Effects of sevoflurane inhalation anesthesia on intraoperative hepatic blood flow in infants with hepatoblastoma / 肿瘤研究与临床

Objective:To evaluate the effect of different concentrations of sevoflurane inhalation anesthesia on hepatic blood flow in children with hepatoblastoma (HB).Methods:A total of 22 children who underwent radical resection of HB in Shanxi Children's Hospital from January 2019 to August 2021 were perspectively enrolled, including 15 males and 7 females, with an average age of 17±7 months. There were 19 normal children undergoing ultrasound examination without other systemic diseases who received hernia, cryptorchidism, hydrocele of tunica vaginalis surgery during the same period, including 11 males and 8 females, with an average age of 18±5 months. After inhaling different concentrations of sevoflurane preoperatively and intraoperatively, ultrasound apparatus was used to detect the hepatic blood flow (HBF) in HB children. The portal blood flow (PBF), hepatic artery blood flow (HABF), PBF/HABF and HBF were compared between HB children and non-HB children before operation and after inhalation of 1% sevoflurane, 2% sevoflurane.Results:Compared with non-HB children, children with HB had lower PBF [41.9 ml/min (26.8 ml/min, 63.1 ml/min) vs. 66.7 ml/min (41.4 ml/min, 137.2 ml/min), Z = -2.62, P = 0.008], increased HABF [31.2 ml/min (20.4 ml/min, 50.3 ml/min) vs. 12.9 ml/min (5.5 ml/min, 25.0 ml/min), Z = -3.59, P < 0.001], decreased PBF/HABF [1.3 (1.2, 1.4) vs. 6.1 (5.0, 7.5), Z = -5.68, P < 0.001], and the difference in HBF between the both groups was statistically significant ( P>0.05). Compared with the 2% sevoflurane HB group, PBF was reduced [41.1 ml/min (25.0 ml/min, 62.0 ml/min) vs. 63.0 ml/min (40.5 ml/min, 78.3 ml/min), Z = -2.09, P = 0.036] and PBF/HABF was reduced [1.3 (1.1,1.5) vs. 1.8 (1.6, 1.9), Z = -4.01, P<0.001] in the 1% sevoflurane group, and the differences in HABF and HBF were statistically significant (all P>0.05). Conclusion:Relatively low concentration of sevoflurane reduces HBF by reducing PBF for HB children after radical surgery.

Short term olfactory memory and olfactory function after inhalation anesthetic agents: a randomized clinical trial / Memória olfativa de curta duração e função olfativa após anestésicos inalatórios: estudo clínico randomizado

Abstract Background and objectives: This clinical trial aimed to evaluate the effects of two different inhalation anesthetic agents on postoperative olfactory memory and olfactory function in patients who underwent micro laryngeal surgery. Methods: This randomized prospective controlled study consisted of 102 consecutive patients with a voice disorder. The patients underwent micro laryngeal surgery for voice disorders under general anesthesia. Patients who did not meet inclusion criteria and/or declined to participate (n = 34) were excluded from the study. Patients were divided into two groups. Four patients from Group 1 and four patients from Group 2 were lost to follow-up. Group 1 (n = 30) received sevoflurane, and Group 2 (n = 30) received desflurane during anesthesia. We compared the results by performing the pre-op and post-op Connecticut Chemosensory Clinical Research Center Olfactory test. Results: Thirty-three patients (55%) were male and 27 (45%) were female. The mean age was 48.18 ± 13.88 years (range: 19‒70 years). Preoperative and postoperative olfactory functions did not show a significant difference within the groups postoperatively (p > 0.05). Preoperative and postoperative olfactory memory showed a significant decrease 3 hours after the surgery (p < 0.05). Conclusions: Olfactory functions and memory were not affected by desflurane in the early postoperative period. Although sevoflurane did not affect olfactory functions, it had a temporary negative effect on olfactory memory in the early postoperative period.

