Breathing Recovery Time Research Articles

Effect of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia

BackgroundTo analyze the effects of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, and to provide a basis for clinical application.MethodsA total of 111 patients with gastric cancer who were treated with epidural anesthesia combined with general anesthesia were selected as the study subjects, and the patients were randomly divided into group A, group B and group C. The bispectral index (BIS) was maintained by adjusting the infusion speed of anesthetics, the BIS of group A was maintained at 50 ~ 59, the BIS of group B was maintained at 40 ~ 49, and the BIS of group C was maintained at 30 ~ 39. The high-frequency power (HFP), low-frequency power (LFP), total power (TP), mean arterial pressure (MAP), heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP) were measured before anesthesia induction (T1), immediately after intubation (T2), 3 min after intubation (T3), and 6 min after extubation (T4). The cognitive function of the patients was evaluated before and 48 h after surgery.ResultsThe HFP, LFP/HFP, TP, HR, DBP and SBP between the three groups at T1 ~ T3 are significantly difference from each other (P < 0.05). There were significant differences in spontaneous breathing recovery time, eye opening time and extubation time among group A, B and C groups, and group B had the lowest spontaneous breathing recovery time, eye opening time and extubation time (P < 0.05). There was no significant difference in the incidence of adverse reactions during anesthesia between the three groups. The cognitive function score of group B was significantly higher than that of group A and group C (P < 0.05).ConclusionsBIS maintenance of 40 ~ 49 has little effect on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, which is helpful for postoperative recovery.

Application of early enteral nutrition nursing based on enhanced recovery after surgery theory in patients with digestive surgery.

Postoperative nursing can improve the restlessness and gastrointestinal function of patients with tracheal intubation under general anesthesia in digestive surgery. Wide application of various nursing methods and routine nursing in perioperative nursing of patients with general anesthesia in digestive surgery. To investigate the impact of early postoperative enteral nutrition nursing based on the enhanced recovery after surgery (ERAS) theory on postoperative agitation and gastrointestinal recovery in patients undergoing general anesthesia that experienced tracheal intubation. The data of 126 patients with digestive surgery from May 2019 to February 2022 were retrospectively analyzed. According to different nursing methods, they were divided into control group and observation group, with 63 cases in observation group and 63 cases in control group. The patients in the control group had standard perioperative nursing care, whereas those in the observation group got enteral nourishment as soon as possible after surgery in accordance with ERAS theory. Both the rate and quality of gastrointestinal function recovery were compared between the two groups after treatment ended. Postoperative anesthesia-related adverse events were tallied, patients' nutritional statuses were monitored, and the Riker sedation and agitation score (SAS) was used to measure the incidence of agitation. When compared to the control group, the awake duration, spontaneous breathing recovery time, extubation time and postoperative eye-opening time were all considerably shorter (P < 0.05). There was no significant difference in the recovery time of orientation force between the two groups (P > 0.05); however, the observation group had a lower SAS score than the control group (P < 0.05). The recovery time for normal intestinal sounds, the time it took to have the first postoperative exhaust, the time it took to have the first postoperative defecation, and the time it took to have the first postoperative half-fluid feeding were all faster in the observation group than in the control group (P < 0.05); Fasting blood glucose was lower in the observation group compared to the control group (P < 0.05), while the albumin and hemoglobin levels were higher on the first and third postoperative days; however, there was no statistically significant difference in the incidence of anesthesia-related adverse reactions between the two groups (P > 0.05). The extremely early postoperative enteral nutrition nursing based on ERAS theory can reduce the degree of agitation, improve the quality of recovery, promote the recovery of gastrointestinal function, and improve the nutritional status of patients in the recovery period after tracheal intubation under general anesthesia.

