Pub Date : 2019-11-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.022
Juan He, Jianjun Yang, Huilian Bu, Dongmei Wang, Zhisong Li
Objective To evaluate the effect of pectoral nerve (Pecs) blockⅡ combined with general anesthesia on cellular immune function in the patients undergoing radical mastectomy. Methods Eighty-two patients, aged 31-63 yr, with body mass index of 18-24 kg/m2, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective radical mastectomy, were divided into 2 groups (n=41 each) using a random number table method: general anesthesia group (group G) and Pecs blockⅡ combined with general anesthesia group (group P). In group P, Pecs block Ⅱ was performed under ultrasound guidance at 30 min before anesthesia induction, 0.33% ropivacaine 15 ml was injected into the fascia plane between the third intercostal pectoralis major and pectoralis minor, and then 0.33% ropivacaine 30 ml was injected into the anterior serratus muscle between the pectoralis minor and its deep side.Anesthesia was induced with iv propofol, sufentanil and rocuronium and maintained with iv infusion of propofol and intermittent iv boluses of sufentanil.Postoperative PCIA was performed with sufentanil and tropisetron.When visual analoge scale score>3, morphine 5-10 mg was intravenously injected.The intraoperative consumption of sufentanil and postoperative requirement for morphine used as rescue analgesics were recorded.Peripheral venous blood samples were collected before induction and at 3 and 24 h after operation for determination of the levels of T lymphocyte subsets (CD3+ , CD4+ and CD4+ /CD8+ ) by flow cytometry.Patients were followed up for 5 yr to record the survival and recurrence rates. Results The intraoperative consumption of sufentanil and postoperative requirement for morphine used as rescue analgesics were significantly lower in group P than in group G (P 0.05). Conclusion Pecs blockⅡ combined with general anesthesia can improve cellular immune function in the patients undergoing radical mastectomy. Key words: Nerve block; Thoraci cvertebrae; Anesthesia, general; Breastneo plasms; Immune function
{"title":"Effect of pectoral nerve block II combined with general anesthesia on cellular immune function in patients undergoing radical mastectomy","authors":"Juan He, Jianjun Yang, Huilian Bu, Dongmei Wang, Zhisong Li","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.022","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.022","url":null,"abstract":"Objective \u0000To evaluate the effect of pectoral nerve (Pecs) blockⅡ combined with general anesthesia on cellular immune function in the patients undergoing radical mastectomy. \u0000 \u0000 \u0000Methods \u0000Eighty-two patients, aged 31-63 yr, with body mass index of 18-24 kg/m2, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective radical mastectomy, were divided into 2 groups (n=41 each) using a random number table method: general anesthesia group (group G) and Pecs blockⅡ combined with general anesthesia group (group P). In group P, Pecs block Ⅱ was performed under ultrasound guidance at 30 min before anesthesia induction, 0.33% ropivacaine 15 ml was injected into the fascia plane between the third intercostal pectoralis major and pectoralis minor, and then 0.33% ropivacaine 30 ml was injected into the anterior serratus muscle between the pectoralis minor and its deep side.Anesthesia was induced with iv propofol, sufentanil and rocuronium and maintained with iv infusion of propofol and intermittent iv boluses of sufentanil.Postoperative PCIA was performed with sufentanil and tropisetron.When visual analoge scale score>3, morphine 5-10 mg was intravenously injected.The intraoperative consumption of sufentanil and postoperative requirement for morphine used as rescue analgesics were recorded.Peripheral venous blood samples were collected before induction and at 3 and 24 h after operation for determination of the levels of T lymphocyte subsets (CD3+ , CD4+ and CD4+ /CD8+ ) by flow cytometry.Patients were followed up for 5 yr to record the survival and recurrence rates. \u0000 \u0000 \u0000Results \u0000The intraoperative consumption of sufentanil and postoperative requirement for morphine used as rescue analgesics were significantly lower in group P than in group G (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Pecs blockⅡ combined with general anesthesia can improve cellular immune function in the patients undergoing radical mastectomy. \u0000 \u0000 \u0000Key words: \u0000Nerve block; Thoraci cvertebrae; Anesthesia, general; Breastneo plasms; Immune function","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1360-1363"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48606264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.017
