Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.011
Meirong Wang, Huibi Ooyang, Yicheng Lin, Zhipeng Li, M. He, Chui-liang Liu
Objective To investigate the efficacy of ultrasound-guided internal branch of superior laryngeal nerve (ibSLN) block to treat postoperative sore throat (POST) after extubation under general anesthesia. Methods Sixty patients, aged from 18 to 45 years old, American Society of Anesthesiologist (ASA) Ⅰ or Ⅱ who suffered from moderate to severe postoperative sore throat after extubation under general anesthesia were selected. They were divided into two groups according to the random number table method (n= 30): a lidocaine combined with budesonide aerosol inhalation group (group L) and an iBSLN block group (group S). The Visual Analogue Scale (VAS) scores and the significant analgesic efficiency rate of POST were recorded in two groups immediately before treatment (T0), 10 min after treatment (T1), 30 min after treatment (T2), 1 h after treatment (T3), 2 h after treatment (T4), 4 h after treatment (T5), 8 h after treatment (T6), and 24 h after treatment (T7). The mean arterial pressure (MAP), heart rate, and pulse oxygen saturation (SpO2) were also recorded from T0 to T7. Adverse reactions such as chocking on water, regurgitation and aspiration, hoarseness and dyspnea were observed in the two groups, while the score of patient satisfaction towards treatment was evaluated. Results The VAS score of POST in group S was lower than that in group L from T0 to T6 (P<0.05). The significant analgesic efficiency rate of POST in group S was significantly higher than that in group L from T1 to T6 (P<0.05). Compared with group L, heart rate in group S reduced from T1 to T4 (P<0.05), while MAP decreased from T1 to T3 (P<0.05). The satisfaction score of group S was higher than that of group L (P< 0.05). No chocking on water, regurgitation and aspiration, hoarseness, and dyspnea was found in the two groups. Conclusions Ultrasound-guided ibSLN block can effectively treat POST after extubation under general anesthesia, with remarkably improved analgesic effects in comparison with traditional methods where hormone combined with local anesthetic aerosol are inhaled. It provides a good approach to treat POST after extubation under general anesthesia. Key words: Ultrasound-guided; Superior laryngeal nerve; Nerve blocking anesthesia; Postoperative sore throat; Anesthesia, general
目的探讨超声引导下喉上神经内支阻滞治疗全麻拔管后咽喉痛的疗效。方法选择全麻拔管术后出现中重度咽痛的患者60例，年龄18 ~ 45岁，美国麻醉学会(ASA)Ⅰ或Ⅱ会员。按随机数字表法分为两组(n= 30):1例利多卡因联合布地奈德雾化吸入组(L组)和1例iBSLN阻滞组(S组)。记录两组患者治疗前即刻(T0)、治疗后10 min (T1)、治疗后30 min (T2)、治疗后1 h (T3)、治疗后2 h (T4)、治疗后4 h (T5)、治疗后8 h (T6)、治疗后24 h (T7)的视觉模拟评分(VAS)和POST的显著镇痛有效率。T0 ~ T7期间记录平均动脉压(MAP)、心率、脉搏血氧饱和度(SpO2)。观察两组患者出现呛水、反流误吸、声音嘶哑、呼吸困难等不良反应，并评价患者对治疗的满意度。结果T0 ~ T6时，S组POST VAS评分低于L组(P<0.05)。T1 ~ T6期间，S组POST的显著镇痛有效率显著高于L组(P<0.05)。与L组比较，S组T1 ~ T4心率降低(P<0.05)， MAP降低(P<0.05)。S组患者满意度评分高于L组(P< 0.05)。两组患儿均无呛水、反流误吸、声音嘶哑、呼吸困难。结论超声引导下ibSLN阻滞可有效治疗全麻拔管后POST，与传统吸入激素联合局麻气雾剂的方法相比，其镇痛效果明显改善。为全麻拔管后POST的治疗提供了良好的途径。关键词:超声引导;喉上神经;神经阻滞麻醉;术后喉咙痛;麻醉,一般
{"title":"A clinical study of ultrasound-guided internal branch of superior laryngeal nerve block to treat postoperative sore throat after extubation under general anesthesia","authors":"Meirong Wang, Huibi Ooyang, Yicheng Lin, Zhipeng Li, M. He, Chui-liang Liu","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.011","url":null,"abstract":"Objective \u0000To investigate the efficacy of ultrasound-guided internal branch of superior laryngeal nerve (ibSLN) block to treat postoperative sore throat (POST) after extubation under general anesthesia. \u0000 \u0000 \u0000Methods \u0000Sixty patients, aged from 18 to 45 years old, American Society of Anesthesiologist (ASA) Ⅰ or Ⅱ who suffered from moderate to severe postoperative sore throat after extubation under general anesthesia were selected. They were divided into two groups according to the random number table method (n= 30): a lidocaine combined with budesonide aerosol inhalation group (group L) and an iBSLN block group (group S). The Visual Analogue Scale (VAS) scores and the significant analgesic efficiency rate of POST were recorded in two groups immediately before treatment (T0), 10 min after treatment (T1), 30 min after treatment (T2), 1 h after treatment (T3), 2 h after treatment (T4), 4 h after treatment (T5), 8 h after treatment (T6), and 24 h after treatment (T7). The mean