Pub Date : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2019.12.020
Pei Li, Jinlong Wei, Qianzi Yang
The central medial thalamus is located in the common pathway of the ascending activation system and the descending facilitation pathway. It has extensive projective connections with the cortical and sub-cortical nuclei. More evidences indicated that the central medial thalamus may play an important regulatory role in sleep, anesthesia and awakening. By summarizing the relevant experimental results in recent years, this review introduced the projective relationship and functional classification of the central medial thalamus, highlighted the regulatory role and mechanism of the thalamic central median nucleus in sleep, anesthesia and awakening and discussed the application in promoting the transformation from vegetative state to wakefulness. We finally suggested that the central medial thalamus may be the key nucleus in maintaining the wakefulness and mediating the transition from wake state to sleep and anesthesia state. Key words: Thalamus; Central medial thalamus; Sleep; Anesthesia; Wakefulness
{"title":"The research progress of on the role of central medial thalamus in the sleep anesthesia and awakening","authors":"Pei Li, Jinlong Wei, Qianzi Yang","doi":"10.3760/CMA.J.ISSN.1673-4378.2019.12.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2019.12.020","url":null,"abstract":"The central medial thalamus is located in the common pathway of the ascending activation system and the descending facilitation pathway. It has extensive projective connections with the cortical and sub-cortical nuclei. More evidences indicated that the central medial thalamus may play an important regulatory role in sleep, anesthesia and awakening. By summarizing the relevant experimental results in recent years, this review introduced the projective relationship and functional classification of the central medial thalamus, highlighted the regulatory role and mechanism of the thalamic central median nucleus in sleep, anesthesia and awakening and discussed the application in promoting the transformation from vegetative state to wakefulness. We finally suggested that the central medial thalamus may be the key nucleus in maintaining the wakefulness and mediating the transition from wake state to sleep and anesthesia state. \u0000 \u0000 \u0000Key words: \u0000Thalamus; Central medial thalamus; Sleep; Anesthesia; Wakefulness","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"40 1","pages":"1183-1186"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42031148","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2019.12.008
Li-yong Zhang, Hailong Jin
Objective To analyze the incidence and related factor of pulmonary infection in child patients (0-16 years) after brainstem tumor resection. Methods A retrospective analysis was conducted on 103 patients who admitted into department of neurosurgery, Beijing Tiantan Hospital, Capital Medical University and underwent brainstem tumor resection from January 2016 to June 2018. The preoperative, intraoperative and postoperative data were collected to explore the incidence of postoperative pulmonary complications and the effects of related factors on pulmonary infection, and establish a regression model. Results A total of 103 patients were enrolled in this study. There were 46 cases of pulmonary infection (44.7%), with respiratory failure in 16 cases (34.8%) and atelectasis in 4 cases(8.7%). The variables associated with postoperative pneumonia included output volume per kilogram, urine volume per kilogram, operation time, medulla oblongata tumor, serum albumin 1 d after surgery and postoperative application of ventilators. According to multi-variate Logistic regression analysis, the independent risk factors for pulmonary infection in children after brainstem tumor resection were as follows: operation time [odds ratio(OR)=1.008, 95% confidence interval(CI) 1.001-1.015], medulla oblongata tumor(OR=3.312, 95%CI 1.096-8.947), and postoperative application of ventilators(OR=8.042, 95%CI 1.485-43.545). Conclusions The incidence of pulmonary infection is reaching 44.7% in child patients undergoing brainstem tumor resection. Increasing attention should be paid on perioperative management. Operation time, medulla oblongata tumor, and postoperative application of ventilators are the independent risk factors that result in an increased incidence of pulmonary infections after brainstem surgery. Key words: Children; Brain stem; Tumor; Pulmonary infection
