prueba de esfuerzo y parámetros metabólicos no hubo diferencia. Conclusión: En escolares con hábito deportivo habitual hay una mejor capacidad aeróbica que en los controles. La actividad física mejora la aptitud físico-motora y cardiorrespiratoria sin diferencia en la capacidad funcional y pruebas bioquímicas.

Objective: Compare the effects of sport habits on physical and motor aptitude as well as cardiorespiratory fitness in school children. Methods: Fifty-eight male school children with ages between 7,5 to 9,5 years old were studied (33 with regular sport habits activities and 25 controls). The clinical evaluation included: family history, personal, psychobiological habits, anthropometry and blood analysis. Each child participated in a 1000 meters´ race to test his physical and motor fitness. The performance was ranked as deficient, regular, average, good, and excellent. The maximum volume of oxygen (VO2máx) was determined in order to qualify each participant according to his aerobic capacity: low, regular, average, good, and excellent. The cardiac functional capacity was evaluated through treadmill stress test by the calculation of the chronotropic and the evaluation of parasympathetic recovery index. Results: The average time in strength test for the group with sport habits (366,27±38,20 sec) was significantly lower (p<0,001). In term of the physical and motor fitness, children with sport habits performed significantly better (p< 0,005). Moreover, the sport habits group presented a maximum consumption of oxygen significantly greater 45,19 ± 5,50 mL/kg/min than the controls 37,82±8,20 mL/kg/min (p<0,001). By categorizing VO2max, a significantly higher frequency of good and excellent aerobic capacity was found in the group with sport habits (p<0,002). The treadmill stress test and the metabolic parameters no showed significant difference. Conclusions: School children with sport habits showed better aerobic capacity than those with a sedentary lifestyle. The motor function and biochemical tests showed similar results.

Effects of different concentrations of sevoflurane inhalation combined with propofol anesthesia on rocuronium pharmacodynamics / 天津医药

Objective To investigate the effect of different concentrations of sevoflurane inhalation combined with pro?pofol anesthesia on rocuronium pharmacodynamics. Methods Sixty-seven patients, who underwent elective abdominal op?eration in Tianjin Medical University General Hospital from Nov. 2014 to Feb. 2015, were randomly allocated to three groups:propofol combined 0.5 minimum alveolar concentration (MAC) end-tidal concentration of sevoflurane (group Ⅰ, 24 cases), propofol combined 0.75 MAC end-tidal concentration of sevoflurane (group Ⅱ, 20 cases) and propofol combined 1 MAC end-tidal concentration of sevoflurane (groupⅢ, 23 cases). All those patients were given midazolam 0.05 mg/kg, sufen? tanil 0.3μg/kg, etomidate 0.3 mg/kg for anesthesia induction. Rocuronium was given through the T1 mode of Closed-loop muscle relaxant infusion system and infused by 2ED95(0.6 mg/kg). The following variables were recorded:average consump?tion dosage of rocuronium, recovery index, averaged consumption dosage of propofol and remifentanil. Results The aver?aged consumption dosage of rocuronium was decreased in the three groups in turn[(9.71 ± 2.38 vs 7.50 ± 0.98 vs 6.90 ± 1.14)μg·kg-1·min-1,F=18.562,P0.05]. The average consumption dosage of propofol and remifentanil were lower in groupⅢthan those of groupⅠand groupⅡ(P<0.05). Conclusion High concentration of sevoflurane can enhance neuromuscular blockage effect of rocuronium, and decrease the consumption dosage of propofol and remifentanil.

