Effect of cartoon video-assisted preoperative interview on postoperative maladaptive behaviors of preschool pediatric patients / 中华麻醉学杂志

Objective To investigate the effect of cartoon video-assisted preoperative interview on the postoperative maladaptive behaviors of preschool pediatric patients.Methods One hundred preschool pediatric patients,aged 3-6 yr,weighing 12-28 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective strabismus surgery,were divided into 2 groups (n =50 each) using a random number table:cartoon video-assisted preoperative interview group (group Ⅰ) and routine preoperative interview group (group Ⅱ).In group Ⅰ,accompanied by the anesthesiologist,children and their parents watched the cartoon video designed for the perioperative process,and the anesthesiologist answered the questions that their parents had.After completion of tracheal intubation,dexmedetomidine 0.3 and 0.6 μg/kg were infused intravenously over 10 min in group Ⅰ and group Ⅱ,respectively.Three percent-4％ sevoflurane was inhaled to maintain anesthesia.The development and degree of agitation during stay in the post-anesthesia care unit (PACU) were recorded.The emergence time and length of PACU stay were also recorded.Postoperative maladaptive behaviors were assessed with the Post-Hospital Behavior Questionnaire at 1 week after surgery,and the occurrence of behavioral changes was recorded.Results Compared with group Ⅱ,the incidence of emergence agitation was significantly decreased,the degree of emergence agitation was reduced,the emergence time and length of PACU stay were shortened,and the incidence of behavioral changes (4％) was decreased after surgery in group Ⅰ (P＜0.05).Conclusion Cartoon video-assisted preoperative interview can effectively decrease the development of postoperative maladaptive behaviors of the preschool pediatric patients.

Effect of controlled hypotension on myocardial ischemia marker in eye-nose related surgery

We aimed to investigate the effect of different controlled hypotension levels on myocardial enzymes and myocardial ischemia protein in elderly hypertension patients, and then provide clinical evidence of suitable controlled hypotension level for them. Then, 45 elderly hypertension patients received elective eye-nose related surgery with nasal endoscope, who were randomly and evenly divided into three groups, including A, B and C groups, with mean arterial pressure [MAP] decreased by 20%, 30% and 40% respectively. The change of myocardial enzymes, myocardial ischemia modified albumin, score of surgical field quality and 12-lead electrocardiogram at different perioperative points were recorded. Then operative time, urine output and postoperative adverse complications of the patients were recorded too. Myocardial enzymes of group C were higher than that of both group A and B at T4, T5 points [p<0.05]; Myocardial ischemia modified albumin of group C were higher than that of group A and B at T2, T3, T4 and T5 points [p<0.05]; The score of surgical field quality of group A were higher than that of group B and C [p<0.05]; Operation time of group C is less than that of group A and B [p< 0.05]; The change of ST segment in group C is more obvious than that in group A and B [p<0.05]; The incidence of adverse complications of group C is higher than that of group A and B [p<0.05]. Controlled hypotension with MAP reduced by 30% brings minimum myocardial damage and fewer complications, while meeting the demand of surgical field. Thus it is an ideal controlled hypotension level and can be used for elderly hypertension patients safely