Sufentanil combined with nalmefene reduce the adverse events in recovery period of patients undergoing uvulopalatopharyngoplasty – A randomized controlled trial

Background: The opioid receptors related to analgesia are mainly μ recipient, the μ receptor has a two-way mode of action: manifested by opioid analgesics and μ1 Receptor binding produces the desired analgesic effect, and μ2 Receptor binding may cause respiratory depression, nausea and vomiting and other adverse reactions. Nalmefene is an opioid receptor antagonist. Low dose Nalmefene has priority over μ2 Receptor binding makes opioid analgesics turn more to μ1 receptor binding, which is reversed μ2 Receptor mediated nausea, vomiting, respiratory depression and other adverse reactions, but does not reverse the analgesic effect. We assume that sufentanil combined with nalmefene could reduce respiratory adverse events in the patients who underwent uvulopalatopharyngoplasty during recovery.Methods: Patients with UPPP under general anesthesia were selected, and divided into control group (group C) and nalmefene group (group N) randomly. Patients in group N received sufentanil 0.1 μg/kg and nalmefene hydrochloride 0.25μg/kg at the end of the operation. Additionally, patients in group C received sufentanil 0.1 μg/kg at the end of the operation. The heart rate (HR) and mean arterial pressure (MAP) were observed and recorded before operation, immediately after extubation, and 5 min after extubation. The breathing recovery time, tracheal extubation time, consciousness score (Ramsay score、sedation-agitation scale (SAS)) and visual analog score (VAS) were carefully recorded at 5 min after extubation, and the various adverse reactions were monitored during the recovery period.Results: Ninety-six patients were finished our study finally. The breathing recovery and extubation time of group N was significantly shorter than those of group C (P < 0.05). The Ramsay score after extubation in group N was significantly lower as compared to that in group C (P < 0.05). The sedation-agitation scale of group N was observed to be significantly higher than that of group C (P < 0.05). Moreover, the incidences of respiratory depression, nausea and vomiting during the recovery period was significantly less than those in group C (P < 0.05).Conclusion: Nalmefene combined with sufentanil can significantly reduce adverse reactions in the cases of patients after UPPP, which may be beneficial to improve the quality and safety of emergence after general anesthesia.

Anesthesia Effect of Remifentanil Combined with Propofol in Laparoscopic Cholecystectomy and Its Impact on Postoperative Cognitive Recovery.

Objective To investigate the anesthesia effect of remifentanil combined with propofol for laparoscopic cholecystectomy and its impact on postoperative cognitive recovery. Methods A total of 120 patients who underwent laparoscopic cholecystectomy in our hospital from February 2019 to June 2021 were recruited and assigned into either control group or experimental group at a ratio of 1 : 1 via the random number table method. The patients in the control group were anesthetized with fentanyl combined with propofol, and the patients in the experimental group were anesthetized with remifentanil combined with propofol. The clinical basic indicators (extubation time, recovery time, breathing recovery time, and orientation recovery time), and observer's assessment of awareness/sedation (OAA/S) scores and complications were compared between the two groups. Results There was no significant difference in extubation time between the two groups (P > 0.05). The postoperative wake-up time, respiratory recovery time, and orientation recovery time of the experimental group were significantly better than those of the control group (P < 0.05). The OAA/S scores of the patients in the experimental group were significantly higher than those in the control group immediately after surgery, 1 h after surgery, and 3 h after surgery (P < 0.05). There was no significant difference in the OAA/S scores between the two groups on the 1st day after operation (P > 0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (P < 0.05). Conclusion Remifentanil + propofol for laparoscopic cholecystectomy patients has a significant anesthesia effect. This strategy effectively shortens the extubation, awakening, respiratory recovery, orientation recovery time of patients, and OAA/S score, suggest a minor impact on the postoperative cognitive function and state of consciousness. It has a high safety profile and thus is worthy of clinical application.

Robustness of Propofol and Sevoflurane on the Perioperative Immune Function of Patients Undergoing Laparoscopic Radical Nephrectomy.

Objective. This study aimed to evaluate the robustness of propofol combined with sevoflurane in patients undergoing laparoscopic radical nephrectomy and its influence on immune function during perioperative period. A total of 140 patients who underwent laparoscopic nephrectomy in the Department of Oncology of our hospital from January 2018 to January 2020 were divided into the control group and the study group by the random number table method, with 70 cases in each group, who were given sevoflurane anesthesia and sevoflurane combined with propofol anesthesia, respectively. The anesthesia effect and perioperative immune function of the two groups of patients were compared. No remarkable difference was observed in the extubation time, breathing recovery time, and awakening time between the two groups; the extubation coughing score and postextubation restlessness score of the study group were significantly lower than those of the control group; the postoperative renal function indexes of the two groups of patients were not considerably different; after treatment, the CD3+ (%), CD4+ (%), and CD4+/CD8+ of the two groups of patients decreased significantly, with a higher level in the study group. For patients undergoing laparoscopic radical nephrectomy, the combination of propofol and sevoflurane yields a promising outcome in enhancing the anesthesia results and improving the perioperative immune function.