Resumo Introdução e objetivos: O estudo avaliou o efeito pós-operatório de dois agentes anestésicos inalatórios distintos na memória olfativa de curta duração e na função olfativa em pacientes submetidos à microcirurgia de laringe. Método: O estudo prospectivo controlado randomizado avaliou, consecutivamente, 102 pacientes com alteração vocal submetidos à microcirurgia de laringe sob anestesia geral. Trinta e quatro pacientes não obedeceram aos critérios de inclusão e/ou não aceitaram participar do estudo e foram excluídos. Os pacientes foram divididos em dois grupos. Quatro pacientes do Grupo 1 e quatro do Grupo 2 foram perdidos durante o seguimento. O Grupo 1 (n = 30) recebeu sevoflurano durante a anestesia e o Grupo 2 (n = 30), desflurano. Comparamos resultados pré e pós-operatórios de memória olfativa e funções olfativas, realizando o Connecticut Chemosensory Clinical Research Center Olfactory test. Resultados: Foram incluídos um total de 33 (55%) homens e 27 (45%) mulheres. A idade média foi 48,18 ± 13,88 anos (variação: 19-70 anos). As funções olfativas pré e pós-operatórias não apresentaram diferença estatisticamente significante dentro dos grupos no pós-operatório (p > 0,05). A memória olfativa pré e pós-operatória não mostrou diminuição estatisticamente significante quando avaliada três horas após a cirurgia (p< 0,05). Conclusões: Memória e funções olfativas não foram alteradas pelo desflurano no pós-operatório imediato. Embora o sevoflurano não tenha alterado as funções olfativas, causou efeito temporário negativo na memória olfativa no pós-operatório imediato.

Assessment of Efficacy of Comparison of Total I.V. Anaesthesia Using Propofol with an Inhalation Technique: A Hospital Based Study

Background: Postoperative nausea and vomiting can be particularly problematic in ambulatory surgery as it may lead to delay in discharge or unscheduled admission to hospital. Additionally, it has been reported as the anaesthetic complication that is of most concern to patients. Multiple factors, including the anaesthetic agent delivered, are associated with an increased incidence of PONV and the optimal strategy for preventing PONV continues to be debated. Aim of the study: To assess the efficacy of comparison of total I.V. anesthesia Using Propofol with an Inhalation Technique. Materials & Methods: The study was conducted in the department of anesthesia of R.B.M. Hospital, Bharatpur, Rajasthan, India. For the study we selected patient’s admitting to the surgical ward of the medical hospital of the institute. A total of 16 patients were selected for the study. An informed written consent was obtained from each patient after explaining them the procedure and significance of the study verbally. The patients were randomly grouped into two groups, Group 1 and Group 2. Patients in Group 1 underwent anesthesia by IV procedure and patient’s in Group 2 underwent anesthesia by inhalation method. Patients were followed up and monitored for pain, sedation score, nausea and vomiting in the post-operative period for 48 h. Results: A total of 16 patients were included in the study. The patients were randomly grouped into Group 1 and Group 2. We observed that mean age of patients in group 1 was 36.31+12.21 years and in group 2 was 32.21+10.98 years. Number of male patients in group 1 was 5 and in group 2 were 4. We observed that majority of cases had Grade 0 and 1 operative area. Conclusion: The hat total I.V. anesthesia using Propofol offers no significant advantage over inhalation anesthetic technique.

Effect of acute sleep deprivation on learning and memory and hippocampal circadian gene expression after sevoflurane anesthesia in rats / 中华行为医学与脑科学杂志

Objective@#To investigate the role of clock gene Bmal1, Per2 and Egr1 expression in learning and memory undergoing sevoflurane anesthesia after acute sleep deprivation.@*Methods@#72 male SD rats were equally divided into four groups using a random number table (n=18) : normal control group (group Control), do not do any processing; sleep deprivation group (group SD), acute sleep deprivation for 96 h; sevoflurane group (group Sev), suffering 2.5% sevoflurane for 3 h; sleep deprivation+sevoflurane group (group SD+Sev), 96 h sleep deprivation followed by 3 h 2.5% sevoflurane inhalation. The Morris water maze, for spatial memory acquisition test, was used to measure the time percent of target quadrant and numbers of platform-site crossovers before sleep deprivation (T0) and at 1 d (T1), 3 d (T2), 7 d (T3) after inhalation anesthesia. Rats were sacrificed after spatial memory acquisition test. Brain hippocampus samples were obtained for determination of Bmal1, Per2 and Egr1 expression by Western blot, and neuron morphology was observed by the Nissl staining.@*Results@#Compared with Control group, the percentage of time in target quadrant and the numbers of platform-site crossovers were significantly decreased at T1 and T2 in Sev group (P<0.05); and compared with Control group, the percentage of time in target quadrant and the numbers of platform-site crossovers were also significantly decreased at T1, T2 and T3 in SD group rats (P<0.05). Compared with Sev group rats (the percentages of time in target quadrant: T1: (32.37±1.36)%; T2: (30.91±1.26)%; T3: (33.78±2.20)%; the numbers of platform-site crossovers: T1: (4.55±0.39); T2: (3.11±0.37); T3: (3.95±0.34)), the percentages of time in target quadrant (T1: (27.20±1.42)%; T2: (28.19±1.04)%; T3: (30.06±1.22)%) and the numbers of platform-site crossovers (T1: (3.11±0.46); T2: (3.30±0.38); T3: ( 3.20±0.39)) in SD+Sev group rats were significantly decreased at T1, T2 and T3 (all P<0.05). Compared with control group, the levels of hippocampal proteins Bmal1, Per2 and Egr1 were significantly reduced at T1 in Sev group (P<0.05). Compared with control group, the level of hippocampal protein Per2 was significantly increased, but the levels of hippocampal proteins Bmal1 and Egr1 were significantly decreased at T1 and T2 in SD group (P<0.01). Compared with Sev group, the levels of hippocampal proteins Bmal1 and Egr1 were significantly reduced at T1, T2 and T3 in SD+Sev group (P<0.01), and the protein level of hippocampal Per2 was significantly decreased at T1, but then increased at T2 and T3 in SD+Sev group (P<0.01). The hippocampal Nissl staining in CA1 at T2 revealed that there were irregular distribution of pyramidal neurons existed in Sev group, and vacuolar degeneration with vague outlines of pyramidal neurons in SD group, while pyramidal neuron atrophy and few number of Nissl bodies, compared with control group, were observed in SD+Sev group.@*Conclusion@#Acute sleep deprivation following with sevoflurane anesthesia resulted in hippocampal memory impairment, which was associated with abnormal expression of hippocampal Bmal1, Per2 and Egr1.

