Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.004
Jihong Xu, Jiali Zhu, Xia Chen, Jinbao Li
Objective To observe the levels of angiopoietin (Ang) and Tie2 in the peripheral blood of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and analyze their relationship with patient prognosis. Methods Thirty one patients scheduled for cardiac surgery with CPB from January 2017 to December 2017 were enrolled. Their peripheral blood samples were collected before surgery (T1), 6 h after surgery (T2), Day 1 after surgery (T3), Day 3 after surgery (T4), and Day 5 after surgery (T5) to measure and compare the level of lactic acid (Lac) and blood cell counts. The enzyme-linked immunosorbent assay (ELISA) was adopted to determine and compare the levels of plasma Ang-1, Ang-2 and soluble Tie2 (sTie2). The relationship between the levels of Ang and Tie2, and the duration of CPB and the length of postoperative stay in the intensive care unit (ICU) for the patients were analyzed. Results Compared with those at T1, the number of white blood cells (WBCs) and neutrophils remarkably increased from T2 to T5, the level of Lac obviously increased at T2, at T3 and T4, the concentration of Ang-1 obviously decreased, and the concentration of Ang-2 obviously increased, and the ratio of Ang-1/Ang-2 and sTie2 level remarkably declined from T2 to T4 (P<0.05). Compared with those at T2, the level of Lac obviously decreased from T3 to T5, at T3 and T4, the concentration of Ang-1 and the ratio of Ang-1/Ang-2 remarkably declined, and the concentration of Ang-2 obviously increased, and the level of sTie2 remarkably increased at T4 and T5 (P<0.05). Compared with those at T3, the ratio of Ang-1/Ang-2 obviously decreased at T4, while the ratio of Ang-1/Ang-2 and sTie2 level remarkably increased at T5 (P<0.05). Compared with those at T4, the concentration of Ang-1 and the ratio of Ang-1/Ang-2 remarkably increased at T5 (P<0.05). At T3, the ratio of Ang-1/Ang-2 was negatively related with the duration of CPB and the length of ICU stay, with a correlation coefficient of −0.64 and −0.59, respectively (P<0.01), the level of sTie2 was negatively related with the duration of CPB and the length of ICU stay, with a correlation coefficient of −0.93 and −0.69, respectively (P<0.01). Conclusions The levels of plasma Ang and Tie2 dynamically change in the perioperative period of patients undergoing cardiac surgery with CPB, which facilitates patient management after surgery, so as to shorten the length of ICU stay. Key words: Cardiac surgery; Cardiopulmonary bypass; Angiopoietin; Tie2; Endothelial cells; Inflammatory reaction
{"title":"Dynamic observation of the expression of angiopoietin/Tie2 in the perioperative period of patients undergoing cardiac surgery with cardiopulmonary bypass","authors":"Jihong Xu, Jiali Zhu, Xia Chen, Jinbao Li","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.004","url":null,"abstract":"Objective \u0000To observe the levels of angiopoietin (Ang) and Tie2 in the peripheral blood of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and analyze their relationship with patient prognosis. \u0000 \u0000 \u0000Methods \u0000Thirty one patients scheduled for cardiac surgery with CPB from January 2017 to December 2017 were enrolled. Their peripheral blood samples were collected before surgery (T1), 6 h after surgery (T2), Day 1 after surgery (T3), Day 3 after surgery (T4), and Day 5 after surgery (T5) to measure and compare the level of lactic acid (Lac) and blood cell counts. The enzyme-linked immunosorbent assay (ELISA) was adopted to determine and compare the levels of plasma Ang-1, Ang-2 and soluble Tie2 (sTie2). The relationship between the levels of Ang and Tie2, and the duration of CPB and the length of postoperative stay in the intensive care unit (ICU) for the patients were analyzed. \u0000 \u0000 \u0000Results \u0000Compared with those at T1, the number of white blood cells (WBCs) and neutrophils remarkably increased from T2 to T5, the level of Lac obviously increased at T2, at T3 and T4, the concentration of Ang-1 obviously decreased, and the concentration of Ang-2 obviously increased, and the ratio of Ang-1/Ang-2 and sTie2 level remarkably declined from T2 to T4 (P<0.05). Compared with those at T2, the level of Lac obviously decreased from T3 to T5, at T3 and T4, the concentration of Ang-1 and the ratio of Ang-1/Ang-2 remarkably declined, and the concentration of Ang-2 obviously increased, and the level of sTie2 remarkably increased at T4 and T5 (P<0.05). Compared with those at T3, the ratio of Ang-1/Ang-2 obviously decreased at T4, while the ratio of Ang-1/Ang-2 and sTie2 level remarkably increased at T5 (P<0.05). Compared with those at T4, the concentration of Ang-1 and the ratio of Ang-1/Ang-2 remarkably increased at T5 (P<0.05). At T3, the ratio of Ang-1/Ang-2 was negatively related with the duration of CPB and the length of ICU stay, with a correlation coefficient of −0.64 and −0.59, respectively (P<0.01), the level of sTie2 was negatively related with the duration of CPB and the length of ICU stay, with a correlation coefficient of −0.93 and −0.69, respectively (P<0.01). \u0000 \u0000 \u0000Conclusions \u0000The levels of plasma Ang and Tie2 dynamically change in the perioperative period of patients undergoing cardiac surgery with CPB, which facilitates patient management after surgery, so as to shorten the length of ICU stay. \u0000 \u0000 \u0000Key words: \u0000Cardiac surgery; Cardiopulmonary bypass; Angiopoietin; Tie2; Endothelial cells; Inflammatory reaction","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"143-147"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44104139","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.1673-4378.2020.02.012