arterial pressure (MAP), heart rate, and pulse oxygen saturation (SpO2) were also recorded from T0 to T7. Adverse reactions such as chocking on water, regurgitation and aspiration, hoarseness and dyspnea were observed in the two groups, while the score of patient satisfaction towards treatment was evaluated. \u0000 \u0000 \u0000Results \u0000The VAS score of POST in group S was lower than that in group L from T0 to T6 (P<0.05). The significant analgesic efficiency rate of POST in group S was significantly higher than that in group L from T1 to T6 (P<0.05). Compared with group L, heart rate in group S reduced from T1 to T4 (P<0.05), while MAP decreased from T1 to T3 (P<0.05). The satisfaction score of group S was higher than that of group L (P< 0.05). No chocking on water, regurgitation and aspiration, hoarseness, and dyspnea was found in the two groups. \u0000 \u0000 \u0000Conclusions \u0000Ultrasound-guided ibSLN block can effectively treat POST after extubation under general anesthesia, with remarkably improved analgesic effects in comparison with traditional methods where hormone combined with local anesthetic aerosol are inhaled. It provides a good approach to treat POST after extubation under general anesthesia. \u0000 \u0000 \u0000Key words: \u0000Ultrasound-guided; Superior laryngeal nerve; Nerve blocking anesthesia; Postoperative sore throat; Anesthesia, general","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"177-181"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47781904","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.014
Linlin Ji, Lei Guo
Propofol is a main representative of intravenous anesthetics, with the advantages of rapid onset, rapid awakening, and perfect function recovery. However, at present, there is no clinical method for monitoring its concentration in a real-time manner. Due to the disadvantages of traditional methods, such as complex sample pretreatment, long-time measurement, and large equipment in some assays which is unable to be placed in the operating room, increasing attention has been drawn towards rapid detection of propofol. The current paper is designed to comprehensively describe how to perform rapid detection of propofol concentrations. This article mainly discusses the rapid detection methods and principles of blood propofol concentrations and exhaled concentrations, so as to facilitate clinical application and to instruct anesthesiologists for evaluating anesthesia depth in a fast and real-time manner. Key words: Propofol; Drug concentration; Blood concentration; Expiratory gas; Rapid detection
{"title":"Research progress on rapid detection of propofol","authors":"Linlin Ji, Lei Guo","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.014","url":null,"abstract":"Propofol is a main representative of intravenous anesthetics, with the advantages of rapid onset, rapid awakening, and perfect function recovery. However, at present, there is no clinical method for monitoring its concentration in a real-time manner. Due to the disadvantages of traditional methods, such as complex sample pretreatment, long-time measurement, and large equipment in some assays which is unable to be placed in the operating room, increasing attention has been drawn towards rapid detection of propofol. The current paper is designed to comprehensively describe how to perform rapid detection of propofol concentrations. This article mainly discusses the rapid detection methods and principles of blood propofol concentrations and exhaled concentrations, so as to facilitate clinical application and to instruct anesthesiologists for evaluating anesthesia depth in a fast and real-time manner. \u0000 \u0000 \u0000Key words: \u0000Propofol; Drug concentration; Blood concentration; Expiratory gas; Rapid detection","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"191-195"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43542886","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.021
Dengyang Han, N. Yang
Neurofibrillary tangle (NFT) formed by hyperphosphorylated Tau is considered to be one of the important reasons of cognitive impairment. Hyperphosphorylated Tau exists in many forms in the central nervous system, producing toxic effects on neurons and activating microglia to induce immune response. This paper aims to explore the neurotoxicity of pathological Tau and to elucidate the role of microglia in its association with cognitive impairment. By regulating the differentiation direction of microglia and controlling the secretory factors of differentiated microglia, we can intervene in the cognitive impairment caused by pathological Tau protein. Key words: Tau; Microglia; Neurodegenerative disease; Cognitive impairment
