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Objective·To explore the safety of elective therapeutic cardiac catheterization in congenital heart disease (CHD) children with recent upper respiratory tract infection (URI) (within two weeks),so as to provide guidance for clinical anesthesia management.Methods·A total of 140 CHD children of American Society of Anesthesiologist (ASA) Ⅱ～Ⅲ undergoing tracheal intubation general anesthesia for elective therapeutic cardiac catheterization,aged 3 months to 15 years,were divided into URI group and non-URI group according to history of recent URI.The incidence of perioperative respiratory adverse events (PRAEs) [i.e.laryngospasm,bronchospasm,breath holding ≥ 15 s,pulse blood oxygen saturation (SpO2)＜95％(≥ 10 s),cough,and glossoptosis] and postoperative dysphoria,fever,copious sputum,and vomiting within 24 h after operation were observed and compared.Results·Compared with non-URI group,recent URI increased significantly the overall incidence of PRAEs (any complications of PRAEs) (P=0.001),particularly the incidence of SPO2＜95％ (P=0.014) and cough (P=0.000).Compared with children aged from 4-15 in URIgroup,the overall incidence of PRAEs (P=0.003),SPO2＜95％ (P=0.018),and cough (P=0.027) of children younger than 3 years increased significantly.Besides,compared with non-URI group,recent URI increased significantly the incidence of postoperative copious sputum (P=0.002).Conclusion·Recent URI increases significantly the incidence of perioperative complications in CHD children undergoing elective therapeutic cardiac catheterization.These complications are short and easily managed,and no serious adverse events occurred in CHD children.
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Objective·To observe the changes of perfusion index (PI),bispectral index (BIS),heart rate (HR),systolic blood pressure (SBP) and respiratory rate (RR) under pulling stimuli in children undergoing open inguinal hernia repairs with spontaneous ventilation,so as to evaluate the clinical value of PI in monitoring the stress response.Methods·Thirty children undergoing selective open inguinal hernia repairs with American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ were recruited.Anesthesia was induced with fentanyl and propofol,and was maintained with sevoflurane after the insertion of laryngeal mask.The PI,BIS,HR,SBP and RR were observed at the following time points:before induction of anesthesia (T0),before pulling hernia sac (T1),at the time point of pulling hernia sac (T2),1 min after pulling hernia sac (T3) and 5 min after pulling hernia sac (T4).Results·Compared with the baseline level at T0,the PI value at T1,T3 and T4 increased significantly (P=0.000,P=0.033 and P=0.000,respectively).The BIS,HR and SBP values at T1-T4 were significantly lower than baseline levels at T0(all P=0.000).The PI values at T2 and T3 reduced significantly compared with T1.The HR value at T2 was significantly higher than that ofT1 (P=0.033).Compared with the SBP values at T1,the SBP values at T3 and T4 were significantly higher (P=0.000 and P=0.011,respectively).And the RR values at T2 and T3 were higher than that at T1 (both P=0.000).The proportion of children with positive stress response based on PI was significantly higher than that based on other variables (all P=0.000).Conclusion·Perfusion index can reflect the noxious stimuli of the pulling hernia sac effectively and immediately.
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Aim The effects of midazolam on the whole-cell sodium currents in rat sympathetic neurons were studied to explore the mechanisms where by midazolam mediates hypotension. Methods Whole-cell patch-clamp recordings were performed on enzymatically isolated rat superior cervical sympathetic neurons. Results Midazolam dose-dependently blocked the whole-cell sodium currents evoked by a voltage step to 0 mV from a holding potential of -80 mV with a mean drug concentration required to produce 50% current inhibition (IC50) values of 18.35 ?mol?L-1; Clinically relevant concentration of midazolam(0.3 ?mol?L-1) reduced sodium peak currents by 19.98%(P