Dailiang Hou, Chengwen Li, Chengwei Song, Kang-kang Zhang, G. Zhang, Ning Yu, Shilei Wang
Objective To evaluate the application of bilateral thoracic paravertebral block (bTPVB) combined with general anesthesia in thoracoscopic-laparoscopic esophagectomy (TLE) and its effects on early postoperative recovery. Methods Seventy patients with esophageal cancer scheduled for TLE were divided into two groups according to the random number table method (n=35): a general anesthesia group (group G) and a bTPVB combined with general anesthesia group (group B). Five patients were excluded due to intraoperative blood transfusion, traditional open surgery or other reasons. Finally, 32 patients were included into group G and 33 patients in group B, respectively. Standardized general anesthesia was performed in both groups. Paravertebral blocks at the right T7‒T8 level and the left T8‒T9 level were performed 15 min before anesthesia induction in group B. Then, perioperative hemodynamics, the length of anesthesia and surgery, the use of anesthetics and vasoactive agents during operation in both groups were recorded. The use of sufentanil in the post-anesthetic care unit (PACU) and flurbiprofen axetil in the thoracic intensive care unit (ICU) for rescue analgesia were recorded. The eye-opening time, extubation time, sedation-agitation scale scores of PACU admission and discharge, the length of PACU stay, postoperative delirium, and pulmonary function 48 h after surgery were recorded. The Visual Analogue Scale (VAS) scores at resting and upon coughing and the cumulative doses of sufentanil were assessed 0, 4, 8, 12, 24, 36 h and 48 h after surgery. Results There was no statistical difference in hemodynamic parameters between the two groups at each time point (P>0.05). Compared with group G, the intraoperative doses of sufentanil, the length of PACU stay, the rate of intraoperative nitroglycerin use, and the rate of sufentanil use for rescue analgesia in PACU and the rate of flurbiprofen use for rescue analgesia in thoracic ICU significantly reduced in group B (P<0.05). Compared with pre-operative levels, the forced vital capacity (FVC) and the forced expiratory volume in first second significantly decreased in both groups 48 h after surgery (P<0.05), where a more remarkable decrease was found in group G (P< 0.05). Group G presented marked higher VAS scores 0, 4, 8 h and 12 h after surgery at resting and upon coughing, and 24 h after surgery upon coughing, compared with group B (P<0.05). The cumulative doses of sufentanil in group B were obviously lower than those in group G 4, 8, 12, 24, 36 h and 48 h after surgery (P<0.05). Conclusions The use of bTPVB combined with general anesthesia in TLE can effectively decrease the doses of analgesics during the perioperative period, alleviate early postoperative pain, and improve postoperative pulmonary function, so as to promote early postoperative recovery. Key words: Paravertebral block; Anesthesia, general; Thoracoscopy; Laparoscopy; Radical esophagectomy
{"title":"Effects of bilateral thoracic paravertebral block on intraoperative anesthesia and early postoperative recovery in patients undergoing thoracoscopic-laparoscopic esophagectomy","authors":"Dailiang Hou, Chengwen Li, Chengwei Song, Kang-kang Zhang, G. Zhang, Ning Yu, Shilei Wang","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.012","url":null,"abstract":"Objective \u0000To evaluate the application of bilateral thoracic paravertebral block (bTPVB) combined with general anesthesia in thoracoscopic-laparoscopic esophagectomy (TLE) and its effects on early postoperative recovery. \u0000 \u0000 \u0000Methods \u0000Seventy patients with esophageal cancer scheduled for TLE were divided into two groups according to the random number table method (n=35): a general anesthesia group (group G) and a bTPVB combined with general anesthesia group (group B). Five patients were excluded due to intraoperative blood transfusion, traditional open surgery or other reasons. Finally, 32 patients were included into group G and 33 patients in group B, respectively. Standardized general anesthesia was performed in both groups. Paravertebral blocks at the right T7‒T8 level and the left T8‒T9 level were performed 15 min before anesthesia induction in group B. Then, perioperative hemodynamics, the length of anesthesia and surgery, the use of anesthetics and vasoactive