BACKGROUND Sedation with propofol injections is associated with a risk of addiction,but remimazolam benzenesulfonate is a comparable anesthetic with a short elimination half-life and independence from cell P450 enzyme...BACKGROUND Sedation with propofol injections is associated with a risk of addiction,but remimazolam benzenesulfonate is a comparable anesthetic with a short elimination half-life and independence from cell P450 enzyme metabolism.Compared to remimazolam,remimazolam benzenesulfonate has a faster effect,is more quickly metabolized,produces inactive metabolites and has weak drug interactions.Thus,remimazolam benzenesulfonate has good effectiveness and safety for diagnostic and operational sedation.AIM To investigate the clinical value of remimazolam benzenesulfonate in cardiac surgery patients under general anesthesia.METHODS A total of 80 patients who underwent surgery in the Department of Cardiothoracic Surgery from August 2020 to April 2021 were included in the study.Using a random number table,patients were divided into two anesthesia induction groups of 40 patients each:remimazolam(0.3 mg/kg remimazolam benzenesulfonate)and propofol(1.5 mg/kg propofol).Hemodynamic parameters,inflammatory stress response indices,respiratory function indices,perioperative indices and adverse reactions in the two groups were monitored over time for comparison.RESULTS At pre-anesthesia induction,the remimazolam and propofol groups did not differ regarding heart rate,mean arterial pressure,cardiac index or volume per wave index.After endotracheal intubation and when the sternum was cut off,mean arterial pressure and volume per wave index were significantly higher in the remimazolam group than in the propofol group(P<0.05).After endotracheal intubation,the oxygenation index and the respiratory index did not differ between the groups.After endotracheal intubation and when the sternum was cut off,the oxygenation index values were significantly higher in the remimazolam group than in the propofol group(P<0.05).Serum interleukin-6 and tumor necrosis factor-αlevels 12 h after surgery were significantly higher than before surgery in both groups(P<0.05).The observation indices were re-examined 2 h after surgery,and the epinephrine,cortisol and blood glucose levels were significantly higher in the remimazolam group than in the propofol group(P<0.05).The recovery and extubation times were significantly lower in the remimazolam group than in the propofol group(P<0.05);there were significantly fewer adverse reactions in the remimazolam group(10.00%)than in the propofol group(30.00%;P<0.05).CONCLUSION Compared with propofol,remimazolam benzenesulfonate benefited cardiac surgery patients under general anesthesia by reducing hemodynamic fluctuations.Remimazolam benzenesulfonate influenced the surgical stress response and respiratory function,thereby reducing anesthesia-related adverse reactions.展开更多
Objective: To evaluate the effect of acupuncture therapy on the side effect of Etomidate anesthesia and to determine the best timing of acupuncture intervention during Etomidate anesthesia. Methods: Female patients wi...Objective: To evaluate the effect of acupuncture therapy on the side effect of Etomidate anesthesia and to determine the best timing of acupuncture intervention during Etomidate anesthesia. Methods: Female patients with rectal cancer scheduled to receive radical resection were randomly divided into four groups: a control group(group Ⅰ), a preoperative acupuncture group(group Ⅱ), an intraoperative acupuncture group(group Ⅲ), and a postoperative acupuncture group(group Ⅳ), 25 subjects in each group. The levels of serum cortisol, blood glucose, and gastrin of patients were monitored at the following time-points: preoperative(T0, when having entered the operating room), intraoperative(T1, 30 min after skin cutting), the end of operation(T2, after suturing skin), and postoperative(T3, postoperative 24 h). The cases with massive hemorrhage, unsteady vital sign during operation or operation time longer than 5 h were eliminated, and 92 cases were enrolled into the results of the study. Results: The blood sugar in the four groups increased significantly at T2 and T3, compared to T0(P < 0.05); the blood sugar reached((.(((1.5() mmol(( at T2 in group Ⅲ, and the increase was statistically significant compared to those of the other groups(P<0.05). The levels of serum cortisol of all patients were in normal range. Compare to T0, the cortisol level decreased in group Ⅰ, Ⅲ, at each point, and the decreases Ⅳ were statistically significant(P<0.05). Compared to the other groups, the cortisol level was increased at T1 and T3 in group Ⅱ, and the change was statistically significant(P<0.05). Compared to T0, the gastrin level at T3 increased in group Ⅰ, Ⅲand Ⅳ, but decreased in group Ⅱ, and the changes had statistical significance(P<0.05). Compared to the other groups, the decrease of gastrin level in group Ⅱat T3 was statistically significant(P<0.05). Conclusion: Acupuncture before operation can keep blood sugar and serum cortisol steady during Etomidate anesthesia and reduce gastrin after Etomidate anesthesia, hence regulating the Etomidate-related stress responses effectively.展开更多
