Clinical Effect Of Different Doses Research Articles

Clinical effect of different doses of ciprofol for induction of general anesthesia in elderly patients: A randomized, controlled trial.

Ciprofol is a newly developed intravenous anesthetic agent with improved pharmacokinetic properties. Compared to propofol, ciprofol exhibits stronger binding to the GABAA receptor and elicits a greater enhancement of GABAA receptor-mediated neuronal currents in vitro. The aims of the present clinical trials were to examine the safety and efficacy of different doses of ciprofol for induction of general anesthesia in elderly patients. A total of 105 elderly patients undergoing elective surgery were randomized, in a 1:1:1 ratio, to receive one of three sedation regimens: (1) the C1 group (0.2mg/kg ciprofol), (2) the C2 group (0.3mg/kg ciprofol), (3) the C3 group (0.4mg/kg ciprofol). The primary outcome was the incidence of various adverse events, including hypotension, hypertension, bradycardia, tachycardia, hypoxemia, and injection pain. The secondary outcomes of efficacy were the success rate of general anesthesia induction, the time to anesthesia induction, and the frequency of remedial sedation was recorded in each group. Adverse events occurred in 13 patients (37%) in group C1, 8 patients (22%) in group C2, and 24 patients (68%) in group C3. Compared with group C2, the total incidence of adverse events was significantly higher in group C1 and group C3 (p < .001).The success rate of general anesthesia induction in the three groups was 100%. Compared with group C1, the frequency of remedial sedation was significantly lower in group C2 and group C3. The outcomes demonstrated that ciprofol at a dose of 0.3mg/kg has good safety and efficacy in the induction of general anesthesia in elderly patients. Overall, ciprofol is a new and viable option for the induction of general anesthesia in elderly patients undergoing elective surgery.

Clinical Application of Esketamine Hydrochloride in Children with Emergence Agitation under Sevoflurane Anesthesia

Objective: To investigate the clinical effect of different doses of esketamine in preventing emergence agitation (EA) in children under sevoflurane general anesthesia.&#x0D; Methods: 80 children who underwent elective tonsillectomy or (and) adenoidectomy in our hospital were selected. The children were allocated randomly to one of four groups receiving saline(group C), esketamine hydrochloride 0.25 mg/kg (group K0.25), esketamine hydrochloride 0.5 mg/kg (group K0.5)or esketamine hydrochloride 0.75 mg/kg (group K0.75) . The children in each group were administered the study drugs 10 minutes before the end of surgery.All children were maintained anesthesia with sevoflurane. The recovery characteristics, including the time to extubation, delivery time from the PACU, postoperative nausea and vomiting, agitation and modified CHEOPS score were recorded and analyzed.&#x0D; Results: Immediately after extubation, the modified CHEOPS score and postoperative recovery agitation score of the three groups of children receiving intravenous esketamine were lower than those of group C (P&lt;0.05), but there was no statistical difference between the three groups significance (P&gt;0.05). When leaving the PACU, the postoperative awakening agitation scores of the children in the K0.25 and K0.5 groups were lower than those in the C group (P&lt;0.05), but there was no significant difference between the K0.75 and C groups (P&gt; 0.05). Compared with group C, postoperative extubation time and PACU stay time were significantly prolonged in K0.75 and K0.5 groups (P&lt;0.05).&#x0D; Conclusions: Low-dose (0.25 mg/kg) of esketamine hydrochloride can reduce the incidence of emergent agitation and postoperative pain,and has little effect on anesthesia recovery.

Comparison of the effects of different doses of oxycodone on endotracheal intubation during general anesthesia induction period