{"title":"The role of microglia activation by pathological Tau protein in cognitive impairment","authors":"Dengyang Han, N. Yang","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.021","url":null,"abstract":"Neurofibrillary tangle (NFT) formed by hyperphosphorylated Tau is considered to be one of the important reasons of cognitive impairment. Hyperphosphorylated Tau exists in many forms in the central nervous system, producing toxic effects on neurons and activating microglia to induce immune response. This paper aims to explore the neurotoxicity of pathological Tau and to elucidate the role of microglia in its association with cognitive impairment. By regulating the differentiation direction of microglia and controlling the secretory factors of differentiated microglia, we can intervene in the cognitive impairment caused by pathological Tau protein. \u0000 \u0000 \u0000Key words: \u0000Tau; Microglia; Neurodegenerative disease; Cognitive impairment","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"221-224"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44251109","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.007
Min Wang, Rui Wang, Jua Wang, Yulan Li, Xiaohui Wang
Objective To investigate the relationship between shivering and amniotic fluid entering into the blood during cesarean section, and provide new thoughts for prevention and treatment of shivering during cesarean section. Methods This was a prospective, double-blinded, and controlled study. A total of 57 puerperants [American Society of Anesthesiologists (ASA)ⅠorⅡ] received subarachnoid block, whose shivering were observed and classified by chief anesthesiologists. Their general information (name, age, height and weight), blood loss, fluid intake, gestational age, neonatal weight, the length of operation, neonatal 1 minute Apgar score and shivering grade were recorded. Their anal temperatures before anesthesia, 30 min after anesthesia and at the end of the operation were measured and recorded. The puerperants were divided into four groups according to Dewitte shivering classification: grade 0 is a non-shivering group (group 0); shivering grades 1 to 3 were divided into groups 1, 2 and 3, respectively, where groups 1 to 3 were defined as shivering groups. Then, 2 ml of venous blood were taken from all the puerperants before the end of the operation to detect the concentration of sialyl Tn (sTn) antigen. The correlations between shivering degree and sTn antigen concentrations, gestational age, blood loss, fluid intake, the length of operation, neonatal weight and anal temperature at three time points were analyzed. Results There was no significant difference in age, height, weight, blood loss, fluid intake, gestational age, neonatal weight, the length of operation, and anal temperature at three time points among these groups (P>0.05). Compared to groups 0 and 1, groups 2 and 3 produced higher concentrations of sTn antigen (P<0.05), while the concentration of sTn antigen in group 1 was higher than that in group 0 (P< 0.05). The concentrations of sTn antigen in the shivering groups were significantly higher than that in the non-shivering group (P<0.05). The correlation coefficient between shivering degree and sTn antigen concentration was 0.895 (P<0.01). There was no correlation between shivering degree and gestational age, blood loss, fluid intake, the length of operation, neonatal weight and anal temperature at three time points. Conclusions Puerperant shivering is related with amniotic fluid entering into the blood during cesarean section. Key words: Cesarean section; Shivering; Amniotic fluid; Sialyl Tn antigen
