RESUMO
Objective:To investigate the occurrence of deglutition disorders after extubation in neurosurgery patients, to explore the recovery time and influencing factors, and to provide reference for the development of nursing intervention plan for dysphagia after extubation.Methods:This was a prospective study. A total of 250 patients who underwent oral catheterization under general anesthesia in neurosurgery department and were admitted to the Tenth People′s Hospital of Tongji University from June to December 2022 were selected as the study objects by convenience sampling method. The general demographic and clinical data of the patients were collected to evaluate the occurrence of deglutition disorders after extubation. The outcome and recovery time of deglutition disorders were used as dependent variables. Kaplan-Meier method and Cox proportional hazard regression analysis were used to analyze the recovery time and influencing factors of deglutition disorders after extubation in neurosurgery patients.Results:The incidence of deglutition disorders after extubation was 35.6%(89/250) among 250 cases of neurosurgery patients under general anesthesia by endotracheal intubation, the recovery time of Deglutition Disorders after postoperative extubation was 1 - 16 (5.17 ± 0.43)days. ICU stay days, duration of endotracheal intubation and the first standardized swallowing assessment after extubation were the main influencing factors for the recovery of deglutition disorders in patients with dysphagia after extubation.Conclusions:For patients with deglutition disorders after extubation after neurosurgery, ICU stay days, duration of endotracheal intubation and the first standardized swallowing assessment after extubation affect the process of swallowing function recovery. Medical staff should focus on the risk groups and develop targeted nursing interventions to improve the outcome of patients.
RESUMO
Introduction: The photostress recovery test (PSRT), dependson resynthesis of visual pigments and measures the time torecover after bleaching due to light exposure. Abnormalrecovery times in retinal diseases or toxicity suggests thatthe pathology in these conditions involves the outer layerof the retina or the pigment epithelium. Aim: 1) To measurephotostress recovery time in chronic alcoholics males; (2)To measure photostress recovery time in apparently healthymales; (3) To compare photostress recovery time in apparentlyhealthy males and chronic healthy malesMaterial and methods: Photostress recovery time wasrecorded using Photostress Recovery Tester (GT – 991Medicaid: Chandigarh). The subject was presented with ahigh beam of light focused on the eyes of subjects for shortand fixed period of time. As soon as light stimulation wasover, a word was displayed on screen for subject to read andautomatically the clock started counting in seconds. Whenthe subject recognized the word displayed he pressed the stopbutton on the remote control and read it out aloud, the clockstopped counting and word disappeared.Result: The p-value was statistically significant with a valueof 0.003 showing a comparable difference of PSRT in groupI and group II.Conclusion: Alcohol predisposes nervous tissue to injury viamultiple mechanisms, including the development of oxidativestress. Retina is another among the vulnerable area for redoxchanges caused due alcohol intoxication, with lower thresholdlevels of ethanol tolerance.
RESUMO
Objective@#To investigate the effect of peripheral nerve block combined with venous fast track anesthesia on elderly patients undergoing lower extremity orthopedic surgery.@*Methods@#From September 2015 to December 2017, 64 senile patients with lower extremity orthopedic surgery in the Fifth Hospital of Ningbo were selected in the research.According to the different methods of anesthesia, the patients were divided into observation group (30 cases, application of combined intravenous peripheral nerve block and fast track anaesthesia), and the control group (34 cases, application of simple intravenous general anesthesia). The heart rate, average arterial pressure, spontaneous breathing recovery time, extubation time, complication rate and cognitive function scores of the two groups were compared.@*Results@#The heart rate and average arterial pressure of T1 and T3 in the observation group were significantly lower than those in the control group (P<0.05). The spontaneous breathing recovery time[(8.32±3.26)min] and extubation time[(9.69±4.29)min] in the observation group were significantly shorter than those in the control group[(18.24±5.23)min and (27.24±4.58)min](t=8.961, 15.756, all P<0.05). The incidence rate of postoperative complications in the observation group (3.33%) was significantly lower than that in the control group (20.59%)(χ2=4.338, P<0.05). The cognitive function score of the observation group was significantly higher at 4 h and 8 h after surgery than that of the control group (t=6.745, 8.494, all P<0.05).@*Conclusion@#Peripheral nerve block combined with intravenous fast-track anesthesia is very feasible for elderly patients undergoing lower limb orthopedic surgery.The time for patients to recover from spontaneous breathing and extubation is shorter, and the risk of complications such as delirium, restlessness, nausea and vomiting is lower.
