Neuroprotective effect of bispectral index-guided fast-track anesthesia using sevoflurane combined with dexmedetomidine for intracranial aneurysm embolization

Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1.0 ~tg/kg dexmedetomidine for 15 minutes followed by maintenance with 0.3 ~tg/kg/h until the end of surgery; the other group of patients only underwent pump-controlled infusion of saline. Bispectral index monitoring revealed that dexmedetomidine-assisted anesthesia can shorten the recovery time of spon- taneous breathing, time to eye opening, and time to laryngeal mask removal. Before anesthetic induction and immediately after laryngeal mask airway removal, the glucose and lactate levels were low, the S100~ and neuron-specific enolase levels were low, the perioperative blood pressure and heart rate were stable, and postoperative delirium was minimal. These findings indicate that dexmedetomidine can effectively assist sevoflurane for anesthesia during surgical embolization of intracranial aneurysms, shorten the time to consciousness and extubation, reduce the stress response and energy metabolism, stabilize hemodynamic parameters, and reduce adverse reactions, thereby reducing the damage to the central nervous system. This trial was registered at the Chinese Clinical Trial Registry （http：//www.chictr.org. cn/） （registration number： ChiCTR-IPR- 16008113）.

Mechanisms and status of research on the protective effects of traditional Chinese medicine against ischemic brain injury

Ischemic brain injury occurs when the metabolic needs of brain tissue cannot be met due to insufficient blood supply to the brain.It is one of the main causes of death and adult disability worldwide.The recurrence rate of ischemic brain injury is high.It places a heavy economic burden on families and society,and seriously affects human health and quality of life.In traditional Chinese medicine,ischemic stroke belongs to the category of“stroke”.The use of traditional Chinese medicine to treat stroke has a long history.After years of experimental research,a large amount of theoretical knowledge and practical experience have been accumulated.Promoting blood circulation and removing blood stasis is the basis of traditional Chinese medicine theory on the treatment of ischemic stroke.Commonly used single Chinese medicines include Chuangxiong(Ligusticum chuanxiong hort),Danggui(Angelica sinensis),Danshen(Salvia miltiorrhiza Bunge),Honghua(Carthamus tinctorius L.),Mudanpi(Moutan Cortex),and Huangqi(Astragali Radix).Buyang Huanwu decoction,Xinglou Chengqi decoction,Taohong Siwu decoction,and other traditional Chinese medicine prescriptions are believed to have a protective effect against brain damage caused by ischemic stroke.With the development of modern medical technology,the mechanism of traditional Chinese medicine treatments for ischemic brain injury has gradually been explored.This article reviews the mechanisms of traditional Chinese medicine’s protection against ischemic brain injury and its current clinical application.

Electroacupuncture in perioperative anesthesia and analgesia management:a non-invasive adjuvant treatment

Anesthesia is mainly a kind of reversible functional inhibition of the central nervous system and(or)peripheral nervous system through drugs or other methods.In modern clinical medicine,modern anesthesiology is a comprehensive subject,which mainly includes clinical anesthesia,pain diagnosis and treatment,intensive care treatment,first aid and resuscitation,etc.Electroacupuncture is developed based on acupuncture therapy which is an important part of traditional Chinese medicine.It uses the comprehensive efficacy of acupuncture and electrical stimulation to deliver electrical energy through acupoints to achieve therapeutic effects.It has been widely used in recent years in clinical.This article summarizes the analgesic mechanism of electroacupuncture and its application in different anesthesia methods,so that clinicians have a deeper understanding of the clinical application of electroacupuncture and promote its clinical application.

Stability and compatibility of common traditional Chinese medicine injections matching with fructose injection

In recent years,China has attached great importance to the work of traditional Chinese medicine(TCM),more and more Chinese patent medicines are included in the national medical insurance catalogue,and the clinical application of TCM injections is also increasing.This article reviews a total of 20 literature reports on the compatibility of fructose injections with TCM injections from 2005 to the present,and evaluates the stability based on the appearance,pH,insoluble particles and content changes after compatibility,and provides for the rational use of fructose injections.Theoretical evidence provides options for special patients with special solvent limit.

Prevention of nausea,vomiting and reflux aspiration in two cases of painless hysteroscopy

Objective:To investigate the prevention and management of perioperative nausea and vomiting and reflux aspiration in painless hysteroscopy patients.Methods:The clinical datum of one patient with reflux and postoperative vomiting and another one with a history of multiple postoperative nausea and vomiting during painless hysteroscopy were retrospectively analyzed.Results:In case 1,despite the occurrence of reflux,no significant aspiration or other serious consequences occurred through positive attraction,ondansetron,dexamethasone,droperidol and other drugs and candy treatment,then nausea and vomiting gradually eased.In case 2,due to the reduction of preoperative dosage of sufentanil,prophylactic application of ondansetron,psychological intervention and postoperative candy,no nausea and vomiting occurred during the painless hysteroscopy.The patient recovered quickly with high satisfaction.Conclusion:Patients with a high risk of nausea and vomiting may be ameliorated by positive psychological and drug intervention.Even if patients have intraoperative reflux and postoperative nausea and vomiting,it can be relieved by psychological and drug treatment,and the occurrence of serious complications such as aspiration can be prevented.