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Objective To compare the anesthetic effects,safety and side effects of the mixture with different ratios of etomidate to propofol in painless gastroscopy.Methods Two hundred patients scheduled for painless gastroscopy,95 males and 105 females,aged 18 to 65 years,BMI 18.5-27.0 kg/m2,ASA physical status Ⅰ or Ⅱ,were randomized into two groups,group A (the ratio of eto-midate and propofol volume 1:1);group B (the ratio of etomidate and propofol volume 1:2).All of the patients were injected with sufentanil 0.1 μg/kg at first.All patients were given the first dose of 0.15-0.2 ml/kg intravenously slowly.Repeated doses of 1-2 ml etomidate-propofol were administered to maintain an adequate level of sedation.HR,SBP,DBP and SpO2were monitored.The dosages of etomidate and propofol were recorded.At the same time the induction time,the operation time,the recovery time and the leaving time were recorded.And low blood pressure,hypoxia saturation,re-spiratory obstruction,muscle fibrillation,nausea and vomiting and other adverse reactions were re-corded.Results There was no significant difference between group A and group B in the induction time,the operation time,the recovery time,the leaving time,perioperative hypotension,periopera-tive hypoxia and injection pain.The dosage of etomidate in the group A was significantly more than in the group B (P<0.01).The dosage of propofol in the group A was significantly less than in the group B(P<0.05).The incidence of myoclonus in group A was notably higher than that in the group B (P<0.01),The incidence of nausea and vomiting in group A was higher than that in the group B (P<0.05).Conclusion Etomidate plus propofol (1:2)had less incidence of myoclonus and nausea and vomiting,and it is more suitable for gastroscopy than 1:1 EP mixture.
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Objective To investigate the clinical application of scalp nerve block combined with target-controlled infusion in neurosurgical anesthesia.Methods 40 adult patients undergoing frontotemporal craniotomies were randomly divided into the ropivacaine scalp nerve block group (group R) and control group (group C).The patients in group R received scalp nerve block with 0.5％ ropivacaine before induction while those in group C didnt.We used propofol and remifentanil in target-controlled infusion and atracurium in constant infusion to maintain anesthesia.The heart rate(HR),mean arterial pressure (MAP),bispectral index (BIS) of different time,usage of propofol and remifentanil,extubation time,visual analogue scale,and complication were recorded.Results Both groups had stable hemodynamics.The usage of remifentanil in group R was less than that of group C (t =11.10,P ＜ 0.01).The difference of extubation time,usage of propofol,and incidence of complications were not statistically significant (P ＞ 0.05).The difference of visual analog scale (VAS) (2 hour and 6 hour after operation) was statistically significant (t =5.02,4.60,P ＜0.O1).Conclusions Scalp nerve block combined with target-controlled infusion is simple with less usage of remifentanil and better analgesic effect.
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Objective To evaluate the effects of low tidal-volume ventilation on blood gases and respiratory mechanics during open heart surgery in children with acyanotic congenital heart disease. Methods Forty NYHA class Ⅰ-Ⅱ patients with atrial or ventricular septal defect aged 3-6 yrs weighing 12-18 kg undergoing open heart surgery were randomly divided into 2 groups according to the tidal volume of mechanical ventilation: group A low tidal volume(V_r=7ml?kg~(-1),n=20) and group B conventional tidal volume(V_T=9 ml?kg~(-1), n=20). The respiratory rate(RR) was 21-23 bpm, I: E ratio 1:2 and FiO_2 100% in both groups. The patients were premedicated with intramuscular morphine 0.1 mg?kg~(-1) and scopolamine 0.01 mg?kg~(-1). Anesthesia was induced with midazolam 0.1 mg?kg~(-1), fentanyl 10 ?g?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with infusion of fentanyl 4 ?g?kg~(-1)?h~(-1) and vecuronium 80 ?g?kg?h~(-1) supplemented with isoflurane inhalation(