Prevalence survey of implementation status of appropriate technique of Traditional Chinese Medicine in perioperative period in China / 中华麻醉学杂志

Objective:To investigate the implementation status of appropriate technique of Traditional Chinese Medicine (TCM) in the perioperative period in China using questionnaires.Methods:From May to June 2022, the questionnaire designed by ourselves was sent to anesthesiologists participating in the survey through the WeChat platform nationwide, and the system automatically recorded the survey.Results:A total of 6 230 anesthesiologists participated in the questionnaire survey, there were 6 160 valid questionnaires, with an effective rate of 98.88%.The anesthesiologists participating in the questionnaire survey were distributed in 16 provincial administrative regions in China, of which the rate from tertiary hospitals was 32.59%, the rate from secondary hospitals was 67.41%, and the application rate of TCM appropriate techniques in the perioperative period was 9.8%.The application rate of TCM appropriate techniques in the perioperative period was higher in tertiary hospitals than in secondary hospitals (9.51% vs. 6.31%, P<0.05), and the application rate was significantly higher in TCM hospitals than in integrated Chinese and Western Medicine hospitals and Western medicine general hospitals (26.15% vs.7.26% vs. 2.49%, P<0.05). Among the provinces participating in the survey, Guangdong Province had the highest application rate of TCM appropriate techniques in the perioperative period (13.60%). In the anesthesiologists carried out TCM appropriate techniques in the perioperative period, the highest application rate of TCM appropriate techniques in non-drug therapy was 59.0%, and the highest application rate in abdominal surgery was 47.4%, and most anesthesiologists (68.1%) selected TCM appropriate techniques according to the type of surgery in patients.Anesthesiologists who applied TCM appropriate techniques in the perioperative period believed that TCM appropriate technique cloud reduce the development of nausea and vomiting in the perioperative period (66.8%), alleviate perioperative pain (54.8%), promote the recovery of perioperative gastrointestinal function (49.8%), and reduce the development of perioperative neurocognitive disorders (47.0%). The main reasons for the lack of TCM appropriate techniques in the perioperative period were the lack of standardized technical training and relevant guidelines (87.11%), the lack of relevant charging items (58.30%), the technical level of operators (46.20%), the lack of support by surgeons (43.40%), and the non-cooperation of patients (27.10%). Conclusions:At present, the application rate of TCM appropriate techniques in the perioperative period is generally low, and the application rate varies greatly among different provinces and hospitals of different levels.Publicity should be expanded through multiple channels, various forms of technical training should be carried out, the implementation plan and guidelines of TCM appropriate technologies should be continuously optimized, and the promotion and application of TCM appropriate techniques in the perioperative period should be strengthened.

Accuracy of dexmedetomidine titration in diagnosis of restless legs syndrome / 中华麻醉学杂志

The medical records of patients of both sexes with sleep disorders treated with multimodal sleep therapy for which patient controlled sleep with dexmedetomidine was the main method, aged≥18 yr, with body mass index of 18-30 kg/m 2, from February 2019 to January 2021, were collected.Dexmedetomidine 60 ml/h (4 μg/ml) was intravenously infused until non-rapid eye movement (NREM) Ⅲ phase was reached or the consumption of dexmedetomidine reached 1 μg/kg.Whether dexmedetomidine induced restless legs syndrome (RLS) was judged according to the Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition). When the titration was stopped and on the next day after emergence from anesthesia, clinical diagnosis was performed according to Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition) to determine whether RLS was combined or not.Kappa consistency analysis was used to assess the consistency between dexmedetomidine titration and the Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 Edition) in diagnosis of RLS.The sensitivity and specificity of diagnosis of RLS by dexmedetomidine titration were calculated.A total of 39 patients were included and 8 patients had RLS symptoms which were judged accroding to dexmedetomidine titration.The results of Kappa consistency test showed that there was a strong consistency between dexmedetomidine titration and Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition) (Kappa value 1.0, P<0.01). The sensitivity and specificity of dexmedetomidine titration in judging RLS were 100%.In conclusion, dexmedetomidine titration can accurately judge RLS.