{"title":"Analysis of pulmonary infection and related factors after craniotomy of brain stem tumor resection in children","authors":"Li-yong Zhang, Hailong Jin","doi":"10.3760/CMA.J.ISSN.1673-4378.2019.12.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2019.12.008","url":null,"abstract":"Objective \u0000To analyze the incidence and related factor of pulmonary infection in child patients (0-16 years) after brainstem tumor resection. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted on 103 patients who admitted into department of neurosurgery, Beijing Tiantan Hospital, Capital Medical University and underwent brainstem tumor resection from January 2016 to June 2018. The preoperative, intraoperative and postoperative data were collected to explore the incidence of postoperative pulmonary complications and the effects of related factors on pulmonary infection, and establish a regression model. \u0000 \u0000 \u0000Results \u0000A total of 103 patients were enrolled in this study. There were 46 cases of pulmonary infection (44.7%), with respiratory failure in 16 cases (34.8%) and atelectasis in 4 cases(8.7%). The variables associated with postoperative pneumonia included output volume per kilogram, urine volume per kilogram, operation time, medulla oblongata tumor, serum albumin 1 d after surgery and postoperative application of ventilators. According to multi-variate Logistic regression analysis, the independent risk factors for pulmonary infection in children after brainstem tumor resection were as follows: operation time [odds ratio(OR)=1.008, 95% confidence interval(CI) 1.001-1.015], medulla oblongata tumor(OR=3.312, 95%CI 1.096-8.947), and postoperative application of ventilators(OR=8.042, 95%CI 1.485-43.545). \u0000 \u0000 \u0000Conclusions \u0000The incidence of pulmonary infection is reaching 44.7% in child patients undergoing brainstem tumor resection. Increasing attention should be paid on perioperative management. Operation time, medulla oblongata tumor, and postoperative application of ventilators are the independent risk factors that result in an increased incidence of pulmonary infections after brainstem surgery. \u0000 \u0000 \u0000Key words: \u0000Children; Brain stem; Tumor; Pulmonary infection","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"40 1","pages":"1125-1128"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41606818","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2019.12.016
Qingchun Sun, Ke Ding, Zhenfeng Zhang, Yuan Han, Cao Jun-li
In recent years, the development of functional magnetic resonance imaging (fMRI) in the field of neurology and psychiatry has provided new thoughts for determining the objective diagnostic indicators of postoperative cognitive dysfunction (POCD). This paper introduces the current application of fMRI in the field of POCD both in theory and practice, and provides supports for future exploration and practice. This paper overviews fMRI and its application in neurological and psychiatric diseases, analyzes the theoretical feasibility and technical advantages of fMRI for POCD, lists the current research achievements, and discusses the limits in practice. With the continuous improvement of technology, deepening of application and conduct of joint research, fMRI′s predictive and diagnostic value for POCD will become increasingly prominent in clinical practice. Key words: Functional magnetic resonance imaging; Postoperative cognitive dysfunction
{"title":"Functional magnetic resonance imaging and postoperative cognitive dysfunction","authors":"Qingchun Sun, Ke Ding, Zhenfeng Zhang, Yuan Han, Cao Jun-li","doi":"10.3760/CMA.J.ISSN.1673-4378.2019.12.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2019.12.016","url":null,"abstract":"In recent years, the development of functional magnetic resonance imaging (fMRI) in the field of neurology and psychiatry has provided new thoughts for determining the objective diagnostic indicators of postoperative cognitive dysfunction (POCD). This paper introduces the current application of fMRI in the field of POCD both in theory and practice, and provides supports for future exploration and practice. This paper overviews fMRI and its application in neurological and psychiatric diseases, analyzes the theoretical feasibility and technical advantages of fMRI for POCD, lists the current research achievements, and discusses the limits in practice. With the continuous improvement of technology, deepening of application and conduct of joint research, fMRI′s predictive and diagnostic value for POCD will become increasingly prominent in clinical practice. \u0000 \u0000 \u0000Key words: \u0000Functional magnetic resonance imaging; Postoperative cognitive dysfunction","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"40 1","pages":"1160-1164"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46090178","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2019.12.019
