RÉSUMÉ
Objective:To investigate the effect of nerve block anesthesia on hemodynamics in elderly patients undergoing unilateral lower limb trauma surgery.Methods:From February 2017 to June 2019, 100 elderly patients with unilateral lower extremity trauma admitted in our hospital were selected in this study.According to different anesthesia methods, the patients were divided into two groups, with 50 cases in each group.Group B was given light specific gravity subarachnoid anesthesia, while group A received nerve block anesthesia.The anesthesia effect, hemodynamic parameter changes, complications and incidence of adverse reactions between the two groups were compared.Results:The total effective rate of group A was 98.00%(49/50), which was significantly higher than that of group B[86.00%(31/50)], the difference between the two groups was statistically significant(χ 2=16.973, P<0.05). Before anesthesia, there were no statistically significant differences in diastolic blood pressure, heart rate and blood oxygen saturation between the two groups(all P>0.05). At 15 minutes after anesthesia, the diastolic blood pressure, heart rate and blood oxygen saturation in group A were (70.32±3.42)mmHg, (86.28±2.42)times/min, (139.03±2.63)%, respectively, which in group B were (70.26±1.66)mmHg, (86.73±1.63)times/min, (140.97±1.84)%, respectively.At 30 minutes after anesthesia, the diastolic blood pressure, heart rate and blood oxygen saturation in group A were (68.73±2.11)mmHg, (85.26±0.52)times/min, (136.18±3.89)%, respectively, which in group B were (70.98±1.92)mmHg, (87.24±2.31)times/min, (140.39±0.77)%, respectively.At 60 minutes after anesthesia, the diastolic blood pressure, heart rate, blood oxygen saturation in group A were (67.34±3.25)mmHg, (86.26±1.31)times/min, (134.89±2.37)%, respectively, which in group B were (71.01±3.12)mmHg, (87.39±1.32)times/min, (140.99±1.64)%, respectively.The differences between the two groups were statistically significant( t=11.315, 10.924, 10.599, t=13.411, 8.226, 9.779, t=9.057, 8.497, 10.131, all P<0.05). The incidence of complications and adverse reactions in group A was 2.00%(2/50), which was significantly lower than that in group B[18.00%(9/50)], the difference between the two groups was statistically significant(χ 2=16.913, P<0.05). Conclusion:Nerve block anesthesia is effective in elderly patients with unilateral lower limb trauma surgery, which can effectively stabilize the hemodynamics and reduce the incidence of complications and adverse reactions.
RÉSUMÉ
Objective To investigate the effect of dexmedetomidine hydrochloride on hemodynamics,immune function and inflammatory factors in patients with gynecological laparoscopic operation.Methods According to the random comparison table,86 elderly patients with gynecological laparoscopic operation were divided into observation group(43cases) and control group(43cases).The observation group received conventional general anesthesia,and intravenously pumped with dexmedetomidine hydrochloride.The the control group received conventional general anesthesia,and intravenously pumped with normal saline.The changes of hemodynamics,immune function and inflammatory factors were observed and compared in different periods in the two groups.Results Compared with before induction,the level of HR increased significantly at intubation(t=-3.257,-5.019,all P0.05),the level of MAP increased significantly at intubation in control group(t=-2.122,P0.05);Compared with before induction,the levels of CRP and IL-6 increased significantly at after operation and 24 h after operation in the two groups(CRP:t=-9.974,-16.872;IL-6:t=-7.284,-11.449,all P0.05),the levels of CD+3,CD+4,CD+4/CD+8 and NK decreased significantly after operation in the control group(t=11.514,10.317,9.180,6.815,all P<0.05),there were statistically significant differences after operation in the two groups(t=10.232,10.298,7.728,4.900,all P<0.05),and the level of NK decreased significantly at 24h after operation in the control group(t=4.362,P<0.05).Conclusion Dexmedetomidine hydrochloride can keep hemodynamics stability,reduce immune function damage and inflammation.
RÉSUMÉ
Objective To explore the effect of dexmedetomidine combined with sufentanil on postoperative analgesia , early postoperative cognitive function and serum inflammatory factors in patients with laparoscopic gastrectomy of gastric cancer.Methods 80 cases of laparoscopic resection of gastric cancer were randomly assigned to treatment group and control group.The control group were treated by sufentanil 1.6μg/kg.The treatment group were given sufentanil 1.6μg/kg combined with dexmedetomidine 2 μg/kg.The analgesic effect, early cognitive function and serum levels of inflammatory factors were tested and compared after surgery.Results Compared with the control group, the VAS score in 4 h,8 h,24 h and 48 h after surgery were lower in the treatment group (P<0.05), the POCD(P<0.05), the IL-6,IL-10 and TNF-αlevel were lower in the treatment group(P<0.05). Conclusion Dexmedetomidine combined with sufentanil showes better postoperative analgesic effect and fast recovery of cognitive function, regulate the levels of serum inflammatory cytokines after laparoscopic resection of gastric cancer .