{"title":"Exploration of the relationship between puerperal shivering and amniotic fluid entering into the blood during cesarean section","authors":"Min Wang, Rui Wang, Jua Wang, Yulan Li, Xiaohui Wang","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.007","url":null,"abstract":"Objective \u0000To investigate the relationship between shivering and amniotic fluid entering into the blood during cesarean section, and provide new thoughts for prevention and treatment of shivering during cesarean section. \u0000 \u0000 \u0000Methods \u0000This was a prospective, double-blinded, and controlled study. A total of 57 puerperants [American Society of Anesthesiologists (ASA)ⅠorⅡ] received subarachnoid block, whose shivering were observed and classified by chief anesthesiologists. Their general information (name, age, height and weight), blood loss, fluid intake, gestational age, neonatal weight, the length of operation, neonatal 1 minute Apgar score and shivering grade were recorded. Their anal temperatures before anesthesia, 30 min after anesthesia and at the end of the operation were measured and recorded. The puerperants were divided into four groups according to Dewitte shivering classification: grade 0 is a non-shivering group (group 0); shivering grades 1 to 3 were divided into groups 1, 2 and 3, respectively, where groups 1 to 3 were defined as shivering groups. Then, 2 ml of venous blood were taken from all the puerperants before the end of the operation to detect the concentration of sialyl Tn (sTn) antigen. The correlations between shivering degree and sTn antigen concentrations, gestational age, blood loss, fluid intake, the length of operation, neonatal weight and anal temperature at three time points were analyzed. \u0000 \u0000 \u0000Results \u0000There was no significant difference in age, height, weight, blood loss, fluid intake, gestational age, neonatal weight, the length of operation, and anal temperature at three time points among these groups (P>0.05). Compared to groups 0 and 1, groups 2 and 3 produced higher concentrations of sTn antigen (P<0.05), while the concentration of sTn antigen in group 1 was higher than that in group 0 (P< 0.05). The concentrations of sTn antigen in the shivering groups were significantly higher than that in the non-shivering group (P<0.05). The correlation coefficient between shivering degree and sTn antigen concentration was 0.895 (P<0.01). There was no correlation between shivering degree and gestational age, blood loss, fluid intake, the length of operation, neonatal weight and anal temperature at three time points. \u0000 \u0000 \u0000Conclusions \u0000Puerperant shivering is related with amniotic fluid entering into the blood during cesarean section. \u0000 \u0000 \u0000Key words: \u0000Cesarean section; Shivering; Amniotic fluid; Sialyl Tn antigen","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"158-163"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45305625","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.017
Huimin Chen
Burst suppression (BS) is a sign of severe inhibition of electrical activity in the cerebral cortex. Anesthetic is a common reason of inducing BS. Hitherto, the mechanism underlying BS is unclear. The dose of anesthetic alone or in combination inducing BS is an important research target. This review presents current research advances of BS home and abroad, including the relationship between anesthetics and BS, the definition, judgment criteria and prognosis of BS. In the future, burst suppression ratio (BSR) can be used as a routine monitoring index for clinical anesthesia, making it easier for anesthesiologists to adjust the depth of anesthesia. Key words: Burst suppression; Burst suppression ratio; Anesthetics; Bispectral index
{"title":"Burst suppression and its relationship with anesthetics","authors":"Huimin Chen","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.017","url":null,"abstract":"Burst suppression (BS) is a sign of severe inhibition of electrical activity in the cerebral cortex. Anesthetic is a common reason of inducing BS. Hitherto, the mechanism underlying BS is unclear. The dose of anesthetic alone or in combination inducing BS is an important research target. This review presents current research advances of BS home and abroad, including the relationship between anesthetics and BS, the definition, judgment criteria and prognosis of BS. In the future, burst suppression ratio (BSR) can be used as a routine monitoring index for clinical anesthesia, making it easier for anesthesiologists to adjust the depth of anesthesia. \u0000 \u0000 \u0000Key words: \u0000Burst suppression; Burst suppression ratio; Anesthetics; Bispectral index","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"204-207"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45223263","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.006
