International journal of clinical and experimental medicine
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To compare the different outcomes of dexmedetomidine (Dex) vs. propofol combined with sevoflurane in children's laparoscopic surgery by noninvasive continuous cardiac output monitoring (NICOM). ⋯ Compared with propofol, the combination of Dex in children undergoing laparoscopic surgery shows better inhibition on HR.
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Fentanyl-induced cough (FIC) should be effectively prevented in patients requiring stable induction of general anesthesia. We reviewed available randomized-controlled trials (RCTs) that focused on the pre-emptive fentanyl to prevent FIC, and preformed this meta-analysis to clarify the efficacy and to recommend a specific application. The PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Chinese BioMedical Literature Database were searched for relevant RCTs without restriction on the year or language of the publications. ⋯ A total of seven studies were identified for inclusion. Meta-analysis showed that a priming fentanyl dose of 0.5 μg/kg decreased the FIC incidence (RR = 0.29, 95% CI: 0.17-0.49) and severity (WMD = -0.46, 95% CI -0.70 - -0.23) of FIC; however, a priming fentanyl dose of 1.0 μg/kg (RR = 0.26, 95% CI 0.04-1.70; WMD = -0.60, 95% CI -1.33-0.14) or 1.5 μg/kg (RR = 0.94; 95% CI: 0.77-1.15; WMD = -0.08, 95% CI -0.33-0.17) had no effect on FIC. Our meta-analysis demonstrated that pre-emptive low dose of fentanyl could effectively prevent FIC, and the dose of 0.5 μg/kg was recommended.
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Caudal block is the regional anesthetic technique that is used most frequently in pediatric surgery and bupivacaine and levobupivacaine are widely utilized in this technique. Opioid drugs have been added to local anesthetic solutions to prolong duration of analgesia but ideal combination were not found. We compared the postoperative analgesic efficacy of equal concentrations of bupivacaine or levobupivacaine plus tramadol in pediatric patients. ⋯ There were no significant differences between groups for arterial pressures and heart rate values after caudal block and during the operation. Caudal bupivacaine plus tramadol and levobupivacaine plus tramadol have similar postoperative analgesic efficacy. But the use of bupivacaine plus tramadol may cause a greater frequency of urinary retention.
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Penehyclidine hydrochloride (PH), a new anticholinerigic drug associated with few cardiovascular side effects, was used widely as premedication in China. There is no information on the pharmacodynamic interaction between PH and anesthetics for loss of consciousness (LOC). This study was designed to determine the effects of premedicated PH on the propofol dose requirement for LOC and Bispectral Index (BIS) during target-controlled infusion (TCI) of propofol. ⋯ The predicted propofol Ce and consumption based on body weight of each patient were lower in Group PH than Group NS (p < 0.05). BIS values were not significantly changed before propofol infusion, and decreased gradually as propofol Ce increased and were not significantly different when LOC was reached between two groups (p > 0.05). We conclude that premedicated PH reduces the propofol Ce and dose requirement for LOC, but has no effect on BIS.
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The acute respiratory distress syndrome (ARDS) is a syndrome of acute respiratory failure associated with severe inflammation and diffuse alveolar damage. Recent studies have demonstrated that the soluble receptor for advanced glycation end products (sRAGE) plays an important role in the pathogenesis of ARDS. The aim of this study was to ascertain whether plasma levels of sRAGE were elevated in ARDS patients compared with appropriate controls. ⋯ There was no significant difference in plasma sRAGE levels between survivors and non-survivors (P=0.34). Our results demonstrate that elevated levels of plasma sRAGE may provide a useful marker for ventilated ARDS patients. Furthermore, the relationship between plasma sRAGE levels and PaO2:FiO2 ratio in the ARDS population provides the hypothesis that ventilatory strategy may influence alveolar epithelial damage in ARDS.