Objective:To observe the effect of acupoint massage plus acupoint sticking therapy for the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery.Methods:A tota...Objective:To observe the effect of acupoint massage plus acupoint sticking therapy for the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery.Methods:A total of 120 patients undergoing nasal endoscopic surgery were included,and all patients were under trachea intubation and general anesthesia.The patients were randomized into an observation group and a control group,with 60 patients in each group.Patients in the control group received conventional anesthesia resuscitation,while patients in the observation group received acupoint massage plus acupoint sticking therapy on the basis of conventional anesthesia resuscitation.Changes in the heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed at three time points including the end of the surgery (TO),the removal of the tracheal tube (T1) and 10 min after the removal of the tracheal tube (T2).The awakening and tube removal time,choking cough and restlessness,and adverse reactions (dizziness,nausea and vomiting) in 24 h post-surgery period were compared.Results:At T1 and T2,the comparisons of HR,SBP and DBP between the two groups showed statistical significance (all P＜0.05).Intra-group comparisons showed that the HR,SBP and DBP of the control group at T1 and T2 were significant different from those at TO (all P＜0.05).There were significant differences in the awakening time and tube removal time between the two groups (both P＜0.05).The incidences of choking cough and restlessness were 8.3％ and 3.3％ respectively in the observation group,versus 53.3％ and 30.0％ in the control group,and the between-group comparisons showed statistical significance (both P＜0.05).The incidences of dizziness,nausea and vomiting in 24 h post-surgery period were 3.3％,5.0％ and 0.0％ respectively in the observation group,versus 43.3％,33.3％ and 25.0％ in the control group,and the between-group comparisons showed statistical significance (all P＜0.05).Conclusion:Acupoint massage plus acupoint sticking therapy can effectively regulate the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery,and maintain a stable internal environment.展开更多
基金The First Affiliated Hospital of Nanchang University Ethics Committee.
文摘BACKGROUND Sedation with propofol injections is associated with a risk of addiction,but remimazolam benzenesulfonate is a comparable anesthetic with a short elimination half-life and independence from cell P450 enzyme metabolism.Compared to remimazolam,remimazolam benzenesulfonate has a faster effect,is more quickly metabolized,produces inactive metabolites and has weak drug interactions.Thus,remimazolam benzenesulfonate has good effectiveness and safety for diagnostic and operational sedation.AIM To investigate the clinical value of remimazolam benzenesulfonate in cardiac surgery patients under general anesthesia.METHODS A total of 80 patients who underwent surgery in the Department of Cardiothoracic Surgery from August 2020 to April 2021 were included in the study.Using a random number table,patients were divided into two anesthesia induction groups of 40 patients each:remimazolam(0.3 mg/kg remimazolam benzenesulfonate)and propofol(1.5 mg/kg propofol).Hemodynamic parameters,inflammatory stress response indices,respiratory function indices,perioperative indices and adverse reactions in the two groups were monitored over time for comparison.RESULTS At pre-anesthesia induction,the remimazolam and propofol groups did not differ regarding heart rate,mean arterial pressure,cardiac index or volume per wave index.After endotracheal intubation and when the sternum was cut off,mean arterial pressure and volume per wave index were significantly higher in the remimazolam group than in the propofol group(P<0.05).After endotracheal intubation,the oxygenation index and the respiratory index did not differ between the groups.After endotracheal intubation and when the sternum was cut off,the oxygenation index values were significantly higher in the remimazolam group than in the propofol group(P<0.05).Serum interleukin-6 and tumor necrosis factor-αlevels 12 h after surgery were significantly higher than before surgery in both groups(P<0.05).The observation indices were re-examined 2 h after surgery,and the epinephrine,cortisol and blood glucose levels were significantly higher in the remimazolam group than in the propofol group(P<0.05).The recovery and extubation times were significantly lower in the remimazolam group than in the propofol group(P<0.05);there were significantly fewer adverse reactions in the remimazolam group(10.00%)than in the propofol group(30.00%;P<0.05).CONCLUSION Compared with propofol,remimazolam benzenesulfonate benefited cardiac surgery patients under general anesthesia by reducing hemodynamic fluctuations.Remimazolam benzenesulfonate influenced the surgical stress response and respiratory function,thereby reducing anesthesia-related adverse reactions.