Jian Pan, Huibin Su, G. Lu, H. Qu, Yuxian Zhao, Xiao-qi Ji, Lili Chen
Objective To evaluate the effects of different concentrations of nalbuphine hydrochloride mixed with sufentanil for postoperative patient-controlled intravenous analgesia (PCIA) on inflammatory response in the patients undergoing gynecological tumor laparotomy. Methods One hundred and twenty-five patients, aged 22-64 yr, weighing 50-75 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective laparotomy for gynecologic tumors, were divided into 5 groups (n=25 each) by a random number table method: sufentanil 1 μg/ml group (group S), sufentanil 0.75 μg/ml + nalbuphine 0.25 mg/ml group (group N1), sufentanil 0.5 μg/ml + nalbuphine 0.5 mg/ml group (group N2) , sufentanil 0.25 μg/ml + nalbuphine 0.75 mg/ml group (group N3), and nalbuphine 1 mg/ml group (group N4). Postoperative PCA (granisetron 9 mg was added, the PCA solution was diluted to 150 ml in normal saline, a loading dose of 2 ml, background dose of 2 ml/h, a self-controlled dose of 1 ml/time, and a lockout interval of 15 min) was performed.Flurbiprofen 50 mg was intravenously injected for rescue analgesia, maintaining a static visual analog scale score ≤ 4 and a dynamic (cough) visual analog scale score ≤ 6.Venous blood samples were collected from the upper extremity before induction (T1), at 1 h after incision (T2), at the end of operation (T3), and at 24 and 48 h after operation (T4, 5) for determination of serum concentrations of interleukin-6(IL-6), tumor necrosis factor-alpha and IL-10.The effective pressing times of PCIA, requirement for rescue analgesia, development of nausea and vomiting and somnolence, and postoperative anal exhaust time were recorded within 24 h after surgery. Results Compared with group S, the concentrations of IL-6 and tumor necrosis factor-alpha in serum were significantly decreased, and the concentration of IL-10 was increased at T4, 5 in N1 and N2 groups, the anal exhaust time was significantly shortened, and the incidence of nausea and vomiting was decreased in the other groups, the effective pressing times of PCIA and requirement for rescue analgesia were significantly decreased in group N2, and the incidence of somnolence was significantly increased in group N4 (P<0.05). Conclusion Sufentanil 0.5 μg/ml plus nalbuphine hydrochloride 0.5 mg/ml provides good PCIA, effectively reduces inflammatory responses and decreases the occurrence of adverse reactions in the patients undergoing gynecological tumor laparotomy. Key words: Nalbuphine; Sufentanil; Femininity; Neoplasms; Analgesia, patient-controlled; Inflammation
{"title":"Effects of different concentrations of nalbuphine hydrochloride mixed with sufentanil for postoperative patient-controlled intravenous analgesia on inflammatory response in patients undergoing gynecological tumor laparotomy","authors":"Jian Pan, Huibin Su, G. Lu, H. Qu, Yuxian Zhao, Xiao-qi Ji, Lili Chen","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.017","url":null,"abstract":"Objective To evaluate the effects of different concentrations of nalbuphine hydrochloride mixed with sufentanil for postoperative patient-controlled intravenous analgesia (PCIA) on inflammatory response in the patients undergoing gynecological tumor laparotomy. Methods One hundred and twenty-five patients, aged 22-64 yr, weighing 50-75 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective laparotomy for gynecologic tumors, were divided into 5 groups (n=25 each) by a random number table method: sufentanil 1 μg/ml group (group S), sufentanil 0.75 μg/ml + nalbuphine 0.25 mg/ml group (group N1), sufentanil 0.5 μg/ml + nalbuphine 0.5 mg/ml group (group N2) , sufentanil 0.25 μg/ml + nalbuphine 0.75 mg/ml group (group N3), and nalbuphine 1 mg/ml group (group N4). Postoperative PCA (granisetron 9 mg was added, the PCA solution was diluted to 150 ml in normal saline, a loading dose of 2 ml, background dose of 2 ml/h, a self-controlled dose of 1 ml/time, and a lockout interval of 15 min) was performed.Flurbiprofen 50 mg was intravenously injected for rescue analgesia, maintaining a static visual analog scale score ≤ 4 and a dynamic (cough) visual analog scale score ≤ 6.Venous blood samples were collected from the upper extremity before induction (T1), at 1 h after incision (T2), at the end of operation (T3), and at 24 and 48 h after operation (T4, 5) for determination of serum concentrations of interleukin-6(IL-6), tumor necrosis factor-alpha and IL-10.The effective pressing times of PCIA, requirement for rescue analgesia, development of nausea and vomiting and somnolence, and postoperative anal exhaust time were recorded within 24 h after surgery. Results Compared with group S, the concentrations of