Inhibitory effects of dexmedetomidine on cardiovascular responses of endotracheal intubation in chronic smokers / 中华全科医师杂志

From May 2012 to May 2013, 60 chronic male smokers received an intravenous infusion of dexmedetomidine 1 μg/kg (Group D, n=30) or an equal volume of normal saline (Group C, n=30) before anesthesia induction.At time of dexmedetomidine or normal saline dosing , after induction of anesthesia, 1 and 3 min after intubation, the heart rates and rate-pressure products were significantly lower in Group D than Group C ( P<0.05 ).Thus the dosing of dexmedetomidine before anesthesia induction could suppress the cardiovascular responses of endotracheal intubation in chronic smokers and avoid increasing myocardial oxygen consumption so as to protect heart functions.

Effect of lung protection mechanical ventilation on respiratory function in the elderly undergoing spinal fusion / 中南大学学报(医学版)

OBJECTIVE@#To determine the effect of lung protection mechanical ventilation on respiratory function in the elderly undergoing spinal fusion.@*METHODS@#Sixty 70-85 year old patients, ASA class II or III, undergoing spinal fusion were randomly assigned into 2 groups (30 in each group): a protection mechanical ventilation group (group P) and a conventional mechanical ventilation group (group C). Low VT and low level positive end expiratory pressure (PEEP) mechanical ventilation were applied in group P (VT=6mL/kg, RR=12-18 b/min, I:E=1:2, PEEP=10 cmH2O, alveolar recruitment performed once every 15 min), while traditional ventilation was used in group C ( VT=10-12 mL/kg, RR=12 b/min, I:E=1:2). Arterial blood samples were taken and pH, PaO2, PaCO2, PaO2/FiO2, A-aDO2, HR, SBP, DBP and CVP were recorded before the operation (T0), 1 h after tracheal intubation (T1), tracheal extubation immediately (T2), 1 h after tracheal extubation (T3), 1 d, 2 d, and 3 d after the operation (T4, T5, and T6). The pulmonary complication was also examined 1 d after the operation.@*RESULTS@#At T1, T2, T3, T4 and T5, PaO2 and PaO2/FiO2 in group P were higher than those in group C, but A-aDO2 in group P was lower than that in group C. Five patients had bronchitis, 5 had hyoxemia, and 3 had atelectasis in group C, but 2 bronchitis in group P. The incidence of pulmonary complication was 43.3% in group C and 6.6% in group P. There was no significant difference in HR, SBP, DBP and CVP between the 2 groups.@*CONCLUSION@#Lung protection mechanical ventilation improves the arterial oxygenation and accelerates the recovery of respiratory functions in elderly patients after spinal fusion operation, with no influence on hemodynamics.

Effect of ulinastatin on thromboxane B₂ and deep vein thrombosis in elderly patients after hip joint replacement / 中南大学学报(医学版)

OBJECTIVE@#To determine the effect of ulinastatin on plasma thromboxane B(2) and deep vein thrombosis(DVT) in elderly patients after hip joint replacement.@*METHODS@#Eighty ASAI-IIpatients aged 65-81 years undergoing hip joint replacement were randomly divided into 4 groups (n=20): Group U1 (ulinastatin 5 000 U/kg);Group U2 (ulinastatin 10 000 U/kg); Group U3 (ulinastatin 20 000 U/kg); and Group C (the same volume of saline as control).The blood samples were collected at 5 time points: preoperation (T(1)), immediately after the operation (T(2)), 1 d (T(3)), 2 d (T(4)) and 3 d after the operation (T(5)), respectively. Thromboxane B(2) was detected, and DVT was also examined through color Doppler ultrasonography 3 d after the operation.@*RESULTS@#Compared with T(1), the level of thromboxane B(2) significantly increased in Group C at T(2)-5, in Group U1 at T(2-4), in Group U2 and U3 at T(2) (P0.05).@*CONCLUSION@#Ulinastatin can inhibit blood thromboxane B(2) level in dose dependent manner and prevent DVT in elderly patients after hip joint replacement.