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Abstract Objective: The aim of this study was to evaluate whether sufentanil can reduce emergence delirium in children undergoing transthoracic device closure of ventricular septal defect (VSD) after sevoflurane-based cardiac anesthesia. Methods: From February 2019 to May 2019, 68 children who underwent transthoracic device closure of VSD at our center were retrospectively analyzed. All patients were divided into two groups: 36 patients in group S, who were given sufentanil and sevoflurane-based cardiac anesthesia, and 32 patients in group F, who were given fentanyl and sevoflurane-based cardiac anesthesia. The following clinical data were recorded: age, sex, body weight, operation time, and bispectral index (BIS). After the children were sent to the intensive care unit (ICU), pediatric anesthesia emergence delirium (PAED) and face, legs, activity, cry, consolability (FLACC) scale scores were also assessed. The incidence of adverse reactions, such as nausea, vomiting, drowsiness and dizziness, was recorded. Results: There was no significant difference in age, sex, body weight, operation time or BIS value between the two groups. Extubation time (min), PEAD score and FLACC scale score in group S were significantly better than those in group F (P<0.05). No serious anesthesia or drug-related side effects occurred. Conclusions: Sufentanil can be safely used in sevoflurane-based fast-track cardiac anesthesia for transthoracic device closure of VSD in children. Compared to fentanyl, sufentanil is more effective in reducing postoperative emergence delirium, with lower analgesia scores and greater comfort.
Subject(s)
Humans , Male , Female , Child , Anesthetics, Inhalation , Emergence Delirium , Anesthesia, Cardiac Procedures , Heart Septal Defects, Ventricular/surgery , Adjuvants, Anesthesia/therapeutic use , Methyl Ethers , Retrospective Studies , Sufentanil/therapeutic use , SevofluraneABSTRACT
Objective Learning and memory function is the form of brain higher nervous activity .Hippocampus is the main parts responsible for learning and memory function .Once damaged , it will seriously affect the quality of life in patients .The purpose of this paper was to observe the effects of neonatal repeated intermittent sevoflurane inhalation on learning-memory function and Tau protein , p-Tau protein in brain hippocampus in juvenile and adult rats . Methods Twenty-four healthy SD rats ( n=24 ) were randomly di-vided into juvenile sevoflurane inhalation group ( n=6) , juvenile con-trol group ( n=6);adult sevoflurane inhalation group ( n=6) , and adult control group ( n=6) .Rats in juvenile sevoflurane inhalation group and adult sevoflurane inhalation group inhaled 2.6%sevoflurane at the postnatal 7th day, 14th day, 21th day ( P7,P14,P21) for 2 hours.Rats in juvenile control group and adult control group inhaled the carrier gas (1L/min Air+1L/min O2) at the same time for 2 hours.During P31~37, Morris water maze test was conducted in juvenile sevoflurane inhalation group and juvenile control group to detect the behavior.During P91~97, Morris water maze test was conducted in adult sevoflurane inhalation group and adult control group to detect the behavior .Then hippocampi were taken out to detect the expression levels of Tau protein and p -Tau protein. Results ( 1) Comparison of escape latency at the same time ① Juvenile period: no statistical difference between sevoflurane inhalation group (52.04±41.90,29.77±14.23, 19.87±5.71,22.74±13.73,21.91±9.07) and control group (47.82±8.06,25.26±12.53,23.79±9.49, 20.00±10.10, 14.03±7.55) had (P>0.05).② Adult period: no statistical difference between sevoflurane inhalation group (42.00± 14.12, 26.87±16.93, 19.80±13.76, 15.06±8.45, 8.66±4.82) and control group (41.97±25.66,22.88±10.04,15.88±5.20,9.26± 3.98,11.33±6.05 (P>0.05).(2) Comparison of spatial probe test results:no statistical difference in the swimming times from original area,swimmingresidencetime,swimmingdistanceandspeedbetweengroups(P>0.05).(3)Tauproteinexpressiondetection ①Juvenile period:In the hippocampal CA1 region, CA3 region, DG region, the expression level of Tau in the sevoflurane inhalation group (0.237±0.015, 0.324±0.024,0.226±0.019) was higher than the control group (0.185±0.024,0.232±0.040, 0.184±0.018) (P>0.01).②Adult peroid:no statistically significant difference between sevoflurane inhalation group and control group (P>0.05). (4)p-Tau(Ser396)proteinexpressiondetection ①Juvenileperiod:nostatisticallysignificantdifferencebetweensevofluraneinhala-tion group and control group ( P>0.05) .②Adult period:The expression level in the hippocampal CA3 region of sevoflurane inhalation group (0.170±0.005) was higher than control group (0.158±0.011) (P0.05). Conclusion Neonatal repeated intermittent sevoflurane inhalation has done no harm to learn-ing and memory function of juvenile and adult rats , however , it can result in the significant increase of hippocampal Tau protein expres-sion level in juvenile rats and the increase of hippocampal p-Tau protein expression level in adult rats .
