Assessment of Stroke Volume Variation Perioperatively by Using Arterial Pressure with Cardiac Output / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To observe the sensitivity of stroke volume variation (SVV) for assessing volume change during induction period of general anesthesia.</p><p><b>METHODS</b>Patients who underwent orthopaedic surgery under general anesthesia and mechanical ventilation were divided into two groups randomly. Patients in the group Ⅰwere subjected to progressive central hypovolemia and correction of hypovolemia sequentially; patients in the Group Ⅱ were exposed to hypervolemia alone. Each step was implemented after 5 minutes when the hemodynamics was stable. SVV and cardiac index (CI) were recorded, and Pearson's product-moment correlation was used to analyze correlation between SVV and CI.</p><p><b>RESULTS</b>Forty patients were included in this study, 20 cases in each group. For group Ⅰ patients, SVV was increased significantly along with blood volume reduction, and changes in CI were negatively correlated with changes in SVV (r=-0.605, P<0.01); SVV decreased significantly along with correction of blood volume; changes in CI were negatively correlated with changes in SVV (r=-0.651, P<0.01). For group Ⅱ patients, along with blood volume increase, SVV did not change significantly; changes in CI revealed no significant correlation with changes in SVV (r=0.067, P>0.05).</p><p><b>CONCLUSION</b>SVV is a useful indicator for hypovolemia, but not for hypervolemia.</p>

Comparative study between single dose dexmedetomidine and fentanyl in the management of emergence agitation in adult patients after general anesthesia / 临床麻醉学杂志

Objective To investigate the effects of single dose of dexmedetomidine and fentynyl on treatment of emergence agitation in adult patients after general anesthesia.Methods Sixty patients suffering from emergence agitation after general anesthesia were divided into two groups randomly(n=30 each):dexmedetomidine group (group D)and fentaynl group (group F).Patients in group D received dexmedetomidine at a dose of 0.5μg/kg,and those in group F received fentanyl at a dose of 1μg/kg respectively.If patients still agitate after above treatment,intermission infusion of propofol at bolus of 1.0 mg/kg was used for further treatment till patients attain peaceful state.Results Twen-ty-nine paients in group D had no agitation,only one patient had mild agitation after administration of dexmedetomidine,while four patients had severe agitation,four patients had moderate agitation and 9 patients had mild agitation after administration of fentanyl(P<0.05);the time from first treatment to no agitation in group D was (11±3)min,shorter than that in group F (27±9)min (P<0.05);the dose of propofol used in group D was (50±0)mg,less than accumulative doses of propofol in group F (270±40)mg (P<0.05);21 (70%)patients in group D had radycardia and 9 (30%)patients in group F had respiratory depression(P<0.05).Conclusion Intravenous dexmedetomidine at a dose of 0.5 μg/kg attainted was effective in treating emergence agitation in adult patients after general anes-thesia as compared with fentanyl.