IL-6 and tumor necrosis factor-alpha in serum were significantly decreased, and the concentration of IL-10 was increased at T4, 5 in N1 and N2 groups, the anal exhaust time was significantly shortened, and the incidence of nausea and vomiting was decreased in the other groups, the effective pressing times of PCIA and requirement for rescue analgesia were significantly decreased in group N2, and the incidence of somnolence was significantly increased in group N4 (P<0.05). Conclusion Sufentanil 0.5 μg/ml plus nalbuphine hydrochloride 0.5 mg/ml provides good PCIA, effectively reduces inflammatory responses and decreases the occurrence of adverse reactions in the patients undergoing gynecological tumor laparotomy. Key words: Nalbuphine; Sufentanil; Femininity; Neoplasms; Analgesia, patient-controlled; Inflammation","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1340-1343"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49460476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.018
Yi-ze Li, M. Han, Lin-lin Zhang, Lin Su, Xin Wang, K. Xie, Yonghao Yu, Guolin Wang
Objective To evaluate the relationship between euchromatic histone-lysine N-methyltransferase (G9a) and sodium-dependent activation of potassium channel (Slack) in the spinal cord dorsal horn during remifentanil-induced hyperalgesia in a rat model of incisional pain. Methods Clean-grade healthy male Sprague-Dawley rats, aged 1 month, weighing 100-120 g, were divided into 4 groups (n=6 each) by a random number table method: normal saline group (S group), vector group (V group), vector plus remifentanil plus incisional pain group (VRI group), and G9a-siRNA plus remifentanil plus incisional pain group (DRI group). In VRI group and DRI group, vector 1 μl was injected into the L4-5 spinal dorsal horn, 3 days later remifentanil 1 μg·kg-1·min-1 was intravenously infused via the tail vein for 60 min, and the model of incisional pain was established simultaneously.The equal volume of normal saline was given instead in S and V groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 24 h before remifentanil infusion (T0) and 2, 6, 24 and 48 h after infusion (T1-4). Rats were sacrificed after behavioral tests, and the L4, 5 segments of spinal dorsal horns were taken for determination of the expression of G9a, H3K9me2 and Slack by Western blot. Results Compared with S group, TWL was significantly shortened, and MWT was decreased at T1-4, the expression of G9a and H3K9me2 was up-regulated, and the expression of Slack was down-regulated in VRI group (P<0.05). Compared with VRI group, the TWL was significantly prolonged and MWT was increased at T1-4, the expression of G9a and H3K9me2 was down-regulated, and Slack expression was up-regulated in DRI group (P<0.05). Conclusion The mechanism by which remifentanil induces hyperalgesia is related to up-regulating G9a and H3K9me2 expression and down-regulating Slack expression in the spinal dorsal horn of rats with incisional pain. Key words: Piperidines; Hyperalgesia; Spinal cord; Histone-lysine N-methyltransferase; Potassium channels
目的探讨瑞芬太尼致痛觉过敏大鼠脊髓背角钠依赖性钾通道激活与常染色组蛋白-赖氨酸n -甲基转移酶(G9a)的关系。方法1月龄、体重100 ~ 120 g的清洁级健康雄性sd - dawley大鼠，采用随机数字表法分为生理盐水组(S组)、载体组(V组)、载体加瑞芬太尼加切口疼痛组(VRI组)、G9a-siRNA加瑞芬太尼加切口疼痛组(DRI组)，每组n=6。VRI组和DRI组大鼠腰4 ~ 5脊背角注射载体1 μl, 3 d后经尾静脉滴注瑞芬太尼1 μg·kg-1·min-1，持续60 min，同时建立切口疼痛模型。S组和V组改为等量生理盐水。在瑞芬太尼输注前24 h (T0)和输注后2、6、24、48 h (T1-4)测量机械足戒断阈值(MWT)和热足戒断潜伏期(TWL)。行为学实验后处死大鼠，取脊髓背角L4、5节段，Western blot法检测G9a、H3K9me2、Slack的表达。结果与S组比较，VRI组在T1-4时TWL显著缩短，MWT降低，G9a、H3K9me2表达上调，Slack表达下调(P<0.05)。与VRI组相比，DRI组在T1-4时TWL显著延长，MWT升高，G9a、H3K9me2表达下调，Slack表达上调(P<0.05)。结论瑞芬太尼诱导痛觉过敏的机制与上调切口痛大鼠脊髓背角G9a和H3K9me2表达，下调Slack表达有关。关键词:哌啶类;痛觉过敏;脊髓的;Histone-lysine N-methyltransferase;钾离子通道
{"title":"Relationship between G9a and Slack in spinal cord dorsal horn during remifentanil-induced hyperalgesia in a rat model of incisional pain","authors":"Yi-ze Li, M. Han, Lin-lin Zhang, Lin Su, Xin Wang, K. Xie, Yonghao Yu, Guolin Wang","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.018","url":null,"abstract":"Objective \u0000To evaluate the relationship between euchromatic histone-lysine N-methyltransferase (G9a) and sodium-dependent activation of potassium channel (Slack) in the spinal cord dorsal horn during remifentanil-induced hyperalgesia in a rat model of incisional pain. \u0000 \u0000 \u0000Methods \u0000Clean-grade healthy male Sprague-Dawley rats, aged 1 month, weighing 100-120 g, were divided into 4 groups (n=6 each) by a random number table method: normal saline group (S group), vector group (V group), vector plus remifentanil plus incisional pain group (VRI group), and G9a-siRNA plus remifentanil plus incisional pain group (DRI group). In VRI group and DRI group, vector 1 μl was injected into the L4-5 