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Objective To explore the effects of different ventilation modes of tracheobronchial foreign body in children with fiberoptic operation under general anesthesia.Methods Sixty children (1ys≤ age≤3ys) undergoing fiberoptic bronchoscopy tracheal foreign body removal according to the combinations of different ventilation modes during and after fiberoptic bronchoscopy (FOB) procedures were divided into group A [volume control ventilation (VCV) + VCV,n =20],group B [pressure control ventilation (PCV) + VCV,n =20] and group C (PCV + PCV,n =20) randomly.The P mean,Pmax,and PetCO2 during and after fiberoptic bronchoscopy procedures were monitored.The SpO2,PaO2,and PaCO2 after mechanical ventilation 1.5 hours were recorded.Results Compared to group A,groups B and C had lower P max and P mean (P ＜ 0.05) during the FOB procedures.Compared to groups A and B,group C had a lower P max and P mean (P ＜0.01) after the FOB procedures.At the 1.5 hours after the procedure,all the children showed significant increase in SpO2 and PaO2 (P ＜ 0.05) and decrease in PaCO2 (P ＜ 0.05) in groups A,B,and C.Conclusions When fiberoptic bronchoscopy in tracheobronchial foreign body operation is applied in children undergoing general anesthesia,the pressure control ventilation (VCV) mode can decrease the pressure of airway (Paw) and PaCO2 than volume control mode during procedure.
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Objective To observe the influence of dezocine used before end of operation on postoperative recovery and its inter-vention effect on postoperative pain in the patients with gynecological laparoscopic operation .Methods 60 patients(ASA Ⅰ - Ⅱ ) scheduled hysterectomy operation by gynecological laparoscopy were randomly divided into the observation group (dezocine group , n=30) and the control group(normal saline group ,n=30) .Remifentanil combined with propofol was intravenously given for con-ducting endotracheal intubation general anesthesia .The observation group was given dezocine 0 .1mg/kg(diluting to 10mL by nor-mal saline) at 30-40 min before the end of operation ,while the control group was given the same volume of physiological saline . Blood pressure ,heart rate(HR) ,recovery time ,adverse reactions during the recover period and postoperative pain before induction , after injection and before recovery were recorded .Results The elevation of mean arterial pressure(MAP) and the increase of HR during the recovery period in the observation group were lower than those in the control group (P0 .05) .PO2 ,PCO2 and SaO2 had no statistical difference between the two groups (P>0 .05);the postoperative agitation-sedation scores(PASS) and the visual ana-logue scale(VAS) scores in the observation group were significantly lower than those in the control group (P<0 .05) ,and the oc-currence rate of chills also was lower than that in the control group (P<0 .05) .Conclusion Intravenous dezocine before the end of operation in the gynecological laparoscopic operation can effectively inhibit the cardiovascular stress reaction ,does not affect the re-covery speed ,moreover can decrease the restlessness during the recovery period and postoperative pain .
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Objective To evaluate the effects of dexmedetomidine on the cerebral oxygen metabolism in elderly patients undergoing general anesthesia.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 60-87 yr,scheduled for elective abdominal surgery under general anesthesia,were randomly divided into 2 groups (n =25 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with iv injection of midazolam,fentanyl,atracurium and propofol.The patients were tracheally intubated and mechanically ventilated.In group D,dexmedetomidine 1.0μg/kg was infused intravenously over 20 min before induction of anesthesia,while the equal volume of normal saline was given in group C.Before induction of anesthesia,at 0 and 10 min after tracheal intubation and at the end of operation (T0-3),blood samples were taken from the radial artery and jugular bulb for blood gas analysis.Arteriovenous blood O2 content difference (DajvO2) and cerebral O2 extraction rate (CERO2) were calculated at the same time.The development of emergence agitation and postoperative delirium within 48 h after surgery were recorded.Resets Compared with the baseline values at T0,the Da-jvO2 and CERO2 were significantly decreased at T1-3 in the two groups (P ＜ 0.05).Compared with group C,the Da-jvO2 and CERO2 were significandy decreased at T2-3,and the incidence of emergence agitation and postoperative delirium within 48 h after surgery was decreased in group D (P ＜ 0.05).Conclusion Dexmedetomidine can improve the cerebral oxygen metabolism and reduce the development of postoperative delirium in elderly patients undergoing general anesthesia.
