RESUMEN
Objective To investigate the effect of intravenous anesthesia with sufentanil combined with propofol on hemodynamics and oxygen metabolism in patients with esophageal cancer under high altitude.Methods 60 patients with esophageal cancer radical surgery was selected from March 2015 to March 2017 in our hospital and were divided into two groups according to the random number table,30 patients in each group.Patients in the control group were given with fentanyl and propofol intravenous anesthesia,and patients in the observation group were given sufentanil combined with propofol anesthesia.The occurrence of restlessness during the recovery of anesthesia in the two groups were observed,the spontaneous breathing recovery time,extubation time and postoperative Mini-mental State Examination (MMSE) score were recorded,and the indexes of hemodynamics and oxygen metabolism were measured at the time of before induction of anesthesia (T0),tracheal intubation (T1),skin incision (T2),thoracotomy (T3),free esophagus (T4),esophageal catheter removal time (T5).Results The spontaneous respiration recovery time and extubation time of the observation group were significantly shorter than those of the control group (P ＜ 0.05).The degree of restlessness in the observation group was weaker than that in the control group (P ＜ 0.05).Mean arterial pressure (MAP) in the control group at T2-T4 were significantly higher than those in T0 (P ＜ 0.05),but MAP and heart rate (HR) in the observation group at T1-T5 were significantly lower than those of T0 (P ＜ 0.05).Compared with T0 group,oxygen saturation (SpO2),oxygen saturation of mixed venose blood (SvO2) and oxygen delivery (DO2) at T1-T5 were significantly decreased (P ＜ 0.05),oxygen consumption (VO2) at T2-T4 was significantly increased (P ＜ 0.05),especially in the control group (P ＜ 0.05).The MMSE scores of the two groups were significantly lower than those before the operation (P ＜ 0.05),and the scores in observation group was significantly higher than the control group (P ＜ 0.05).Conclusions The intravenous anesthesia with sufentanil combined with propofol is more helpful in maintaining hemodynamic stability and oxygen metabolism balance than intravenous anesthesia with fentanyl combined with propofol and has little effect on postoperative anesthesia recovery and cognitive function.
RESUMEN
Objective To explore the safe and effective intravenous anesthetic regimen for intemperants' painless endoscopy.Methods 120 cases of intemperants,aged 25-65 years old,ASA grade Ⅰ or Ⅱ,were randomly divided into 3 groups (n =40):sulfentanyl group (group S),midazolam and sulfentanyl group(group MS),ketamine and sulfentanyl group (group KS).Group S were intravenous injected with sufentanil 0.1 μg/kg,propofol 1-2 mg/kg,etomidate 0.1 mg/kg.Group MS and group KS were additional intravenous injected with midazolam 0.01 mg/kg and ketamine 0.1 mg/kg on the basis of Group S respectively.The occurrence of hypoxia,cough,body movement and blood pressure were recorded,the use of vasoactive drugs and the recovery time were also recorded.Results There are no statistical significant difference of age,gender,and testing time among the three groups (P ＞0.05).Compared with the group S,the total dose of propofol,the incidence of hypoxemia and hypotension,the incidence of body movement and cough reaction in group MS and group KS were all lower (P ＜ 0.01).And compared with the group MS,the patients have lower incidence of hypoxemia and hypotension in group KS (P ＜ 0.05).All the patients were awake well (P ＞ 0.05).Conclusions Small doses of midazolam or ketamine combined with sulfentanyl,propofol and etomidate are safe and effective in the process of anesthesia during endoscopic diagnosis and treatment of intemperants.
RESUMEN
Objective To investigate the analgesic efficacy and safety of decozine combined with sufentanil on patients after laparoscopic radical gastrectomy.Methods Sixty patients undergoing laparoscopic radical gastrectomy,American Society of Anesthesiologists (ASA) Ⅰ ～ Ⅱ,were selected,and were randomly divided into two groups.All of the patients were treated with intravenous-inhalation combined anesthesia,and was given patient controlled intraveous analgesia (PCIA) when the patient was awoken.PCIA was administered with subsequent bolus of 0.5 ml with lockout time 15 minutes and background infusion of 2 ml/h.A ratio (3 μg/kg) of sufentanil and 0.5 mg palonosetron were mixed in PCIA pump in sufentanil group (S group);and 1.5 μg/kg sufentanil,0.3 mg/kg dezocine,and 0.5 mg palonosetron in PCIA were mixed in dezocine combined with sufentainl group (DS group),they were diluted to 100 ml with saline.The visual analogue scale (VAS),Bruggrmann comfort scale (BCS),Ramsay and incidence of adverse reactions of two groups were observed in 2 h (T1),6 h (T2),12 h (T3),24 h (T4),48 h(T5) after operation.Results There was no significant difference of VAS and BCS between two groups at each time point after operation (P ＞ 0.05);The Ramsay score of S group was significantly higher than that of DS group at T1,T2,and T3 (P ＜ 0.05).The Ramsay scores of two groups at T4,T5 were lower than those of T1,T2,and T3.The incidence of nausea,vomiting of DS group was significantly lower than that of S group (P ＜0.05).Conclusions Dezocine combined with sufentainl used in PCIA on postoperative gastric cancer patients can obtain satisfactory analgesic effects,but has fewer side effects than single sufentainl.