RESUMO
Objective@#To explore the anesthetic effect of sufentanil combined with propofol with different target control concentration for breast cancer patients.@*Methods@#From January 10, 2015 to December 20, 2017, according to the digital table, 80 patients with breast cancer in the Maternal and Child Health Hospital of Cixi were randomly divided into three groups: group A(28 cases, the intraoperative sufentanil plasma target control concentration was 0.2ng/mL), group B (27 cases, the intraoperative sufentanil plasma target control concentration was 0.4ng/mL), group C (24 cases, the intraoperative sufentanil plasma target control concentration was 0.8ng/mL). The plasma target control concentration of propofol in three groups was 3μg/mL.The hemodynamic level[mean arterial pressure(MAP), heart rate(HR)], blood oxygen saturation(SpO2), recovery time, respiratory recovery time and incidence of adverse reactions were compared among the three groups.@*Results@#The MAP of T2, T3 and T4 in group A, group B and group C[T2: (78.56±7.42)mmHg vs.(76.98±7.65)mmHg vs.(69.36±7.69)mmHg; T3: (88.24±7.61)mmHg vs.(86.95±7.59)mmHg vs.(69.41±7.70)mmHg; T4: (72.32±7.51)mmHg vs.(69.24±7.21)mmHg vs.(66.52±6.85)mmHg], HR[T2: (73.65±8.75)times/min vs.(73.49±8.69)times/min vs.(68.36±7.79)times/min; T3: (76.75±8.95)times/min vs.(75.58±7.96)times/min vs.(68.65±7.36)times/min; T4: (71.42±7.41)times/min vs.(70.24±6.49)times/min vs.(64.39±6.62)times/min] showed significant differences[F(MAP)= 8.524, 15.365, 5.325; F(HR)=8.104, 12.521, 5.015, all P<0.05]. However, there were no statistically significant differences in SpO2 among group A, group B and group C in T2, T3 and T4(all P>0.05). There were no statistically significant differences in resuscitation time and respiratory recovery time among group A, group B and group C (all P>0.05). There was no statistically significant difference in the incidence of adverse reactions among group A, group B and group C(P>0.05).@*Conclusion@#0.8ng/mL sufentanil combined with 3μg/mL propofol has better anesthetic effect on patients undergoing breast cancer surgery, which is helpful to maintain hemodynamic stability.
RESUMO
Objective To analyze and discuss the effect of heat preservation on the recovery time of BIS and the concentration of propofol in the recovery period of the elderly patients with general anesthesia in order to provide guidance for clinical treatment.Methods78 elderly patients with general anesthesia were selected as the subjects, and the patients were divided into the control group and the study group with 39 cases in each group.The patients were divided into the control group and the study group.Control group, only to be liquid input and covered by drapes, research group take liquid input and peritoneal flushing fluid heating and heating blanket coverage of insulation measures, were recorded and compared between the two groups from anesthesia began to operation to complete the different time points of esophageal temperature and MAP, and to observe the recovery time of patients and effect compartment concentration differences.ResultsTwo groups at T0, T1 esophageal temperature no significant difference, study group t2-t6 esophageal temperatures were significantly higher than those of the control group (P<0.05), maps of the other two groups at different time points had no significant difference;when two groups of patients with propofol withdrawal BIS values had no significant difference (P<0.05), and in the time of discontinuation BIS is more than or equal to 80 recovery time and effect compartment concentration have significant difference (P<0.05).ConclusionThe surgical treatment of elderly patients with general anesthesia can help maintain the body temperature, shorten the recovery time of BIS and reduce the concentration of propofol in the recovery period.