Comparison of the Effects of Sufentanil/Fentanyl Combined with Propofol on Stress Responses and Hemodynamics in Patients with Hypertensive Intracerebral Hemorrhage

To observe the effects of sufentanil/fentanyl combined with propofol on the stress response and hemodynamics in patients with hypertensive intracerebral hemorrhage. The control group received anesthesia with fentanyl plus propofol, while the observational group received sufentanil plus propofol. The hemodynamic measures, including diastolic blood pressure, systolic blood pressure, heart rate and stress response measures, including plasma angiotensin II, aldosterone and serum norepinephrine, in the two groups 5 min before induction of anesthesia (T0), at endotracheal intubation (T1), 5 min after endotracheal intubation (T2) and at postoperative extubation (T3) were compared, and the anesthesia recovery and adverse reactions in the two groups after surgery were also compared. At T0~T3, the DBP, SBP and HR in the observational group fluctuated less than the control group (p<0.05). At T1, T2 and T3, the plasma angiotensin II, aldosterone and serum norepinephrine in the observational group were lower than those in the control group (p<0.05). There were no significant differences between the groups in the extubation time, awakening time and spontaneous breathing recovery time after surgery (p>0.05). The incidence of adverse reactions in the observational group was 12.24 % (6/49), lower than that in the control group 29.17 % (14/48) (p<0.05). Sufentanil-propofol anesthesia for patients with hypertensive intracerebral hemorrhage can steady intraoperative hemodynamic status, relieve stress responses of the body, reduce the incidence of adverse reactions and does not affect postoperative anesthesia recovery.

Effects of Combined Epidural Anesthesia and General Anesthesia on Cognitive Function and Stress Responses of Elderly Patients Undergoing Liver Cancer Surgery.

This study aimed at exploring the effects of combined epidural anesthesia and general anesthesia on the cognitive function and stress responses of elderly patients undergoing liver cancer surgery. One hundred and fifteen elderly patients were enrolled as research subjects. They were admitted to our hospital and underwent liver cancer surgery from August 2017 to May 2019. Fifty five cases were treated with general anesthesia (GA) (GA group), while the other sixty cases were treated with combined epidural anesthesia and general anesthesia (joint group). Scoring standards of Mini-Mental State Examination (MMSE) were used to evaluate the patients before and after operation. Their operating time, total fluid input (TFI), spontaneous breathing recovery time (SBRT), preoperative and postoperative indices of stress responses (epinephrine (EPI), cortisol (Cor), and norepinephrine (NE)), and postoperative adverse reactions were observed. There were statistically significant differences between the two groups with respect to anesthesia time, TFI, postoperative SBRT, and postoperative directional recovery time (DRT) (cP < 0.05). There was no difference in operating time, total fluid loss (TFL), and hospitalization time (P > 0.05). After operation, patients in both groups experienced a cognitive decline of different degrees and the MMSE scores decreased. There was no significant difference in the score between the two groups before operation and 3 days and 7 days after operation (P > 0.05). The score was significantly better in the joint group than that in the GA group at 6 hours and 1 day after operation (P < 0.05). There were no significant differences in levels of EPI, Cor, and NE between the two groups before operation (P > 0.05), but there were significant differences after operation. The total incidence of postoperative adverse reactions was 11.67% in the joint group and 25.45% in the GA group. In conclusion, combined epidural anesthesia and general anesthesia can significantly reduce postoperative cognitive dysfunction and inhibit postoperative stress responses in elderly patients undergoing liver cancer surgery. It has good application value in clinical practice.