Long Yang
Effective prevention and treatment of perioperative myocardial ischemia-reperfusion injury is an important problem to be urgently solved by multiple disciplines. Optimizing the energy metabolism of ischemic myocardium is essential to alleviate myocardial ischemia/reperfusion injury. It has been confirmed that AMP-activated protein kinase (AMPK) is an important hub of energy metabolism, and can reduce ischemic myocardial injury by increasing glucose uptake, promoting autophagy and inhibiting apoptosis. This paper summarizes the protective effect and mechanism of AMPK in ischemic heart disease, and provides theoretical evidence for seeking the strategy of preventing and treating myocardial ischemia/reperfusion injury with AMPK as the target. Key words: AMP-activated protein kinase; Myocardial ischemia; Energy metabolism
{"title":"The role of AMP-activated protein kinase in ischemic heart disease","authors":"Long Yang","doi":"10.3760/CMA.J.ISSN.1673-4378.2019.12.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2019.12.019","url":null,"abstract":"Effective prevention and treatment of perioperative myocardial ischemia-reperfusion injury is an important problem to be urgently solved by multiple disciplines. Optimizing the energy metabolism of ischemic myocardium is essential to alleviate myocardial ischemia/reperfusion injury. It has been confirmed that AMP-activated protein kinase (AMPK) is an important hub of energy metabolism, and can reduce ischemic myocardial injury by increasing glucose uptake, promoting autophagy and inhibiting apoptosis. This paper summarizes the protective effect and mechanism of AMPK in ischemic heart disease, and provides theoretical evidence for seeking the strategy of preventing and treating myocardial ischemia/reperfusion injury with AMPK as the target. \u0000 \u0000 \u0000Key words: \u0000AMP-activated protein kinase; Myocardial ischemia; Energy metabolism","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"40 1","pages":"1178-1182"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45120757","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2019.12.009
Hai-Bin Sun, Xiao-Qing Zhao, Jingli Zhu
Objective To estimate the effects of endothelial progenitor cell(EPC) on acute rejection after lung transplantation. Methods Twenty-four Wistar rats were randomly divided into three groups (n=8): a sham operation group (opening chest alone, group S), a control group[intravenous injection of phosphate buffer saline (PBS) after orthopedic left lung transplantation, group C] and an endothelial progenitor cell group(intravenous injection of EPC+PBS after orthopedic left lung transplantation, group EPC). The donor was SD rat. Total sixteen SD rats were used. The blood of three groups of recipient rats was collected from femoral artery on Day 7 after operation. Then the oxygenation index (PaO2/FiO2) was measured by blood gas analysis while the concentrations of serum inflammatory factor intercellular cell adhesion molecule-1 (ICAM-1) and lymphocytefunctionassociatedantigen-1 (LFA-1) were measured by ELISA. The lungs of sacrificed rats were taken. Then, partial lung tissues were used to measure the dry and wet tissues specific gravity. other part of lung tissues were used to measure concentrations of inflammatory factors interferon-γ(IFN-γ) and interleukin(IL)-2, IL-10 by enzyme linked immunosorbent assay (ELISA) and to evaluate reject reaction by hematoxylin-eosin (H-E) staining. Results Compared with the group C, PaO2/FiO2 was increased whereas the wet/dry weight ratio and protein concentrations were decreased in group EPC(P<0.05). The levels of serum ICAM-1, LFA, IFN-γ and IL-2 in transplanted lung tissues were down-regulated, but the level of IL-10 was up-regulated in group EPC(P<0.05). The reject reaction score of group C (4.3±1.1) and group EPC(2.4±0.8) were higher than the score in group S(0). Conclusions EPC is able to relieve lung acute reject reaction after lung transplantation. Key words: Lung transplantation; Acute rejection; Endothelial progenitor cell
