目的 探討在丙泊酚誘導麻醉的改良電休克治療中腦雙頻譜指數(BIS)與動作發作時間的關系，以及其他因素對電休克動作發作時間的影響。 方法 2012年4月－5月，記錄28名患者的107次治療中的不同時刻腦雙頻譜指數（BIS）值誘導前、睫毛反射消失時、治療前即刻、動作發作結束即刻、動作發作結束后60 s）、麻醉藥物劑量、動作發作時間及治療不良反應，并根據動作發作時間將治療分為A組（治療無效組，動作發作時間＜17 s）和B組（治療有效組，動作發作時間≥17 s）。探討不同時刻BIS值與癲癇發作時間的關系并比較A、B組之間BIS值、麻醉藥物劑量差異。 結果 兩組間睫毛反射消失時及治療前即刻BIS值差異有統計學意義（P＜0.05）。動作發作時間與治療前即刻BIS值呈正相關（r=0.245，P=0.012），與治療次數呈負相關（r=?0.283，P=0.004）。 結論 治療前即刻BIS值與動作發作時間呈正相關，因此，此時的BIS值也許可以作為預測動作發作時間長短的指標。
目的 研究腦電雙頻指數（BIS）在小兒麻醉中的應用，為BIS在小兒臨床麻醉上的廣泛應用及提高小兒麻醉的安全性提供依據。 方法 2011年1月－3月擬行腹部外科手術的患兒60例，男39例，女21例；年齡1～4歲，美國麻醉醫師協會分級Ⅰ～Ⅱ級，隨機分為兩組，每組各30例。S組：七氟醚、瑞芬太尼和維庫溴銨維持麻醉；P組：丙泊酚、瑞芬太尼和維庫溴銨維持麻醉。采用BIS監測麻醉深度，將BIS控制在50 ± 5，記錄麻醉誘導前到手術探查期間不同時點的血流動力學參數及蘇醒、拔管時間。 結果 手術過程中P組血壓及心率明顯低于麻醉前水平（P＜0.05）。S組蘇醒迅速、完全，蘇醒時間與P組比較差異有統計學意義（P＜0.05）。S組的血流動力學穩定性優于P組，蘇醒時間、拔管時間相對較短。麻醉誘導前兩組的BIS值均為97 ± 1，意識消失時的BIS值為71 ± 2。BIS值為50 ± 5時，結果顯示手術過程中（T4、T5、T6、T7）兩組的心率、血壓都很平穩。 結論 BIS作為小兒麻醉鎮靜深度的監測指標有臨床意義。
目的:比較七氟醚吸入麻醉和丙泊酚、瑞芬太尼靜脈麻醉用于小兒手術的臨床效果。方法:100例1～8歲的患兒隨機分為丙泊酚、瑞芬太尼組(A組)與七氟醚吸入組(B組）。麻醉誘導后,A組持續輸注丙泊酚和瑞芬太尼維持麻醉,B組吸入七氟醚維持麻醉。術中根據生命體征調整丙泊酚、瑞芬太尼的輸注速度及七氟醚的吸入濃度,記錄術中循環變化、術后麻醉恢復情況。結果:與B組相比,A組術中MAP下降明顯(Plt;005)。結論:與A組相比,B組術中生命體征控制平穩;術后清醒迅速、完全、平穩,拔管時間無明顯差異。
目的 觀察右美托咪啶復合丙泊酚靶控靜脈麻醉在纖維支氣管鏡檢查術中的麻醉效果。 方法 2010年12月－2012年4月，將60例行纖維支氣管鏡檢查術的患者隨機分為丙泊酚麻醉組（對照組）和右美托咪啶復合丙泊酚麻醉組（觀察組），每組各30例。觀察記錄不同時點平均動脈壓（MAP）、心率、呼吸次數（RR）、脈搏血氧飽和度（SpO2），鎮靜評分、手術時間、蘇醒時間、丙泊酚總用量、不良反應發生率及患者滿意度。 結果 所有患者均能順利完成操作，誘導入睡后觀察組MAP、心率下降（P＜0.05），丙泊酚總用量、不良反應發生率均少于對照組（P＜0.05），鎮靜評分優于對照組（P＜0.05）；兩組RR、SpO2、蘇醒時間、手術時間及患者滿意度差異無統計學意義（P＞0.05）。 結論 右美托咪定復合丙泊酚靶控輸注適用于纖維支氣管鏡檢查術麻醉，是一種更加安全有效的麻醉方法。
目的 探討丙泊酚-瑞芬太尼對肝臟缺血再灌注損傷的保護作用以及作用機制。 方法 2009年6月－2011年12月選擇擇期需阻斷肝門的肝臟手術患者40例，隨機分為丙泊酚-瑞芬太尼組（P組）和異氟醚組（I組），每組20例。在術前（T0）和肝門阻斷開放后30 min（T1）、60 min（T2）、6 h（T3）、24 h（T4）、72 h（T5）分別抽取動脈血，測定天冬氨酸氨基轉移酶（AST）、丙氨酸氨基轉移酶（ALT）和腫瘤壞死因子α（TNF-α）的含量。 結果 兩組AST、ALT、TNF-α較術前均有增高，差異有統計學意義（P＜0.05）；P組增高幅度明顯低于I組，差異有統計學意義（P＜0.05）。 結論 丙泊酚-瑞芬太尼對肝臟缺血再灌注損傷具有保護作用，抑制TNF-α的產生可能為其作用機制之一。
目的 探討全憑靜脈麻醉中腺苷對丙泊酚用量的影響。 方法 2011年1月－12月期間59例行擇期手術的患者全憑靜脈麻醉，隨機分為腺苷靜脈持續輸注組（A組）和對照組（B組），A組患者麻醉誘導后持續輸注腺苷70 μg/（kg·min），直至術畢。B組麻醉后按常規處理。比較兩組患者麻醉時間、蘇醒時間、瑞芬太尼用量，麻醉過程中平均動脈壓（MAP）、心率，以及麻醉過程中丙泊酚的用量。同時記錄使用腺苷過程中的不良反應。 結果 兩組患者麻醉時間、蘇醒時間、瑞芬太尼用量比較均無明顯差異，無統計學意義（P＞0.05）。兩組患者麻醉過程中MAP、心率比較亦無明顯差異，無統計學意義（P＞0.05）。兩組患者麻醉過程中丙泊酚平均用量比較，A組明顯低于C組，差異有統計學意義（P＜0.05），且不良反應發生率低。 結論 腺苷能明顯降低全憑靜脈麻醉中丙泊酚的使用劑量。
ObjectiveTo evaluate the association of anesthesia regime (volatile or intravenous anesthetics) with the occurrence of postoperative pulmonary complications (PPCs) in adult patients undergoing elective cardiac surgery under cardiopulmonary bypass (CPB).MethodsThe electronic medical records of 194 patients undergoing elective cardiac surgery under CPB at West China Hospital, Sichuan University between September 2018 and February 2019 were reviewed, including 92 males and 102 females with an average age of 53 years. The patients were classified into a volatile group (n=94) or a total intravenous anesthesia (TIVA) group (n=100) according to anesthesia regimen during surgery (including CPB). The primary outcome was the incidence of PPCs within first 7 d after surgery. Secondary outcomes included incidence of reintubation, duration of mechanical ventilation, ICU stay and hospital stay.ResultsThere was no significant difference in the incidence of PPCs between the two groups (RR=1.020, 95%CI 0.763-1.363, P=0.896), with an incidence of 48.9% in the volatile group and 48.0% in the TIVA group. Secondary outcomes were also found no significant difference between the two groups (P>0.05).ConclusionNo association of anesthesia regimen with the incidence of PPCs is found in adult patients undergoing elective cardiac surgery under CPB.