Artificial Intelligence-Based Inferior Vena Cava Images under Dezocine Anesthesia in Detection of Bile Duct Injury after Laparoscopic Cholecystectomy

This study focused on the segmentation effects of an artificial intelligence-based algorithm of CT images, to detect the bile duct injury (BDI) after laparoscopic cholecystectomy (LC) under dezocine anesthesia. This study was based on the maximum between-class variance (Otsu) algorithm; it introduced the image grayscale mapping method to increase the accuracy of the target area segmentation within the CT image and compare the segmentation effect with the threshold segmentation and the regional growth segmentation algorithm. 46 patients treated with laparoscopic cholecystectomy (LC) were used as research objects, and all patients were inspected in the abdominal CT examination. According to the anesthetic drug selection, patients were divided into control group (conventional anesthesia) and dezocine group (conventional anesthesia + dezocine), with 23 cases in each group. And it compared the difference between the respiratory recovery time, the wake time, the tube time, and the postoperative 3, 6, 12, and 24 h after surgery, and complication after LC evaluation of bile duct injury (BDI). It was found that the algorithm in this study can segment the target area in CT image accurately. Compared with the threshold segmentation and region growing segmentation algorithms, its Dice similarity coefficient (DSC) and Jaccard similarity coefficient (JSC) were higher ( P &lt; 0.05 ). There was no statistically significant difference in postoperative spontaneous breathing recovery time, wake-up time, and extubation time between the dezocine group and the control group ( P &gt; 0.05 ), but in the dezocine group, the visual analogue scale (VAS) scores at 3, 6, 12, and 24 hours after the surgery were lower ( P &lt; 0.05 ). 27 patients developed BDI after the surgery, and they were classified as per the Strasberg classification standard. It was found that 6 cases were evaluated as type A, 4 cases were type B, 2 cases were type C, 6 cases were type D, and 9 cases were type E. It was concluded that the algorithm in this study can segment the target area of the CT image accurately, assisting the doctor in diagnosis. The use of dezocine before LC can effectively relieve patients’ postoperative pain. This study provides a basis for the diagnosis and treatment of gallbladder disease and the detection of complications.

Effects of Additional Intraoperative Administration of Sufentanil on Postoperative Pain, Stress and Inflammatory Responses in Patients Undergoing Laparoscopic Myomectomy: A Double-Blind, Randomized, Placebo-Controlled Trial.

PurposeAlthough pain after laparoscopic surgery is assumed to be minor, many women still suffer from unexpected postoperative pain. Thus, we aimed to assess whether additional intraoperative administration of sufentanil could help to improve postoperative pain and related agitation, stress, and inflammation response in patients undergoing laparoscopic myomectomy.Patients and MethodsForty female patients with uterine myoma scheduled for laparoscopic myomectomy under general anesthesia were randomized to receive sufentanil (group T, n=20) or normal saline (group C, n=20) 1h before the end of the surgery. The postoperative pain, agitation, stress, inflammation, and adverse effects were measured.ResultsAs the primary outcome, the visual analog scale (VAS) pain score was significantly reduced in group T as compared with group C at each measured time point in a post-anesthesia care unit (PACU), VAS 5 min (31.5 ± 2.7 vs 40.6 ± 5.6) (P<0.001), VAS 30 min (36.5 ± 4.5 vs 46.0 ± 2.9) (P<0.001), VAS 1h (37.8 ± 4.0 vs 48.6 ± 5.5) (P<0.001). The secondary outcomes, including the sedation agitation scale (SAS) scores, plasma concentrations of epinephrine and norepinephrine, and the levels of plasma interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-α) in group T were remarkably lower than those in group C (P < 0.001). The cough cases in group T also showed a significant reduction in comparison with group C (P < 0.05). In addition, the anesthetic recovery time, including the spontaneous breathing recovery time and extubation time, were not significantly different between the two groups, as were the cases of respiratory depression and postoperative delirium (P > 0.05).ConclusionFor patients undergoing laparoscopic myomectomy, administration of sufentanil 1 h before the end of surgery shows excellent analgesic and sedative effects, alleviated postoperative stress and inflammatory responses, reduced incidence of cough, without prolonging anesthetic recovery time and increasing adverse reactions.

