RESUMEN
Objective To study shorten the time of initial oral intake and fluid intake after general anesthesia in patients receiving oral and maxillofacial surgery,and to reduce the patient′s discomfort and adverse reactions and promote the postoperative recovery. Methods A total of 160 patients were divided into control group and observation group with 80 cases each by random digits table method from April to September in 2014. Patients in control group were allowed to take food orally 6 h after they emerged from anesthesia; while those in observation group were allowed to drink water after 2 h at emergence from anesthesia and take liquid food after 4 h. The mis-aspiration,the fasting glucose,blood pressure,heart rate and the rate of thirst,hunger,nausea,vomiting were observed. Results The rate of thirst, hunger, nausea, vomiting in observation group were significantly lower than those in control group(4 cases vs. 73 cases, 15 cases vs. 76 cases, 10 cases vs. 29 cases, 1 case vs. 7 cases), and there were significant differences, P0.05, the t value of systolic blood pressure, diastolic blood pressure were-2.73,-2.56. Conclusion Shorten the time of taking food for patients undergoing the oral and maxillofacial surgery,in order to relieve uncomfortable symptoms,prevent hypoglycemia and the hemodynamic disturbance after anesthesia, and promote recovery,early postoperative feeding should be suggested on the premise that they are fully awake.
RESUMEN
As surgical and graft preservation techniques have improved and immunosuppressive drugs have advanced, liver transplantation (LT) is now considered the gold standard for treating patients with end-stage liver disease worldwide. However, despite the improved survival following LT, severe hemodynamic disturbances during LT remain a serious issue for the anesthesiologist. The greatest hemodynamic disturbance is postreperfusion syndrome (PRS), which occurs at reperfusion of the donated liver after unclamping of the portal vein. PRS is characterized by marked decreases in mean arterial pressure and systemic vascular resistance, and moderate increases in pulmonary arterial pressure and central venous pressure. The underlying pathophysiological mechanisms of PRS are complex. Moreover, risk factors associated with PRS are not fully understood. Rapid and appropriate treatment with vasopressors, volume replacement, or venesection must be provided depending on the cause of the hemodynamic disturbance when hemodynamic instability becomes profound after reperfusion. The negative effects of PRS on postoperative early morbidity and mortality are clear, but the effect of PRS on postoperative long-term mortality remains a matter of debate.