RESUMEN
Objective To investigate the risk factors for postoperative delirium in patients undergoing noncardiac surgery. Methods From September-December 2009, 480 patients undergoing elective noncardiac surgery were included in this study. The criteria for enrolment of the patients in this study were (1) age ≥ 65 yr,(2) age ＜ 65 yr if associated with coronary artery disease, hypertension, diabetes mellitus, brain injury, cerebral hemorrhage, cerebral infarct, emphysema, chronic bronchitis; duration of operation ≥ 3 h and intraoperative blood loss was expected to exceed 20% of blood volume. The diagnosis of delirium was based on Confusion Assessment Method (CAM). Multivariate logistic regression was used to analyze the risk factors for postoperative delirium.Results Postoperative delirium developed in 79 patients during the first three postoperative days. The incidence of postoperative delirium was 16.5%. The logistic stepwise regression analysis indicated that the risk factors for delirium included advanced age, method of anesthesia, long operation, postoperative pain, emphysema and alcholic. Conclusion Age, method of anesthesia, long operation, postoperative pain, emphysema and alcholic are risk factors for postoperative delirium in patients undergoing noncardiac surgery.
RESUMEN
Objective To investigate the risk factors for postoperative delirium in patients undergoing spine operation under total intravenous anesthesia. Methods Two hundred patients undergoing elective spine operation were included in this study. Patients' perioperative informations were recorded. The diagnosis of delirium was based on Confusion Assessment Method (CAM). The patients were divided into 2 groups according to the occurrence of delirium within 3 days after operation: postoperative delirium group and no postoperative delirium group. Multivariate logistic regression was used to analyze the risk factors for postoperative delirium. Results Postoperative delirium developed in 39 patients during the first three postoperative days. The incidence of postoperative delirium was 19.5%. The logistic stepwise regression analysis indicated that the risk factors for delirium included age, intraoperative blood loss and alcohol abuse. Conclusion Age, large amount of intraoperative blood loss and alcohol abuse are risk factors for postoperative delirium in patients undergoing spine operation under total intravenous anesthesia.
RESUMEN
To study action mechanism and time of administration of indomethacin in SMAO shock rabbits. Method:Thirty-two SMAO shock rabbits were randomly divided into four groups: control group A,indomethacin 5mg/kg I.V. at the occlusion of superior mesenteric artery (group B), indomethacin 5mg/kg L V. immediately after clamp being removed(group C) and the same dose 30min after clamp being removed(group D). Survival rate,hemodynamics, plasma calcium, myocardial calcium, TXB_2 and 6-keto-PGF_1. levels were observed in 4h shock period. Myocardial apecmen were examined with electronic microscope. Result: After indomethacin I.V,the survival rate was higher and bemodynamie better than those of controll. The plasma calcium level remained stable in indomethacin groups. Myocardial calcium content of group B and C was lower than that of group D and A. The TXB_2 and 6-ketoPGF_1. contents were similar in all groups. Under electronic microscope, the damages were slightest in group C and most serious in group D and A among the four groups. Conclusion:Indomethacin has a beneficial effect on the SMAO shock rabbits ,the mechanism of which can be related to improving myocardium contractivity as well as to blocking calcium channel,rather than the action through prostaglandins. The time of administration should be early as possible after shock.
RESUMEN
Objective To investigate the effect of propofol anesthesia on stress response and immune function of laproscopic cholecystectomy.Methods Corticosterone,glucose,complement concentrations in plasma of 20 ASAⅠ～Ⅱ patients under propofol combined anesthesia undergoing elective laproscopic cholecystectomy,were respectively determined before anesthesia,operation,gallbladder ablation and after de-intubation.Results After anesthesia,blood glucose increased while C3 and CH50 decreased gradually(P