agents during operation in both groups were recorded. The use of sufentanil in the post-anesthetic care unit (PACU) and flurbiprofen axetil in the thoracic intensive care unit (ICU) for rescue analgesia were recorded. The eye-opening time, extubation time, sedation-agitation scale scores of PACU admission and discharge, the length of PACU stay, postoperative delirium, and pulmonary function 48 h after surgery were recorded. The Visual Analogue Scale (VAS) scores at resting and upon coughing and the cumulative doses of sufentanil were assessed 0, 4, 8, 12, 24, 36 h and 48 h after surgery. \u0000 \u0000 \u0000Results \u0000There was no statistical difference in hemodynamic parameters between the two groups at each time point (P>0.05). Compared with group G, the intraoperative doses of sufentanil, the length of PACU stay, the rate of intraoperative nitroglycerin use, and the rate of sufentanil use for rescue analgesia in PACU and the rate of flurbiprofen use for rescue analgesia in thoracic ICU significantly reduced in group B (P<0.05). Compared with pre-operative levels, the forced vital capacity (FVC) and the forced expiratory volume in first second significantly decreased in both groups 48 h after surgery (P<0.05), where a more remarkable decrease was found in group G (P< 0.05). Group G presented marked higher VAS scores 0, 4, 8 h and 12 h after surgery at resting and upon coughing, and 24 h after surgery upon coughing, compared with group B (P<0.05). The cumulative doses of sufentanil in group B were obviously lower than those in group G 4, 8, 12, 24, 36 h and 48 h after surgery (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The use of bTPVB combined with general anesthesia in TLE can effectively decrease the doses of analgesics during the perioperative period, alleviate early postoperative pain, and improve postoperative pulmonary function, so as to promote early postoperative recovery. \u0000 \u0000 \u0000Key words: \u0000Paravertebral block; Anesthesia, general; Thoracoscopy; Laparoscopy; Radical esophagectomy","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"182-187"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41543171","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.1673-4378.2020.02.020
Kairui Pu, Zhanqin Zhang, Meiyan Wu, Chaoying Yan
Mitochondria is the main site for oxidative phosphorylation and synthesis of ATP. It plays an important role in maintaining calcium homeostasis, regulating the production of reactive oxygen species, maintaining energy balance and metabolism and inducing programmed cell death. There is increasing evidence that mitochondria can transfer between cells, having protective or harmful effects on the body. Multiple modes have been found to mediate mitochondrial transfer. However, the underlying mechanism is still not fully elucidated. It has been found that mitochondrial transfer plays a significant role in the recovery of various central nervous system diseases. In this review, a brief summary that will be presented on mitochondrial function, mitochondrial transfer and its mechanism, and advances in mitochondrial transfer involved in central nervous system diseases. Key words: Mitochondrion; Transcellular transport; Central nervous system
{"title":"Advances in intercellular transfer of mitochondria involved in central nervous system diseases","authors":"Kairui Pu, Zhanqin Zhang, Meiyan Wu, Chaoying Yan","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.020","url":null,"abstract":"Mitochondria is the main site for oxidative phosphorylation and synthesis of ATP. It plays an important role in maintaining calcium homeostasis, regulating the production of reactive oxygen species, maintaining energy balance and metabolism and inducing programmed cell death. There is increasing evidence that mitochondria can transfer between cells, having protective or harmful effects on the body. Multiple modes have been found to mediate mitochondrial transfer. However, the underlying mechanism is still not fully elucidated. It has been found that mitochondrial transfer plays a significant role in the recovery of various central nervous system diseases. In this review, a brief summary that will be presented on mitochondrial function, mitochondrial transfer and its mechanism, and advances in mitochondrial transfer involved in central nervous system diseases. \u0000 \u0000 \u0000Key words: \u0000Mitochondrion; Transcellular transport; Central nervous system","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"217-220"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48007446","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.1673-4378.2020.02.005
Yuwei Qiu, Jingxiang Wu