Objective To systematically review the impacts of general anesthesia using sevoflurane versus propofol on the incidence of emergence agitation in pediatric patients. Methods Such databases as PubMed, EMbase, Web of Science, The Cochrane Library (Issue 4, 2012), CNKI, CBM, WanFang Data and VIP were electronically searched from inception to December 2012, for comprehensively collecting randomized controlled trials (RCTs) on the impacts of general anesthesia using sevoflurane versus propofol on the incidence of emergence agitation in pediatric patients. References of included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results A total of 9 RCTs involving 692 children were included, of which, six were pooled in the meta-analysis. The results of meta-analysis showed that: a) after anesthesia induction using sevoflurane, intravenous propofol maintenance was associated with a lower incidence of emergence agitation compared with sevoflurane maintenance (RR=0.57, 95%CI 0.39 to 0.84, P=0.004); and b) patients anesthetized with total intravenous propofol had a lower incidence of emergence agitation compared with total inhalation of sevoflurane (RR=0.16, 95%CI 0.06 to 0.39, Plt;0.000 1). Conclusion The incidence of emergence agitation after general anesthesia using sevoflurane is higher than that using propofol. Due to the limited quantity and quality, the application of sevoflurane should be chosen based on full consideration into patients’ conditions in clinic.
Objective To explore the effects of propofol and thiopental sodium injection on convulsive seizure in electro-convulsive therapy(ECT) and to provide evidence to help the selection of intravenous anaesthetics in improved ECT. Methods Total of 111 patients who received ECT in the 3rd Pepole’s Hospital of Panzhihua from July to December 2005 were divided into a thiopental sodium group (n =62) and a propofol group (n =49). These patients received intravenous anaesthesia with suxamethonium plus thiopental sodium or propofol for the implementation of ECT, respectively. The status of convulsive seizure was compared between the two groups. Results There were no significant differences between the two groups in terms of main demographic data, disease category and ECT parameters (Pgt;0.05). Motor seizure and electricity discharge lasted significantly longer in the propofol group than in the thiopental sodium group (Plt;0.01). Conclusion Thiopental sodium can increase the excitation threshold of brain cortical neurons and decrease the level of convulsive seizure induced by ECT. Propofol may decrease the excitation threshold, and increase the level of convulsive seizure under the same ECT parameters, but may have the potential to induce epileptic seizure.
Objective To systematically review the effects of lidocaine for preventing pain on injection of propofol. Methods Databases including The Cochrane Library (Issue 4, 2012), PubMed, MEDLINE, Ovid, HighWire, EMbase, CBM and CNKI were searched electronically to collect literature published from January, 1985 to December, 2012. Randomized controlled trials (RCTs) were indentified about lidocaine for preventing injection pain of propofol. References of the included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assess the quality of the included studies. Then meta-analysis was performed using RevMan 5.1 software. Results Fifteen trials involved 1 332 patients were included. The results of meta-analysis indicated that, adding lidocaine into propofol lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.36, 95%CI 0.30 to 0.44, Plt;0.000 01); using different doses of lidocaine before injection lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.59, 95%CI 0.47 to 0.75, Plt;0.000 1); using different doses of lidocaine after venous occlusion lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.44, 95%CI 0.37 to 0.52, Plt;0.000 01). Conclusion Lidocaine could reduce the pain on injection of propofol. Using lidocaine 40 mg after venous occlusion is a relatively effective method to lower the incidence of pain on injection which is more suitable for outpatient who receive intravenous anesthesia without preoperation medication.