Yingying Wang, Z. Ruan, Y. Wang, Lai Jiang
Objective To evaluate the application of ultrasound measurement of optic nerve sheath diameter (ONSD) for predicting intracranial pressure (ICP) increase after craniocerebral trauma surgery. Methods A total of 120 patients who underwent decompressive craniectomy due to craniocerebral trauma in Department of Surgical ICU, Xinhua Hospital, Shanghai Jiaotong University School of Medicine from June to December 2018 were enrolled. Invasive ICP monitoring was performed by surgeons during surgery. According to invasive ICP values, the patients were divided into two groups: an increased ICP group (ICP>20 mmHg, 1 mmHg=0.133 kPa, n=60) and a normal ICP group (ICP≤20 mmHg, n=60), and their ONSD values were measured. The receiver operating characteristic(ROC) curve was used to investigate the optimal cut-off value of ONSD for detecting ICP elevation in patients after craniocerebral trauma surgery. Results The average ONSD of the eyes in the increased ICP group and the normal ICP group was (5.4±0.4) mm and(4.3±0.4) mm, respectively. The results of variance analysis showed that the difference of ONSD between the two groups were statistically significant (P<0.05). The correlation between the bedside ultrasound ONSD and the ICP of the corresponding individuals after craniocerebral trauma surgery was analyzed, where a significant correlation was determined (r=0.771). The cut-off value of ONSD based on the ROC curve was 4.9 mm, with a sensitivity of 88.3% and a specificity of 90.0%. Conclusions There is a significant correlation between ONSD and ICP. The optimal cur-off value for ICP elevation after craniocerebral trauma surgery is 4.9 mm. Due to measurement techniques, equipment, the experience of observers and the race of subjects, the optimal cut-off value of ONSD requires further studies. Key words: Optic nerve sheath diameter; Ultrasound; Intracranial pressure; Craniocerebral trauma
{"title":"A study on the relationship between optic nerve sheath diameter and intracranial pressure increase after craniocerebral trauma surgery","authors":"Yingying Wang, Z. Ruan, Y. Wang, Lai Jiang","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.006","url":null,"abstract":"Objective \u0000To evaluate the application of ultrasound measurement of optic nerve sheath diameter (ONSD) for predicting intracranial pressure (ICP) increase after craniocerebral trauma surgery. \u0000 \u0000 \u0000Methods \u0000A total of 120 patients who underwent decompressive craniectomy due to craniocerebral trauma in Department of Surgical ICU, Xinhua Hospital, Shanghai Jiaotong University School of Medicine from June to December 2018 were enrolled. Invasive ICP monitoring was performed by surgeons during surgery. According to invasive ICP values, the patients were divided into two groups: an increased ICP group (ICP>20 mmHg, 1 mmHg=0.133 kPa, n=60) and a normal ICP group (ICP≤20 mmHg, n=60), and their ONSD values were measured. The receiver operating characteristic(ROC) curve was used to investigate the optimal cut-off value of ONSD for detecting ICP elevation in patients after craniocerebral trauma surgery. \u0000 \u0000 \u0000Results \u0000The average ONSD of the eyes in the increased ICP group and the normal ICP group was (5.4±0.4) mm and(4.3±0.4) mm, respectively. The results of variance analysis showed that the difference of ONSD between the two groups were statistically significant (P<0.05). The correlation between the bedside ultrasound ONSD and the ICP of the corresponding individuals after craniocerebral trauma surgery was analyzed, where a significant correlation was determined (r=0.771). The cut-off value of ONSD based on the ROC curve was 4.9 mm, with a sensitivity of 88.3% and a specificity of 90.0%. \u0000 \u0000 \u0000Conclusions \u0000There is a significant correlation between ONSD and ICP. The optimal cur-off value for ICP elevation after craniocerebral trauma surgery is 4.9 mm. Due to measurement techniques, equipment, the experience of observers and the race of subjects, the optimal cut-off value of ONSD requires further studies. \u0000 \u0000 \u0000Key words: \u0000Optic nerve sheath diameter; Ultrasound; Intracranial pressure; Craniocerebral trauma","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"152-157"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44757047","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.018