Effect of positive end-expiratory pressure on respiratory mechanics and pulmonary function in patients receiving continuous hyperthermic peritoneal perfusion / 临床麻醉学杂志

Objective To explore the effects of positive end-expiratory pressure on intraoperative pulmonary function and respiratory mechanics in patients receiving continuous hyperthermic peritoneal perfusion.Methods Ninety patients (55 males,35 females,aged 40-70 years,ASA grade Ⅰ-Ⅲ) undergoing continuous hyperthermic peritoneal perfusion were selected and divided into 3 groups (n=30 each): regular volume controlled ventilation group (group A),5 cm H2O PEEP group (group B) and 10 cm H2O PEEP group (group C).After tracheal intubation,the mechanical ventilation parameters in groups A,B and C were respectively given tidal volume (VT) 10 ml/kg without positive end-expiratory pressure (PEEP),VT 6 ml/kg with 5 cm H2O PEEP,and VT 6 ml/kg with 10cm H2O.PETCO2 was maintained at 35-45 mm Hg.Arterial blood samples were collected for blood gas analysis 5 min after (T1),before CHPP (T2),the end of CHPP (T3),and before the end of mechanical ventilation (T4).Besides,Pplat,Pmean,Ppeak,PaCO2,PaO2were recorded and Cdyn,OI,RI,A-aDO2 as well as VD/VT were calculated at all time points simultaneously.Pulmonary complications during 7 days after surgery were also recorded.Results Compared with group A,Ppeak,Pplat,A-aDO2 and RI were all significantly lower (P<0.05),while OI and VD/VT were higher in groups B and C at T1-T4 (P<0.05);at T2-T4,Cdyn and PaO2 were higher with lower Pmean in groups B and C (P<0.05).Compared with T1,Ppeak,Pplat and Pmean were higher (P<0.05) while Cdyn was lower (P<0.05) in group A at T2-T4;In Group B,Ppeak and Pplat were higher at T3 (P<0.05),Pmean was higher at T2-T4 (P<0.05) and Cdyn was lower at T3,T4 (P<0.05);in group C,Ppeak,Pplat and Pmean were all higher at T2-T4 (P<0.05),Cdyn was lower at T3,T4 (P<0.05);OI and PaO2 were lower (P<0.05),while A-aDO2,VD/VT and RI were all higher (P<0.05) at T2-T4 in the three groups.In addition,the incidence rates of pulmonary infection,hypoxemia,and atelectasis were significantly lower in groups B and C during 7 days after surgery than those of group A (P<0.05).Conclusion PEEP (5 cm H2O) with VT (6 ml/kg) could effectively improve intraoperative pulmonary function and reduce the risk of perioperative pulmonary complications of the patients receiving continuous hyperthermic peritoneal perfusion.

Effect of atorvastatin preconditioning on cognitive function in isoflurane-anaesthetized mice / 中华麻醉学杂志

Objective To evaluate the effect of atorvastatin preconditioning on cognitive function in isoflurane-anaesthetized mice.Methods Forty-eight healthy male C57BL/6 mice,aged 3 months,weighing 27-41 g,were divided into 3 groups (n =16 each) using a random number table:control group (group C),isoflurane anesthesia group (group Ⅰ) and atorvastatin preconditioning plus isoflurane anesthesia group (group AI).Atorvastatin 10 mg/kg was given through a gastric tube into the stomach at the same time every day for 7 consecutive days in group AI.In Ⅰ and AI groups,1.5％ isoflurane was inhaled for 6 h with fresh gas flow of 2 L/min at 1 day after the end of administration.Open field test and Morris water maze test were performed at 1 day after the end of anesthesia.The mice were sacrificed at 1 day after the end of Morris water maze test,and hippocampi were isolated for determination of caspase-3,Bax and Bcl-2 expression (by Western blot) and contents of interleukin-1beta (IL-1β),tumor necrosis factor-alpha (TNF-α) and soluble Aβ1-42 in hippocampal tissues (by enzyme-linked immunosorbent assay).Results There was no significant difference in the parameters of open field test among the three groups (P＞0.05).Compared with group C,the escape latency was significantly prolonged at each time point,the time of staying at the original platform quadrant was shortened,the frequency of crossing the original platform was decreased,the contents of IL-1β,TNF-α and soluble Aβ1-42 were increased,the expression of caspase-3 and Bax was up-regulated,and Bcl-2 expression was down-regulated in Ⅰ and AI groups (P＜0.05).Compared with group Ⅰ,the escape latency was significantly shortened at each time point,the time of staying at the original platform quadrant was prolonged,the frequency of crossing the original platform was increased,the contents of IL-1β,TNF-α and soluble Aβ1-42 were decreased,the expression of caspase-3 and Bax was downregulated,and Bcl-2 expression was up-regulated in group AI (P＜0.05).Conclusion Atorvastatin preconditioning can improve cognitive function in isoflurane-anaesthetized mice,and the mechanism may be association with attenuating hippocampal inflammatory responses,inhibiting over-expression of Aβ1-42 and inhibiting neuronal apoptosis.