Objective To compare the clinical effect of different doses of oxycodone on endotracheal intubation during general anesthesia induction period. Methods Ninety-five patients with endotracheal intubation general anesthesia were selected as the research subjects, and the patients were randomly divided into group A, group B and group C. 31 patients in group A received intravenous administration of oxycodone 0.20mg/kg, 32 patients in group B received intravenous administration of oxycodone 0.25mg/kg, and 32 patients in group C received intravenous administration of oxycodone 0.30mg/kg.The adrenaline, norepinephrine, dopamine concentration, as well as mean arterial pressure and heart rate at different time points were compared among the three groups. Results The mean arterial pressure and heart rate at T0 time point were decreased to varying extent compared with those at T1 time point(t=23.618, 7.412; 22.928, 9.063; 32.636, 9.422, P=0.000, 0.000; 0.000, 0.000; 0.000, 0.000). The heart rate, mean arterial pressure at T2, T3 and T4 time points in group A were increased compared with T0 time point(t=13.834, 6.506, 7.015; 17.604, 14.796, 16.323, P=0.000, 0.000, 0.000; 0.000, 0.000, 0.000). The adrenaline, norepinephrine and dopamine at T2, T3 and T4 time points in group A were increased compared with T0 time point(t=121.662, 64.533, 15.687; 31.498, 16.933, 9.286; 39.712, 116.049, 147.102, P=0.000, 0.000, 0.000; 0.000, 0.000, 0.000; 0.000, 0.000, 0.000). The heart rate, mean arterial pressure, adrenaline, norepinephrine and dopamine at T2, T3 and T4 time points in group B and group C were decreased significantly compared with those in group A(t=19.586, 31.972, 16.844, 27.087; 14.046, 14.822, 15.377, 23.826; 7.756, 14.396, 13.268, 23.342, 100.573, 104.010, 37.612, 38.892, 107.377, 117.969; 56.135, 56.757, 24.223, 25.300, 95.057, 82.088; 22.878, 25.731, 5.532, 5.934, 134.763, 83.628, P=0.000, 0.000, 0.000, 0.000, 0.000, 0.000; 0.000, 0.000, 0.000, 0.000, 0.000, 0.000; 0.000, 0.000, 0.000, 0.000, 0.000, 0.000; 0.000, 0.000, 0.000, 0.000; 0.000, 0.000, 0.000, 0.000; 0.000, 0.000, 0.000, 0.000), and the differences were statistically significant(all P<0.05). Conclusion During the induction of general anesthesia, the appropriate dose of oxycodone in patients with endotracheal intubation was 0.25mg/kg, which could effectively maintain the hemodynamic stability, such as mean arterial pressure, and could reduce the stress response. Key words: Anesthesia, intratracheal; Dose-response relationship, drug; Oxycodone

The application effect of different doses of dexmedetomidine combined with remifentanil anesthesia in oral and maxillofacial surgery

Objective To explore the clinical effect of different doses of dexmedetomidine combined with remifentanil anesthesia in oral and maxillofacial surgery. Methods 135 patients with oral and maxillofacial surgery were randomly divided into three groups according to the random number table method, 45 cases in each group.All patients received dexmedetomidine and remifentanil anesthesia, the dexmedetomidine doses of A, B and C group were 0.4, 0.6, 0.8μg·kg-1·h-1.MAP, HR, SpO2 and Rasmay score in the three groups were observed before administration(T0), after administration of 5min(T1), 10min(T2), 20min(T3), 30min(T4), and the analgesic effects of patients were observed. Results Comparison within the group, the MAP, HR at T0-T4 showed a significant downward trend in all groups, the differences were statistically significant(F=3.651, 3.985, 4.212, all P 0.05). The analgesic effect of C group was significantly better than B group and A group(93.3%, 82.3%)(χ2=3.998, 4.234, all P<0.05). In C group, the incidence rates of hypoxemia, bradycardia(less than 55 times/min) were significantly higher than those of A group and B group (χ2=3.365, 3.112, 3.365, 3.365, all P<0.05). Conclusion In oral and maxillofacial surgery anesthesia, dexmedetomidine combined with remifentanil has good anesthetic effect, with the increase of dexmedetomidine dose, sedative effect is better, but the incidence rate of adverse reaction is increased. Key words: Anesthesia; Dexmedetomidine; Remifentanil; Oral and maxillofacial surgery

Comparison of the effects of different doses of methylprednisolone therapy for children with severe hand, foot and mouth disease

Objective To compare the clinical effects of different doses of methylprednisolone therapy for children with severe hand, foot and mouth disease(HFMD). Methods According to different dosage methods, 240 children with severe HFMD were divided into large dose group, medium dose group and small dose group, 80 cases in each group.The three groups were given different doses of methylprednisolone infusion on the basis of conventional treatment: large dose group(5~10mg·kg·-1d-1), medium dose group(3~5 mg·kg·-1d-1), small dose group(1~2mg·kg·-1d-1). Results The time of fever sustaining, panic ease, mechanical ventilation, duration of hypertension and heart rate recovery of the medium-dose group were (47.93±4.72)h, (45.54±2.42)h, (51.43±6.85)h, (53.66±7.62)h, (52.45±7.84)h, which were significantly shorter than those of the small-dose and large-dose group(all P 0.05). Conclusion Medium dose of methylprednisolone in the treatment of children with severe HFMD has significant effect and less adverse reactions, which is worthy of promotion. Key words: 【Keywords】 Hand, Foot and Mouth Disease; Methylprednisolone; Child