Pei Wang, Huai-long Chen, Weiwei Qin, Mingshan Wang
Sleep is an important physiological activity to maintain normal physiological functions of human body. With the acceleration of human life rhythm, the number of sleep disorders is increasing gradually at the same time. At present, many studies have shown that general anesthetics can cause loss of consciousness by acting on the sleep-wake circuit, and thus have a certain impact on human sleep in a short period of time. Propofol is one of the general anesthetics. Further observation and discussion of the effects of propofol on patients with sleep disorders will help to understand the effects of propofol on the prognosis and rehabilitation of patients. But studies on propofol and sleep disorders are rare. In this paper, by introducing the mechanism and regulating factors of sleep, the mechanism and influencing factors of sleep disorder, effect of propofol on sleep and its molecular targets leading to loss of consciousness are summarized. Also, the possible effects and underlying mechanisms of propofol on sleep disorders are summarized. Key words: Propofol; Anesthetics, general; Loss of consciousness; Sleep; Sleep disorder
{"title":"Propofol and sleep disorders","authors":"Pei Wang, Huai-long Chen, Weiwei Qin, Mingshan Wang","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.018","url":null,"abstract":"Sleep is an important physiological activity to maintain normal physiological functions of human body. With the acceleration of human life rhythm, the number of sleep disorders is increasing gradually at the same time. At present, many studies have shown that general anesthetics can cause loss of consciousness by acting on the sleep-wake circuit, and thus have a certain impact on human sleep in a short period of time. Propofol is one of the general anesthetics. Further observation and discussion of the effects of propofol on patients with sleep disorders will help to understand the effects of propofol on the prognosis and rehabilitation of patients. But studies on propofol and sleep disorders are rare. In this paper, by introducing the mechanism and regulating factors of sleep, the mechanism and influencing factors of sleep disorder, effect of propofol on sleep and its molecular targets leading to loss of consciousness are summarized. Also, the possible effects and underlying mechanisms of propofol on sleep disorders are summarized. \u0000 \u0000 \u0000Key words: \u0000Propofol; Anesthetics, general; Loss of consciousness; Sleep; Sleep disorder","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"208-211"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45291699","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.015
Y. Dai, Hao Wu, Ying Chen, X. Gu, Tianjiao Xia
Postoperative cognitive dysfunction (POCD) is a degraded cognitive function after surgical anesthesia, and severely affects the quality of life after surgery. So far, the pathophysiological mechanism is not clear, but central inflammation is considered to be important during the process. This article reviews the progress on the possible connection between POCD and central inflammation. Surgical anesthesia causes systemic inflammatory response in the whole body, while inflammatory factors can lead to inflammation in the central nervous system through direct entry into the blood-brain barrier (BBB), and impairment of the BBB or activation of multiple signaling pathways. Central inflammation affects patients' cognitive function to cause POCD through delayed inflammation resolution, direct action of inflammatory factors or indirect action of non-inflammatory mediators. Meanwhile, the risk factors of POCD are closely related to central inflammation. Interventions based on central neuroinflammation mechanism may have positive effects on the prevention and control of POCD. Key words: Postoperative cognitive dysfunction; Central nervous system; Inflammation; Inflammatory factor; Blood brain barrier