Effect of goal-directed fluid therapy on outcomes following abdominal surgery: a meta-analysis / 中华麻醉学杂志

Objective To systcmatically rcvicw the effect of goal-directed fluid therapy (GDFT) on outcomes following abdominal surgery.Methods Pubmed,Embase,CINAHAL,Scopus and Cochrane Library were searched from 1980 to May 2016 to identify randomized controlled trials involving the effect of GDFT on outcomes following abdominal surgery in adults (aged＞ 18 yr).GDFT served as therapy group,and conventional fluid therapy served as control group.The major evaluation indexes included the postoperative mortality rate,incidence of postoperative complications and length of hospital stay.The secondary evaluation index was the recovery of postoperative gastrointestinal function.Meta-analysis was conducted using the RevMan 5.1 and Stata 12.0 softwares.Results Forty-five randomized controlled trials involving 6344 patients were included in our meta-analysis,and there were 3406 cases in therapy group and 2938 cases in control group.The results of mcta-analysis showed that compared with control group,the number of patients who developed postoperative complications was significantly decreased,the length of hospital stay was shortened,and the time to first flatus and time to first liquid diet were shortened in therapy group (P＜0.05).There was no significant difference in the mortality rate between the two groups (P＞0.05).Conclusion GDFT can promote outcones following abdominal surgery and exerts no effects on the survival rate in patients.

Effect of electric vagal stimulation on postoperative cognitive dysfunction in aged rats / 中华麻醉学杂志

Objective To evaluate the effect of electric vagal stimulation on postoperative cognitive dysfunction in aged rats.Methods Thirty healthy Sprague-Dawley rats of both sexes,aged 18-20 months,weighing 390-550 g,were randomly divided into 3 groups (n=10 each) using a random number table:control group (group C),surgery group (group S),and electric vagal stimulation group (group V).Incision of the right carotid sheath was performed,and the vagal nerve was exposed after anesthesia in S and V groups.The right vagus nerve was stimulated for 30 min with continuous electric rectangular pulses (1 ms,10 Hz,1-2 V) after surgery in group V.The Morris water maze place navigation test was performed at 4,3,2 and 1 days before surgery and 2 days after surgery.The cognitive function was assessed using spatial probe and open field tests conducted at 2 days after surgery.The escape latency,the number of crossing the platform,the number of crossing the grid,the number of standing on the back legs,and the time animals spent in the central square were recorded.After the end of behavioral testing,venous blood samples were collected from the jugular vein for determination of concentrations of serum tumor necrosis factor-alpha (TNF-α),interleukin (IL)-1β and IL-6 using enzyme-linked immunosorbent assay.Results Compared with group C,the number of crossing the platform,the number of crossing the grid,and the number of standing on the back legs were significantly decreased,the escape latency and the time animals spent in the central square were significantly prolonged,and the concentrations of serum TNF-α,IL-1β and IL-6 were significantly increased at 2 days after surgery in group S (P＜0.05).Compared with group S,the number of crossing the platform,the number of crossing the grid,and the number of standing on the back legs were significantly increased,the escape latency and the time animals spent in the central square were significantly shortened,and the concentrations of serum TNF-α,IL-1β and IL-6 were significantly decreased at 2 days after surgery in group V (P＜0.05).Conclusion Electric vagal stimulation can improve the postoperative cognitive dysfunction in aged rats.