RESUMEN
Objective To investigate the sedation and analgesia clinical effects of dexmedetomidine and midazolam sufentanil in severe acute pancreatitis patients with mechanical ventilation.Methods Sixty four patients with mechanical ventilation in severe acute pancreatitis were randomly divided into dexmedetomidine and midazolam groups,and 32 cases in each group.All patients were routinely given sufentanil continuous intravenous analgesia.The patients in dexmedetomidine group received dexmedetomidine 1.0 μg/kg loading dose by intravenous injection and followed with 0.2 ～ 0.7 μg/(kg · h) continuous intravenous infusion.The patients in midazolam group received midazolam:0.05 mg/kg loading dose by intravenous injection and followed with 0.02 ～0.08 mg/(kg · h) continuous intravenous infusion.The sedation and analgesia effects and inflammation index changes in two groups were observed.Results The analgesia and sedation onset time,awake time and time of live in intensive care unit (ICU) in dexmedetomidine group were significantly superior to the midazolam group (P ＜ 0.05).Before weaning from mechanical ventilation the white blood cell count,C-reaction protein (CRP),heart rate,and respiratory frequency index in dexmedetomidine group were significantly better than those in midazolam group (P ＜ 0.05).The adverse event's incidence rate in dexmedetomidine group (9.38％) was ignificantly lower s than that in midazolam group (31.25％) (P ＜0.05).Conclusions The application of dexmedetomidine combined with sufentanil in severe acute pancreatitis patients with mechanical ventilation may play a good role of sedative and analgesic effects,and alleviating the inflammatory reaction of patients,as well as fewer adverse events.
RESUMEN
Objective To investigate the dose-effect relationship of sufentanil combined with dexmedetomidine which used in clinical effectiveness and safety of intravenous analgesia after hip arthroplasty.Methods Sixty patients (after hip arthroplasty) were randomly divided into three groups:group A (sufentanil 0.5 μg/kg),group B (sufentanil 0.75 μg/kg),and group C (sufentanil 1 μg/kg).Each group was combined with dexmedetomidine 1.5 μg/kg in patient controlled analgesia (PCA) pump.Mean arterial pressure (MAP),heart rate (HR),SpO2,numerical rating scale (NRS) scores,and Ramsay sedation scores were recorded at T1 (4 h after operation),T2 (8 h after operation),T3 (24 h after operation),and T4(48 h after operation).Harris hip scores were recorded at T0(preoperative),T3,and T4.The total number of pushing patient controlled intravenous analgesia (PCIA),dezocine dosage,and the occurrence of adverse events in each group situation were recorded.Results There were no significant differences in MAP,HR,and SpO2 among groups.Compared to group A,NRS scores of groups B and C were lower during the analgesia (P ＜0.01).Compared to group A,Ramsay sedation scores of groups B and C were higher at T1,and T2 (P ＜ 0.01).Compared to group A,Harris hip scores of groups B and C were higher at T3,and T4 (P ＜ 0.01).Compared to group C,adverse reactions of groups A and B were less during the analgesia (P ＜ 0.01).Compared to group A,the total number of press PCIA and dezocine amount were decreased in groups B and C (P ＜ 0.01).Conclusions The 0.75 μg/kg sufentanil combined with 1.5 μg/kg right beauty holds the minimum for intravenous analgesia effect after hip arthroplasty and calm exactly satisfied,less adverse reaction,for PCIA ideal drug formula.
RESUMEN
Objective To explore preventive effect of low-dose sufentanil combined with parecoxib sodium for hyperalgesia of remifentanil anesthesia after postoperative.Methods A total of 120 patients undergoing elective abdominal surgery under general anesthesia was randomly divided into three groups that were given intraoperative remifentanil infusion.At the 30 minutes before surgery,group A were given intravenous sufentanil 0.1 μg/kg combined with 40 mg parecoxib sodium,group B were given intravenous sufentanil 0.2 μg/kg combined with 40 mg parecoxib sodium,and group C were given normal saline 5 ml.Postoperative recovery time,extubation time,postoperative 1,2,6,12,and 24 h visual analog scale (Visual Analogue Scale/Score,VAS) score,and after 24 h additional analgesia number of cases and the restless occurrence of three groups were compared.Results Awakening time and extubation time of group B was significantly longer than groups A and C [(10.9 ± 1.3) min vs (8.6 ± 0.6) min,(8.2 ± 0.7) min;(14.0 ± 2.1) min vs (10.7 ± 2.2) min,(10.8 ± 1.2) min,all P ＜ 0.01].Each point VAS scores of groups A and B were significantly lower than group C (P ＜0.01).After 24 h,the number of cases additional analgesic medication,and restlessness occurrence of group C were significantly more than the number of cases of groups A and B (P ＜ 0.01),the number of cases and the restless occurrence after 24 h additional analgesic drugs of group A were more than group B,but there was no significant difference between two groups (P ＞ 0.05).Conclusions Low dose sufentanil together with parecoxib sodium can inhibit after-remifentanil-induced hyperalgesia,and will not appear awakening time and extubation time delays and safe.