RESUMO
PURPOSE: To evaluate the factors affecting successful occlusion treatment and visual recovery time in patients with amblyopia when best corrected visual acuity (BCVA) improved up to 1.0 after occlusion. METHODS: Forty-eight patients aged 2 to 13 years old with amblyopia due to refractive errors or strabismus were selected. The duration of treatment needed to achieve a BCVA of 1.0 was compared according to the cause of amblyopia (anisometropia, strabismus, combined), initial BCVA of the amblyopic eye, and the age at treatment, as well as other factors. RESULTS: The mean age of amblyopic treatment was 5.4 years old and the mean duration of treatment was 22.9 months. The duration of treatment was longer in children whose initial BCVA was lower than 0.2, those with spherical equivalent of the amblyopic eye higher than +3.0D and those older than 6 years old. However, there were no significant differences according to the cause of amblyopia. CONCLUSIONS: The duration of treatment needed to achieve a BCVA of 1.0 was prolonged when the initial BCVA in the amblyopic eye was lower than 0.2, the age at treatment was more than 6 years old, or the spherical equivalent of the amblyopic eye was higher than +3.0D at treatment. These factors can be used to predict the duration of occlusion treatment.
Assuntos
Criança , Humanos , Ambliopia , Erros de Refração , Estrabismo , Acuidade VisualRESUMO
Objective To analyze and discuss the effect of heat preservation on the recovery time of BIS and the concentration of propofol in the recovery period of the elderly patients with general anesthesia in order to provide guidance for clinical treatment.Methods 78 elderly patients with general anesthesia were selected as the subjects, and the patients were divided into the control group and the study group with 39 cases in each group.The patients were divided into the control group and the study group.Control group, only to be liquid input and covered by drapes, research group take liquid input and peritoneal flushing fluid heating and heating blanket coverage of insulation measures, were recorded and compared between the two groups from anesthesia began to operation to complete the different time points of esophageal temperature and MAP, and to observe the recovery time of patients and effect compartment concentration differences.Results Two groups at T0, T1 esophageal temperature no significant difference, study group T2-T6 esophageal temperatures were significantly higher than those of the control group (P<0.05), maps of the other two groups at different time points had no significant difference;when two groups of patients with propofol withdrawal BIS values had no significant difference, and in the time of discontinuation BIS is more than or equal to 80 recovery time and effect compartment concentration have significant difference (P<0.05).Conclusion The surgical treatment of elderly patients with general anesthesia can help maintain the body temperature, shorten the recovery time of BIS and reduce the concentration of propofol in the recovery period.
RESUMO
Objective To explore the effect of the diet recovery time on postural hypotension after gynecological laparoscopic operation. Methods A total of 300 patients undergoing gynecological laparoscopy were randomly divided into observation group and control group according to the order of admission,150 cases in each group. Patients in observation group took liquid food since recovery from anesthetic, their appetite and dietary levels restored to preoperative level within 24 h after surgery from liquid diet to regular diet. Patients in control group were given routine nursing care of diet after belly operation. Results The diet recovery time and the anal exhaust time of patients in observation group were (21.2±3.5) h and (15.5±4.7) h, the control group were (46.8±5.4) h and (23.4±5.4) h, there was significant difference between two groups (t=7.543,5.126, P<0.05).The incidence rate of orthostatic hypotension in observation group was 9.3% (14/150), the control group was 33.3% (50/150), there wassignificant difference between two groups (χ2=8.907, P<0.05). Conclusions Patients undergoing gynecological laparoscopy took food as soon as possible, their appetite and dietary levels restored to preoperative level within 24 h after operation. It didn′ t increase abdominal distension, but helped the intestinal function recovery and helped to reduce the incidence of postoperative orthostatic hypotension.