Effects of controlled heart rate on nasal mucosa blood flow during nitroglycerin-induced controlled hypotension in patients undergoing endoscopic sinus surgery / 中华麻醉学杂志

Objective To evaluate the effects of controlled heart rate (HR) on the nasal mucosa blood flow (NMBF) during nitroglycerin (NTG)-induced controlled hypotension in the patients undergoing endoscopic sinus surgery.Methods Seventy-two ASA physical status Ⅰ or Ⅱ patients of both sexes,weighing 49-85 kg,with body mass index ＜ 30 kg/m2 and Lund-Mackay score between 7 and 15,scheduled for elective endoscopic sinus surgery,were randomly divided into 2 groups (n =36 each) using a random number table:NTG group (group N) and NTG-induced controlled hypotension combined with esmolol group (group E).Controlled hypotension was induced with continuous iv infusion of NTG at 1-3 μg· kg-1 · min-1 before surgery,and MAP was maintained at 70％ of baseline value until the end of surgery.In group E,when MAP was decreased to 70％ of baseline value,esmolol was infused intravenously at 20-100 μg· kg-1 · min-1,the consumption was adjusted according to the HR,and the HR was maintained at 60-70 beats/min until termination of controlled hypotension.Before induction of anesthesia (T0),after topical anesthesia (T1),at 15,30 and 45 min of controlled hypotention (T2-4),and at packing hemostasis at the end of surgery (T5),HR,stroke volume (SV) and cardiac output (CO) were recorded.NMBF was monitored at T1-T4.Blood samples were drawn from the radial artery and jugular blub at T1-T5 for blood gas analysis.Arteriovenous blood O2 difference (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated.The quality of the surgical field in terms of blood loss was rated by the same attending surgeon.Results Compared with group N,HR,SV and CO at T2-T5,NMBF at T2-T4 and the volume of blood loss in the surgical field was significantly decreased in group E (P ＜ 0.01).There was no significant difference in Da-jvO2 and CERO2 between the two groups (P ＞ 0.05).Conclusion Controlled HR (60-70 beats/min) can reduce the NMBF during nitroglycerin-induced controlled hypotension in the patients undergoing endoscopic sinus surgery without causing tissue hypoperfusion.

Effect of delayed preconditioning with morphine on ischemic cerebral injury in mice and the role of classical protein kinase C / 中华麻醉学杂志

Objective To evaluate the effect of delayed preconditioning with morphine on ischemic cerebral injury in mice and the role of classical protein kinase C (cPKC).Methods Forty male BALB/C mice,weighing 20-22 g,were randomly divided into 4 groups (n =10 each):sham operation group (group S),ischemic cerebral injury group (group ICI),morphine preconditioning group (group MP) and cPKC inhibitor Go6983 group (group G).Ischemia was induced by middle cerebral artery occlusion (MCAO).In S group,the middle cerebralartery was only exposed but not occluded.In MP group,morphine 10 mg/kg was injected intraperitoneally 24 h before MCAO.In G group,morphine 10 mg/kg was injected intraperitoneally 24 h before MCAO and 5 μl Go6983 (6nmol) was injected into the left lateral cerebral ventricle immediately before MCAO.The neurologic deficit was evaluated and scored according to neurological disability status scale in a blind nanner 6 h after MCAO.The animals were sacrificed and brains were immediately removed for measurement of the brain edema and infarct volume.Apoptotic rate was calculated.Results Compared with S group,the neurologic deficit scores,infarct volume,brain edema and apoptotic rate were significantly increased in ICI,MP and G groups (P ＜ 0.01).Compared with group ICI,the neurologic deficit scores,infarct volume,brain edema and apoptotic rate were significantly decreased in group MP (P ＜ 0.01),and no significant change was found in the parameters mentioned above in group G (P ＞ 0.05).Conclusion Delayed preconditioning with morphine can reduce ischemic cerebral injury in mice and activation of classical cPKC signaling pathway is involved in the mechanism.

Efficacy of anesthesia with BIS-guided etomidate TCI in combination with iv remifentanil infusion for noncardiac surgery: a prospective randomized single-blinded multicenter controlled clinical study / 中华麻醉学杂志