{"title":"Effects of endothelial progenitor cells on acute lung rejection after lung transplantation","authors":"Hai-Bin Sun, Xiao-Qing Zhao, Jingli Zhu","doi":"10.3760/CMA.J.ISSN.1673-4378.2019.12.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2019.12.009","url":null,"abstract":"Objective \u0000To estimate the effects of endothelial progenitor cell(EPC) on acute rejection after lung transplantation. \u0000 \u0000 \u0000Methods \u0000Twenty-four Wistar rats were randomly divided into three groups (n=8): a sham operation group (opening chest alone, group S), a control group[intravenous injection of phosphate buffer saline (PBS) after orthopedic left lung transplantation, group C] and an endothelial progenitor cell group(intravenous injection of EPC+PBS after orthopedic left lung transplantation, group EPC). The donor was SD rat. Total sixteen SD rats were used. The blood of three groups of recipient rats was collected from femoral artery on Day 7 after operation. Then the oxygenation index (PaO2/FiO2) was measured by blood gas analysis while the concentrations of serum inflammatory factor intercellular cell adhesion molecule-1 (ICAM-1) and lymphocytefunctionassociatedantigen-1 (LFA-1) were measured by ELISA. The lungs of sacrificed rats were taken. Then, partial lung tissues were used to measure the dry and wet tissues specific gravity. other part of lung tissues were used to measure concentrations of inflammatory factors interferon-γ(IFN-γ) and interleukin(IL)-2, IL-10 by enzyme linked immunosorbent assay (ELISA) and to evaluate reject reaction by hematoxylin-eosin (H-E) staining. \u0000 \u0000 \u0000Results \u0000Compared with the group C, PaO2/FiO2 was increased whereas the wet/dry weight ratio and protein concentrations were decreased in group EPC(P<0.05). The levels of serum ICAM-1, LFA, IFN-γ and IL-2 in transplanted lung tissues were down-regulated, but the level of IL-10 was up-regulated in group EPC(P<0.05). The reject reaction score of group C (4.3±1.1) and group EPC(2.4±0.8) were higher than the score in group S(0). \u0000 \u0000 \u0000Conclusions \u0000EPC is able to relieve lung acute reject reaction after lung transplantation. \u0000 \u0000 \u0000Key words: \u0000Lung transplantation; Acute rejection; Endothelial progenitor cell","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"40 1","pages":"1129-1133"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47083008","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2019.12.011
Huiying Zhang
When high airway pressure occur under general anesthesia, we should comprehensively consider the presence of respiratory obstruction, and the effects of tube wall dissection cannot be excluded. When tube wall dissection is determined, it is necessary to replace the tube in time. In the current study, we report a case of high airway pressure due to reinforced endotracheal tube wall dissection, so as to share the perioperative experiences and inadequacies and provide reference for management of the patients under the same condition. Key words: Endotracheal tube; Dissection; High airway pressure; Airway obstruction
{"title":"Reinforced endotracheal tube wall dissection leads to high airway pressure: one case","authors":"Huiying Zhang","doi":"10.3760/CMA.J.ISSN.1673-4378.2019.12.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2019.12.011","url":null,"abstract":"When high airway pressure occur under general anesthesia, we should comprehensively consider the presence of respiratory obstruction, and the effects of tube wall dissection cannot be excluded. When tube wall dissection is determined, it is necessary to replace the tube in time. In the current study, we report a case of high airway pressure due to reinforced endotracheal tube wall dissection, so as to share the perioperative experiences and inadequacies and provide reference for management of the patients under the same condition. \u0000 \u0000 \u0000Key words: \u0000Endotracheal tube; Dissection; High airway pressure; Airway obstruction","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"40 1","pages":"1139-1140"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45034136","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2019.12.002
Xiuxia Wu