Objective To investigate the incidence of difficult intubation with double-lumen endobronchial tube (DLT) in anesthesia induction, and discuss how to deal with difficult intubation with DLT and strategy to achieve pulmonary isolation during surgery. Methods Medical records from patients scheduled for intubation with DLT in the Anesthesia Information Database of Shanghai Chest Hospital from May 2009 to May 2012 were retrospectively analyzed to search cases using the following three keywords: "difficult intubation", "intubation with DLT" and "one-lung ventilation (OLV)". The primary outcome was the incidence of difficult intubation with DLT, while the secondary outcomes were airway evaluation in patients with difficult intubation before surgery, management strategy to solve difficult intubation, the way to achieve perioperative lung collapse, and perioperative complications related to intubation. Results A total of 11 017 patients were included in the current study. Difficult intubation happened in 112 patients (1.0%). Among the 112 patients, 22 patients (19.6%) had predictable or suspected difficult airway, while the other 90 patients (80.4%) showed no obvious clinical signs of difficult intubation before induction. Furthermore, 90 patients (80.4%) adopted two or more types of intubation devices. There were 22 patients who were intubated with single-lumen endotracheal tubes after induction, where 2 patients were successfully implanted with DLT through the guidance of exchange catheters for pulmonary isolation, 13 patients were implanted with bronchial blockers under a fiberbronchoscope, and 7 patients received low tidal volume ventilation. There was no case of severe cardiovascular complications. Conclusions DLT has strict requirements for the conditions of glottic exposure, and airway assessment before anesthesia should be more cautious. The use of visual tools improves the safety and effectiveness of intubation with DLT. Bronchial blockers provide more choices for difficult intubation with DLT. Key words: Double-lumen endobronchial tube; Difficult intubation; Difficult airway; Thoracic anesthesia; One lung ventilation
{"title":"Difficult intubation and management strategy of double-lumen endobronchial tube in anesthesia induction: a retrospective study of 11 017 patients for thoracic surgery","authors":"Yuwei Qiu, Jingxiang Wu","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.005","url":null,"abstract":"Objective \u0000To investigate the incidence of difficult intubation with double-lumen endobronchial tube (DLT) in anesthesia induction, and discuss how to deal with difficult intubation with DLT and strategy to achieve pulmonary isolation during surgery. \u0000 \u0000 \u0000Methods \u0000Medical records from patients scheduled for intubation with DLT in the Anesthesia Information Database of Shanghai Chest Hospital from May 2009 to May 2012 were retrospectively analyzed to search cases using the following three keywords: \"difficult intubation\", \"intubation with DLT\" and \"one-lung ventilation (OLV)\". The primary outcome was the incidence of difficult intubation with DLT, while the secondary outcomes were airway evaluation in patients with difficult intubation before surgery, management strategy to solve difficult intubation, the way to achieve perioperative lung collapse, and perioperative complications related to intubation. \u0000 \u0000 \u0000Results \u0000A total of 11 017 patients were included in the current study. Difficult intubation happened in 112 patients (1.0%). Among the 112 patients, 22 patients (19.6%) had predictable or suspected difficult airway, while the other 90 patients (80.4%) showed no obvious clinical signs of difficult intubation before induction. Furthermore, 90 patients (80.4%) adopted two or more types of intubation devices. There were 22 patients who were intubated with single-lumen endotracheal tubes after induction, where 2 patients were successfully implanted with DLT through the guidance of exchange catheters for pulmonary isolation, 13 patients were implanted with bronchial blockers under a fiberbronchoscope, and 7 patients received low tidal volume ventilation. There was no case of severe cardiovascular complications. \u0000 \u0000 \u0000Conclusions \u0000DLT has strict requirements for the conditions of glottic exposure, and airway assessment before anesthesia should be more cautious. The use of visual tools improves the safety and effectiveness of intubation with DLT. Bronchial blockers provide more choices for difficult intubation with DLT. \u0000 \u0000 \u0000Key words: \u0000Double-lumen endobronchial tube; Difficult intubation; Difficult airway; Thoracic anesthesia; One lung ventilation","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"148-151"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42623253","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.1673-4378.2020.02.003
Kai Wang, Hongmei Gao, Guangbao He, Xianhua Li, Bo Li, Guang Chen