Investigating the application value of propofol combined with sufentanil and dexmedetomidine in cosmetic anesthesia

Objective: To investigate the effects of propofol combined with sufentanil and dexmedetomidine in cosmetic anesthesia. Methods: The clinical data of 40 plastic surgery patients admitted to the hospital from June to November 2019 were retrospectively analyzed. According to the different anesthesia methods during surgery, they were divided into control group (propofol combined with sufentanil and normal saline, 20 cases) and was compared with the observation group (propofol combined with sufentanil and dexmedetomidine, 20 cases). The anesthetic effect, total dosage of propofol, spontaneous breathing recovery time, and adverse reactions were compared between the two groups. Results: The total dosage of propofol in the observation group was less than that in the control group, and the spontaneous breathing recovery time was shorter than that in the control group. The difference was statistically significant (P?0.05). There was no significant difference in the anesthetic effect and adverse reaction rate between the two groups (P&gt;0.05). Conclusion: The application of propofol in combination with sufentanil and dexmedetomidine in cosmetic anesthesia can reduce the dosage of propofol, speed up the anesthesia recovery, and have better anesthetic effect and safety.

Clinical effects and safety evaluation of dexmedetomidine hydrochloride combined with etomidate fat emulsion in patients undergoing interventional treatment of stroke during anesthesia.

Stroke patients are often elderly and afflicted with comorbidities that can make them more susceptible to surgical complications during anesthesia, such as respiratory depression. This study examined the clinical effects of dexmedetomidine hydrochloride combined with etomidate fat emulsion in patients undergoing interventional treatment of stroke during anesthesia. 90 patients with stroke admitted at the Second Hospital of Dalian Medical University between February 2015 and March 2016 were selected for interventional treatment in the study. The patients were randomly divided into three different treatment groups, with 30 patients in each group. Group A patients were treated with dexmedetomidine hydrochloride, group B patients were treated with etomidate fat emulsion, and group C patients were treated with dexmedetomidine hydrochloride combined with etomidate fat emulsion. Mean arterial blood pressure (MAP), heart rate (HR), wake-up time, and extubation time were compared and analyzed for the patients of each group at different time points. MAP and HR of patients in group C were notably decreased after anesthesia, and were significantly lower than patients in groups A and B (p<0.05). MAP and HR of the patients in groups A and B did not significantly change over the different time points. The three groups also did not show dramatic changes when patients were extubated after 3 min (p>0.05). Further data on wake-up time, extubation, and spontaneous breathing recovery time among the patients did not show any significant differences in the three groups (p>0.05). However, the prevalence of complications in group C was lower than in groups A and B (p<0.05). Dexmedetomidine hydrochloride combined with etomidate fat emulsion in patients undergoing interventional treatment of stroke during anesthesia has potential value in clinical applications, through the maintenance of ideal hemodynamics and a reduction in complications.

Effects of intravenous anesthesia with sufentanil combined with propofol on hemodynamics and oxygen metabolism in patients with esophageal cancer under high altitude

Objective To investigate the effect of intravenous anesthesia with sufentanil combined with propofol on hemodynamics and oxygen metabolism in patients with esophageal cancer under high altitude. Methods 60 patients with esophageal cancer radical surgery was selected from March 2015 to March 2017 in our hospital and were divided into two groups according to the random number table, 30 patients in each group. Patients in the control group were given with fentanyl and propofol intravenous anesthesia, and patients in the observation group were given sufentanil combined with propofol anesthesia. The occurrence of restlessness during the recovery of anesthesia in the two groups were observed, the spontaneous breathing recovery time, extubation time and postoperative Mini-mental State Examination (MMSE) score were recorded, and the indexes of hemodynamics and oxygen metabolism were measured at the time of before induction of anesthesia (T0), tracheal intubation (T1), skin incision (T2), thoracotomy (T3), free esophagus (T4), esophageal catheter removal time (T5). Results The spontaneous respiration recovery time and extubation time of the observation group were significantly shorter than those of the control group (P<0.05). The degree of restlessness in the observation group was weaker than that in the control group (P<0.05). Mean arterial pressure (MAP) in the control group at T2-T4 were significantly higher than those in T0 (P<0.05), but MAP and heart rate (HR) in the observation group at T1-T5 were significantly lower than those of T0 (P<0.05). Compared with T0 group, oxygen saturation (SpO2), oxygen saturation of mixed venose blood (SvO2) and oxygen delivery (DO2) at T1-T5 were significantly decreased (P<0.05), oxygen consumption (VO2) at T2-T4 was significantly increased (P<0.05), especially in the control group (P<0.05). The MMSE scores of the two groups were significantly lower than those before the operation (P<0.05), and the scores in observation group was significantly higher than the control group (P<0.05). Conclusions The intravenous anesthesia with sufentanil combined with propofol is more helpful in maintaining hemodynamic stability and oxygen metabolism balance than intravenous anesthesia with fentanyl combined with propofol and has little effect on postoperative anesthesia recovery and cognitive function. Key words: Sufentanil/AD; Propofol/AD; Anesthesia, intravenous/MT/AE; Esophageal neoplasms/SU; Hemodynamics