spinal dorsal horn, 3 days later remifentanil 1 μg·kg-1·min-1 was intravenously infused via the tail vein for 60 min, and the model of incisional pain was established simultaneously.The equal volume of normal saline was given instead in S and V groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 24 h before remifentanil infusion (T0) and 2, 6, 24 and 48 h after infusion (T1-4). Rats were sacrificed after behavioral tests, and the L4, 5 segments of spinal dorsal horns were taken for determination of the expression of G9a, H3K9me2 and Slack by Western blot. \u0000 \u0000 \u0000Results \u0000Compared with S group, TWL was significantly shortened, and MWT was decreased at T1-4, the expression of G9a and H3K9me2 was up-regulated, and the expression of Slack was down-regulated in VRI group (P<0.05). Compared with VRI group, the TWL was significantly prolonged and MWT was increased at T1-4, the expression of G9a and H3K9me2 was down-regulated, and Slack expression was up-regulated in DRI group (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The mechanism by which remifentanil induces hyperalgesia is related to up-regulating G9a and H3K9me2 expression and down-regulating Slack expression in the spinal dorsal horn of rats with incisional pain. \u0000 \u0000 \u0000Key words: \u0000Piperidines; Hyperalgesia; Spinal cord; Histone-lysine N-methyltransferase; Potassium channels","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1344-1347"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42672229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.026
Wenchao Yin, Haibin Jia, Wenzhi Wu, Lan Zhang, Chunyan Wang
Objective To evaluate the effect of propofol on H2O2-induced necroptosis in rat cardiomyocytes. Methods H9C2 cells at the logarithmic growth phase were divided into 4 groups (n= 9 each) using a random number table method: control group (group C), H2O2 group, propofol group (group P) and dimethyl sulfoxide group (group D). Cells were incubated in normal DMEM medium in group C. H2O2 was added to the culture medium with the final concentration of 500 μmol/L in group H2O2.Propofol at the final concentration of 50 μmol/L and the equal volume of dimethyl sulfoxide were added to the cell medium at 30 min before H2O2 exposure in group P and group D, respectively.After 12-h culture or incubation with H2O2, cardiomyocytes necrosis was detected by PI staining, reactive oxygen species (ROS) level was determined by DCFH-DA staining, and the expression of receptor-interacting serine/threonine-protein kinase 1 (RIPK1), RIPK3 and mixed lineage kinase domain-like protein (MLKL) was determined by Western blot. Results Compared with group C, necrosis rate and ROS level were significantly increased, and the expression of RIPK1, RIPK3 and MLKL was up-regulated in H2O2 and D groups (P<0.05). Compared with group H2O2, necrosis rate and ROS level were significantly decreased, and the expression of RIPK1, RIPK3 and MLKL was down-regulated in group P (P<0.05). Conclusion Propofol can attenuate H2O2-induced necroptosis in cardiomyocytes of rats. Key words: Propofol; Hydrogen peroxide; Myocytes, cardiac; Necroptosis
{"title":"Effect of propofol on H2O2-induced necroptosis in rat cardiomyocytes","authors":"Wenchao Yin, Haibin Jia, Wenzhi Wu, Lan Zhang, Chunyan Wang","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.026","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.026","url":null,"abstract":"Objective \u0000To evaluate the effect of propofol on H2O2-induced necroptosis in rat cardiomyocytes. \u0000 \u0000 \u0000Methods \u0000H9C2 cells at the logarithmic growth phase were divided into 4 groups (n= 9 each) using a random number table method: control group (group C), H2O2 group, propofol group (group P) and dimethyl sulfoxide group (group D). Cells were incubated in normal DMEM medium in group C. H2O2 was added to the culture medium with the final concentration of 500 μmol/L in group H2O2.Propofol at the final concentration of 50 μmol/L and the equal volume of dimethyl sulfoxide were added to the cell medium at 30 min before H2O2 exposure in group P and group D, respectively.After 12-h culture or incubation with H2O2, cardiomyocytes necrosis was detected by PI staining, reactive oxygen species (ROS) level was determined by DCFH-DA staining, and the expression of receptor-interacting serine/threonine-protein kinase 1 (RIPK1), RIPK3 and mixed lineage kinase domain-like protein (MLKL) was determined by Western blot. \u0000 \u0000 \u0000Results \u0000Compared with group C, necrosis rate and ROS level were significantly increased, and the expression of RIPK1, RIPK3 and MLKL was up-regulated in H2O2 and D groups (P<0.05). Compared with group H2O2, necrosis rate and ROS level were significantly decreased, and the expression of RIPK1, RIPK3 and MLKL was down-regulated in group P (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Propofol can attenuate H2O2-induced necroptosis in cardiomyocytes of rats. \u0000 \u0000 \u0000Key words: \u0000Propofol; Hydrogen peroxide; Myocytes, cardiac; Necroptosis","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1376-1378"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41932629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.034
