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Objective@#To study the median effective dose of ketorolac tromethamine combined with different doses of sufentanil.@*Methods@#From February 2016 to June 2017, 60 cases of cesarean section were selected.According to the random number table method, they were divided into two groups, with 30 cases in each group.Group I was treated with sufentanil 0.75μg/kg+ dexmedetomidine 200μg, while sufentanil 1μg/kg+ dexmedetomidine 200μg was used in group II.The first two groups were added to pump 150 mg ketorolac tromethamine, gradually increased or decreased in accordance with 30mg effect according to satisfaction or dissatisfaction.The median effective dose of ketorolac tromethamine in the two groups was analyzed.@*Results@#After operation, the systolic blood pressure[(112.5±9.6)mmHg vs.(122.5±8.4)mmHg, (114.2±9.9)mmHg vs.(124.1±8.2)mmHg]and heart rate[(80.6±13.5)times/min vs.(90.5±16.5)times/min, (77.6±15.5)times/min vs.(88.2±18.8)times/min]in the two groups were significantly lower than those before operation (t=4.587, 5.248, 4.214, 3.983, all P<0.05). The VSA scores of the two groups decreased significantly[(6.8±2.4)points, (3.4±1.4)points, (2.1±0.9)points, (6.9±3.1)points, (3.5±1.7)points, (2.2±0.7)points], the difference was statistically significant at different time points (F=4.977, P<0.05). ED50 and 95% confidence interval of ketorolac tromethamine in the group I was 91.75mg, 78.69-106.98mg, which in the group II was 72.44mg, 60.40-86.90mg.@*Conclusion@#Ketorolac tromethamine combined with sufentanil has good analgesia effect, less adverse reaction.When sufentanil was given at 0.75 and 1μg/kg, the ED50 of ketorolac tromethamine were 91.75mg and 72.44mg.
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Background The study on eye surface damage following phacoemulsification with intraocular lens (IOL) implantation is increasingly concerned,and these symptoms were associated with dry eye and often treated by polyethylene glycol eyedrops to remit the discomfortableness.Recombinant bovine basic fibroblast growth factor (rb-bFGF) eyedrops contains neurotrophic factors, but its effect on eye surface damage is worth researching.Objective This study was to evaluate the repair effects of rb-bFGF on ocular surface injury after phacoemulsification with IOL implantation.Methods A randomized controlled trail was designed.Ninety eyes of 72 consecutive patients with age-related cataract were enrolled in Fenyang Hospital of Shanxi Province from September 2010 to August 2013 under the informed consent.Phacoemulsification with IOL implantation was performed on all the eyes, and tobramycin and dexamethasone eye drops was used for 15 days as basis therapy.According to the treatment sequence,the operative eyes were assigned to rb-bFGF eyedrops group, polyethylene glycol eyedrops group and basis therapy group.rb-bFGF drops and polyethylene glycol drops were topically administered 4 times per day since the first day after surgery for consecutive 30 days in corresponding group,and only basis therapy was maintained in the basis therapy grouply.Corneal fluorescence (FL) staining scores,breakup time of tear film (BUT) and Schirmer Ⅰ test (S Ⅰ t) without topical anesthesia were examined in 1 day before operation and 1 day,7 days, 15 days and 30 days after operation.The efficacy was intergrouply compared.Results No significant differences were seen in the demography and the relevant surface examinational outcomes among the rb-bFGF group, polyethylene glycol drops group and the basis therapy group before surgery (age : F =1.50;gender :x2 =0.336, both at ＞ 0.05;FL : F =0.31;BUT:F =0.65;S Ⅰ t: F =0.57;all at P ＞ 0.05).Compared with the before operation, FL scores were obviously increased,and BUT values were reduced and S Ⅰ t values were elavated in all the eyes early stage of surgey and then gradually improved with the lapse of postoperative time, showing significant differences (Ftime =7.83,7.32,7.17, all at P＜0.01).The FL scores,BUT and S Ⅰ t in 15 days after surgery in the rb-bFGF drops group and 30 days after surgery in the polyethylene glycol drops group was closed to those of before surgery (all at P＞0.05).However,there were still significant differences between the before and after operation in the basis were closed to those of before surgery therapy group (all at P＜0.05).In addition, significant differences were found in corneal FL scores, BUT and S Ⅰ t among these three groups (Fgroup =5.08,4.15,4.61, all at P＜0.05).In postoperative 15 days and 30 days, the S Ⅰ t values were (12.32±1.18) and (11.32±1.98) mm/5 rmin,which were significantly lower than (14.36±1.77) and (13.36±2.32) mm/5 min in the polyethylene glycol drops group and (17.25 ±2.24) and (13.25 ±2.53) mm/5 min in the basis therapy group (all at P ＜ 0.05).Conclusions The topical application of rb-bFGF combined with tobramycin and dexamethasone eyedrops can improve the dry eye-related symptoms and promote the repair of the ocular surface injury after phacoemulsification with IOL implantation,and the clinical efficacy of rb-bFGF eyedrops is better than that of polyethylene glycol eyedrops or only tobramycin and dexamethasone eyedrops.