RESUMO
Objective To explore the effects of sedationand hemodynamics on different ages patients with the same concentration of dexmedetomidine under general anesthesia.Methods A total of 264 patients (ASAⅠ-Ⅱ)with orthopaedic surgery under general anesthesia in our hospital from April 2013 to May 2015 were divided into 3 groups by age,the young group (group Y,n =76),middle age group (group M, n =107),and old age group (group O,n =81 ).Fifteen minutes before anesthesia,patients were infused dexmedetomidine with 1 μg/kg, maintain the concentration of 0.5 μg·kg-1 ·h-1 and stop at 30 minutes before surgery finished.The SBP、DBP、BIS、HR before anesthesia (T1),pump injection start(T2),tracheal intubation(T3),1 minute after intubation(T4),5 minutes after skin incision(T5),endotracheal ex-tubation(T6)were observed.The dosage of propofoland remifentanil in anesthesia,duration from stop infusion to endotracheal extubation, Ramsay score and adverse reactions 5 minutes after PACU also need to be recorded.Results The level of SBP and DBP were significantly increased at T2,T3 in all groups.Compared with group O,both group Y and group M increased significantly,the difference was statistically significant(P 0.05).Compared with T1,the level of HR and BIS were signifi-cantly decreased at T2-T5,the difference was statistically significant(P 0.05). There was no significant difference in the total adverse reaction between group Y and group M(P >0.05),but it was significantly lower than that of group O(P <0.05).Conclusion Dexmedetomidine has good sedative effect in all groups,but older group have more adverse reac-tions and wake up time is extended.The concentratiuon of dexmedetomidine should be adjusted according to the age of patients.
RESUMO
Objective Controversies remain as to the recovery time, recovery quality, and incidence of peri-recovery adverse reactions of the patient receiving general anesthesia with remifentanil and sufentanil.This study aimed to systematically assess the qual-ity of recovery from general anesthesia with remifentanil and sufentanil. Methods Randomized controlled trials ( RCTs) were re-trieved from The Cochrane Library, PubMed, MEDLINE, EMbase, Ovid, Springer, Web of Science, CNKI, CBM, VIP, and Wan-Fang Data.According to the modified Jadad quality scale, the literature retrieved was screened and subjected to quality evaluation and meta-analysis was performed on the included studies using the RevMan 5.1 software. Results Thirty-three RCTs involving 2175 pa-tients were finally included.The results of meta-analysis showed no significant differences between the remifentanil and sufentanil groups undergoing thyroid surgery either in the recovery time to spontaneous breathing ( T1) and eye-opening ( T2) and endortracheal extubation time ( T3 ) ( P >0.05 ) or in the incidence rate of postoperative nausea and vomiting (PONV) (P>0.05).T1, T2 and T3 were significantly shorter in the sufentanil than in the remifentanil group in other types of surgery (P<0.05).The patients with level-1 Ramsay score were remarkably more in the remifentanil than in the sufentanil group ( MD =13.67, 95% CI 2.67 -69.91 ) ( P <0.05), and the VAS scores were markedly higher in the former than in the latter group at 30 minutes (MD=3.37, 95% CI 3.28-3.46) and 1 hour after extubation (MD=2.53, 95% CI 2.43 -2.63) (P<0.05). Conclusion Compared with sufentanil, remifentanil provides a quicker recovery but a weaker analgesia effect and a higher rate of post-operative agitation.However, sufentanil produces a better pain relief and a higher quality of recovery after operation.