Z. Hu, Min Wu, S. Lyu, Huizhen Yang, Shengqun Liu
{"title":"Accuracy of ultrasound disappearance of lung sliding and B-line for diagnosis of pneumothorax in patients with tracheoscopy","authors":"Z. Hu, Min Wu, S. Lyu, Huizhen Yang, Shengqun Liu","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.034","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.034","url":null,"abstract":"","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1405-1406"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43343277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the occurrence of subglottic tracheal stenosis after tracheotomy in the patients with cicatricial diathesis. Methods From May 2012 to May 2017, the tracheotomized patients in intensive care unit who were readmitted for airway therapy were selected.Patients with subglottic tracheal stenosis were assigned to cicatricial diathesis group and non-cicatricial diathesis group.Samples of tracheal stenosis were obtained for routine pathological examination, and the results were recorded.The degree of tracheal stenosis was classified according to the Myer-Cotton grade.The time of bearing a tracheal cannula and time of subglottic trachea stenosis were recorded, and the therapeutic effect was also recorded. Results A total of 2 276 racheotomized patients (139 with cicatricial diathesis and 2 137 with non-cicatricial diathesis) were included in this study, the incidence of subglottic tracheal stenosis was 2.90%, and the incidence of subglottic tracheal stenosis was significantly higher in patients with cicatricial diathesis than in those with non-cicatricial diathesis (P<0.01). Compared with non-cicatricial diathesis group, the Myer-Cotton grade was significantly increased, the time of subglottic tracheal stenosis occurred was shortened, the treatment times were increased, the rate of effective treatment was decreased, and the scar formation rate was increased in cicatricial diathesis group (P<0.01). Conclusion Patients with cicatricial diathesis are more likely to develop subglottic tracheal stenosis after tracheotomy, with severe degree and poor treatment effect. Key words: Tracheal stenosis; Keloid; Tracheostomy
{"title":"Occurrence of subglottic tracheal stenosis after tracheotomy in patients with cicatricial diathesis","authors":"E. Chang, X. Ruan, Ningtao Li, Mingyang Sun, Shengli Zhou, Jiaqiang Zhang","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.009","url":null,"abstract":"Objective \u0000To investigate the occurrence of subglottic tracheal stenosis after tracheotomy in the patients with cicatricial diathesis. \u0000 \u0000 \u0000Methods \u0000From May 2012 to May 2017, the tracheotomized patients in intensive care unit who were readmitted for airway therapy were selected.Patients with subglottic tracheal stenosis were assigned to cicatricial diathesis group and non-cicatricial diathesis group.Samples of tracheal stenosis were obtained for routine pathological examination, and the results were recorded.The degree of tracheal stenosis was classified according to the Myer-Cotton grade.The time of bearing a tracheal cannula and time of subglottic trachea stenosis were recorded, and the therapeutic effect was also recorded. \u0000 \u0000 \u0000Results \u0000A total of 2 276 racheotomized patients (139 with cicatricial diathesis and 2 137 with non-cicatricial diathesis) were included in this study, the incidence of subglottic tracheal stenosis was 2.90%, and the incidence of subglottic tracheal stenosis was significantly higher in patients with cicatricial diathesis than in those with non-cicatricial diathesis (P<0.01). Compared with non-cicatricial diathesis group, the Myer-Cotton grade was significantly increased, the time of subglottic tracheal stenosis occurred was shortened, the treatment times were increased, the rate of effective treatment was decreased, and the scar formation rate was increased in cicatricial diathesis group (P<0.01). \u0000 \u0000 \u0000Conclusion \u0000Patients with cicatricial diathesis are more likely to develop subglottic tracheal stenosis after tracheotomy, with severe degree and poor treatment effect. \u0000 \u0000 \u0000Key words: \u0000Tracheal stenosis; Keloid; Tracheostomy","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1311-1314"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49229348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.005
