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Objective To observe and compare the efficacy and safety between propofol-remifentanil and propofol-fentanyl for anesthesia of artificial abortion.Methods 200 ASA I patients scheduled for painless artificial abortion were randomly divided into two groups.R group were given intravenous remifentanil 1.0μg/kg then propofol 1～1.5mg/kg(n=100);F group were given intravenous fentanyl 0.05mg then propofol 1～1.5mg/kg(n=100).Total propofol dosage,analgesic effect during intro-and post-operative,consciousness loss time,wake-up time and independenly leaving time were recorded.BP,HR,SpO2 and side effects such as nausea and vomiting were observed during intro-and post-operative.Results The dosage of propofol was less in group R than that in group F[(80.4±10.8)mg vs(110.1±13.6)mg,P＜0.01)];consciousness loss time,wake-up time and independenly leave hospital time were shorter in group R than that in group F(P＜0.05);SpO2 down range and rate were significandy higher in group R(P＜0.05);Incidence of nausea and somnolence in group R was obviously lesS than that in group F.Conclusion Artifical abortion can be preformed effectively and safely with propofol-remifentanil or propofol-fentanyl,but propofol-remifentanil especially fits for painless artificial abortion compared with propofol-fantanyl.
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Objective To investigate the effects of acute hypervolemic hemodilution (AHH) on cerebral O2 supply/consumption and energy metabolism in patients undergoing elective surgery under general anesthesia combined with continuous epidural block. Methods Fourteen ASA Ⅰ or Ⅱ patients of both sexes (9 male, 5 female) aged 44-62 yrs weighing 55-70 kg undergoing elective surgery under general anesthesia combined with epidural block were enrolled in this study. Lactated Ringer's solution 6-8 ml?kg-1 was infused before anesthesia. After correct placement of epidural catheter was confirmed radial artery was cannulated for BP monitoring and blood sampling. BP, EGG, SpO2 and PET CO2 were continuously monitored during anesthesia. General anesthesia was induced with fentanyl, midazolam, propofol and rocuronium and maintained with iaoflurane and intermittent i. v. boluses of vecuronium. The patients were intubated and mechanically ventilated. PET CO2 was maintained at 30-35 mm Hg. Epidural block was produced by a mixture of 1.33 % lidocaine + 0.167 % dicaine. Right internal jugular vein was retrogradely cannulated and advanced cephalad until jugular bulb for blood sampling. AHH was conducted by infusing 6% HES 20 ml?kg-1 at 50 ml?min-1 after induction of general anesthesia. Blood samples were taken from artery (a) and jugular venous bulb (jv) simultaneously before AHH (T0) at 15 min (T1) and 120 min (T2) after AHH was accomplished for blood gas analysis and determination of Hb, glucose and lactate concentrations. Cerebral O2 extraction rate (CERO2), glucose extraction rate (CMRglu) , arterial-jugular bulb venous O2 content difference (D a-jvO2) and arterial-jugular bulb venous lactate difference (VADL) were calculated. Results At the end of AHH Hct and Hb decreased by 20% as compared to the baseline values before AHH. S jvO2 was significantly higher, D a-jvO2 smaller and CERO2 lower at T1 than at T0. There were no significant differences in BP, HR, CMRglu and VADL at all time points. Conclusion AHH can increase cerebral O2 supply and has no significant effect on cerebral glucose metabolism during operation performed under general anesthesia combined with epidural block.