The Daily Life Functions of Elderly Peritrochanteric Fracture Patients after Surgical Treatment

PURPOSE: Although most peritrochanteric fractures in old age necessitates surgical treatment, daily life functions are still impaired after discharge. We assessed the types of peritrochanteric fracture, risk factors, and functional recovery in elderly patients who were over 65 years old. We also tried to determine factors for recovery to daily life. MATERIALS AND METHODS: From January 2006 to December 2007, among 61 patients who were over 65 years old with the possibility of 1 year follow-up, 50 patients were selected through interviews. After verifying age, sex, mode, types of fracture, and method, we analyzed daily living activities with a functional recovery index and estimated recovery of daily life functions after surgery, assuming a score increase if functional recovery was good. RESULTS: The mean age was 75.8 years, and females (31 patients, 62%) exceeded males. Slipping (27 patients, 54%) was the most common cause of fracture, and the intertrochanteric femur fracture was the most common fracture type (34, 68%). The average functional recovery index decreased 16.24% compared with the pre-operation value, having a tendency to decrease more in old age and female patients. Subtrochanteric femur fracture showed a 17.6% decrease in functional recovery index among the fracture types. CONCLUSION: In elderly patients over 65 years, the functional recovery index after peritrochanteric fracture decreased 16.24% on average compared with the preoperation state. The largest decrease was in basic life ability. The functional recovery index decreased more in old age, females, and subtrochanteric femur fracture, which indicates these factors influence functional recovery.

The Effects of Furosemide on the Recovery from Neuromuscular Blockade Induced by Vecuronium / 대한마취과학회지

BACKGROUND: The interactions between furosemide and muscle relaxants is controversial. In this study, the effects of furosemide on the recovery from neuromuscular blockade induced by vecuronium were investigated in thirty ASA class 1 or 2 adult patients undergoning elective orthopedic surgery under the general aneshtesia with O2-N2O-enflurane. METHODS: Furosemide was administered intravenously at 20% spontaneous recovery of first twitch height of TOF(T1) under the neuromuscular monitoring using Relaxograph?(Datex Co. Finland) as follows: placebo in control group, 5mg in group 1 and 20mg in group 2. Recovery index(RI) defined as the time from 25% to 75% recovery of T1, urinary output during this period and serum K+ levels at 10% and 75% recovery of T1 were measured. RESULTS: RI was shortened significantly in group 1 (11.2+/-3.4 min.) and group 2 (14.9+/-2.7 min.) compared with control group (19.3+/-4.0 min.)(P<0.05). The urinary output was significantly greater in the groups received furosemide than that in the control group(P<0.05), but serum K+ levels were not significantly changed after administration of furosemide. CONCLUSIONS: Furosemide facilitates recovery of neuromuscular blockade induced by vecuronium.

Effect of Fentanyl on the Action Duration of Vecuronium under the General Anesthesia Using Enflurane-N2O / 대한마취과학회지

To evaluate the interaction between fentanyl and vecuronium, I have studied the recovery of train-of-four(TOF) responses after administration of vecwonium in 40 patients under enflurane-N2O inhalational anesthesia. Patients were allocated randomly to 2 groups of 20 patients each to receive: 3 ug/kg fentanyl(fentanyl group) and normal saline of same volume (control group) 10 min before administration of 0.1 mg/kg vecuronium. The times from initial administration of vecuronium to the first appearances of Tl, T2, T3, and T4 differed significantly between groups (p<0.01): 15.8+/-6.5 min, 21.4+/-7.2 min, 25.1+/-8.2 min, and 27.9+/-8.7 min in the control group, and 22.7+/-5.1 min, 28.4+/-5.3 min, 31.9+/-5.9 min, and 34.7+/-6.7 min in the fentanyl group, respectively. However, the T2-T4 recovery index did not differ significantly between groups: 5.9+/-3.1 min in the control group, and 6.3+/-3.0 min in the fentanyl group. It is concluded that fentanyl can slightly prolong the action duration of vecuronium, but not affect it during the recovery from muscle relaxation.