RESUMO
Background: Music has been used in exercise classes for many decades. The role of music in increasing the exercise performance is well recognized but there is very little information about effect of music on post-exercise recovery time. Methods: The present study was conducted to see the effect of musical sounds on post-exercise recovery time following moderate exercise with Harvard step test in young healthy volunteers. 30 young healthy volunteers (17 males, 13 females) aged between 17 to 20 years were recruited for the study. Pulse rate, systolic BP, diastolic BP were recorded prior to exercise in lying down position. The participants were subjected to moderate exercise by Harvard step test for 3 minutes on 3 consecutive days. They were allowed to rest in silence on 1st day, rest with hearing slow music on 2nd day and rest with hearing fast music on 3rd day. During the post-exercise relaxation time PR, SBP and DBP were measured immediately and after every 1 min. until the parameters returned to resting values. Data was statistically analysed using ANOVA test and 0.05 level of significance was set prior to the study. Results: The result showed that with slow music, recovery time of pulse rate (5.2 ± 2.1), systolic blood pressure (3.9 ± 1.1) and diastolic blood pressure (3.2 ± 1.7) were significantly faster as compared to both no music and fast music. Conclusion: The study concluded that music hastens post-exercise recovery and slow music has greater relaxation effect than fast or no music.
RESUMO
Objective To investigate the influence factor of the recovery time of oculomotor nerve palsy (ONP) after traumatic carotid-cavernous sinus fistula (TCCF) treated by balloon embolization.Methods The clinical data of 76 patients with ONP after TCCF were retrospectively analyzed.All patients accepted intravascular balloon embolization treatment.Nonparametric test was applied to make single factor analysis of the influence factor of ONP recovery time,and linear regression analysis was applied to make multiple factor analysis.Results Seventy-six patients (100.0％) had a perfect occlusion for orificium fistulae after operation immediately,and 73 patients (96.1％) retained the internal carotid artery.Patients were followed up for 6-70 months,with an average of 34.2 months and no death cases.Seventy patients (92.1％) succeeded for embolization at the first time,and 6 patients (7.9％) relapsed after embolization for 6 weeks.The reasons of relapse was balloon leak,and no patients recurred after twice embolization.Seventy-six patients (100.0％) had recovery from ONP,and recovery time was (42.17 ± 32.39) d.The single factor analysis showed that the courses of diseases,fistula location,eye-tubercle location,degree of ONP,balloon quantity,state of internal carotid artery were the factor affecting the ONP recovery time (P ＜ 0.01 or ＜ 0.05).The linear regression analysis showed that the courses of the disease,fistula location,degree of ONP,balloon quantity were independent factor affecting the ONP recovery time (P ＜ 0.01).Conclusions Intravascular balloon embolization in the treatment of ONP after TCCF is safe and reliable.The courses of diseases,fistula location,degree of ONP and balloon quantity are the influencing factor of the oculomotor nerve functional recovery time,and should be given enough attention.
RESUMO
Objective To explore the value of minute ventilation recovery time (VERT) as a weaning predictor in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD).Methods A prospective study was performed from March 2008 to July 2012.Fifty-two COPD patients under mechanical ventilation for more than 48 hours in our RICU tolerated a spontaneous breathing trial (SBT) and were ready for planned extubation.After SBT,these patients were placed back on their pre-SBT ventilator settings for up to 25 minutes,during which VERT was obtained.VERT was defined as the time for minute ventilation to return to baseline measured before SBT.Respiratory rate,tidal volume,minute ventilation and respiratory rate/tidal volume ratio were also obtained before SBT and just after SBT.Arterial blood gas data were measured and recorded before weaning.According to the weaning outcome,the patients were classified as successful group (40 cases) or failed group (12 cases).VERT and other quantitative variables were compared using t test.A multiple logistic regression was performed to explore possible factors associated with the weaning outcome.The sensitivity and specificity of VERT for predictive capacity in weaning were assessed using ROC cure.Results VERT and respiratory rate after SBT were significantly different between two groups.Multiple logistic regression revealed that VERT was the only predictor associated with weaning outcome (b =0.282,P ＜0.001).The area under ROC curve for VERT was 0.957 (95％ CI:O.907-1.008).With a cut-off value of 10.5 minutes,the sensitivity and specificity of VERT for predicting weaning failure were 1.0 and 0.85,respectively.Conclusions VERT may be a new predictor for extubation and determination of mechanical ventilation weaning in patients with COPD.VERT is a variable to be easily measured thereby being conveniently used in clinical practice.