Objective To observe the effect of multimode anesthesia monitoring and management in the operation of elderly patients with gastrointestinal tumor and fragile brain function. Methods One hundred and nine cases of patients with fragile brain function who underwent elective total intravenous anesthesia for gastrointestinal tumor surgery were divided into observation group (58 cases) and control group (51 cases). The control group received routine anesthesia monitoring management during operation, while the observation group received multi-mode anesthesia monitoring management during operation, including cardiac inde (CI), stroke volume variation(SVV), bispectral index(BIS), train-of-four stimulation(TOF) and regional cerebral oxygen saturation(rScO2). The following indexes were observed and compared between the two groups: ① Intraoperative dosage of related anesthetics. ② Ramsay sedation score and Visual Analogue Scale(VAS) score at 10 min and 1 h, 6 h, 24 h, 48 h, 72 h after operation. ③ Heart rate(HR) and mean artery pressure (MAP) at admission (T0), infusion load of dexmedetomidine (T1), 1 min after intubation (T2), after skin incision (T3), after operation(T4), 1 min after extubation(T5). ④ Postoperative recovery, the relevant indicators are the opening time from the end of operation to the call, the time from the end of operation to extubation, the time of postanesthesia care unit(PACU) residence, the time of gastrointestinal function recovery and hospitalization. ⑤ Postoperative delirium (POD) and the occurrence of postoperative cognitive dysfunction(POCD). Results The dosage used of propofol and cisatracurium besylate in the observation group were significantly less than the dosage used in control group(P<0.05). The postoperative Ramsay sedation scores of observation group at 1, 6, 24, 72 h were significantly higher than the score of the control group(P<0.05), the postoperative VAS at 10 min, 1 h, 6 h, 24 h, 48 h were significantly lower than the control group(P<0.05). The HR at T1-T5 time and MAP at T2-T5 time of observation group were significantly lower than the HR and MAP of control group(P<0.05). Postoperative observation group and called the open end of the operation time, extubation time, PACU dwell time and hospitalization time were significantly shorter than the values of control group (P<0.05). The total POD incidence rate in patients of the observation group in were significantly lower than the rate of the control group(P<0.05). Conclusions The application of multi-mode anesthesia monitoring and management in the operation of elderly patients with gastrointestinal cancer and fragile brain function is satisfactory. Key words: Multimode anesthesia monitoring and management; Fragile brain function; Gastrointestinal tumor; Aged
目的观察多模式麻醉监测与管理在老年胃肠道肿瘤及脑功能脆弱患者手术中的效果。方法将109例脑功能脆弱的胃肠道肿瘤手术患者随机分为观察组（58例）和对照组（51例）。对照组在手术过程中接受常规麻醉监测管理，观察组在手术期间接受多模式麻醉监测管理。包括心脏inde（CI）、搏出量变化（SVV）、双频谱指数（BIS）、TOF和区域脑血氧饱和度（rScO2）。观察并比较两组患者术中相关麻醉剂的用量术后10分钟及1小时、6小时、24小时、48小时、72小时的Ramsay镇静评分和视觉模拟量表（VAS）评分。③入院时的心率（HR）和平均动脉压（MAP）（T0），右美托咪定输注量（T1），插管后1分钟（T2），皮肤切开后（T3），手术后（T4），拔管后1分钟术后恢复，相关指标为手术结束至呼叫的开放时间、手术结束至拔管的时间、麻醉后监护室（PACU）驻留时间、胃肠功能恢复及住院时间。⑤术后谵妄（POD）和术后认知功能障碍（POCD）的发生。结果观察组丙泊酚和苯磺酸顺阿曲库铵的用量明显少于对照组（P<0.05），观察组术后1、6、24、72 h Ramsay镇静评分明显高于对照组（P<0.01），观察组T1-T5时HR和T2-T5时MAP均显著低于对照组（P<0.05），PACU停留时间和住院时间明显短于对照组（P＜0.05），观察组年POD总发生率明显低于对照组（P＜0.05）并且脆弱的大脑功能是令人满意的。关键词：多模式麻醉监测与管理；大脑功能脆弱；胃肠道肿瘤；老化
{"title":"The application of multi-mode anesthesia monitoring and management in the operation of elderly patients with gastrointestinal tumor and fragile brain function","authors":"Xiuxia Wu","doi":"10.3760/CMA.J.ISSN.1673-4378.2019.12.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2019.12.002","url":null,"abstract":"Objective \u0000To observe the effect of multimode anesthesia monitoring and management in the operation of elderly patients with gastrointestinal tumor and fragile brain function. \u0000 \u0000 \u0000Methods \u0000One hundred and nine cases of patients with fragile brain function who underwent elective total intravenous anesthesia for gastrointestinal tumor surgery were divided into observation group (58 cases) and control group (51 cases). The control group received routine anesthesia monitoring management during operation, while the observation group received multi-mode anesthesia monitoring management during operation, including cardiac inde (CI), stroke volume variation(SVV), bispectral index(BIS), train-of-four stimulation(TOF) and regional cerebral oxygen saturation(rScO2). The following indexes were observed and compared between the two groups: ① Intraoperative dosage of related anesthetics. ② Ramsay sedation score and Visual Analogue Scale(VAS) score at 10 min and 1 h, 6 h, 24 h, 48 h, 72 h after operation. ③ Heart rate(HR) and mean artery pressure (MAP) at admission (T0), infusion load of dexmedetomidine (T1), 1 min after intubation (T2), after skin incision (T3), after operation(T4), 1 min after extubation(T5). ④ Postoperative recovery, the relevant indicators are the