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Objective:To investigate the effects of chronic exposure to low concentration sevoflurance on hippocampus in SD fetal rats.Methods:Totally sixty female SD rats at clean grade weighing 240-260 g were randomly divided into four groups , the control group and sevoflurane groups (n=15).The three experimental groups were respectively treated with 30 mg· L-1(parts permillion1 × 10 -6), 100 mg· L-1 and 300 mg· L-1 sevoflurane with 6-hour inhalation, qd for 2 weeks, while the control group breathed fresh air with the same volume .After mating conception , the rats inhaled the same concentration sevoflurane or air till scarification on the 19 th day.Half of brain in the fetal rats was withdrawn to prepare the paraffin specimens , and immunohistochemistry was used to detect the apoptosis in hippocampal CA 1 region associated with protein Bcl-2 and Bax.The hippocampus was stripped from the other half of brain and 10%homogenate was prepared, and the activity level of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) were detected.Results:Bcl-2 in hippocampus CA1 region in 300 mg· L-1 group was lower than that in the control group , while Bax was higher than that in the control group (P0.05).Conclusion:Low concentration inhalation of sevoflurane above 300mg· L-1 can enhance the cell apoptosis in hippocampus through increasing the oxidative stress reaction in embryonic brain of SD rat resulting in excessive MDA and reduced SOD.
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Objective To investigate the effects of different concentrations of sevoflurane on adhesion and expression of CD 44 in human breast cancer cell line MCF‐7 .Methods The cells were randomly divided into 4 groups :control group and 3 sevoflurane groups exposed to 1 .7% ,3 .4% and 5 .1% sevollurane for 2 ,4 and 6 h respectively .Cell adhesion rate was detected by adhesion test and the expression of CD44 mRNA and protein was determined by qRT‐PCR .Results in Treat 1 ,2 ,3 ,the adhesion rate at 2 ,4 ,6 h were lower than that before treat ,mRNA expression of CD44 reduced (P<0 .05);the adhesion rate of Treat 2 and Treat 3 at 4 and 6 h were lower than that of 2 h ,and the mRNA expression of CD44 reduced (P<0 .05);the adhesion rate of Treat 2 and Treat 3 at 6 h were lower than that of 4 h ,and the mRNA expression of CD44 reduced (P<0 .05);compared with Control group ,the adhesion rate of Treat 1 ,2 and 3 at 2 ,4 ,6 h were all lower ,mRNA expression of CD44 reduced (P<0 .05);the differences between each group were statisyicaly significant(P<0 .05) .Conclusion Sevoflurane can inhibit cell adhesion in a concentration and duration of exposure dependent manner ,and its mechanism could be related with the down regulation of CD44 expression .
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Objective: To systematically review the cardioprotective of sevoflurane in patients undergoing heart surgery under cardiopulmonary bypass,so as to provide evidence for anesthesia decision of cardiac surgery. Methods: Trials about the cardioprotective effect of sevoflurane under CPB were collected through electronic search of Medline, CNKI, and CMBdisk (from the date of database establishment to October 2008); manual search was also conducted. Based on the inclusion and exclusion criteria, fourteen randomized-controlled trials were finally included in the present analysis. The details of the trial design, the characters of the subjects, and the results of the studies were reviewed and analyzed using RevMan 4.2 software. Results: The 14 trials involved 1226 patients, including 616 receiving sevoflurane and 610 receiving total intravenous anesthesia (TIVA). Compared with TIVA, our analysis showed the following results. (1) Cardiac function: sevoflurane significantly increased the postoperative cardio index (CI, P < 0.01) and cardiac output (CO, P < 0.01). (2) Serum cTnI concentration at 24 h postoperation: sevoflurane group was significantly lower than that of TIVA group (P < 0.01). (3) Sevoflurane significantly decreased the period of mechanical ventilation (P < 0.01) and the length of intensive care unit stay (P < 0.01), but the postoperative hospital stay was similar between the two groups. (4) The postoperative usage of inotropic agent was lower in sevoflurane group (P < 0.01). There were no significant differences in the mortality (P = 0.59), the incidence of atrial fibrillation (P = 0.11), and the myocardial infarction rate (P = 0.11) between the two groups. Conclusion: Sevoflurane has cardioprotective effect in patients undergoing heart surgery under CPB.
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0.05).After reperfusion,Sevo group and Post group resulted in a significant increase(P