Relationship of impaired brain function after sevoflurane-nitrous oxide anesthesia and CREB signal pathway / 局解手术学杂志

Objective To explore the relationship of impaired brain function after emergency inhalation anesthesia of sevoflurane com -bined with nitrous oxide and cyclic AMP response element binding protein(CREB)signal pathway.Methods A total of 442 patients who were admitted into our hospital from January 2014 to April 2017 were selected as the object of this study.And these patients were divided into 3 groups according to different anesthesia ways,namely the inhalation anesthesia group(118 cases),the local anesthesia group(206 cases), and the control group(118 cases).The blood cyclic adenosine monophosphate(cAMP)concentration were examined by the mini mental state examination(MMSE)score scale.At the same time,the 60 rats were randomly divided into the anesthesia group(n=30)and the con-trol group(n=30).The learning and memory function of the two groups were evaluated by Morris water maze test,and the expressions of cAMP and CREB were measured.Results The blood cAMP concentration and MMSE score in the inhalation anesthesia group were signifi -cantly decreased after inhalation anesthesia(P<0.05).In the place navigation test,rats of the anesthesia group cost much more time to find the platform compared with rats in the control group, and rats of the anesthesia group encountered less times of crossing the platform com-pared with rats in the control group,and the difference was significant(P<0.05).Western blot showed that patients of the anesthesia group had lower cAMP and expression of p-CREB protein,with significant difference(P<0.05).Conclusion Brain function decline after sevoflu-rane inhalation anesthesia combined with nitrous oxide may induced by increasing the nucleus of the second messenger CAMP /Ca2+pathway and decreasing the expression of CREB.

Sevoflurane inhalation anesthesia with propofol intravenous anesthesia on blood flow in patients with pediatric hernia operation and anesthesia quality dynamics / 中国生化药物杂志

Objective To observe the contrast sevoflurane anesthesia and propofol intravenous anesthesia in children hernia surgery anesthesia on blood flow dynamics in children to assess the quality of anesthesia, anesthesia program aims for the future choose to provide important reference for basis . Methods The surgical treatment of pediatric hernia patients from January 2012 to June 2016 was prospectively selected as the study group, and the rats were divided into two groups by random drawing method. Results There were other children point and T1 relatively SBP, DBP were significantly lower (P<0.05), the observation group were significantly lower than the control group (P<0.05), the control group of children with T2, T3 compared with T1 point HR significantly increased (P<0.05). Conclusion Pediatric hernia surgery using laryngeal mask sevoflurane anesthesia exact effect, maintaining hemodynamic stability, safety, and can be widely used in clinical.

Application of solving difficulty of pediatric patients into the operating room by using combined inhalation anesthesia induction device / 临床麻醉学杂志

Objective To discuss the feasibility and safety of sevoflurane inhale anesthesia with portable combined inhalation anesthesia induction device in solving the difficulty of children entering the operation room.Methods One hundred pediatric patients were enrolled into the study.The pediatric patients were randomly divided into two groups,50 cases in each group.Group A was fraught with a new mode of administration,using portable combined inhalation anesthesia induction device with sevoflurane 2 ml before entering the operation room;group B was fraught with a traditional mode of administration,using in-tramuscular injection with ketamine 4-5 ml/kg before entering the operation room.The analog scale of anes-thetic effect,the number of body movement,adverse reaction were compared between the two groups. Results Compared with group B,time of falling asleep and retention time in the operating room was signif-icantly shorter (P <0.01).And body movement during vein puncture decreased significantly (P <0.01). Moreover,the incidence of adverse affect showed significant reduce compared with group B (P < 0.05 ). Conclusion The combined inhalation anesthesia induction device is simple to produce and easy to carry.To solve the difficulty of convoying children into the operating room,combined inhalation anesthesia induction device with sevoflurane is more effective, safer and more humanized way when compared with the traditional one.