Jinhu Xue, Zhisong Li, F. Xing, Jianjun Yang
Objective To evaluate the effect of thoracic paravertebral block (PVB) combined with general anesthesia on the early postoperative recovery of patients undergoing laparoscopic cholecystectomy. Methods Sixty patients of both sexes, aged 45-64 yr, with body mass index of 18.5-32.0 kg/m2, with American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into 2 groups (n=30 each) using a random number table method: general anesthesia group (group GA) and thoracic PVB combined with general anesthesia group (group TPGA). Thoracic PVB was performed under ultrasound guidance at the right vertebral level T7 at 30 min before operation, and 0.375% ropivacaine 0.4 ml/kg was intermittently injected when air or blood was not found after withdrawing from the catheter at the angle between the T7 transverse process and the pleura in group TPGA.Lidocaine was injected for local infiltration anesthesia, and patients received no thoracic PVB at 30 min before operation in group GA.Patient-controlled intravenous analgesia (PCIA) was performed with sufentanil after operation in two groups.When the visual analogue scale score ≥4 points, tramadol 1-2 mg/kg or dizocin 0.1 mg/kg was intravenously injected for rescue analgesia.The intraoperative consumption of remifentanil, postoperative effective pressing times of PCIA, consumption of sufentanil within 2 days after operation, requirement for rescue analgesia, and development of nausea and vomiting were recorded.Quality of Recovery-15 was used to assess the early postoperative quality of recovery at 1 and 2 days after operation. Results Compared with group GA, the intraoperative consumption of remifentanil, postoperative effective pressing times of PCIA, consumption of sufentanil within 2 days after operation, rate of rescue analgesia and incidence of nausea and vomiting were significantly decreased, and Quality of Recovery-15 scores were increased at 1 and 2 days after operation in group TPGA (P<0.05). Conclusion Compared with general anesthesia, thoracic PVB combined with general anesthesia is helpful in promoting early postoperative recovery when used for the patients undergoing laparoscopic cholecystectomy. Key words: Nerve block; Anesthesia, general; Recovery
{"title":"Effect of thoracic paravertebral block combined with general anesthesia on early postoperative recovery of patients undergoing laparoscopic cholecystectomy","authors":"Jinhu Xue, Zhisong Li, F. Xing, Jianjun Yang","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.005","url":null,"abstract":"Objective \u0000To evaluate the effect of thoracic paravertebral block (PVB) combined with general anesthesia on the early postoperative recovery of patients undergoing laparoscopic cholecystectomy. \u0000 \u0000 \u0000Methods \u0000Sixty patients of both sexes, aged 45-64 yr, with body mass index of 18.5-32.0 kg/m2, with American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into 2 groups (n=30 each) using a random number table method: general anesthesia group (group GA) and thoracic PVB combined with general anesthesia group (group TPGA). Thoracic PVB was performed under ultrasound guidance at the right vertebral level T7 at 30 min before operation, and 0.375% ropivacaine 0.4 ml/kg was intermittently injected when air or blood was not found after withdrawing from the catheter at the angle between the T7 transverse process and the pleura in group TPGA.Lidocaine was injected for local infiltration anesthesia, and patients received no thoracic PVB at 30 min before operation in group GA.Patient-controlled intravenous analgesia (PCIA) was performed with sufentanil after operation in two groups.When the visual analogue scale score ≥4 points, tramadol 1-2 mg/kg or dizocin 0.1 mg/kg was intravenously injected for rescue analgesia.The intraoperative consumption of remifentanil, postoperative effective pressing times of PCIA, consumption of sufentanil within 2 days after operation, requirement for rescue analgesia, and development of nausea and vomiting were recorded.Quality of Recovery-15 was used to assess the early postoperative quality of recovery at 1 and 2 days after operation. \u0000 \u0000 \u0000Results \u0000Compared with group GA, the intraoperative consumption of remifentanil, postoperative effective pressing times of PCIA, consumption of sufentanil within 2 days after operation, rate of rescue analgesia and incidence of nausea and vomiting were significantly decreased, and Quality of Recovery-15 scores were increased at 1 and 2 days after operation in group TPGA (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Compared with general anesthesia, thoracic PVB combined with general anesthesia is helpful in promoting early postoperative recovery when used for the patients undergoing laparoscopic cholecystectomy. \u0000 \u0000 \u0000Key words: \u0000Nerve block; Anesthesia, general; Recovery","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1294-1297"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41934909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.016