Objective To investigate the effects of two approaches of anesthesia maintenance, propofol and sevoflurane, on early cognitive function of elderly patients after ambulatory surgery. Methods Sixty elderly patients who were scheduled for laparoscopic cholecystectomy as ambulatory surgery were selected. The patients were divided into two groups according to the random number table method (n=30): a propofol group and a sevoflurane group. Neuropsychological test scores were recorded one day before surgery and 24 h after surgery respectively. Venous blood was extracted before anesthesia induction and 24 h after surgery. The levels of plasma insulin-like growth factor 1 (IGF-1), serum interleukin (IL)-6, IL-1β and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA). Both groups were compared for the scale scores and inflammatory factor changes before and after surgery. Results Both approaches of anesthesia maintenance could result in postoperative neurocognitive function changes in some patients, including 2 cases (6.9%) in the sevoflurane group and 2 cases (6.7%) in the propofol group, without statistical difference in the incidence between the two groups (P>0.05). There was no statistical difference in neuropsychological test scores between the two groups before and after surgery (P>0.05). There was no statistical difference in the levels of inflammatory factors between the two groups before anesthesia induction and 24 h after surgery (P>0.05). Conclusions These two approaches of general anesthesia maintenance have no effect on the changes of early cognitive function in elderly patients after ambulatory surgery, without effect on the levels of blood inflammatory factors 24 h after surgery. Key words: Elderly people; Neurocognitive disorder; Ambulatory surgery; Anesthesia, general; Propofol; Sevoflurane
{"title":"Effects of propofol and sevoflurane on early congnitive function of elderly patients after ambulatory surgery","authors":"Kai Wang, Hongmei Gao, Guangbao He, Xianhua Li, Bo Li, Guang Chen","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.003","url":null,"abstract":"Objective \u0000To investigate the effects of two approaches of anesthesia maintenance, propofol and sevoflurane, on early cognitive function of elderly patients after ambulatory surgery. \u0000 \u0000 \u0000Methods \u0000Sixty elderly patients who were scheduled for laparoscopic cholecystectomy as ambulatory surgery were selected. The patients were divided into two groups according to the random number table method (n=30): a propofol group and a sevoflurane group. Neuropsychological test scores were recorded one day before surgery and 24 h after surgery respectively. Venous blood was extracted before anesthesia induction and 24 h after surgery. The levels of plasma insulin-like growth factor 1 (IGF-1), serum interleukin (IL)-6, IL-1β and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA). Both groups were compared for the scale scores and inflammatory factor changes before and after surgery. \u0000 \u0000 \u0000Results \u0000Both approaches of anesthesia maintenance could result in postoperative neurocognitive function changes in some patients, including 2 cases (6.9%) in the sevoflurane group and 2 cases (6.7%) in the propofol group, without statistical difference in the incidence between the two groups (P>0.05). There was no statistical difference in neuropsychological test scores between the two groups before and after surgery (P>0.05). There was no statistical difference in the levels of inflammatory factors between the two groups before anesthesia induction and 24 h after surgery (P>0.05). \u0000 \u0000 \u0000Conclusions \u0000These two approaches of general anesthesia maintenance have no effect on the changes of early cognitive function in elderly patients after ambulatory surgery, without effect on the levels of blood inflammatory factors 24 h after surgery. \u0000 \u0000 \u0000Key words: \u0000Elderly people; Neurocognitive disorder; Ambulatory surgery; Anesthesia, general; Propofol; Sevoflurane","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"138-142"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45036265","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.1673-4378.2020.02.002
Weiwei Wu, Yue-Jun Xu, Yue Zou, Caixiang Jin
Objective To explore the effects of parecoxib sodium on the inflammatory factors of septic patients induced by abdominal infection and the function of intestinal barrier. Methods Clinical data were collected from 97 septic patients who were admitted into Nanjing Integrated Traditional Chinese and Western Medicine Hospital due to abdominal infection and received treatment from April, 2015 to October, 2017. According to the random number table method, the patients were divided into two groups: a treatment group (parecoxib, n=50) and a control group (normal saline, n=47). Both groups were compared for general information, I-fatty acid-binding protein (I-FABP), diamine oxidase (DAO), D-lactate (D-Lac), interleukin-6 (IL-6), C reactive protein (CRP) and tumor necrosis factor-α (TNF-α) before and after treatment, and morality after treatment. Results There was no statistical difference in general information between the two groups (P>0.05). No statistical difference was found in intestinal barrier function and inflammatory indicators in both groups before treatment (P>0.05). The two groups presented remarkably reduced levels of I-FABP, DAO and D-Lac after treatment, compared with their levels before treatment, and the levels of I-FABP, DAO and D-Lac in the treatment group were obviously lower than those in the control group (P<0.05). The two groups presented remarkably reduced levels of IL-6, CRP and TNF-α after treatment, compared with their levels before treatment, and the levels of IL-6, CRP and TNF-α in the treatment group were obviously lower than those in the control group (P<0.05). The 28-day mortality of the treatment group (12.0%, 6/50) was obviously lower than that of the control group (31.9%, 14/47) (χ2=4.683, P=0.03). Conclusions Parecoxib sodium can relieve inflammatory reaction, while protecting the intestinal barrier function in septic patients, with good safety. Key words: Parecoxib; Sepsis; Intestinal barrier; Inflammatory reaction