Establishment of an animal model by placing one end of PICC in hepatic portal vein of a Beagle dog and leaving the other end out of its body / 军事医学

Objective To establish an animal model by placing one end of PICC in the hepatic portal vein of a beagle dog and leaving the other end out of its body.Methods Six Beagle dogs were given respiration anesthesia through orotracheal intubation.An incision was made through the right rectus abdominalis to locate the superior mesenteric vein (SMA) and the main hepatic portal vein.The left branch of SMA was separated and cut to put PICC into the main hepatic portal vein before being ligated and fixed.The other end of PICC was elicited through the right abdominal wall and passed beneath the skin to the back neck and fastened in case of movement.Results The anesthetic effect was good and all the operations were successful.The mean operation time was about an hour and the mean blood loss was about 15 ml.The incision healed 5-7 d after operation.Conclusion The establishment of the model can improve the effects of liver-targeting drugs,which can cut down the dosage,lower the cost of treatment and experiment and reduce the adverse effect of medicines.Through PICC,we can directly draw blood from the hepatic portal vein to measure the blood concentration before the first pass elimination.Then according to the concentration,we can calculate the absorption rate in the gastrointestinal tract,which can facilitate related experimental studies.

Effect of dexmedetomidine on restlessness in recovery stage in patients with fracture undergoing combined intravenous inhalation anesthesia and operation / 中国生化药物杂志

Objective To investigate the effect of dexmedetomidine on restlessness in recovery stage in patients with limbs fracture undergoing combined intravenous inhalation anesthesia and operation.Methods Eighty patients with limbs fracture undergoing combined intravenous inhalation anesthesia and operation in our hospital were randomly divided into the control group and the dexmedetomidine group,40 cases in each group.Before operation, patients in the dexmedetomidine group were given dexmedetomidine 0.5 μg/kg intravenously in 15 min;patients in the control group were given the same volume of 0.9% saline solution.The recovery time, extubation time, the incidence of restlessness, agitation score and sedation score were compared between the two groups.Results The recovery time and extubation time had no significant difference between the two groups.The incidence of restlessness and agitation score in the dexmedetomidine group were significantly lower than those in the control group(P<0.05),while the sedation score in the dexmedetomidine group was significantly higher than that in the control group(P<0.05).Conclusion Dexmedetomidine can reduce the incidence of restlessness and the degree of restlessness in patients limbs fracture undergoing combined intravenous inhalation anesthesia and operation.

Influence of Etomidate or Sevoflurane Combined with Sacral or Epidural Block Anesthesia on Anesthesia Effects and Inflammatory Factors / 中国药房

OBJECTIVE:To investigate the influence and safety of etomidate or sevoflurane combined with sacral or epidural block anesthesia on anesthesia effects and inflammatory factors. METHODS:160 children undergoing surgery selected from our hospital during Feb. 2012 to Dec. 2015 were divided into group A and B according to random number table,with 80 cases in each group. Group A was given etomidate 3 mg/(kg·h)for anesthesia maintenance+sacral or epidural block;group B received sevoflu-rane inhalation 1%-3% for anesthesia maintenance+sacral or epidural block. The anesthesia effects were compared between 2 groups as well as the levels of serum S100β,NSE,Aβ and inflammatory factors before and after surgery. The occurrence of ADR was observed. RESULTS:There was no statistical significance in SpO2 between 2 groups before and after surgery(P>0.05). The anesthesia induction time,postoperative recovery time and heart rate of group A were significantly longer or higher than those of group B,with statistical significance(P0.05). After surgery,the levels of serum S100β,NSE,Aβ,CRP,IL-2 and IL-6 were significantly increased in 2 groups,and group A was significantly higher than group B,with statistical significance (P0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Sevoflurane combined with sacral or epidural block anesthesia is better than etomi-date combin ation anesthesia,with in mild inflammatory reaction and good safety.