opening time from the end of operation to the call, the time from the end of operation to extubation, the time of postanesthesia care unit(PACU) residence, the time of gastrointestinal function recovery and hospitalization. ⑤ Postoperative delirium (POD) and the occurrence of postoperative cognitive dysfunction(POCD). \u0000 \u0000 \u0000Results \u0000The dosage used of propofol and cisatracurium besylate in the observation group were significantly less than the dosage used in control group(P<0.05). The postoperative Ramsay sedation scores of observation group at 1, 6, 24, 72 h were significantly higher than the score of the control group(P<0.05), the postoperative VAS at 10 min, 1 h, 6 h, 24 h, 48 h were significantly lower than the control group(P<0.05). The HR at T1-T5 time and MAP at T2-T5 time of observation group were significantly lower than the HR and MAP of control group(P<0.05). Postoperative observation group and called the open end of the operation time, extubation time, PACU dwell time and hospitalization time were significantly shorter than the values of control group (P<0.05). The total POD incidence rate in patients of the observation group in were significantly lower than the rate of the control group(P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The application of multi-mode anesthesia monitoring and management in the operation of elderly patients with gastrointestinal cancer and fragile brain function is satisfactory. \u0000 \u0000 \u0000Key words: \u0000Multimode anesthesia monitoring and management; Fragile brain function; Gastrointestinal tumor; Aged","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"40 1","pages":"1099-1104"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45494598","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 protective effect of intraoperative and postoperative dexmedetomidine(Dex) on erythrocyte glucose metabolism and lipid peroxidation in patients undergoing heart valve replacements with cardiopulmonary bypass(CPB). Methods Sixty patients undergoing elective heart valve replacements with CPB were randomly divided into control group (group C, n=30) and Dex group (group D, n=30) by random number table method. The patients in group D were intravenously infused 0.5-1.0 μg/kg Dex 15 min before operation, followed by an infusion at a rate of 0.5 μg·kg-1·h-1 until the end of the operation. In group C, Dex was not administered during or after surgery but the same dose of normal saline was injected at the same time and through the same route. The patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia. PCIA solution in group D contained sufentanil 2 μg/kg+Dex 4 μg/kg in 100 ml of normal saline. PCIA solution in group C contained sufentanil 2 μg/kg in 100 ml of normal saline. Infusion rates in both groups were 2 ml/h. The blood glucose, erythrocyte phosphofructokinase (PFK), glucose-6-phosphate dehydrogenase(G-6PD), aldose reductase(AR) activity, erythrocyte lipid peroxidation(ELPO) and glutathione (EGSH) were detected before induction of anesthesia(T1), at the time of leaving operation room (T2), at the time of the first postoperative day (T3) and at the time of the second postoperative day(T4). Results Compared with values of these parameters at T1, the levels of blood glucose, G-6PD, AR and ELPO in group C were significantly increased at the time points of T2 and T4 (P<0.05). The levels of PFK and EGSH in erythrocytes were significantly decreased at the time points of T2 and T4 (P<0.05). Compared with group C, the blood glucose, G-6PD, AR, ELPO were significantly decreased (P<0.05). The erythrocyte PFK and EGSH levels were significantly increased in group D(P<0.05). Conclusions Intraoperative and postoperative Dex therapy can significantly improve erythrocyte glucose metabolism and enhance the antioxidant capacity of erythrocytes after cardiac valve replacement with CPB. Key words: Dexmedetomidine; Cardiopulmonary bypass; Erythrocytes; Glucose metabolism disorders; Lipid peroxidation