Objective To evaluate the efficacy of anesthesia with etomidate administered by TCI in combination with continuous iv remifentanil infusion titrated to maintain BIS values at 40-60 for non-cardiac surgery in a prospective randomized single-blinded multicenter controlled clinical study.Methods Two hundred and forty-four ASA Ⅰ or Ⅱ patients of both sexes aged 20-60 yr undergoing non-cardiac surgery lasting less than 3 h were randomly allocated into 2 groups:etomidate group (group E,n =123) and propofol group (group P,n =121 ).The patients were unpremedicated.A bolus of midazolam 0.03 mg/kg was injected iv immediately before induction of anesthesia.Anesthesia was induced with sufentanil 0.3-0.4 μg/kg and TCI of etomidate (effect-site concentration (Ce) =0.5-1.0 μg/ml) or propofol (Ce =3-4 μg/ml).Tracheal intubation was facilitated with rocuronium 0.9 mg/kg.The patients were mechanically ventilated (VT 8-10 ml/kg,RR 10-12 bpm,FiO2 =1 ).PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with TCI of etomidate ( Ce =0.3-0.8 μg/ml ) or propofol ( Ce =3-4 μg/ml) in combination with continuous iv infusion of remifentanil at 0.1-1.0 μg· kg-1 ·min-1 and intermittent iv boluses of rocuronium.BIS values were maintained at 40-60 during operation.Sufentanil 0.1 μg/kg was administered iv before skin closure.Ce at loss of consciousness,during maintenance of anesthesia and at emergence,the consumption of remifentanil and vasoactive agents,the emergence time and extubation time were recorded.The incidences of injecton pain,post-operative nausea and vomiting (PONV) and emergence agitation were measured.Results Ce of etomidate at loss of consciousness,at emergence and during maintenance of anesthesia was (0.50 ± 0.22),(0.16 ± 0.09) and 0.22-0.39 μg/ml respectively.The incidence of injection pain and the consumption of vasoactive agents were significantly lower but more remifentanil was needed in group E than in group P (P ＜0.05 or 0.01).There was no significant difference in emergence time and extubation time between the 2 groups (P ＞ 0.05).The incidence of PONV and emergence agitation were significantly higher during recovery in group E than in group P ( P ＜ 0.05 ).Conclusion The hemodynamics is stabler during operation,but the incidence of PONV and emergence agitation are significantly higher during recovery in group E than in group P.Etomidate induces little injection pain.

Roles of PI3K/Akt and JAK/STAT signal transduction pathways in reduction of myocardial ischemia/reperfusion injury by postconditioning with α7nAChR agonist in rats / 中华麻醉学杂志

Objective To evaluate the roles of PI3K/Akt and JAK/STAT signal transduction pathways in reduction of myocardial ischemia/reperfusion (I/R) injury by postconditioning with α subunit-containing nicotinic acetylcholine receptor (α7nAChR) agonist in rats.Methods Sixty Sprague-Dawley rats,weighing 290-320 g,were randomly divided into 4 groups (n =15 each):I/R group,ischemic preconditioning group (IPC group),ischemic postconditioning group (IPOC group) and postconditioning with specific α7nAChR agonist PNU282987 group ( PNU group ).Myocardial I/R was produced by 30 min occlusion of left anterior descending coronary artery followed by 180 min reperfusion in the 4 groups.The animals were subjected to 3 cycles of 5 min myocardial ischemia and 5 min reperfusion before 30 min myocardial ischemia in IPC group.The animals underwent 3 cycles of 10 s myocardial ischemia at 5 s intervals before 180 min reperfusion in group IPOC.PNU282987 2.4 mg/kg was injected intraperitoneally immediately before the reperfusion.At 60 min of reperfusion,5 rats in each group were sacrificed and the hearts were removed to determine the expression of Akt and STAT3 mRNA,phosphorylated Akt (p-Akt) and phosphorylated STAT3 (p-STAT3) in myocardial tissues.The left 10 rats in each group were sacrificed at 180 min of reperfusion and the hearts were removed to measure the infarct size.Results Compared with I/R group,the expression of STAT3 mRNA and p-Akt was significantly up-regulated in IPC group,and the expression of p-Akt and p-STAT3 was significantly up-regulated in IPOC group ( P ＜ 0.05).The infarct size was significantly reduced in IPC,IPOC and PNU groups compared with I/R group ( P ＜ 0.05 ).Conclusion The mechanism by which α7nAChR agonist postconditioning reduces myocardial I/R injury is not related to PI3K/Akt and JAK/STAT signal transduction pathways in rats.