Effects of isoflurane and pentobarbital on the establishment of subarachnoid block model in rats / 西安交通大学学报(医学版)

Objective To compare the effects of isoflurane and pentobarbital on the establishment of subarachnoid block model in rats.Methods 60 SD rats aged 4 months were randomly divided into Group A (n =30) and Group B (n=30).Rats in Group A received intraperitoncal injection of 10 g/L pentobarbital sodium solution 30 mg/kg and 1/4 of the initial dosage was added according to the operation effect.The induction and maintenance of anesthesia were achieved by isoflurane inhalation in Group B during operation.We recorded the time of anesthesia induction,quality of anesthesia,time of anesthesia,time of operation,and recovery time.The heart rate,respiration frequency,temperature,and saturation of blood oxygen were recorded during operation.We compared death from anesthesia and success of modeling in the two groups.Results There was no significant difference between the groups with regard to age,weight,body temperature or saturation of blood oxygen (P＞ 0.05).Compared to Group B,heart rate decreased 1-60 minutes after anesthesia and respiration frequency decreased 5 minutes after anesthesia in Group A (P＜0.05).The time of anesthesia induction,time of anesthesia,time of operation,and recovery time were shorter in Group B (P＜0.05).The quality of anesthesia was better in Group B (P＜0.05).The success rate of modeling was higher but mortality rate of anesthesia was lower in Group B than in Group A (P＜0.05).Conclusion Compared with intraperitoneal injection of pentobarbital sodium,isoflurane inhalation can provide a better anesthetic effect during the operation to establish a rat model of subarachnoid block.

Eletrocardiografia em onças-pardas (Puma concolor) anestesiadas com sevoflurano ou isoflurano / Electrocardiography in pumas (puma concolor) anesthetized with sevoflurane or isoflurane

O objetivo deste trabalho foi descrever os achados eletrocardiográficos de 11 onças- pardas (Puma concolor). Os animais foram sedados com 0,15mg/kg de detomidina associado a 5mg/kg de cetamina e mantidos anestesiados com sevoflurano (GSEVO, n=6) ou isoflurano (GISO, n=5). A frequência cardíaca foi de 95 ± 13bpm. As alterações observadas nos animais no GSEVO foram: atrial standtill com condução ventricular, episódios isolados de contração ventricular prematura, bloqueio atrioventricular de primeiro grau, diminuição da amplitude do complexo QRS, onda S profunda e aumento da amplitude da onda T. No grupo GISO, observou-se bloqueio de ramo direito do feixe de His, bloqueio atrioventricular de primeiro grau e aumento da amplitude da onda T. Arritmias não puderam ser associadas ao uso dos anestésicos inalatórios devido à não sensibilização do miocárdio às catecolaminas. Achados como o BAV de primeiro grau pode ter ocorrido devido ao uso de agonistas alfa-2 adrenérgicos. Este estudo aumentou o conhecimento sobre as alterações eletrocardiográficas em onças-pardas anestesiadas, entretanto mais estudos são necessários para correlacionar estes achados ao uso de agentes anestésicos.(AU)

The aim of this study was to describe electrocardiographic findings in pumas (Puma concolor). The animals were sedated with 0.15mg/kg of detomidine plus 5mg/kg of ketamine and anesthetized with sevoflurane (GSEVO, n=6), or isoflurane (GISO, n=5). The heart rate was 95 ± 13bpm. The changes observed on GSEVO animals were: atrial standstill with ventricular conduction, isolated episodes of ventricular premature contraction, atrioventricular blockage of first degree, reduction of the amplitude of the QRS complexes, deep S wave, and increase of the amplitude of the T wave. In the GISO group a right bundle branch block of the His bundle, atrioventricular blockage of first degree and of the amplitude of the T wave. Arrhythmias couldn´t be related to the use of inhalant anesthesia due to the lack of myocardial awareness to catecholamines. Findings such as atrioventricular block in first degree may have occurred due to the use of alfa-2 adrenergic agonists. This study improved the knowledge about electrocardiographic alterations in anesthetized pumas, however further studies are required to correlate these findings to the use of anesthetic agents.(AU)

Evaluation of cardiopulmonary parameters and recovery from anesthesia in cougars (Puma concolor) anesthetized with detomidine/ketamine and isoflurane or sevoflurane / Avaliação de parâmetros cardiorrespiratórios e recuperação da anestesia em pumas (Puma concolor) anestesiados com detomidina/cetamina e isoflurano ou sevoflurano