{"title":"Possible association between postoperative cognitive dysfunction and central neuroinflammation","authors":"Y. Dai, Hao Wu, Ying Chen, X. Gu, Tianjiao Xia","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.015","url":null,"abstract":"Postoperative cognitive dysfunction (POCD) is a degraded cognitive function after surgical anesthesia, and severely affects the quality of life after surgery. So far, the pathophysiological mechanism is not clear, but central inflammation is considered to be important during the process. This article reviews the progress on the possible connection between POCD and central inflammation. Surgical anesthesia causes systemic inflammatory response in the whole body, while inflammatory factors can lead to inflammation in the central nervous system through direct entry into the blood-brain barrier (BBB), and impairment of the BBB or activation of multiple signaling pathways. Central inflammation affects patients' cognitive function to cause POCD through delayed inflammation resolution, direct action of inflammatory factors or indirect action of non-inflammatory mediators. Meanwhile, the risk factors of POCD are closely related to central inflammation. Interventions based on central neuroinflammation mechanism may have positive effects on the prevention and control of POCD. \u0000 \u0000 \u0000Key words: \u0000Postoperative cognitive dysfunction; Central nervous system; Inflammation; Inflammatory factor; Blood brain barrier","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"196-199"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47749359","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.013
Yan Liang, Tiande Yang
Mechanical valve dysfunction is a life-threatening complication in patients after mechanical valve replacement. Its risk will significantly increase when the patients have to undergo non-cardiac surgery again. In the current article, we reported a case in which a patient suffered from mechanical valve dysfunction after lumbar spine surgery under general anesthesia. Unfortunately, the patient died of heart failure at last. This article is to summarize the experience and drawbacks during preoperative preparations and anesthesia management so as to provide reference for clinical use. Key words: Mitral valve; Cardiac valve replacement; Mechanical valve dysfunction; Prone position; Lumbar surgery
{"title":"Mechanical valve dysfunction in lumbar surgery: one case report","authors":"Yan Liang, Tiande Yang","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.013","url":null,"abstract":"Mechanical valve dysfunction is a life-threatening complication in patients after mechanical valve replacement. Its risk will significantly increase when the patients have to undergo non-cardiac surgery again. In the current article, we reported a case in which a patient suffered from mechanical valve dysfunction after lumbar spine surgery under general anesthesia. Unfortunately, the patient died of heart failure at last. This article is to summarize the experience and drawbacks during preoperative preparations and anesthesia management so as to provide reference for clinical use. \u0000 \u0000 \u0000Key words: \u0000Mitral valve; Cardiac valve replacement; Mechanical valve dysfunction; Prone position; Lumbar surgery","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"188-190"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49292768","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.001
Nan Song, Fu-hai Ji, Jiao Ma
Objective To investigate the effects of p38 mitogen-activated protein kinase (p38MAPK)- sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2α (SERCA2α) signaling pathway on myocardial ischemia/reperfusion injury (I/RI) in rats. Methods Forty-five male SD rats (250 ‒ 300 g in weight) were divided into three groups according to the random number table method (n=15): group A, group B and group C. Group A was used to measure the size of myocardial infarct. Group B was adopted to determine the levels of p38MAPK and SERCA2α protein in myocardial tissues. Group C was used to examine the expression of SERCA2α mRNA in myocardial tissues. Then, rats in groups A, B and C were divided into three groups by the random number table method respectively (n=5): a sham-operated group (group sham), an ischemia/reperfusion (I/R) group (group I/R), and an ischemia/reperfusion+SB203580 group (group I/R+S). Group I/R+S was intraperitoneally injected with p38MAPK inhibitor SB203580 (2 mg/kg) 1 h before surgery, while the other two groups were injected with an equal volume of normal saline 1 h before surgery. A model of myocardial I/RI was established in rats through ligation of the left anterior descending (LAD) coronary artery over 30 min before reperfusion