{"title":"The protective effect of dexmedetomidine on erythrocyte in patients undergoing cardiac valve replacement during perioperative period","authors":"Yafei Ma, Yi Feng, Zhong-Tao Guo, Xinhong Qi, Linbo Zhang, Lijuan Wei","doi":"10.3760/CMA.J.ISSN.1673-4378.2019.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2019.12.005","url":null,"abstract":"Objective \u0000To investigate the protective effect of intraoperative and postoperative dexmedetomidine(Dex) on erythrocyte glucose metabolism and lipid peroxidation in patients undergoing heart valve replacements with cardiopulmonary bypass(CPB). \u0000 \u0000 \u0000Methods \u0000Sixty patients undergoing elective heart valve replacements with CPB were randomly divided into control group (group C, n=30) and Dex group (group D, n=30) by random number table method. The patients in group D were intravenously infused 0.5-1.0 μg/kg Dex 15 min before operation, followed by an infusion at a rate of 0.5 μg·kg-1·h-1 until the end of the operation. In group C, Dex was not administered during or after surgery but the same dose of normal saline was injected at the same time and through the same route. The patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia. PCIA solution in group D contained sufentanil 2 μg/kg+Dex 4 μg/kg in 100 ml of normal saline. PCIA solution in group C contained sufentanil 2 μg/kg in 100 ml of normal saline. Infusion rates in both groups were 2 ml/h. The blood glucose, erythrocyte phosphofructokinase (PFK), glucose-6-phosphate dehydrogenase(G-6PD), aldose reductase(AR) activity, erythrocyte lipid peroxidation(ELPO) and glutathione (EGSH) were detected before induction of anesthesia(T1), at the time of leaving operation room (T2), at the time of the first postoperative day (T3) and at the time of the second postoperative day(T4). \u0000 \u0000 \u0000Results \u0000Compared with values of these parameters at T1, the levels of blood glucose, G-6PD, AR and ELPO in group C were significantly increased at the time points of T2 and T4 (P<0.05). The levels of PFK and EGSH in erythrocytes were significantly decreased at the time points of T2 and T4 (P<0.05). Compared with group C, the blood glucose, G-6PD, AR, ELPO were significantly decreased (P<0.05). The erythrocyte PFK and EGSH levels were significantly increased in group D(P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Intraoperative and postoperative Dex therapy can significantly improve erythrocyte glucose metabolism and enhance the antioxidant capacity of erythrocytes after cardiac valve replacement with CPB. \u0000 \u0000 \u0000Key words: \u0000Dexmedetomidine; Cardiopulmonary bypass; Erythrocytes; Glucose metabolism disorders; Lipid peroxidation","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"40 1","pages":"1113-1116"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42998233","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2019.12.018
Yu Wang, Gang Wu, Haixia Lyu, Feidi Wang
The high incidence of postoperative cognitive dysfunction in elderly people make it great concerned within anesthesia research community. Photobiomodulation is proved to be effective and has recently used for brain protection. This review summarizes the mechanism action of postoperative cognitive function disorder, photobiomodulation mechanism and the possibilities of photobiomodulation to protect postoperative cognitive function in elderly people. This article will provide a new thought to protect postoperative cognitive function in elderly people. Key words: Postoperative cognitive dysfunction; Photobiomodulation; Aged
{"title":"Research progress in the protective effects of photobiomodulation on the postoperative cognitive function in elder patients","authors":"Yu Wang, Gang Wu, Haixia Lyu, Feidi Wang","doi":"10.3760/CMA.J.ISSN.1673-4378.2019.12.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2019.12.018","url":null,"abstract":"The high incidence of postoperative cognitive dysfunction in elderly people make it great concerned within anesthesia research community. Photobiomodulation is proved to be effective and has recently used for brain protection. This review summarizes the mechanism action of postoperative cognitive function disorder, photobiomodulation mechanism and the possibilities of photobiomodulation to protect postoperative cognitive function in elderly people. This article will provide a new thought to protect postoperative cognitive function in elderly people. \u0000 \u0000 \u0000Key words: \u0000Postoperative cognitive dysfunction; Photobiomodulation; Aged","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"40 1","pages":"1172-1177"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42140659","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2019.12.007
Y. Song, Zhi-mei Zhang, Fanceng Ji