Effect of Doxapram on the Recovery from Vecuronium and Atracurium Neuromuscualr Block / 대한마취과학회지

The purpose of this study is to investigate the effects of doxapram on the rates of spontaneous and neostigmine-induced recovery from neuromuscular block with vecuronium and atracurium. Following intravenous injection of either vecuronium (40 patients) or atracurium (40 patients), recovery index (RI) was measured without administering either doxapram or neostigmine (Group 1), or after administration of a combination of neostigmine 40 ug/kg and doxapram 1 mg/kg (Group 2), neostigmine 40 ug/kg (Group 3) or doxapram 1 mg/kg (Group 4) when twitch tension returned to 25% block of train of four response, each of the four group had 10 patients. The results were such that RI was significantly prolonged after vecuronium in the presence of doxapram compared with Group 1 (13.5 min vs 8.2 min). There was no significant difference in the RI after atracurium in the presence of doxapram compared with Group 1 (7.0 min vs 7.1 min). There was rapid recovery which was significant when neostigmine was administered with or without doxapram (2.4 min vs 2.3 min respectively after vecuronium; 2.3 min vs 2.4 min respectively after atracurium). The authors conclude that administration of doxapram in situation where neuromuscular block with vecuronium is not adequately antagonized does not contribute to rapid recovery from neuromuscular block.

Neuromuscular Blocking Actions of Mivacurium in Pediatric Patients / 대한마취과학회지

The surgeries based on the outpstient department have increased recently. One of the indications of outpatient surgery is chemical peeling of the face that usually re- quires only deep sedation of short duration. The purpose of this study was to evaluate the effeets of ketamine and midszolam for out patient facial chemical peeling. Fifty-nine unpremedicated patients undergoing chemical peeling of the face were anesthetized with bolus intravenous injection of 1mg/kg of ketamine and 0.1 mg/kg of midazolam. Additional dose of ketamine(10-20mg) was given as needed. During operation, we observed systolic and diastolic blood pressure with noninvasive blood pressure monitor and peripheral oxygen saturation(SpO2) with pulse oximeter. All patients were allowed to breathe spontane- ously without ventilatory support during the operation. There was no case of airway ob- struction and SpO2 value was over 97% in most cases. The systolic and diastolic blood pressure and pulse rate were increased after the injection of ketamine and midazolam. And we observed the untoward effect of anesthetics such as the purposeless movement(6.8%), involuntary phonation(3.4%), skin rash(3.4%) and headache(1.7%). In postoperative analysis about the recall, bad dream, mood, and the degree of satisfaction of this type of anesthesia, the rate of patient's positive acceptance was high(86.4%) and the reeovery time was 58min. We conclude that combination of intravenous ketamine and midszolam can produce satisfactory anesthesia with few complications for outpatient chemical peeling surgery of the face.

The Effect of Small Dose of Hydrocortisone to the Recovery Index from Neuromuscular Blockade Induced with Vecuronium / 대한마취과학회지

Several investigators have described an interaction between muscle relaxants and hydrocortisones which have showed different results. The exact mechanism of this action is not clear and ther conflicting results have further confusion. The experimental methods were two ways. In the one of method, a group that vecuronium 0.1mg/kg was given intravenously is control and a group that hydrocortisones of various doses(0.3, 0.5 and 1 mg/kg) were administered into vein when T1 was appeared is compared. In the another of method, a control group was anticholinesterase(pyridostigmine 0.12 mg/kg, robinul 0.004mg/kg) were given at the time when T1 reached 25% and a group treated with hydrocortisone 0.5 mg/kg when T1 was appeared is compared. Neuromuscular blockade was measured by recording the twitch response following ulnar nerve stimulation by EMG(ABM, Datex Co. 2Hz 30mA supramaximal voltage). The recovery time from 25% to 75% recovery of twitch height was measured according to recovery index(RI). The results obtained were as follows: `) The RI of control group treated with vecuronium 0.1mg/kg alone was 40.32+/-20.24 minutes and the group which hydrocortisone 0.5mg/kg was combined, was shorten to 18.79+/-5.17 minutes, but in the group combined with hydrocortisone 1.0mg/kg and 0.3mg/kg, the RI was also tended to short, but not significant. 2) In the RI of vecuronium 0.1mg/kg, anticholinesterases were given, was 8.46+/-5.06 minutes and the group combined with hydrocortisone 0.5mg/kg was shorten to 4.77+/-1.82 minutes significantly. Conclusively, in the small doses of hydrocortisone, there is a effect of antagonism to the vecuronium induced blockade and a potentiated effect to the anticholinesterase activity to the vecuronium.

