Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2018-06-15 Cooperative journals: 《南方医科大学学报》
Abstract： Objective To compare the safety of sevoflurane anesthesia with laryngeal mask and tracheal intubation in cesarean section in women with heart disease. Methods Fifty-two pregnant women with heart diseases undergoing cesarean section were randomized into laryngeal mask (LAM) group and tracheal intubation group. In LAM group, 6% sevoflurane was given at the rate of 6 L/min for induction with a maintenance sevoflurane concentration of 3%. In the intubation group, 1.5 mg/kg propofol and 1 μg/kg remifentanil were injected intravenously, and after achieving D0 with Narcotrend monitoring, 0.9 mg/kg rocuronium was injected and intubation was performed 1 min later. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) were recorded in the two groups before anesthesia induction (T0), at intubation or laryngeal mask placement (T1), skin incision (T2), and extubation or laryngeal mask removal (T3). The surgery to fetal birth time, uterine incision to fetal childbirth time, drug discontinuation to awake time, and newborn Apgar scores were also recorded. Sevoflurane consumption and maternal comfort during hospitalization were compared between the two groups. Results In LAM group, HR and MBP at T1 and T3 were significantly lower than those in the intubation group (P<0.05). The drug discontinuation to extubation time and to awaken time were significantly shorter in LAM group than in the intubation group (P<0.05), but the operation time and fetal child birth time were comparable between the two groups (P>0.05). The women in LAM group reported better physical and psychological comforts than those in the intubation group (P<0.05). The neonatal Apgar scores and the scores of health education, satisfaction with hospital environment and service were all similar between the two groups (P>0.05). Conclusion Sevoflurane anesthesia with laryngeal mask can achieve satisfactory anesthetic effects in cesarean section in women with heart disease.
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2018-06-15 Cooperative journals: 《南方医科大学学报》
Abstract：目的:探讨右美托咪定对行肺癌根治术的患者围手术期炎症及肺功能保护作用的影响。方法选取我院2014年5月~2016年5月的124例肺癌根治术患者进行研究，随机分为试验组和对照组各62例，对照组采用单一药物麻醉，试验组在对照组的基础上进行右美托咪定麻醉，比较手术开始前（T0）、单肺通气（OLV）30 min（T1）、OLV 60 min（T2）及手术结束（T3）2组患者的血清中IL-1β、IL-10 以及肿瘤坏死因子（TNF）-α水平变化，采用酶联免疫法（ELISA）测定两组术中肺脏组织标本匀浆中丙二醛（MDA）、髓过氧化物酶（MPO）以及黄嘌呤氧化酶（XOD）水平，观察2 组的动脉血氧分压（PaO2）、氧合指数（OI）、气道平台压（APP）和气道阻力（AR）。结果2组患者在T1和T2时间点IL-1β、IL-10、TNF-α、MDA、MPO、XOD均明显升高，而且试验组的IL-1β、IL-10、TNF-α、MDA水平明显低于对照组，MPO、XOD明显高于对照组，差异具有统计学意义（P<0.05）；2组患者在T1和T2点的PaO2、OI明显降低，气道平台压和气道阻力明显升高，但是试验组气道平台压和气道阻力明显低于对照组，PaO2和OI明显高于对照组，差异具有统计学意义（P<0.05）。结论肺癌根治术麻醉患者中采用右美托咪定麻醉可以有效的减轻肺部炎症反应，并对患者的肺功起到重要保护作用。
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2018-01-25 Cooperative journals: 《南方医科大学学报》
Abstract： Objective To study the protective effect of dexmedetomidine against perioperative inflammation and on pulmonary function in patients undergoing radical resection of lung cancer. Methods From May, 2014 to May, 2016, 124 patients with lung cancer receiving radical surgeries were randomized into experimental group (n=62) and control group (n=62). The patients in the control group received a single anesthetic agent for anesthesia, and additional dexmedetomidine was given in the experimentalgroup.Thelevelsofseruminterleukin-1β(IL-1β),IL-10,andtumornecrosisfactor-alpha(TNF-α)weremeasured before the operation (T0), at 30 min (T1) and 60 min (T2) during one lung ventilation (OLV) and at the end of operation (T3). Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of malondialdehyde (MDA), myeloperoxidase (MPO) and xanthine oxidase (XOD), and the arterial oxygen partial pressure (PaO2), oxygenation index (OI), airway plateau pressure (APP) and airway resistance (AR) were also recorded. Results At the time points of T1 and T2, IL-1β, IL-10, MDA, MPO, TNF-α, and XOD levels were significantly increased in both of the groups, but the levels of IL-1, IL-10, TNF-α and MDA weresignificantlylowerandMPOandXODlevelssignificantlyhigherintheexperimentalgroupthaninthecontrolgroup(P< 0.05). In both groups, PaO2 and OI decreased and APP and AR increased significantly at T1 and T2, but APP and AR were significantly lower and PaO2 and OI significantly higher in the experimental group than in the control group (P<0.05). Conclusion Anesthesia with dexmedetomidine in lung cancer patients undergoing radical surgery can effectively reduce the inflammatoryresponseofthelungsandprotectthelungfunctionofthepatients.
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2017-12-21 Cooperative journals: 《南方医科大学学报》
Abstract： Objective To explore the anesthetic effect and safety of ultrasound-guided thoracic paravertebral blockade in video-assisted thoracoscopic sympathectomy for treatment of palmar hyperhidrosis. Methods A total of 120 patients undergoing video-assisted thoracoscopic sympathectomy for moderate or severe hyperhidrosis were randomized to receive ultrasound-guided thoracic paravertebral blockade (group A, n=60) or general anesthesia with tracheal intubation (group B, n=60). In both groups routine monitoring and radial artery catheterization were used. The patients in group A were given oxygen inhalation via a nasal tube after thoracic paravertebral blockade, and those in group B had intratracheal intubation. Blood gas analyses were conducted 5 min before and 5 min after the operation and the clinical outcomes and complications were recorded in each group. Results All the patients completed the operations safely and none of the patients with thoracic paravertebral blockade required conversion to general anesthesia. Significant differences were recorded between groups A and B in anesthetic preparation time (6.26�.09 vs 46.32�5.76 min), awakening time (6.26�.09 vs 46.32�5.76 min), and mean hospitalization expense (6355.54�26.00 vs 8932.25�25.98 RMB Yuan). Compared with those in group B, the patients in group A showed a significantly lower rate of postoperative throat discomfort (0% vs 100%), a shorter monitoring time (2 h vs 12 h), and faster recovery time for food intake (2 h vs 6 h). The parameters of artery blood gas analysis both before and after the operation were similar between the two groups, but the postoperative variations differed significantly between the two groups in pH value and PaCO 2 but not in PaO 2 . Conclusion Ultrasound-guided thoracic paravertebral blockade is safe and effective in video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis and is associated with less complications and better postoperative recovery.
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