RESUMEN
@#Lung transplantation is the only treatment for patients with end-stage lung diseases. And this field is also a research hotspot in the international field at presen. Relevant researches not only promote the progress and development of lung transplantation, but also improve the life quality of patients after transplantation. With the development of lung transplantation technology, the guidelines for identifying candidates are constantly being revised, and the source of donor lungs has always been an urgent problem for all transplantation centers. The standardized management during transplantation period involves anesthesia induction, intraoperative fluid management, airway management, management of important operative steps and postoperative pain management. Extracorporeal life support (ECLS) includes cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO). With the progress and development of ECLS technology, the advantages of ECMO as a bridge for lung transplantation, intraoperative and postoperative circulatory support are becoming more and more prominent, enabling recipient patients to successfully pass the period of lung transplantation. Although lung transplantation in basic science and clinical researches has got a lot of progress, to improve the survival rate after transplantation, we must overcome many challenges including how to successfully perform lung transplantation, expand lung donor library, induce tolerance, and prevent complications after transplantation, primary graft dysfunction (PGD), cell and antibody mediated rejection and infection.
RESUMEN
Objective: To evaluate the effect of priming atracurium over onset time and intubating time of general anesthesia between different genders
Methodology: Sixty-six male and sixty-four female patients, ASA I-II, aged 18-65 years, were randomly divided into four groups: group M[1]: male patients with saline priming; group M[2]: male patients with priming atracurium dose of 0.05 mg/kg; group F[1]: female patients with saline priming; group F[2]: female patients with priming atracurium dose of 0.05 mg/kg. General anesthesia was induced with midazolam[0.1 mg*kg[-1]] propofol[0.75 mg*kg[-1]], intubation dose of atracurium [0.5 mg*kg[-1]], fentanyl [3 micro g*kg[-1]]. The incidences of dizziness, diplopia, heavy eyelids and dyspnea were observed. Neuromuscular tension was quantified by using TOF-Guard neuromuscular monitor, and intubating time was defined as the duration from the infusion of intubation dose of atracurium to the time when T4/T1=0
Results: The intubating time of group F2 was shorter than that of group F1. There was no significant difference between group M1 and group M2. The incidences of dizziness, diplopia and heavy eyelids in group F2 were higher than those in group M2
Conclusion: Atracurium priming technique could shorten the intubation time of female patients, but not for male patients, and the gender plays a key role in affecting the clinical outcome of atracurium priming