Yifei Liu, P. Deng, Aihua Shu
Objective To investigate the efficacy of ultrasound-guided right phrenic nerve block in preventing shoulder pain after total laparoscopic hysterectomy. Methods A total of 160 patients, aged 45-65, weighing 50-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective total laparoscopic hysterectomy, were divided into 2 groups (n = 80 each) using the random number table method: control group (group C) and right phrenic nerve block group (R group). The right phrenic nerve blockade was performed before induction of anesthesia, and 0.375% ropivacaine 6 ml was injected in R group.Tracheal intubation was used for total intravenous anesthesia in two groups.The severity of postoperative shoulder pain was assessed using visual analogue scale score.When visual analogue scale score≥4, ketorolac tromethamine 30 mg was given.The development of shoulder pain and consumption of analgesics within 72 h after operation were recorded. Results Compared with group C, the incidence of postoperative shoulder pain and consumption of analgesics were significantly decreased in group R (P< 0.05). Conclusion Ultrasound-guided right phrenic nerve block can prevent shoulder pain after total laparoscopic hysterectomy. Key words: Phrenic nerve; Nerve block; Laparoscopy; Hysterectomy; Shoulder pain
{"title":"Efficacy of ultrasound-guided right phrenic nerve block in preventing shoulder pain after total laparoscopic hysterectomy","authors":"Yifei Liu, P. Deng, Aihua Shu","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.016","url":null,"abstract":"Objective \u0000To investigate the efficacy of ultrasound-guided right phrenic nerve block in preventing shoulder pain after total laparoscopic hysterectomy. \u0000 \u0000 \u0000Methods \u0000A total of 160 patients, aged 45-65, weighing 50-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective total laparoscopic hysterectomy, were divided into 2 groups (n = 80 each) using the random number table method: control group (group C) and right phrenic nerve block group (R group). The right phrenic nerve blockade was performed before induction of anesthesia, and 0.375% ropivacaine 6 ml was injected in R group.Tracheal intubation was used for total intravenous anesthesia in two groups.The severity of postoperative shoulder pain was assessed using visual analogue scale score.When visual analogue scale score≥4, ketorolac tromethamine 30 mg was given.The development of shoulder pain and consumption of analgesics within 72 h after operation were recorded. \u0000 \u0000 \u0000Results \u0000Compared with group C, the incidence of postoperative shoulder pain and consumption of analgesics were significantly decreased in group R (P< 0.05). \u0000 \u0000 \u0000Conclusion \u0000Ultrasound-guided right phrenic nerve block can prevent shoulder pain after total laparoscopic hysterectomy. \u0000 \u0000 \u0000Key words: \u0000Phrenic nerve; Nerve block; Laparoscopy; Hysterectomy; Shoulder pain","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1337-1339"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43030156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.010
Shuang Han, Kun He, Dongdong Yu, Yuying Hu, Yajing Wu, Junfang Rong
Objective To evaluate the effect of inhaled aerosolized budesonide and salbutamol on hypoxia-inducible factor-1α (HIF-1α)/vascular endothelial growth factor (VEGF) signaling pathway in collapsed lung tissues of rabbits undergoing one-lung ventilation (OLV). Methods Twenty-four healthy male New Zealand white rabbits, aged 5-6 months, weighing 2.5-3.0 kg, were randomized into 3 groups (n=8 each) using a random number table method: two-lung ventilation (TLV) group, OLV group, and budesonide and salbutamol aerosol inhalation group (group B+ S). Bilateral lungs were ventilated for 3 h in group TLV, and the left lung was ventilated for 2 h followed by 1-h TLV in group OLV and B+ S group.In group B+ S, aerosolized salbutamol 0.15 mg/kg and budesonide 1 mg in normal saline (2 ml in total) was inhaled before OLV.The equal volume of normal saline was given instead in TLV and OLV groups.Volume-controlled ventilation was used in each group.Before beginning of aerosol inhalation (T0), immediately after the end of aerosol inhalation (T1), and at 1, 2 and 3 h