Comparison of the clinical effect of different doses of rosuvastatin in the treatment of hyperlipidemia and carotid atherosclerotic plaque in young ischemic stroke patients

Objective To observe the efficacy and safety of rosuvastatin in the treatment of hyperlipidemia and carotid atherosclerotic plaque in young ischemic stroke patients. Methods In prospective study, 264 young ischemic stroke patients with hyperlipidemia and carotid atherosclerotic plaque were randomly divided into low dose group, middle dose group, high dose group, 88 cases in each group.All patients were given rosuvastatin immediately after dinner, in doses of 5mg, 10mg, 20mg, respectively, for eight months.Then, the changes of hyperlipidemia and carotid atherosclerotic plaque in the three groups were surveyed, and its safety by the observation of clinical symptoms and monitoring of adverse reactions after eight months were assessed. Results Before treatment, the blood fat and carotid atherosclerosis plaque index in the three groups had no statistically significant differences (all P>0.05). After treatment, the total cholesterol, triglycerides, low-density lipoprotein cholesterol of the high dose group were (1.67±0.68)mmol/L, (3.23±0.53)mmol/L, (1.83±0.62)mmol/L, which of the middle dose group were (1.93±0.74)mmol/L, (3.73±0.23)mmol/L, (2.24±0.73)mmol/L, which of the low dose group were (2.16±0.77)mmol/L, (4.06±0.93)mmol/L, (2.93±0.35)mmol/L.These indicators were decreased than before treatment [(2.79±0.72)mmol/L, (5.40±0.67)mmol/L, (3.64±1.03)mmol/L, (2.75±0.81)mmol/L, (5.59±0.95)mmol/L, (3.43±0.92)mmol/L and (2.83±0.53)mmol/L, (5.84±0.79)mmol/L, (3.83±0.88)mmol/L]. The decrease of the high dose group was higher than the middle and low dose group, the difference was statistically significant(F=6.61, P 0.05), and no serious adverse reaction was found. Conclusion The high dose rosuvastatin treatment can reverse the nature of plaque, decrease the thickness of the plaques and lower blood lipid of young ischemic stroke with hyperlipidemia and carotid atherosclerotic plaque, which is better than middle and low dose, and has better security.There is no serious adverse reaction.It is worth for clinical promotion. Key words: Brain ischemic; Hyperlipidemia; Rosuvastatin; Carotid atherosclerosis plaque

Clinical effect of different doses of mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding

Objective To analyze the effect and safety of different doses of mifepristone treating perimenopa-usal dysfunctional uterine bleeding.Methods 80 patients with perimenopausal dysfunctional uterine bleeding were collected.According to the medicine of 5,10mg,25mg mg doses,80 cases were divided into the low dose group （n=26）,middle dose group （n=26） and high dose group （n=28）.The treatment results,endometrial thickness change, sex hormone level change and the adverse reaction were observed after 3 months.Results In terms of treatment effect,the effective rate in the middle dose group （92.3%） and high dose group （82.1%） were better than that of the low dose group（61.5%）（F=3.98,P〈0.05）;The inhibitory effect of endometrium in the middle dose group and high dose group were superior to the low dose group（ F=4.34,P〈0.05）;All three groups of sex hormone level was significantly lower in the body;Middle and high dose group of the adverse reactions of treatment process was more,the adverse reaction happening far higher than that of the low dose and dose group （F=3.97,P〈0.05）. Conclusion 10mg mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding has good effect, less adverse reactions,which is worthy of clinical application. Key words: Uterine hemorrhage; Perimenopause; Mifepristone

Clinical applications of different doses of leuprorelin acetate in in vitro fertilization-embryo transfer