{"title":"Effects of parecoxib sodium on the intestinal barrier function of septic patients induced by abdominal infection","authors":"Weiwei Wu, Yue-Jun Xu, Yue Zou, Caixiang Jin","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.002","url":null,"abstract":"Objective \u0000To explore the effects of parecoxib sodium on the inflammatory factors of septic patients induced by abdominal infection and the function of intestinal barrier. \u0000 \u0000 \u0000Methods \u0000Clinical data were collected from 97 septic patients who were admitted into Nanjing Integrated Traditional Chinese and Western Medicine Hospital due to abdominal infection and received treatment from April, 2015 to October, 2017. According to the random number table method, the patients were divided into two groups: a treatment group (parecoxib, n=50) and a control group (normal saline, n=47). Both groups were compared for general information, I-fatty acid-binding protein (I-FABP), diamine oxidase (DAO), D-lactate (D-Lac), interleukin-6 (IL-6), C reactive protein (CRP) and tumor necrosis factor-α (TNF-α) before and after treatment, and morality after treatment. \u0000 \u0000 \u0000Results \u0000There was no statistical difference in general information between the two groups (P>0.05). No statistical difference was found in intestinal barrier function and inflammatory indicators in both groups before treatment (P>0.05). The two groups presented remarkably reduced levels of I-FABP, DAO and D-Lac after treatment, compared with their levels before treatment, and the levels of I-FABP, DAO and D-Lac in the treatment group were obviously lower than those in the control group (P<0.05). The two groups presented remarkably reduced levels of IL-6, CRP and TNF-α after treatment, compared with their levels before treatment, and the levels of IL-6, CRP and TNF-α in the treatment group were obviously lower than those in the control group (P<0.05). The 28-day mortality of the treatment group (12.0%, 6/50) was obviously lower than that of the control group (31.9%, 14/47) (χ2=4.683, P=0.03). \u0000 \u0000 \u0000Conclusions \u0000Parecoxib sodium can relieve inflammatory reaction, while protecting the intestinal barrier function in septic patients, with good safety. \u0000 \u0000 \u0000Key words: \u0000Parecoxib; Sepsis; Intestinal barrier; Inflammatory reaction","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"134-137"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44726774","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.1673-4378.2020.02.016
Zhen Wang, Yuzhu Tao, Zhong Wang, Linlin Zhang
Opioid drugs, acting with the opioid receptors, are commonly used in clinical anesthesia and analgesia, but there is no effective preventive strategies for its side effects such as respiratory depression, hyperalgesia, and opioid tolerance. Naloxone and Nalmefene , these two drugs are mainly used for postoperative snooze and respiratory depression relieve. In recent years, it has been reported that preadministration of ultralow-dose opioid receptor antagonists can significantly alleviate postoperative opioid tolerance and hyperalgesia. This review summarized research advances of the effect and potential mechanism of ultralow-dose opioid receptor antagonist on adverse reactions induced by opioid receptor agonists. With further study of opioid agonists combined with ultralow-dose antagonists, new ideas will be generated for prevention of side effects caused by opioid drugs. Key words: Naloxone; Nalmefene; Hyperalgesia; Opioid tolerance
{"title":"Research advances in mechanisms about the effect of pretreatment with low-dose opioid antagonist on opioid-induced side effects","authors":"Zhen Wang, Yuzhu Tao, Zhong Wang, Linlin Zhang","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.016","url":null,"abstract":"Opioid drugs, acting with the opioid receptors, are commonly used in clinical anesthesia and analgesia, but there is no effective preventive strategies for its side effects such as respiratory depression, hyperalgesia, and opioid tolerance. Naloxone and Nalmefene , these two drugs are mainly used for postoperative snooze and respiratory depression relieve. In recent years, it has been reported that preadministration of ultralow-dose opioid receptor antagonists can significantly alleviate postoperative opioid tolerance and hyperalgesia. This review summarized research advances of the effect and potential mechanism of ultralow-dose opioid receptor antagonist on adverse reactions induced by opioid receptor agonists. With further study of opioid agonists combined with ultralow-dose antagonists, new ideas will be generated for prevention of side effects caused by opioid drugs. \u0000 \u0000 \u0000Key words: \u0000Naloxone; Nalmefene; Hyperalgesia; Opioid tolerance","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"200-203"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47821414","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.1673-4378.2020.02.010