Characteristics of collapse of upper airway in patients with obstructive sleep apnea-hypopnea syndrome when muscle is fully relaxed / 中华麻醉学杂志

Objective To investigate the characteristics of upper airway collapse in patients with obstructive slcep apnea hypopnea syndrome (OSAHS) when muscle is fully relaxed.Methods Thirty male ASA Ⅱ or Ⅲ patients with OSAHS aged 20-59 yr with body mass index 21-36 kg/m2 and apnea-hypopnea index (AHI) of 28-102times/h were studied.The patients were sedated with iv midazolam 1 mg and sufentanil 5 μg.Nasotracheal intubation was then performed under topical anesthesia with 1％ dicaine.After confirmation of correct position of nasotracheal tube,anesthesia was induced with propofol 0.5 mg/kg and vecuronium 0.08 mg/kg and maintained with target-controlled infusion of propofol and remifentanil.BIS was maintained at 40-60.Fiberopticnasopharyngoscope and pressure transducer were inserted via contralateral nasal cavity and connected with imaging workstation.The site and length of the obstruction were measured and calibrated.Positive pressure was applied to the pharyngeal cavity and gradually increased in increments of 1 cm H2O until 20 cm H2O.The change in cross-section area and critical opening pressure at different planes in pharyngeal cavity were recorded.Results Complete obstruction occurred at the plane of hard palate in one patient (3％).The soft palate and uvula completely collapsed in all 30 patients (100 ％).The collapse occurred at tongue level in 23 patients (77 ％).Every 1 cm H2O increase in pressure produced increase in cross-section area by (10 ± 4)mm2 at the level of hard palate and by(28 ± 18) mm2 at the level of soft palate and uvula.The critical opening pressure ranged from 3 to 18 cm H2O and was≤ 15 cm H2O in 90％ patients.Conclusion Soft palate and uvula collapse in all patients with OSAHS when muscle is fully relaxed.The critical opening pressure is ≤ 15 cm H2O in 90％ patients.

Comparison of different general anesthesia induction methods in children laryngeal papilloma ectomy / 中国耳鼻咽喉头颈外科

OBJECTIVE To find the safer anesthesia induction methods in children with laryngeal papilloma combined by dyspnea.METHODS 50 laryngeal papilloma children with II degree laryngeal obstruction were randomly divided into 2 groups:inhalational group and intravenous group,no muscle relaxant was used in either of the groups.MAP,and SpO2 were observed at one minute before and after induction.The intubation condition was also assessed and compared between the 2 groups.RESULTS MAP and HR in intravenous group were significantly higher than those of inhaled group after intubation [(68.7?6.4)mmHg vs.(64.0?8.0)mmHg;(142.6? 13.8)bpm vs.(124.6?12.5)bpm;P0.05].For the intubation condition,the satisfactory rate in inhaled group was higher than that of intravenous group,P

Sufentanil combined with lornoxicam for analgesia after uvulopalatopharyngoplasty surgery / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate theanalgesic efficiency and safety of patient-controlled intravenous analgesia (PCIA) with sufentanil, lornoxicam and sufentanil combined with lornoxicam after Han-uvulopalatopharyngoplasty (H-UPPP) surgery. METHODS Sixty patients after H-UPPP surgery for PCIA were randomly divided into three groups: group S (sufentanil 2.0 ?g/kg), group L (lornoxicam 0.5 mg/kg) and group SL (sufentanil 1.0 ?g/kg + lornoxicam 0.4 mg/kg). The efficiency of analgesia was assessed by VAS (visual analogue scale) and Ramsay score at 2, 6, 12, 24, 48 hours after PCIA. The MAP, HR, SpO2 and side effects were also recorded. RESULTS Group S and SL showed good pain relief and sedation. In Group L VAS score was higher but Ramsay score was lower than that of group S and SL at 2, 6, 12 hours after PCIA (P

Patient-controlled analgesia with flurbiprofen plus sufentanyl after FESS / 中国耳鼻咽喉头颈外科

0.05). However, the sedation score of patients in the control group was signicantly greater than that in the experimental group during the rst 20 hours and more dizziness occurred in the control group (P

The Effect of Fentanyl for Patient-controlled Analgesia after Functional Endoscopic Sinus Surgery / 医学研究杂志

Objective To observe the analgesic effects and the side effects of fentanyl after the FESS with general anesthesia.Methods 101 adult male patients,ASA Ⅰ～Ⅱ,undergoing elective FESS were divided into two groups randomly,received fentanyl through PCA or no analgesia.The PCA device was set at background infusion 0.1?g/(kg?h),bolus dose 0.4?g/kg?time,lockout time 15 minutes.The maximum dose is 600?g per day.Virtual signs,VAS,Ramsay sedation,dizzy,nausea,vomit and appetite were observed after the operation for two days.Results The VAS of the two groups is significant different in the time of the second morning and 24 hours later after the operation(P