RESUMO
Objective To investigate the awaken effect of naloxon on dexmedetomidine anesthetized mice and its mechanism. Methods Thirty Kunming mice of clean grade were randomly divided into 3 groups which included NAL group (Naloxon group), ATI group(Atipamezole group)and NS group (Normal Saline group). All groups were given dexme?detomidine 1 mg·kg-1 intraperitoneally. Naloxon 2 mg·kg-1, atipamezole 2 mg·kg-1 and normal saline 10 mL·kg-1 were ran?domly given intraperitoneally to the NAL, ATI and NS group respectively 90 minutes after dexmedetomidine administration. At timepoints prior to dexmedetomidine administration and 5, 15, 30, 60, 90, 95, 105, 120, 180 minutes after it, the sedative and analgesic effects besides recovery time (based on restore of righting reflex loss) were assessed. Results Sedation and analgesia effects became apparent within 5 minutes, and peaked at approximately 60 minutes then spontaneously recovered at 180 minutes after injection of dexmedetomidine. The sedative and analgesic effects were reduced in both ATI and NAL groups. Compared with ATI group, the sedation scores were higher at 95, 105 and 120 minutes after dexmedetomidine admin?istration than those in NAL group (P0.05). The analgesic scores were not statistically significant at time points of 95, 105, 120 and 180 min?utes between NAL group and ATI group, but they were lower in NAL group compared with NS group at timepoints of 95, 105 and 120 minutes (P>0.05). The recovery time in ATI and NAL group were shorter than that in NS group (F=1 793.368, P0.05). Conclusion Naloxone had a certain awaken effect on dexmedetomidine anesthetized mice.
RESUMO
A perda rápida de peso é altamente prevalente entre atletas de luta. No judô, há um período entre a pesagem e o início da competição no qual atletas podem se recuperar da perda de peso. Apesar desse tempo ser determinante para o desempenho, nenhum estudo avaliou seu padrão de duração. Este estudo objetivou determinar o padrão de duração do tempo entre a pesagem e o início das lutas em competições oficiais de judô. Foram analisados 117 atletas do sexo masculino (classes juvenil, júnior e sênior) durante duas competições oficiais. Registraram-se o horário de término da pesagem e do início da primeira luta de cada atleta. O tempo médio de recuperação foi de aproximadamente quatro horas. A maior parte dos atletas teve aproximadamente 2,5 - 5 horas entre a pesagem e o início das lutas. O período para a classe sênior foi significantemente maior do que o das classes júnior e juvenil (p < 0,01) e o da classe júnior foi significantemente maior do que o da classe juvenil (p < 0,01). Conclui-se que os tempos de recuperação aqui registrados são provavelmente padrões para competições de mesmo porte e esquema organizacional, embora os tempos específicos para as classes etárias possam se modificar. O período que a maioria dos atletas teve para recuperar-se é suficiente para adequada ingestão de alimentos e líquidos, o que minimiza o impacto da perda de peso sobre o desempenho e estimula a pratica de métodos agressivos de perda rápida de peso.
Rapid weight loss is highly prevalent among combat sport athletes. After the weigh-in, there is a period in which athletes can refeed and rehydrate before the combats. The length of this recovery period is determinant for performance in the subsequent combats. No study, however, has determined the time patterns of such period. The purpose of this study was to determine the patterns of recovery time between the weigh-in and the first combats during judo competitions. One hundred and seventeen juvenile, junior and senior male athletes were analyzed during two São Paulo state competitions. The time at which each athlete has finished the weight-in and the time at which they have started the first combat were recorded and then the recovery period between weigh-in and combats was calculated. Average recovery time was approximately four hours. Most athletes had a 2.5 to 5-hour recovery time between the weigh-in and the first combat. Senior athletes had a significant longer recovery time compared to junior and juvenile (p < 0.001). Junior athletes also had a significant longer recovery time in comparison to juvenile athletes (p < 0.001). In conclusion, the patterns for recovery time presented in this study are likely to be a standard if competitions of similar size and organization are considered. Recovery period for the majority of athletes is enough to allow them to refeed and rehydrate, so the impact of weight loss on performance would be minimal. This can stimulate athletes to engage in potentially harmful rapid weight loss procedures.