Clinical Study of Duration of Vecuronium after Pancuronium / 대한마취과학회지

Vecuronium has been used for long surgical procedure by infusion or intermittent injection. However, such methods are not economical. It may be that the use of longer acting pancuronium followed by vecuronium would offer the advantages of economy and rapid recovery. The aim of this study was to investigate the duration of effect of vecuronium administered after pancuronium. Eighteen patient reguiring prolonged major surgery were given intravenous pancuronium 0.06 mg/ kg (ED95) after induction of anesthesia and a dose of pancuronium 0.06 mg/kg (Group I, nine patients) or vecuronium 0.01 mg/kg (Group II, nine patients) was given at the recovery of neuromuscular transmission where the response to the first stimulus (T1) was 25% of control response. As a result, the time of onset, recovery time of 25%, 50% and 75% of control response T1 and recovery index was to be shorter with vecuronium than with pancuronium. It is concluded that vecuronium administered at the end of surgery after pancuronium is effective for shorting the duration of recovery time.

The Effect of Neostigmine Pretreatment on Vecuronium Induced Neuromuscular Blockade / 대한마취과학회지

Prolonged neuromuscular blockade following succinylcholine may be seen when anticho- linesterase had been administered prior to reverse nondepolarizing muscle relaxant-induced paralysis, possibly anticholinesterase has been reported to inhibit serum cholinesterase activity. Our study was undertaken in order to understand the effect of a nondepolarizing muscle relaxant (vecuronium) following neostigmine pretreatment. In this study, we assessed the effect of vecuronium induced neuromuscular blockade using a train of four, 2 Hz stimulations on ulnar nerve. Patients admitted to our hospital for elective operations were divided into two groups, each group consisting of 16 patients. In group I, vecuronium 0.1 mg/kg was .administered according to the priming principle following normal saline, in group II, vecuronium 1.0mg/kg was administered according to the priming principle following neostigmine 0.05 mg/kg and glycopyrrolate 0.003 mg/kg pretreatment. Then the time for Tl to reach 5% or less(second), and the time for Tl to reach from 25% to 75%(recovery index) were measured in both groups. The time for Tl to reach 5% or less in group I(92.8+/-14.72 second) and group II(97.5+/-16.43 seconds) were not siginificant. However the recovery indexof group I(10.2 5+/-1.93 minute) and group II(8.5+/-1.80 minute) showed significant shortening in group II(p<0. 05)

Clinical Evaluation of the Neruomuscular Blocking Effect of Isoflurane / 대한마취과학회지

Isoflurane, which has only recently been introduced into clinical practice, is a nonflammable halogenated ether used as an inhalation anesthetic. It has pharmacological, physical, and clinical properties similar to those of halothane and enflurane: however, it differs from botn in several important aspecs. The potent neuromuscular blocking action of sioflurane in desirable, because it reduces the requirement for muscle relaxants and allows lower doses of anesthesis. To quantitatively clarify the neuromuscular blocking effect of isoflurane, neuromuscular function was monitored by "Train of Four" stimulus with and without administration of muscle relaxants under halothane and isoflurane anesthesis, respectively, in 60 patients. The patients were divided into 4 groups(halothane anesthesia without muscle relaxants, halothane anesthesis with muscle relaxants, isoflurane anesthesia without muscle relaxants and isoflurane anesthesia with muscle relaxants). Twich responses of thenar muscle were monitored and analysed for the value of maximaum twich depression by halothane and isoflurane anesthesia, respectively, and the onset time, degree of maximal neuromuscular blockade, duration of action and recovery index of pnscuronium bromide under halothane and isoflurane anesthesia, respectively. The results were as follows: 1) Isoflurane exhibited a neuromuscular blocking effect 2,3 times more potent than halothane. 2) Neuromuscular depression by halothane and isoflurane was not accompanied by "fade". 3) The recovery time from nuromuscular blockade by succinylcholine in isoflurane anesthesia was increased significantly compared with halothane anesthesia. 4) The duration of action and the recovery index were increased significantly in isoflurane anesthesia compared with halothane anesthesia.