Ketamine and propofol in combination for sedation during cystoscope in elderly male patients / 中华老年医学杂志

Objective To study the safety and efficacy of target-controlled infusion (TCI) sedation with low dose ketamine and propofol during rigid cystoscopy in elderly male patients. Methods Forty-five elderly male patients with I - III grade of the American Society of Anesthesiologists (ASA)rigid cystoscopy examination were divided into 3 groups randomly: group A, 2% lydocaine gel was filled in urethra, n=15; group B, 2% lydocaine gel filled with propofol TCI sedation, n=15; group C, 2% lydocaine gel filled with combined ketamine and propofol TCI sedation, n= 15. The mean artery pressure (MAP), heart rate(HR), pulse oxygen saturation (SPO2)were measured at 5 time points; preoperation, during local anesthesia, inserting the scope, during testing and the end of testing. The concentration of effect room, wake time when alertness and calm grading (OAA/S)was 3 scores in B and C groups and visual analogue scale( VAS) score of pain after operation were detected. Results The MAP and HR at the time point of inserting the scope in group A had significant difference,compared with preoperation(P0. 05) . In group A, 10 cases pain VAS score were light pain, 4 moderate and 1 severe. In group B and C,no pain and no memory of the operation were reported. Conclusions TCI sedation with low dose of ketamine and propofol in elderly male patients under rigid cystoscope has good effects on sedation, analgesia and anterograde amnesia. The hemodynamics is stable and wake time is short.

Influence of Heat and Moisture Exchanger Filter on Temperature of Inspiratory and Endotracheal Gas / 医疗卫生装备

Objective To investigate the influence of heat and moisture exchanger filter(HMEF)on the temperature of inhaled and endotracheal gas during mechanical ventilation. Methods Thirty patients (ASAI-II) were selected and divided randomly into 2 groups: control group and HMEF group. The temperature of inhaled gas was monitored with hygrothermograph and the temperature of endotracheal gas was monitored with temperature probe. Baseline values were set at the moment of intubation and then the values were recorded at the first hour after intubation and the second hour after intubation. Results With the increase of the mechanical ventilation time, the temperature of inhaled and endotracheal gas decreased significantly in control group and increased significantly in HMEF group; The temperature of both inhaled and endotracheal gas in HMEF group were significantly higher than that in control group at the moment of the first hour after intuba- tion and the second hour after intubation; There was correlation between the temperature of inhaled gas and the temperature of endotracheal gas at the moment of intubation, but it was not the same at the moment of the first hour after intubation or the second hour after intubation. Conclusion HMEF can make the cold inhaled gas warmer when it reached the trachea; Temperature probe may be better than hygrothermograph for monitoring the temperature of trachea.

Effects of propofol on the anoxic response of primary cultured hippocampal neurons / 中华麻醉学杂志

Objective To evaluate the effects of different concentration of propofol on the anoxic response of primary cultured hippocampal neurons Methods Newborn (

Effects of propofol on cultured hippocampal neurons injured by glutamic acid / 中华麻醉学杂志

Objective Propofol has been found to have anti-lipid peroxidation effect. We aimed to evaluate the effects of propofol on primarily cultured hippocampal neurons injured by glutamic acid. Methods Hippocampal neurons were obtained from newborn Wistar rats (within 24 h after birth) and cultured for 12 days. The 12 d cultured hippocampal neurons were randomly divided into three groups : (1) control group; (2) glutamate group in which cells were incubated with glutamate 100 ?mol?L-1 for 24 h; (3) propofol-glutamate group in which cells were incubated with propofol 500 ?mol?L-1 and glutamate 100 ?mol?L-1 for 24 h. Cell survival rate (MTT), apoptosis (flow cytometry) and C-fos protein (immuno-histochemistry) production were determined in each group. Results C-fos protein and apoptosis were significantly increased and survival rate was decreased in glutamate group compared with those in control group ( P

Effects of lidocaine and ketamine on resting membrane potential of cultured anoxic hippocampal neurons / 中华麻醉学杂志

Objective To investigate the effects of lidocaine and ketamine on resting membrane potentials of primary cultured anoxic hippocampal neurons using patch-clamp technique. Methods Hippocampal neurons were isolated from newborn Wistar rats (