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Objective To investigate the effect of preoperative acute hypervolemic hemodilution with 6% hydroxyethyl starch 130/0.4(HES130/0.4)and polygeline on hemodynamic response and variance regularity of hemodynamic response in open-and close-thoracic cavity in undergoing thoracotomy patients. Methods Sixty patients undergoing thoracotomy,ASA physical status ⅠorⅡ,aged 20~65 yeansold,weighing 45~70kg,were randomly divided three group:HES130/0.4 group ( group A,n=20) ,Polygeline group ( group B,n=20) and Ringer's solution group (group C,n=20).They were respectively infused 20ml/ (kg?h) with HES130/0.4,polygeline and Ringer's solution in one hour before infuseing followed Ringer's 10ml/ (kg?h). The Blood Pressure (BP) and heart rate (HR) were recorded.RPP was calculated before induction(baseline),5min before and 10 min after open thoracic cavity,5min before and 10min after close thoracic cavity. And central venous pressure (CVP) was measured at immediately after deep venous puncture ,5min before and 10min after open thoracic cavity,5min before and 10min after close thoracic cavity. Results The changes of hemodynamics in Ringer's solution group in operation were obvious as compared with baseline before operation.HES130/0.4 and polygeline were relatively stable.Two groups had no significant difference.The CVP of HES130/0.4 and polygeline groups increased obviously before and after open thoracic cavity,but the blood pressure was relatively stable.Only systolic blood pressure increased obviously as compared with Ringer's solution group at 5min before open thoracic cavity. At 10min after open thoracic cavity,HR and CVP in three groups increased obviously as compared with 5 min before open thoracic cavity.At 5 min before close thoracic cavity,blood pressure and CVP in three groups decreased obviously as compared with 10 min after open thoracic cavity. Conclusion The preoperative acute hypervolemic hemodilution with HES 130/ 0.4 and polygeline in undergoing thoracotomy patients can keep hemodynamics more stable and improve tolerance of patients to withstand hypovolemics.
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Objective To investigate the effect of rocuronium of on the function of acetylcholine receptor (AchR)/channel in cone neurons of hippocampal cortex in rats.Methods SD rats of both sexes (2-5 days old) were killed by decapitation. Brain was immediately removed and hippocampal cortex was cut into slices which were incubated in decalcified and magnesium-free artificial cerebro-spinal fluid (CSF) and mechanically dissociated and then digested in artificial CFS containing 2.5% trypsin. Cell suspension was prepared. The AchR/channel function was studied in the absence and presence of various concentrations of rocuronium (0, 0.05, 0.1, 0.2, 0.4mmol? L-1) and/or atropine 0.1 mmol ?L-1 using patch clamp technique.Results (1) The conductance, open probability (P0) and short term open constant (?01) were significantly higher in R-0.05 group than those in the control group (R-0) , but there was no significant difference in long term open constant (?02) , short term close constant( (?c1) and long term close constant(?c2) between the two groups. The conductance, P0 ,?01 ,?02 , ?c1, and ?c2 were significantly longer or higher in R-0.0, 0.2 and 0.4 groups than those in control group. (2) There was no significant difference in the conductance, P0 , ?01 , ?02 , ?c1 , and ?c2, between R-0.5 and control group but those in R-0.0, 0.2 and 0.4 groups were significantly higher or longer than control group, when rocuronium was used with atropine. Conclusions AchR/channel ( muscarinic and nicotinic ) in cone neuron of hippocampal cortex were excited by different concentrations of rocuronium. The results suggest that adverse effect may be induced on CNS by rocuronium in case it permeates the injured blood-brain barrier.