Assuntos
Humanos , Masculino , Atletas , Desempenho Atlético , Pesos e Medidas Corporais , Artes Marciais , Redução de PesoRESUMO
The role of music in increasing the exercise performance is well recognised. There is very little information about effect of music on time taken for post exercise recovery. We examined the effect of music and different musical tempo on post exercise recovery time, following treadmill work. 30 volunteers (15 male, 15 female) subjected to isotonic exercise (submaximal treadmill work) on three consecutive days. They were allowed to rest in silence on the first day, rest by hearing slow music on second day and rest with fast music on third day. Parameters such as Pulse rate, blood pressure, rating of perceived exertion (RPE) were measured at predetermined intervals. Repeated measures ANOVA test showed that with slow music, recovery time of systolic blood pressure (SBP) (7.9±2.5), diastolic blood pressure (DBP) (5.5±3.4) pulse rate recovery (PR) (8.0±2.3) and recovery from exertion (RPE) (7.7±2.5) were significantly faster when compared to both no music and fast music. The individual music preference made no significant difference in the relaxation time. The study concluded that music hastens post exercise recovery and slow music has greater relaxation effect than fast or no music, recovery time being independent of the gender and individual music preference.
RESUMO
BACKGROUND: The usual dose of succinylcholine for tracheal intubation is 1.0 mg/kg. If the patient is not ventilated by face mask after administration of the succinylcholine (1.0 mg/kg), the patient may experience significant hemoglobin desaturation. The purpose of the present study was to evaluate an appropriate dose of succinylcholine for tracheal intubation in Korean. METHODS: Sixty patients scheduled for elective surgery were randomly divided into three groups; group I (succinylcholine 0.3 mg/kg, n = 20), group II (succinylcholine 0.6 mg/kg, n = 20), group III (succinylcholine 1.0 mg/kg, n = 20). All patients were not premedicated. After loss of consciousness, the patients received succinylcholine 0.3, 0.6, 1.0 mg/kg, respectively. The contraction responses of the adductor pollices muscle were monitored by using TOF. Tracheal intubation was accomplished as the height of T1 was inhibited maximally. Then, intubation scores were recorded. The recovery times from neuromuscular blockade in groups II and III were also measured. RESULTS: The acceptable conditions for tracheal intubation were 30%, 100%, and 100%, respectively in groups I, II, and III. The onset time was 80.4 +/- 15.5 sec, 69.6 +/- 13.1 sec, and 56.1 +/- 9.3 sec, respectively. The recovery time (T1 = 90%) was 446.0 +/- 86.2 sec, 694.0 +/- 84.7 sec, respectively in groups II and III. The onset time was the fastest in group III. But the recovery time in group III was slower than in group II. CONCLUSIONS: We concluded that 0.6 mg/kg of succinylcholine is an appropriate dose for tracheal intubation in Korean except for rapid sequence intubation.
Assuntos
Humanos , Contratos , Hemoglobinas , Intubação , Máscaras , Músculos , Bloqueio Neuromuscular , Succinilcolina , InconsciênciaRESUMO
BACKGROUND: Rocuronium is considered a good candidate for rapid-sequence induction of anesthesia. Increased dose of rocuronium shortens the onset time but prolongs the duration of action. However, the ceiling effect of onset time appears when larger doses are used.Clinical trials have not shown the exact dose of ceiling effect. We performed this study to find dose producing the ceiling effect of onset time. METHODS: One hundred forty young male adults were randomized to oneof seven doses of rocuronium:0.6, 0.7, 0.8, 0.9, 1.0, 1.1 or 1.2 mg/kg.Anesthesia was induced with IV thiopental sodium and maintained with sevoflurane after tracheal intubation. Neuromuscular block was monitored with acceleromyography using single twitch.The onset time, the recovery of single twitch to 10% and also the changes in hemodynamics were checked. RESULTS: A dose of up to 1.0 mg/kg shortens the onset time but no further decrement was seen with doses larger than 1.0 mg/kg.The recovery time was prolonged as doses were increased but there were no differences in the hemodynamics. CONCLUSIONS: This study showed that in young male adults under IV induction with thiopental sodium, the ceiling effect of onset time appeared with rocuronium doses in excess of 1.0 mg/kg.