基金approved by the Ethics Committee of the Affiliated Hospital of Guilin Medical University,Guangxi,Chinasupported by the Key Research Project of Guangxi Health(No.2010053)the Traditional Chinese Medicine and National Medicine Inheritance and Innovation Project of Guangxi(No.GZZC13-20)
文摘Objective: To evaluate the effect of acupuncture therapy on the side effect of Etomidate anesthesia and to determine the best timing of acupuncture intervention during Etomidate anesthesia. Methods: Female patients with rectal cancer scheduled to receive radical resection were randomly divided into four groups: a control group(group Ⅰ), a preoperative acupuncture group(group Ⅱ), an intraoperative acupuncture group(group Ⅲ), and a postoperative acupuncture group(group Ⅳ), 25 subjects in each group. The levels of serum cortisol, blood glucose, and gastrin of patients were monitored at the following time-points: preoperative(T0, when having entered the operating room), intraoperative(T1, 30 min after skin cutting), the end of operation(T2, after suturing skin), and postoperative(T3, postoperative 24 h). The cases with massive hemorrhage, unsteady vital sign during operation or operation time longer than 5 h were eliminated, and 92 cases were enrolled into the results of the study. Results: The blood sugar in the four groups increased significantly at T2 and T3, compared to T0(P < 0.05); the blood sugar reached((.(((1.5() mmol(( at T2 in group Ⅲ, and the increase was statistically significant compared to those of the other groups(P<0.05). The levels of serum cortisol of all patients were in normal range. Compare to T0, the cortisol level decreased in group Ⅰ, Ⅲ, at each point, and the decreases Ⅳ were statistically significant(P<0.05). Compared to the other groups, the cortisol level was increased at T1 and T3 in group Ⅱ, and the change was statistically significant(P<0.05). Compared to T0, the gastrin level at T3 increased in group Ⅰ, Ⅲand Ⅳ, but decreased in group Ⅱ, and the changes had statistical significance(P<0.05). Compared to the other groups, the decrease of gastrin level in group Ⅱat T3 was statistically significant(P<0.05). Conclusion: Acupuncture before operation can keep blood sugar and serum cortisol steady during Etomidate anesthesia and reduce gastrin after Etomidate anesthesia, hence regulating the Etomidate-related stress responses effectively.
文摘Objective:To observe the effect of acupoint massage plus acupoint sticking therapy for the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery.Methods:A total of 120 patients undergoing nasal endoscopic surgery were included,and all patients were under trachea intubation and general anesthesia.The patients were randomized into an observation group and a control group,with 60 patients in each group.Patients in the control group received conventional anesthesia resuscitation,while patients in the observation group received acupoint massage plus acupoint sticking therapy on the basis of conventional anesthesia resuscitation.Changes in the heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed at three time points including the end of the surgery (TO),the removal of the tracheal tube (T1) and 10 min after the removal of the tracheal tube (T2).The awakening and tube removal time,choking cough and restlessness,and adverse reactions (dizziness,nausea and vomiting) in 24 h post-surgery period were compared.Results:At T1 and T2,the comparisons of HR,SBP and DBP between the two groups showed statistical significance (all P＜0.05).Intra-group comparisons showed that the HR,SBP and DBP of the control group at T1 and T2 were significant different from those at TO (all P＜0.05).There were significant differences in the awakening time and tube removal time between the two groups (both P＜0.05).The incidences of choking cough and restlessness were 8.3％ and 3.3％ respectively in the observation group,versus 53.3％ and 30.0％ in the control group,and the between-group comparisons showed statistical significance (both P＜0.05).The incidences of dizziness,nausea and vomiting in 24 h post-surgery period were 3.3％,5.0％ and 0.0％ respectively in the observation group,versus 43.3％,33.3％ and 25.0％ in the control group,and the between-group comparisons showed statistical significance (all P＜0.05).Conclusion:Acupoint massage plus acupoint sticking therapy can effectively regulate the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery,and maintain a stable internal environment.