Yaoping Zhao, Y. Tao, Nan Cai, Shaoqiang Zheng, Long Cheng
Objective To observe the effects of ultrasound-guided retrolaminar block on postoperative analgesia in patient undergoing video-assisted thoracoscopic lobectomy. Methods Forty patients scheduled for video-assisted thoracoscopic lobectomy were divided into two groups according to the random number table method (n=20): a retrolaminar block combined with general anesthesia group (group R) and a general anesthesia group (group G). Before general anesthesia, patients in group R underwent ultrasound-guided retrolaminar block and could feel the blocked plane 20 min after blockage. Both groups adopted the same method for general anesthesia. Patients in the two groups received postoperative patient controlled intravenous analgesia (PCIA). The Visual Analogue Scale (VAS) scores at resting and during movement were recorded 2, 6, 18, 24 h and 48 h after operation. The length of post-anesthesia care unit (PACU) stay, the times of PCIA pressing, the doses of sufentanil after surgery, the needs for rescue analgesia, side effects, the length of hospitalization stay, and patient satisfaction were recorded. Results In group R, the number of sensory block segments at the midclavicular line was (5.7±0.9) 20 min after retrolaminar block. The VAS scores at resting and during movement in group R were lower than those of group G 2, 6, 18, 24, and 48 h after surgery (P 0.05). Conclusions Ultrasound-guided retrolaminar block is safe and effective for patients undergoing video-assisted thoracoscopic lobectomy, and can provide good postoperative analgesia, with good patient satisfaction. Key words: Ultrasoundguidance; Retrolaminar block; Pulmonary lobectomy; Postoperative analgesia
{"title":"Effects of ultrasound-guided retrolaminar block on postoperative analgesia in patient undergoing video-assisted thoracoscopic lobectomy","authors":"Yaoping Zhao, Y. Tao, Nan Cai, Shaoqiang Zheng, Long Cheng","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.010","url":null,"abstract":"Objective \u0000To observe the effects of ultrasound-guided retrolaminar block on postoperative analgesia in patient undergoing video-assisted thoracoscopic lobectomy. \u0000 \u0000 \u0000Methods \u0000Forty patients scheduled for video-assisted thoracoscopic lobectomy were divided into two groups according to the random number table method (n=20): a retrolaminar block combined with general anesthesia group (group R) and a general anesthesia group (group G). Before general anesthesia, patients in group R underwent ultrasound-guided retrolaminar block and could feel the blocked plane 20 min after blockage. Both groups adopted the same method for general anesthesia. Patients in the two groups received postoperative patient controlled intravenous analgesia (PCIA). The Visual Analogue Scale (VAS) scores at resting and during movement were recorded 2, 6, 18, 24 h and 48 h after operation. The length of post-anesthesia care unit (PACU) stay, the times of PCIA pressing, the doses of sufentanil after surgery, the needs for rescue analgesia, side effects, the length of hospitalization stay, and patient satisfaction were recorded. \u0000 \u0000 \u0000Results \u0000In group R, the number of sensory block segments at the midclavicular line was (5.7±0.9) 20 min after retrolaminar block. The VAS scores at resting and during movement in group R were lower than those of group G 2, 6, 18, 24, and 48 h after surgery (P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Ultrasound-guided retrolaminar block is safe and effective for patients undergoing video-assisted thoracoscopic lobectomy, and can provide good postoperative analgesia, with good patient satisfaction. \u0000 \u0000 \u0000Key words: \u0000Ultrasoundguidance; Retrolaminar block; Pulmonary lobectomy; Postoperative analgesia","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"173-176"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48328399","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 : 2020-01-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.01.017
Yueqi Zhang, Zhendong Xu
