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Objective To evaluate the safety and effect of laryngeal mask airway (LMA) general anesthesia in neonatal laparoscopic pyloromyotomy. Methods The clinical data of 100 neonates who had underwent laparoscopic pyloromyotomy were retrospectively analyzed. The neonates were divided into LMA group (50 cases) and tracheal intubation group (50 cases) according to the anesthesia method. The heart rate and mean arterial pressure (MAP) were recorded at the time points of preanesthesia (T0), tracheal intubation (T1), 10 min after tracheal intubation (T2) and extubation (T3), and the extubation time, and consumption of sevoflurane and postoperative complications were also recorded. Results All the 2 groups had smooth intubation and LMA, and the operation was completed successfully under laparoscope. There was no conversion to laparotomy. In LMA group, there were no statistical difference in heart rate and MAP at all the time points (P>0.05). The heart rate and MAP at T1 and T3 in tracheal intubation group were significantly higher than those at T0, and there were statistical differences (P<0.05). The heart rate and MAP at T1 and T3 were significantly lower than those in tracheal intubation group, heart rate:(131.1 ± 11.0) times/min vs. (146.9 ± 13.7) times/min and (131.9 ± 9.8) times/min vs. (147.3 ± 14.6) times/min; MAP: (44.2 ± 5.5) mmHg (1 mmHg = 0.133 kPa) vs. (47.9 ± 8.4) mmHg and (45.1 ± 7.3) mmHg vs. (49.1 ± 9.4) mmHg, and there were statistical differences (P<0.01 or<0.05). The extubation time, consumption of sevoflurane and incidences of postoperative complications in LMA group were significantly lower than those in tracheal intubation group:(6.1 ± 2.2) min vs. (12.5 ± 3.6) min, (2.9 ± 1.1) ml vs. (5.1 ± 1.9) ml and 4％ (2/50) vs. 48％ (24/50), and there were statistical differences (P<0.01). Conclusions LMA anesthesia in neonatal laparoscopic surgery is activated to maintain the steadiness of hemodynamics, which has less stress, anesthetic drugs consumption and respiratory complications compared with tracheal intubation .
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PURPOSE: Alendronate has been proposed as a local and systemic drug treatment used as an adjunct to scaling and root planing (SRP) for the treatment of periodontitis. However, its effectiveness has yet to be conclusively established. The purpose of the present meta-analysis was to assess the effectiveness of SRP with alendronate on periodontitis compared to SRP alone. METHODS: Five electronic databases were used by 2 independent reviewers to identify relevant articles from the earliest records up to September 2016. Randomized controlled trials (RCTs) comparing SRP with alendronate to SRP with placebo in the treatment of periodontitis were included. The outcome measures were changes in bone defect fill, probing depth (PD), and clinical attachment level (CAL) from baseline to 6 months. A fixed-effect or random-effect model was used to pool the extracted data, as appropriate. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Cochrane χ² and I2 tests. RESULTS: After the selection process, 8 articles were included in the meta-analysis. Compared with SRP alone, the adjunctive mean benefits of locally delivered alendronate were 38.25% for bone defect fill increase (95% CI=33.05–43.45; P<0.001; I²=94.0%), 2.29 mm for PD reduction (95% CI=2.07–2.52 mm; P<0.001; I²=0.0%) and 1.92 mm for CAL gain (95% CI=1.55–2.30 mm; P<0.001; I²=66.0%). In addition, systemically administered alendronate with SRP significantly reduced PD by 0.36 mm (95% CI=0.18–0.55 mm; P<0.001; I²=0.0%) and increased CAL by 0.39 mm (95% CI=0.11–0.68 mm; P=0.006; I²=6.0%). CONCLUSIONS: The collective evidence regarding the adjunctive use of alendronate locally and systemically with SRP indicates that the combined treatment can improve the efficacy of non-surgical periodontal therapy on increasing CAL and bone defect fill and reducing PD. However, precautions must be exercised in interpreting these results, and multicenter studies evaluating this specific application should be carried out.