The aim of this study was to assess the cardiopulmonary effects, the onset time after the administration of a detomidine/ketamine combination, and the recovery from anesthesia of cougars (Puma concolor) anesthetized with detomidine/ketamine and isoflurane or sevoflurane for abdominal ultrasound imaging. Fourteen animals were randomly allocated into two experimental groups: GISO (n=7) and GSEVO (n=7). Chemical restraint was performed using 0.15mg/kg detomidine combined with 5mg/kg ketamine intramuscularly; anesthesia induction was achieved using 2mg/kg propofol intravenously and maintenance with isoflurane (GISO) or sevoflurane (GSEVO). The following parameters were assessed: heart rate, respiratory rate, systolic and diastolic arterial blood pressure, mean arterial blood pressure, oxyhemoglobin saturation, rectal temperature, central venous pressure, and end-tidal carbon dioxide. The time to sternal recumbency (TSR) and time to standing position (TSP) were also determined. There was not statistically significant difference for the cardiopulmonary variables or TSP whereas TSR was significantly shorter in GSEVO. The time to onset of anesthesia was 11.1±1.2 minutes and 11.3±1.8 minutes for GISO and GSEVO, respectively. The anesthesia of cougars with detomidine/ketamine and isoflurane or sevoflurane was conducted with safety, cardiopulmonary stability, and increased time to sternal recumbency in the GISO group.

O objetivo do presente estudo foi avaliar os efeitos cardiorrespiratórios e a recuperação anestésica de onças-pardas (Puma concolor) submetidas à anestesia com detomidina/cetamina e isofluorano ou sevofluorano para avaliação ultrassonográfica abdominal. Para isso, foram utilizados 14 animais divididos aleatoriamente em dois grupos experimentais GISO (n=7) e GSEVO (n=7). Foram submetidos à contenção química com detomidina 0,15mg/kg associada à cetamina 5mg/kg pela via intramuscular, induzidos com propofol 2mg/kg pela via intravenosa e mantidos com isofluorano (GISO) ou sevofluorano. Foram avaliados os parâmetros: frequência cardíaca e respiratória, pressão arterial sistólica, média e diastólica saturação de oxihemoglobina, temperatura retal, pressão venosa central e fração expirada de dióxido de carbono. O tempo para adoção de decúbito esternal e posição quadrupedal também foram avaliados. Não houve diferença estatística para as variáveis cardiorrespiratórias e no tempo para adoção da posição quadrupedal. O tempo para adoção de decúbito esternal foi significativamente menor no GSEVO em relação ao GISO. Concluiu-se que a anestesia de onças pardas com detomidina/cetamina e isoflurano ou sevoflurano foi realizada de maneira segura, com estabilidade cardiorrespiratória e com aumento no tempo para adoção de decúbito esternal no GISO.

A comparative study of GASMAN software and traditional way in the teaching of inhalation anes-thesia / 中华医学教育探索杂志

Objective To compare and observe the effect of GASMAN software computer aided and traditional teaching method in the teaching of inhalation anesthesia. Methods 48 members of interns who need to enter the inhalation anesthesia department to study the theory of inhalation anesthesia were ran-domly divided into either GASMAN software group or traditional group with 24 people in each group, using the above two methods to carry on the study of inhalation anesthesia. After the end of the teaching course, the study effect and the satisfaction degree of the two groups of students were investigated by the written exam and questionnaire. SPSS 11.5 was used for statistical analysis, using±s to express measurement data. The results of the examination were compared with the independent sample t test, and the satisfaction survey feedback was compared with chi square test, The difference was statistically significant (P<0.05 ). Result The mean score of GASMAN software group (95.4 ±2.7) was significantly higher than that of tra-ditional group (85.0 ±3.5) (t=11.5,P=0.000). Satisfaction survey results showed that GASMAN computer assisted instruction software learning was easier for students to accept, and there were significant difference between two groups (P=0.001). Conclusion Teaching mode of GASMAN software is a good learning technique of inhalation anesthesia, which is worthy of promotion.

The effect of dexmedetomidine on the end-tidal concentration of sevoflurane during recovery from breast cancer surgery under general anaesthesia / 天津医药

Objective To investigate the effects of dexmedetomidine on the end-tidal concentration of sevoflurane during recovery from breast cancer surgery under general anaesthesia. Methods A total of 120 patients undergoing unilateral breast cancer radical operation were randomly divided into four groups:group C (infusion of saline, n=30), group D0.5 [infusion of dexmedetomidine 0.5μg/(kg·h) during operation, n=30], group D0.6 [dexmedetomidine 0.6μg/(kg·h), n=30] and group D0.7 [dexmedetomidine 0.7 μg/(kg · h), n=30]. The end-tidal concentrations of sevoflurane during surgery and postoperation were observed. The end-tidal concentration of sevoflurane on palinesthesia was recorded. The time from stopping administration of anesthetic drug to palinesthesia and the operation time were recorded. The palinesthesia of patients from general anaesthesia and the degree of emergence agitation of the patient were measured using Riker ’s sedation-agitation scale. The operation time, anesthesia time, intraoperative remifentanil dosage, intraoperative auditory evoked potential index (AAI), sevoflurane inhalation concentration and the corresponding time were recorded. Results There were no significant differences in clinical data, remifentanil dosage, operation time and AAI between four groups. The anesthesia time was longer in group D0.7 than that in the other three groups (P7 was lower in groups D0.5, D0.6 and D0.7 (P4 was significantly higher in group D0.6 and group D0.7 than that in group C and group D0.5, but the ratio of score>6 was lower (P3 was higher in group D0.7 than that of other three groups (P<0.05). Intraoperative cardiac tachycardia was found in group D0.6 and group D0.7 (4 cases, 13%and 8cases, 7%). Conclusion Sevoflurane inhalation anesthesia and intravenous infusion of dexmedetomidine 0.6μg/(kg·h) can effectively reduce intraoperative sevoflurane dosage, the end-tidal concentration of sevoflurane during recovery, and the occurrence of agitation in patients undergoing general anesthesia.