Assuntos
Adulto , Humanos , Masculino , Androstanóis , Anestesia , Hemodinâmica , Intubação , Éteres Metílicos , Bloqueio Neuromuscular , TiopentalRESUMO
BACKGROUNDS/AIMS: Toxic hepatitis has recently been discovered to be a major cause of acute hepatitis. We studied the clinical features and prognosis of patients diagnosed with toxic hepatitis at a single institution. METHODS: A retrospective analysis was performed using medical records of 159 cases of toxic hepatitis that were diagnosed from March 2003 to March 2008. Patients were selected based on a RUCAM score of 4 or above. RESULTS: The incidence was higher in women (n=97) than in men (n=62). The age (mean+/-SD) of the patients was 51+/-15 years . The major causes of the disease included the use of Korean traditional therapeutic preparations (34.0%), herbal medicines (41.5%), and drugs prescribed by a physician (23.9%). At the time of admission, jaundice was the most common symptom (41.5%), and the results of a liver serum battery were as follows: aspartate aminotransferase, 729.4+/-877.0 IU/L; alanine aminotransferase, 857.1+/-683.0 IU/L; total bilirubin, 6.4+/-6.5 mg/dL; and alkaline phosphatase, 209.8+/-130.0 IU/L. The hospitalization period was 10.0+/-9.5 days, and the duration of recovery from liver injury was 31.0+/-29.5 days. The factors associated with the hospitalization period included the presence of anorexia and the serum levels of albumin and bilirubin at the time of admission (P<0.05). A high serum bilirubin level and a history of alcohol ingestion were associated with a delayed recovery (Plt;0.05). The sex, age, BMI, and duration of medication were not significantly related to the hospitalization and recovery periods. CONCLUSIONS: The main cause of acute toxic hepatitis in the current study was the use of herbal medicines. The severity of liver injury at the time of admission was a major factor significantly associated with the hospitalization and recovery periods.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Aguda , Consumo de Bebidas Alcoólicas , Bilirrubina/sangue , Medicamentos de Ervas Chinesas , Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Tempo de Internação , Prontuários Médicos , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
Objective:To investigate the effects of three different anesthetic techniques on pere-anesthesia circulation,stree response and post-anesthesia recovery in patients undergoing leparoscopic cholecystectomy(LC).Methods:Sixty-six ASA Ⅰ or Ⅱ patients aged 18 to 60 undergoing selected LC surgery were randomly divied into 3 groups(n=22).The patients in group I were induced and maintained with remifentanil and sevoflurane.The patients in group Ⅱ with fentanil,propofol and isoflurane,while the patients in group Ⅲ with remifentanil and propofol TCI.MAP and HR were measured before induction,before intubation,at 5 min after intubation,1 min and 15 min after the establishmen of CO2 pneumoperitoneum and at the end of operation.Blood cortisol(Cor)and blood glucose(Glu)were measured before induction,after induction 5 min and at the end of operation;Blood interleukin-6(IL-6)was measured before induction and at the end of operation.Postoperative recovery time,Alddret ≥9,the rate of PONV and VAS score were measured on the first postoperative day.Results:There were significant decreases of MAP in group Ⅰ and Ⅱ before intubation(P 0.05).Conclusion:The three anesthetic techniques can be used safely on LC operation,anesthesia with remifentanil and sevoflurane,anesthesia with remifentanil and propofol TCI have shorter post-operative recovery time and high quality compared with the anesthesia with fentanil,isoflurane and propofol.LC operation can cause obvious stress response of the body,significant postoperative pain and high rate of PONV,which should be actively dealt with.