for 10 min. After the end of reperfusion, blood gas analysis was performed to monitor the internal environment of rats. Western blot was used to detect the expression of phospho-p38MAPK (p-p38MAPK) and SERCA2α protein in myocardial tissues. Real-time quantitative PCR (RT-qPCR) was used to detect the expression of SERCA2α mRNA in myocardial tissues. Myocardial ischemia and infarct size were measured by Evans blue and 2, 3, 5-triphenyl tetrazolium chloride (TTC) double staining. Results There was no statistical difference in the results of gas blood analysis among the three groups (P>0.05). Compared with group sham, groups I/R and I/R+S presented remarkable increases in myocardial infarct size and the levels of p-p38MAPK protein (P<0.05), and marked decreases in the levels of SERCA2α protein and mRNA (P<0.05). Compared with group I/R, group I/R+S produced remarkably decreased myocardial infarct size and p-p38MAPK protein levels (P<0.05), and marked increased amounts of SERCA2α protein and mRNA (P<0.05). Conclusions p38MAPK may be involved in myocardial I/RI in rats through mediating SERCA2α. Key words: Myocardial reperfusion injury; p38 mitogen-activated protein kinase; Sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2α
{"title":"Involvement of p38 mitogen-activated protein kinase in myocardial ischemia/reperfusion injury through down-regulating sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2α in rats","authors":"Nan Song, Fu-hai Ji, Jiao Ma","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.001","url":null,"abstract":"Objective \u0000To investigate the effects of p38 mitogen-activated protein kinase (p38MAPK)- sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2α (SERCA2α) signaling pathway on myocardial ischemia/reperfusion injury (I/RI) in rats. \u0000 \u0000 \u0000Methods \u0000Forty-five male SD rats (250 ‒ 300 g in weight) were divided into three groups according to the random number table method (n=15): group A, group B and group C. Group A was used to measure the size of myocardial infarct. Group B was adopted to determine the levels of p38MAPK and SERCA2α protein in myocardial tissues. Group C was used to examine the expression of SERCA2α mRNA in myocardial tissues. Then, rats in groups A, B and C were divided into three groups by the random number table method respectively (n=5): a sham-operated group (group sham), an ischemia/reperfusion (I/R) group (group I/R), and an ischemia/reperfusion+SB203580 group (group I/R+S). Group I/R+S was intraperitoneally injected with p38MAPK inhibitor SB203580 (2 mg/kg) 1 h before surgery, while the other two groups were injected with an equal volume of normal saline 1 h before surgery. A model of myocardial I/RI was established in rats through ligation of the left anterior descending (LAD) coronary artery over 30 min before reperfusion for 10 min. After the end of reperfusion, blood gas analysis was performed to monitor the internal environment of rats. Western blot was used to detect the expression of phospho-p38MAPK (p-p38MAPK) and SERCA2α protein in myocardial tissues. Real-time quantitative PCR (RT-qPCR) was used to detect the expression of SERCA2α mRNA in myocardial tissues. Myocardial ischemia and infarct size were measured by Evans blue and 2, 3, 5-triphenyl tetrazolium chloride (TTC) double staining. \u0000 \u0000 \u0000Results \u0000There was no statistical difference in the results of gas blood analysis among the three groups (P>0.05). Compared with group sham, groups I/R and I/R+S presented remarkable increases in myocardial infarct size and the levels of p-p38MAPK protein (P<0.05), and marked decreases in the levels of SERCA2α protein and mRNA (P<0.05). Compared with group I/R, group I/R+S produced remarkably decreased myocardial infarct size and p-p38MAPK protein levels (P<0.05), and marked increased amounts of SERCA2α protein and mRNA (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000p38MAPK may be involved in myocardial I/RI in rats through mediating SERCA2α. \u0000 \u0000 \u0000Key words: \u0000Myocardial reperfusion injury; p38 mitogen-activated protein kinase; Sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2α","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"129-133"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48073511","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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