of ventilation (T2-4), arterial blood samples were obtained for blood gas analysis.Oxygenation index was calculated.The rabbits were sacrificed at the end of ventilation, and lower lobe tissues were obtained from the collapsed lung for examination of the pathological changes (with a light microscope) which were scored and for determination of HIF-1α and VEGF expression in lung tissues (by Western blot). Results Compared with group TLV, oxygenation index was significantly decreased at T2-4, the concentration of lactic acid and lung injury score were increased, and the expression of HIF-1α and VEGF was up-regulated in group OLV and group B+ S (P<0.05). Compared with group OLV, oxygenation index was significantly increased at T2-4, the concentration of lactic acid and lung injury score were decreased, and the expression of HIF-1α and VEGF was down-regulated in group S+ B (P<0.05). Conclusion The mechanism by which inhaled aerosolized budesonide and salbutamol reduces OLV-induced injury to the collapsed lung is related to blocking HIF-1α/VEGF signaling pathway in lung tissues of rabbits. Key words: One-lung ventilation; Acute lung injury; Budesonide; Albuterol; Bronchodilator agents; Administration, inhalation
{"title":"Effect of inhaled aerosolized budesonide and salbutamol on HIF-1α/VEGF signaling pathway in collapsed lung tissues of rabbits undergoing one-lung ventilation","authors":"Shuang Han, Kun He, Dongdong Yu, Yuying Hu, Yajing Wu, Junfang Rong","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.010","url":null,"abstract":"Objective \u0000To evaluate the effect of inhaled aerosolized budesonide and salbutamol on hypoxia-inducible factor-1α (HIF-1α)/vascular endothelial growth factor (VEGF) signaling pathway in collapsed lung tissues of rabbits undergoing one-lung ventilation (OLV). \u0000 \u0000 \u0000Methods \u0000Twenty-four healthy male New Zealand white rabbits, aged 5-6 months, weighing 2.5-3.0 kg, were randomized into 3 groups (n=8 each) using a random number table method: two-lung ventilation (TLV) group, OLV group, and budesonide and salbutamol aerosol inhalation group (group B+ S). Bilateral lungs were ventilated for 3 h in group TLV, and the left lung was ventilated for 2 h followed by 1-h TLV in group OLV and B+ S group.In group B+ S, aerosolized salbutamol 0.15 mg/kg and budesonide 1 mg in normal saline (2 ml in total) was inhaled before OLV.The equal volume of normal saline was given instead in TLV and OLV groups.Volume-controlled ventilation was used in each group.Before beginning of aerosol inhalation (T0), immediately after the end of aerosol inhalation (T1), and at 1, 2 and 3 h of ventilation (T2-4), arterial blood samples were obtained for blood gas analysis.Oxygenation index was calculated.The rabbits were sacrificed at the end of ventilation, and lower lobe tissues were obtained from the collapsed lung for examination of the pathological changes (with a light microscope) which were scored and for determination of HIF-1α and VEGF expression in lung tissues (by Western blot). \u0000 \u0000 \u0000Results \u0000Compared with group TLV, oxygenation index was significantly decreased at T2-4, the concentration of lactic acid and lung injury score were increased, and the expression of HIF-1α and VEGF was up-regulated in group OLV and group B+ S (P<0.05). Compared with group OLV, oxygenation index was significantly increased at T2-4, the concentration of lactic acid and lung injury score were decreased, and the expression of HIF-1α and VEGF was down-regulated in group S+ B (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The mechanism by which inhaled aerosolized budesonide and salbutamol reduces OLV-induced injury to the collapsed lung is related to blocking HIF-1α/VEGF signaling pathway in lung tissues of rabbits. \u0000 \u0000 \u0000Key words: \u0000One-lung ventilation; Acute lung injury; Budesonide; Albuterol; Bronchodilator agents; Administration, inhalation","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1315-1318"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46009326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.11.033
Jing-yun Fan, Chen Xiaodong, Shen Jian, B. Gui
{"title":"Reliability of end-expiratory specimens obtained with patented endotracheal tube in determining PETCO2 in pediatric patients","authors":"Jing-yun Fan, Chen Xiaodong, Shen Jian, B. Gui","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.11.033","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.11.033","url":null,"abstract":"","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1403-1404"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45885913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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