Effect of Sevoflurane Inhalation Anesthesia on Stress Reaction and Kynurenicacid Level in Patients Under-going Laparoscopic Cholecystectomy / 中国药师

Objective:To study the effect of sevoflurane inhalation anesthesia on stress reaction and kynurenic acid ( KYNA) level in serum of the patients with laparoscopic cholecystectomy .Methods:Totally 48 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups.Group S(n=24) received sevoflurane inhalation and group V (n=24) received intravenous general anesthesia.The levels of norepinephrine (NE), epinephrine (E), cortisol (Cor), KYNA and neutrophil and the neutrophil/lympho-cyte ratio were measured at five time points, namely T1(before the anesthesia), T2 (just after the surgery) , T3(in the morning of the first day after the surgery ) , T4 ( in the morning of the second day after the surgery ) and T5 ( in the morning of the third day after the surgery).The correlation of Cor, NE, E and NLR with KYNA was studied as well.Results:The levels of Cor, NE and E at the three time points after the surgery (T2, T3 and T4) in group V were significantly higher than those before the surgery (T1) with statistically significant difference (P0.05).And the levels of Cor, NE and E at the three time points after the surgery (T2, T3 and T4) in group S were markedly lower than those in group V at the same time point (P<0.05).After the surgery (T2, T3, T4 and T5), KYNA levels in group V were significantly decreased and NLR values in group V were significantly increased when compared with those of T 1.In group S, KYNA levels and NLR values after the surgery (T2, T3, T4 and T5) were markedly increased , which were higher than those in group V at the same time point with statistically significant difference (P<0.05).The correlation analysis indicated the level of KYNA displayed positive correlation with the levels of NLR , Cr, Z and E (P<0.05).Conclusion:Sevoflurane inhalation anesthesia can inhibit the increase of stress reaction and KYNA level in the patients with laparoscopic cholecystectomy , which may be related with its anti-in ammatory properties .

Surgical site infection after colorectal surgery according to the main anesthetic agent: a retrospective comparison between volatile anesthetics and propofol / 대한마취과학회지

BACKGROUND: Anesthetic agents used for general anesthesia are emerging possible influential factors for surgical site infection (SSI). In this retrospective study, we evaluated the incidence of SSI after colorectal surgery according to the main anesthetic agents: volatile anesthetics vs. propofol. METHODS: A total 1,934 adult patients, who underwent elective colorectal surgery under general anesthesia between January 2011 and December 2013, were surveyed to evaluate the incidence of SSI: 1,519 using volatile anesthetics and 415 using propofol for main anesthetic agents. Patient, surgery, and anesthesia-related factors were investigated from all patients. Propensity-score matching was performed to reduce the risk of confounding and produced 390 patients in each group. RESULTS: Within the propensity-score matched groups, the incidence of SSI was higher in the volatile group compared with the propofol group (10 [2.6%] vs. 2 [0.5%], OR = 5.0 [95% CI = 1.1-2.8]). C-reactive protein was higher in the volatile group than in the propofol group (8.4 ± 5.6 vs. 7.1 ± 5.3 mg/dl, P = 0.001), and postoperative white blood cells count was higher in the volatile group than in the propofol group (9.2 ± 3.2 × 10³/µl vs. 8.6 ± 3.4 × 10³/µl, P = 0.041). CONCLUSIONS: The results of this study suggest that intravenous anesthesia may have beneficial effects for reducing SSI in colorectal surgery compared to volatile anesthesia.