RESUMEN
Objective Study on the best drug compatibility for the double-lumen endobronchial intubation anesthesia. Methods Eighty ASA Ⅰ - Ⅱ patients undergoing selective thoracis surgery requiring intubation with double-lumen tubes were randomly divided into A and B group, with 40 cases in each group.The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), were recorded before induction (T0) , after drug injection (T1), during intubation (T2), and at 1 min (T3), 3 min (T4)and 5 min (T5) after intubation. Results There was no significant difference in SBP, DBP and HR between the two groups at T0[(124. 9 ± 16. 0) mmHg vs (125.8 ±6. 4) mmHg, (73. 1 ±9. 9)mmHg vs (74. 3± 10. 4) mmHg, (81.8 ± 6. 6) times/min vs (82. 4 ± 8. 1) times/min] (P ＞ 0. 05). Compared with parameter at T0, SBP, DBP and HR, parameters in two groups in T1 were all significantly decreased after anesthesia [(94. 8 ± 10. 03) mmHg vs (96. 9 ± 10. 1) mmHg, (57. 3 ± 7. 66) mmHg vs (55.4 ± 7. 03) mmHg,(69. 6 ± 7. 43) times/min vs (66. 3 ± 7. 03) times/min] (P ＜ 0. 05). The cardiovascular parameters at T0,T2, T3, T4 were all comparable with those in group B [SBP: (130 ± 11.6) mmHg, (125.6 ± 10. 43) mmHg,(120. 1 ± 12. 3)mmHg,(116. 8± 11.4)mmHg;DBP:(75.6 ±9. 12)mmHg,(76. 2 ±9. 8)mmHg,(73. 1 ±9. 2) mmHg, (71.6 ± 8.46) mmHg; HR: (88 ± 9. 12) times/min, (82. 9 ± 7.5) times/min, (81.9 ± 8.2)times/min, (79. 9 ± 7. 8) times/min] (P ＞ 0. 05) , which were significantly higher than those in group A [SBP: (146. 3 ± 14. 2) mmHg, (141.2 ± 10. 63) mmHg, (137. 2 ± 13.23) mmHg, (122. 9 ± 11.6) mmHg;DBP: (94. 9 ± 10. 6) mmHg, (84 ± 9.63) mmHg, (79. 9 ± 9) mmHg, (75.8 ± 8. 3) mmHg; HR: (102 ±10. 63) times/min, (97.6 ± 9. 23) times/min, (87. 7 ± 8. 2) times/min, (82. 1 ± 7.32) times/min] (P ＜0. 05). The parameters at T2, T3, T4 in group A were obviously higher than those group B (P ＜ 0. 05).Conclusions Cardiovascular response with double-lumen endobronchial intubation by sufentanil-induced was stronger than fentaty, sufentanil had more stable hemodynamic parameters and it worth to be usd in clinic.
RESUMEN
ObjectiveTo evaluate the efficacy and safety of flurbiprofen axeyil injection combined with sufentanil for postoperative patient undergoing ovarian cancer radical operation.Methods60 postoperative patients undergoing radical ovarian cancer surgery were randomly divided into three groups with 20 cases in each group, including Sufentanil 150 μg (group S) ,Flurbiprofen Axeyil injection 200 mg (group F) ,Flurbiprofen Axeyil injection 100 mg plus Sufentanil 100 μg (group FS).The drugs in each group were added with Azasetron 10 mg and diluted to 100 ml, then infused by a pump in a rate of 2 ml/h.The visual analogue scale (VAS) and Ramesays scores were used to evaluate the analgesic effect at 0.5,2,4,8,12,24 and 48 h after surgery.The incidence of side effects was recorded.ResultsAll the patients showed good pain relief with PCIA.The VAS of group F(3.3 +0.8) at 2 h after operation was slightly higher than that of group S (2.6 + 1.0) and SF (2.8 + 1.1) (P ＜ 0.05), which became similar 4 h later (P ＞0.05).In groups F (2.4 +0.8,2.3 +0.6) and FS(2.9 +0.8,2.6 ±0.4), the average Ramsay score was slightly lower than that in group S(3.8 +0.9,3.6 +0.5) (P ＜0.05).But the differences were not significant within 8 h after operation (P ＞ 0.05).The accidence rates of nausea, vomiting, itching, somnolence of group S(20％ ,15％ ,20％) were significantly higher than those in group F (5％ ,0,5％)and FS(5％,5％ ,5％) (P ＜0.05).No respiratory depression or abnormal bleeding occurred in three groups during the period of postoperative 48 hour.The amount of hydrothorax had no difference between 3 groups (P ＜0.05).ConclusionsIntravenous postoperative analgesia with Flurbiprofen Axeyil injection combined with Sufentanil had a better analgesic effect than Sufentanil or Flurbiprofen Axeyil used alone, and it could significantly reduce the dose requirement of Sufentanil as well as its associated side effects.