Maternal fever in labor is a complication with complicated mechanisms, and plays an important role in delivery outcome and infant prognosis. A great number of clinical studies have found the relationship between epidural analgesia and maternal fever in labor. Recent researches show that the possibility of the non-infectious mechanism of epidural-related maternal fever (ERMF). This review is designed to introduce the research progress in ERMF-related inflammatory mechanism through summarizing the current findings regarding the physical changes of pregnancy and labor, systemic and local inflammation, epidural analgesia and triggers of inflammation. A better understanding of ERMF mechanism is helpful to improve the clinical diagnosis and treatment of maternal fever in labor and allow a better outcome of both mothers and babies. Key words: Epidural analgesia; Maternal; Fever; Inflammation
{"title":"Progress in the research on the inflammatory mechanism of epidural-related maternal fever","authors":"Yueqi Zhang, Zhendong Xu","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.01.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.01.017","url":null,"abstract":"Maternal fever in labor is a complication with complicated mechanisms, and plays an important role in delivery outcome and infant prognosis. A great number of clinical studies have found the relationship between epidural analgesia and maternal fever in labor. Recent researches show that the possibility of the non-infectious mechanism of epidural-related maternal fever (ERMF). This review is designed to introduce the research progress in ERMF-related inflammatory mechanism through summarizing the current findings regarding the physical changes of pregnancy and labor, systemic and local inflammation, epidural analgesia and triggers of inflammation. A better understanding of ERMF mechanism is helpful to improve the clinical diagnosis and treatment of maternal fever in labor and allow a better outcome of both mothers and babies. \u0000 \u0000 \u0000Key words: \u0000Epidural analgesia; Maternal; Fever; Inflammation","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"76-78"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44941389","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 : 2020-01-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.01.013
Jiaxin Li, M. Jian, Jia Dong, Min Zeng
The number of pediatric surgery grows every year. Some studies found that long or repeated exposure to general anesthetics may affect the development of neurological system function in children. This finding is supported by a large number of animal researches currently, without sufficient clinical evidence. This review was to explore the effects of early anesthetic exposure on long-term neurodevelopment in children, so as to provide guidance to determine treatment method and surgery time. This review summarized the latest research progresses, and analyzed the association between early anesthetic exposure in childhood and long-term neurodevelopmental deficits and the sensitive period of the age exposed to anesthesia. At present, clinical researches involve different age populations and types of outcomes. Therefore, the interpretation of outcomes needs the combination of the age exposed to anesthesia, duration of exposure, sample size, outcome indicators, and other factors. It is found that anesthesia exposure in early childhood is associated with long-term neurological deficits, and affected by the frequency of anesthetic exposure to some extent. Key words: Children; Anesthesia; Neurotoxicity; Neurodevelopment
{"title":"Progress in the clinical research on the effects of early anesthetic exposure on the development of neurological system function in children","authors":"Jiaxin Li, M. Jian, Jia Dong, Min Zeng","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.01.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.01.013","url":null,"abstract":"The number of pediatric surgery grows every year. Some studies found that long or repeated exposure to general anesthetics may affect the development of neurological system function in children. This finding is supported by a large number of animal researches currently, without sufficient clinical evidence. This review was to explore the effects of early anesthetic exposure on long-term neurodevelopment in children, so as to provide guidance to determine treatment method and surgery time. This review summarized the latest research progresses, and analyzed the association between early anesthetic exposure in childhood and long-term neurodevelopmental deficits and the sensitive period of the age exposed to anesthesia. At present, clinical researches involve different age populations and types of outcomes. Therefore, the interpretation of outcomes needs the combination of the age exposed to anesthesia, duration of exposure, sample size, outcome indicators, and other factors. It is found that anesthesia exposure in early childhood is associated with long-term neurological deficits, and affected by the frequency of anesthetic exposure to some extent. \u0000 \u0000 \u0000Key words: \u0000Children; Anesthesia; Neurotoxicity; Neurodevelopment","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"58-62"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45105467","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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