Alteração do índice biespectral antes e após estimulação elétrica ou mecânica em cães anestesiados pelo isofluorano / Bispectral index changes before and after electrical or mechanical stimulation in isoflurane-anesthetized dogs

Uma das formas atuais para se avaliar o grau de hipnose e depressão do sistema nervoso central durante a anestesia é o índice biespectral (BIS), que fornece um valor de 0 a 100. Objetivou-se avaliar as alterações do BIS de cães durante a estimulação elétrica e mecânica supra-máxima e sob diferentes concentrações de isofluorano, a fim de verificar se existe uma relação entre este índice e a resposta motora frente à nocicepção. Utilizaram-se sete cães da raça Beagle, dois machos e cinco fêmeas, anestesiados com isofluorano nas concentrações de 2,0; 1,8; 1,6; 1,4 e 1,2%. Os diferentes tipos de estímulo foram utilizados em procedimentos anestésicos diferentes nos mesmos animais, com intervalo mínimo de 15 dias. Os valores de BIS foram anotados por 60 segundos em cada avaliação, derivando médias antes (AE) e depois (DE) de cada estímulo. Os resultados foram analisados por meio de teste t pareado ou Wilcoxon pareado (P<0,05). Houve diferença significativa entre os valores AE e DE em todas as concentrações de isofluorano, exceto 2,0% no estímulo mecânico. Também foi significativa entre a subtração desses valores, quando comparados entre estímulos, em 1,8 e 2,0%. Conclui-se que a resposta frente a estímulos supra-máximos modifica os valores de BIS em cães por meio da superficialização do plano anestésico. Sugere-se o emprego do modelo mecânico para evitar possíveis interferências de corrente elétrica e perda da confiabilidade dos dados.

One of the current methods to assess hypnosis and central depression during anesthesia is the bispectral index (BIS), which generates a number from 0 to 100. The purpose of the present study was to evaluate the changes in BIS during electrical or mechanical supra-maximal stimulation in order to investigate whether there is a relation between this index and motor response to nociception. Seven beagle dogs were included, two males and five females, which were anesthetized with isoflurane at 2.0, 1.8, 1.6, 1.4 and 1.2%. Different types of stimuli were employed at different procedures in the same animals with at least 15 days of interval. The BIS values were recorded during 60 seconds each time and mean values were obtained before (AE) and after (DE) the stimulus. Results were compared through paired t test or Wilcoxon's paired test (P<0.05). Significant differences were found between AE and DE values in almost every isoflurane concentration, as well as between the subtraction of these values, when compared between types of stimuli at 1.8 and 2.0%. In conclusion, the response to supra-maximal stimulation does change BIS values in dogs by decreasing the depth of anesthesia. The use of mechanical stimulation is suggested in order to avoid possible interferences of the electrical current and loss of data reliability.

THE CLINICAL APPLICATION OF ANESTHESIA FOR DENTAL PHOBIA IN CHILDREN'S O-RAL TREATMENT SEVOFLURANE INHALATION / 现代医院

Objective To explore dental phobia in children 's oral treatment sevoflurane inhalation anesthesia clinical results.Methods 100 cases of dental phobia children in our hospital between January 2012 to January 2014 were observed, which were divided to the school -age group and preschool group , 50 patients, respectively.They were all treated with heptafluorobutyric alkyl inhalation anesthesia , and the anesthesia effects were compared .Results The adverse effects, oxygen saturation and mean arterial blood pressure changes and induction of anesthesia in chil -dren awake have statistically significant difference (p <0.05).Conclusion This study suggest that sevoflurane in -halation anesthesia is an effective dental phobia children 's oral therapy, and has a high application value .

Application of case analysis teaching method with GasMan@ software in anesthesia practice course for clinical undergraduates / 中华医学教育探索杂志

Objective To compared the effect of combined teaching method of lecture,case analysis and GasMan@software (LAG) and traditional teaching method (LBL) in inhalation anesthesia practice course.Method 78 anesthesiological undergraduates were randomly assigned to G group (n=39) or Control group (n=39).According to the requirements of clinical anesthesiology in the syllabus,G group used classroom lectures,case analysis and GasMan@software (LAG) teaching method,while Control group used lecture based learning (LBL) teaching method.The students took anonymous quiz and filled teaching effect evaluation form after practice course.Then the exam results were compared between groups to evaluate the teaching effect.SPSS 19.0 was applied to do statistical analysis and t test and x2 test were used.Results Compared to the Control group,G group got better results in objective questions like choosing,judgment,case analysis and average ranks (P=0.000),and there was no significant difference in the identification section (P=0.087),while G group also got better results in subjective questions like learning interests,study efficiency,memorize,logical thoughts,ability of analysis,solving problems and cooperation (P＜0.05).Conclusion Compared to traditional teaching method,the combined use of lecture,case analysis and GasMan@software make students immersive,develop their clinical thinking ability,and improve the teaching effect of inhalation anesthesia practice course significantly.