Objective To determine the minimum local anesthetic concentration of ropivacalne for ultrasound-guided phrenic nerve block in the treatments of central hiccup. Methods In this experiment, sequential experimental method was used to select patients with hiccup after the operation of cerebral hemorrhage. The starting concentration of ropivacaine was 0.25%. The ratio between adjacent concentrations was 1.3. The superficial phrenic nerve on the left anterior scalene muscle of all patients were located by ultrasound. The predetermined concentration of ropiacaine 4 ml was injected. After twenty minutes, whether the injection works or not was judged by observing the symptom of all patients. If the first one is effective, the next injection dose will be decreased one concentration gradient. If the block was not effective, then 4 ml of 1.5% lidocaine will be injected at the same lateral phrenic nerve. If the block is still not effective, the next injection will be ropivacaine with increased one concentration gradient. If the hiccups still did not end, the routine drug treatment will be used. At the same time, with the approval of the patients′ family, after eight hours, we will take the right phrenic nerve block. Then this case will not be included in the data statistic. The next patient continues to use the same initial concentration ropivacaine. The effective cases were included in effective group(group A) while the cases with lidocaine supplement were divided into invalid group (group B). The drug concentration, blocking effect, median effective dose(ED50) and 95% confidence intervals (CI) were calculated according to Dixon and Brownlee methods. Results Ultrasound-guided application of ropivacaine for phrenic nerve block for central hiccup is safe, effective and requires little medication. 95%CI of ultrasound-guided phrenic nerve block for central hiccup is 0.267%-0.335%. Conclusions The minimum effective concentration of ropivacaine in the treatment of central hiccup was 0.299%. Key words: Phrenic nerve; Nerve blocking anesthesia; Hiccup; Ultrasound-guided; Ropivacaine
{"title":"The minimum local anesthetic concentration of ropivacalne for ultrasound-guided phrenic nerve block in the treatments of central hiccup","authors":"Y. Song, Zhi-mei Zhang, Fanceng Ji","doi":"10.3760/CMA.J.ISSN.1673-4378.2019.12.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2019.12.007","url":null,"abstract":"Objective \u0000To determine the minimum local anesthetic concentration of ropivacalne for ultrasound-guided phrenic nerve block in the treatments of central hiccup. \u0000 \u0000 \u0000Methods \u0000In this experiment, sequential experimental method was used to select patients with hiccup after the operation of cerebral hemorrhage. The starting concentration of ropivacaine was 0.25%. The ratio between adjacent concentrations was 1.3. The superficial phrenic nerve on the left anterior scalene muscle of all patients were located by ultrasound. The predetermined concentration of ropiacaine 4 ml was injected. After twenty minutes, whether the injection works or not was judged by observing the symptom of all patients. If the first one is effective, the next injection dose will be decreased one concentration gradient. If the block was not effective, then 4 ml of 1.5% lidocaine will be injected at the same lateral phrenic nerve. If the block is still not effective, the next injection will be ropivacaine with increased one concentration gradient. If the hiccups still did not end, the routine drug treatment will be used. At the same time, with the approval of the patients′ family, after eight hours, we will take the right phrenic nerve block. Then this case will not be included in the data statistic. The next patient continues to use the same initial concentration ropivacaine. The effective cases were included in effective group(group A) while the cases with lidocaine supplement were divided into invalid group (group B). The drug concentration, blocking effect, median effective dose(ED50) and 95% confidence intervals (CI) were calculated according to Dixon and Brownlee methods. \u0000 \u0000 \u0000Results \u0000Ultrasound-guided application of ropivacaine for phrenic nerve block for central hiccup is safe, effective and requires little medication. 95%CI of ultrasound-guided phrenic nerve block for central hiccup is 0.267%-0.335%. \u0000 \u0000 \u0000Conclusions \u0000The minimum effective concentration of ropivacaine in the treatment of central hiccup was 0.299%. \u0000 \u0000 \u0000Key words: \u0000Phrenic nerve; Nerve blocking anesthesia; Hiccup; Ultrasound-guided; Ropivacaine","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"40 1","pages":"1122-1124"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45962938","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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