To evaluate the clinical effect of different doses of leuprorelin acetate in in vitro fertilization-embryo transfer (IVF-ET). From January 2011 to December 2011, the data of 268 patients undergoing IVF and(or) intracytoplasmic sperm injection (ICSI) in Reproductive Medical Center, Clinical College of PLA, Anhui Medical University were studied retrospectively. All the patients were divided into three groups based on with long protocol and controlled ovarian stimulation (COH) including 83 cycles with 1.25 mg of leuprorelin in low dose group, 68 cycles with 1.88 mg of leuprorelin in high dose group, 117 cycles with 1.25 mg of diphereline in control group. The serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E(2)) and progesterone (P) before gonadotropin (Gn) administration on the days 3-5 of the menstrual cycle and on the day of hCG administration were detected, the dose and duration of Gn, number of oocytes retrieved, number of mature oocytes, the rates of fertilization, embryo cleaved, good-quality embryos clinical pregnancy and early miscarriage were compared among three groups. There were no significant differences in age, the level of LH and P on the day of hCG administration among three groups (P > 0.05). The level of FSH was (3.8 ± 1.6) U/L in low dose leuprorelin group, (3.1 ± 1.4) U/L in high dose of leuprorelin group and (2.4 ± 1.3) U/L in diphereline group before Gn administration, which reached statistical difference (P < 0.05). The mean length of Gn stimulation were (9.8 ± 1.7) days in low dose leuprorelin group, (10.5 ± 1.8) days in high dose of leuprorelin group and (11.1 ± 1.4) days in diphereline group, which reached statistical difference (P < 0.05). The mean dose of Gn was (24 ± 7) in low dose of leuprorelin group, which was significantly higher than (27 ± 9) in high dose of leuprorelin group and (28 ± 7) in diphereline group (P < 0.05). The level of LH was (2.7 ± 1.6) U/L in low dose of leuprorelin group and (2.2 ± 1.0) U/L in diphereline group before Gn administration, which reached statistical difference (P < 0.05). The cancel cycles were 5 in low dose of leuprorelin group, 4 in high dose of leuprorelin group and 7 in diphereline group. The number of ovum was (14 ± 7) low dose of leuprorelin group, (13 ± 6) in high dose of leuprorelin group, (14 ± 6) in diphereline group. The rates of fertilization was 66.26% (758/1144) in low dose of leuprorelin group, 67.01% (589/879) in high dose of leuprorelin group and 68.54% (1111/1621) in diphereline group, the rates of good-quality embryos was 64.22% (472/735) in low dose of leuprorelin group, 60.50% (340/562) in high dose of leuprorelin group and 59.59% (640/1074) in diphereline group, clinical pregnancy was 49% (38/78) in low dose of leuprorelin group, 42% (27/64) in high dose of leuprorelin group and 50% (55/110) in diphereline group, early miscarriage was 18% (7/38) in low dose of leuprorelin group, 15% (4/27) in high dose of leuprorelin group and 15% (8/55) in diphereline group, which did not show significant differences (P > 0.05). Both 1.25 mg and 1.88 mg leuprorelin acetate could obtain good down-regulation effect and clinical outcomes. 1.25 mg leuprorelin acetate could decrease patient's costs by reducing Gn dose and duration.

Tormentil for Active Ulcerative Colitis

Tormentil extracts (TE) have antioxidative properties and are used as a complementary therapy for chronic inflammatory bowel disease. In individual patients with ulcerative colitis (UC) positive effects have been observed. To assess the safety, pharmacology, and clinical effects of different doses of TE in patients with active UC. Sixteen patients with active UC [clinical activity index (CAI) >/=5] received TE in escalating doses of 1200, 1800, 2400 and 3000 mg/d for 3 weeks each. Each treatment phase was followed by a 4-week washout phase. The outcome parameters were side effects, CAI, C-reactive protein, and tannin levels in patient sera. Mild upper abdominal discomfort was experienced by 6 patients (38%), but did not require discontinuation of the medication. During therapy with 2400 mg TE per day, median CAI and C-reactive protein improved from 8 (6 to 10.75) and 8 (3 to 17.75) mg/L at baseline to 4.5 (1.75 to 6) and 3 (3 to 6) mg/L, respectively. During therapy, the CAI decreased in all patients, whereas it increased during the washout phase. Neither undegraded nor metabolized tannins could be detected by liquid-mass spectrometry (LC-MS) in patient sera. TE appeared safe up to 3000 mg/d. Tannins from TE are not systemically absorbed. The efficacy in patients with UC should be further evaluated.