Research on the relationship between the body mass index and rewarming in the hypothermia patients with primary liver cancer after surgery

Objective To evaluate the rewarming and?anesthetic recovery regularity in different body mass index(BMI) patients with primary liver cancer by the same rewarming measures. Methods The data of 67 primary liver cancer patients with hypothermia after surgery were analyzed retrospectively and divided into three groups (low BMI group:BMI <18.50 kg/m2,normal BMI group: BMI 18.50-22.99 kg/m2, and high BMI group: BMI ≥23.00 kg/m2) according to the standard of Asian BMI. Rewarming time and speed, spontaneous breathing recovery time,waking time and shivers in the three groups were observed and compared. Results Rewarming time, spontaneous breathing recovery time,waking time were (114.75 ± 21.91), (62.60±23.47), (94.65±20.54) min in low BMI group, (93.46±30.39), (41.19±21.47), (66.11±24.78) min in normal BMI group and (61.43±16.37), (25.81±8.90), (50.57±10.41) min in high BMI group,there were significant differences among three groups (F=25.300, 18.962, 25.647, all P <0.05). Rewarming speed was (0.85±0.13) ℃/h in high BMI group, (0.44±0.10) ℃/h in normal BMI group, (0.47±0.16) ℃/h in low BMI group,there were significant differences among three groups(F=65.810, P<0.05). Conclusions Rewarming for a long time in the primary liver cancer patients with low BMI and hypothermia after surgery by the same measures.More attentions should be paid to management of low BMI patients in the rewarming process, and aggressive measures should be taken to restore body temperature to normal. Key words: Body mass index; Liver neoplasms; Anesthesia recovery period; Rewarming; Hypothermia

Use of low-dose dexmedetomidine in general anesthesia improves postoperative recovery of patients with supratentorial tumors: study protocol for a randomized controlled trial

Background: Favorable quality of recovery from general anesthesia in neurosurgical patients is an important goal for anesthesiologists. Dexmedetomidine is an emerging anesthetic adjuvant characterized by a stable hemodynamic recovery period, and neither its sedative nor analgesic effects influence evaluation of neurological function. We hypothesize that a bolus injection of low-dose dexmedetomidine during general anesthesia within minutes before the end of surgery in patients undergoing craniotomy can improve the quality of recovery from general anesthesia, thereby benefitting the evaluation of early-stage neurological function after surgery. Methods/Design: Patients with supratentorial tumors who have undergone craniotomy under general anesthesia at the Department of Neurosurgery, First Affiliated Hospital of China Medical University are included in this randomized controlled trial. A sample size of 150 patients is needed. Patients in the experimental group are randomly assigned to receive intravenous bolus injection of low- and medium-dose dexmedetomidine (0.4 and 0.8 ΅g/kg, respectively). Patients in the control group receive equal doses of physiological saline. The primary outcome of the study is the quality of recovery from general anesthesia, including awakening time, degree of sedation, spontaneous breathing recovery time, and coughing and bucking at the time of tracheal extubation. Secondary outcomes include postoperative analgesic effects, hemodynamic indices, anesthesia time, operation time, and neurological function assessment. Discussion: The results from this trial will provide optimal evidence for intravenous bolus injections of dexmedetomidine at a dose that can improve the quality of recovery from general anesthesia after craniotomy for supratentorial tumors. Trial registration: ClinicalTrails.gov identifier: NCT02007798; registered on 6 December 2013.

Comparison on the clinical effect of target controlled intravenous anesthesia of propofol combined with fentanyl or remifentanil and isoflurane

Objective To compare the clinical effects of target controlled intravenous anesthesia of propofol combined with fentanyl or remifentanil and isoflurane.Methods 96 ASA Ⅰ-Ⅱ elective surgical patients from June 2010 to February 2012 were randomly divided into three groups of 32 patients:propofol combined with fentanyl target-controlled group (group A),compound propofol remifentanil fentanyl target-controlled group (group B),anesthesia group (group C).Blood pressure,heart rate changes in anesthesia induction and maintenance were observed and recorded; spontaneous breathing recovery time,wake time,time to extubation,orientation recovery time were recorded; during 24 hours follow-up,nausea,vomiting and other adverse events were observed.Results The SBP,DBP,and the MAP,the H R induced by the lowest value in three groups had no significant difference (P＞0.05).Patients of the SBP ＜90 mmHg in Group A and Group B were significantly less than those of group C (P＜0.05).Intubation in Group A and group C were significantly higher than those in group B (P＜0.05).Recovery time of spontaneous breathing,wake time,time to extubation and orientation recovery time in three groups had no significant difference (P＞0.05).Incidence of adverse reactions in group A and group B was significantly lower than that of group C (P＜0.05).Conclusion Compared with isoflurane inhalation anesthesia,propofol combined with fentanyl or remifentanil target controlled intravenous anesthesia is more stable with less adverse reaction. Key words: Propofol; Fentanyl; Remifentanil; Intravenous anesthesia

Observation on the effect of Pentazocine pre-emptive analgesia in patients receiving intercostal nerve cryoanalgesia after post-thoracotomy

Objective To observe the effect ofpentazocine pre-emptive analgesia in patients receiving intercostal nerve cryoanalgesia after post-thoracotomy.Methods 60 patients with elective thoracotomy (ASA grade Ⅰ to grade Ⅱ ) were randomly divided into pre-emptive analgesia group (group A) and the control group (group B).Group A (n=30)received slow bolus injection of pentazocine 0.5 mg/kg 10 minutes before the beginning of operation.Patients in group B (n=30) were injected with saline (0.9％,2ml).Then we recorded the spontancous breathing recovery time,eyes open time and extubation time and analgesia.Visual analong scale scores (VAS) were used for pain degree score evaluation,and also 8CS at 1,4,8,24 hours after operation.We recorded the incidence of disadvantage between the two groups.Results There was no significant difference on the spontaneous breathing recovery time,eyes open time and extubation time between the two groups.VAS of group A was lower than that of group B (P＜0.05).BCS of group A was higher than thatof group B (P＜0.05).The incidence of disadvantage in group A was lower than that in group B (P＜0.05).Conclusion Preoperative application of pentazocine 0.5 mg/kg can effectively reduce the pain of post-thoracotomy patients receiving intercostal nerve cryoanalgesia and will not lead delayed recovery. Key words: Pentazocine; Pre-emptive analgesia; Thoracotomy; Intercostal nerve cryoanalgesi

Effect of fentanyl application on remifentanyl-propofol anesthesia recovery before skinning suture

Objective To discuss the effect of fentanyl application on fentanyl-propofol anesthesia recovery before skinning suture.Methods Thirty cases of thyroid gland adenoma excision were divided into F1,F2 and N groups,1 or 2 μg/kg fentanyl were given before skinning suture in F1or F2 group,N group as control group.The degree of pain and sedation were assessed,recovery time of breathing,consciousness recovery,extubation time and the adverse events were recorded,MAP and HR were continuing monitored.Results Compared with N group,score of VAS grade in F1 and F2 groups were significantly reduced (P ＜ 0.01);Score of Ratings Ramsay in F1 and F2 group were higher than in N group (P ＜ 0.01) ,and increased more significantly in F2 group (P ＜ 0.05).Compared with F1 and N group,recovery time of breathing,consciousness recovery and extubated time were extended in F2 group(P ＜ 0.01).During recovery,MAP and HR were gradually increased in N group,and remained relatively stable in F1 and F2 groups.Conclusion Before skinning suture of thyroid gland adenoma excision,application of 1 μg/kg fentanyl could reduce pain response of remifentanyl discontinuation,but not significantly delay recovery of consciousness and extubated time. Key words: Fentanyl; Remifentanil; Propofol; Postoperative pain