Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controll...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）.展开更多
Objective:To investigate the anesthetic effect of dezocine and remifentanil combined with propofol in painless artificial abortion.Methods:90 cases in total of painlessinduced abortion 1n our hospital from May 2017to ...Objective:To investigate the anesthetic effect of dezocine and remifentanil combined with propofol in painless artificial abortion.Methods:90 cases in total of painlessinduced abortion 1n our hospital from May 2017to May 2020 were retrospectively analyzed,29cases of propofol anesthesia(group A),29cases of dezocine combined with propofol anesthesia(group B),and 32 cases of remifentanil combined with propofol anesthesia(group C)were compared the anesthesia situation.Resuits:Compared with the cases in group A,the incidence of pain,body movement and sPo,90oat the injection site were lower in group B and group C,the use of propofol was reduced,and the VAS scores were lower when the patients begin to awake,and the efficiency was higher than that in group A(P<0.05);there was no statistic difference in the changes of SBP,DBP and HR index data in the operation time,postoperative awake time,and preoperative,intraoperative and postoperative time points of the three groups(P<0.05).Conclusion:Dezocine and remifentamil combined with propofol for painless artificial abortion anesthesia has more significant effect than propofol anesthesia alone,which can relieve patients'pain and reduce the chance of respiratory depression.展开更多
BACKGROUND Although propofol generally reduces blood pressure,rarely,it causes hypertension.However,the mechanism by which propofol increases blood pressure has not been established,and so far,there are only a few rep...BACKGROUND Although propofol generally reduces blood pressure,rarely,it causes hypertension.However,the mechanism by which propofol increases blood pressure has not been established,and so far,there are only a few reported cases.CASE SUMMARY A 46-year-old woman,diagnosed with thyroid cancer,was administered general anesthesia with propofol and remifentanil for a thyroid lobectomy.An increase in the concentrations of intravenous anesthetics further increased her blood pressure.The blood pressure remained stable when anesthesia was maintained with sevoflurane and remifentanil after the interruption of propofol administration.CONCLUSION We concluded that propofol administration was the cause of increased blood pressure.展开更多
Objective:In this study, the effects of combined anesthesia with Remifentanil and Propofol on the hemodynamics and stress state indexes at different times in patients undergoing craniotomy were studied, and the effect...Objective:In this study, the effects of combined anesthesia with Remifentanil and Propofol on the hemodynamics and stress state indexes at different times in patients undergoing craniotomy were studied, and the effects of combined anesthesia with Remifentanil and Propofol on neurological function and inflammatory response in patients undergoing craniotomy were explored.Methods:A total of 92 patients who underwent craniotomy in our hospital from January 2017 to February 2019 were collected and divided into observation group and control group according to their anesthesia methods. 45 patients in the control group received propofol to maintain anesthesia. In the observation group, 47 cases were treated with remifentanil combined with propofol to maintain anesthesia. Changes in hemodynamics (HR, SpO2, MAP) of the two groups were monitored at different times throughout the operation. At the same time by ria method detection in patients with two groups of T0, T1, T2, T3, T4 in serum stress state index (AngⅡ, NE, ALD) changes. The changes of nerve function indexes (NSE, S100) and inflammatory factors (CRP, TNF-α) before and after surgery were compared between the two groups.Results:There were no significant differences in hemodynamics and stress state indicators of T0 between the two groups, and there were no significant differences in preoperative inflammatory reaction and neurological function indicators between the two groups. In the observation group, the changes of HR, SpO2 and MAP at each time point during the operation were less than those in the control group, and the hemodynamic state of the observation group was more stable than that of the control group. The level of AngⅡ, NE, ALD in Control patients in T1, T2, T3, T4 were higher than T0. The level of AngⅡ, NE, ALD of the two groups in T1, T2, T3, T4 are higher than T0. Observation group of patients with T1, T2, T3, T4 AngⅡ level obviously is higher than the control group with time. In the observation group, the levels of NE and ALD were higher at T2, T3 and T4 than at T0. The levels of NE and ALD in T3 and T4 were lower in the observation group than in the control group. Postoperative neurological function (NSE, S100) and inflammatory factors (CRP, TNF-α) were significantly higher in the two groups than in the control group.Conclusion: Combined anesthesia with Remifentanil and Propofol can stabilize the hemodynamic state of patients undergoing craniotomy, reduce cardiovascular stress response and inflammatory response, reduce nerve damage, and play a role in brain protection.展开更多
Aim To study the pharmacokinetics of remifentanil in Chinese aduh patients undergoing elective surgery and compare the results with the data already published. Methods The pharmacokinetics of remifentanil was determin...Aim To study the pharmacokinetics of remifentanil in Chinese aduh patients undergoing elective surgery and compare the results with the data already published. Methods The pharmacokinetics of remifentanil was determined in 10 aduh patients undergoing elective surgery. Remifentanil 5 - 6 μg·kg^-1 was administered within 1 min after the induction of anesthesia. One point five millilitre of arterial blood samples were collected at 0 （baseline）, 1,2, 3, 5,7, 10, 15, 20, 25, 30, 45, 60, and 90 min after drug administration. Remifentanil concentration was assayed by HPLC/MS/MS. Resuits The concentration-time course of remifentanil was best described by a two-compartment model. Total clearance （CL = 2. 149 ± 0. 431 L·min^-1） of remifentanil was greater than the normal hepatic blood flow. The distribution half-life （t1/2α） [ 1.56 ± 0. 52 min （0.73 - 2.31 ） ] and the elimination half-life （t1/2β） [22.07 ± 10.30 min （9, 71 -36.07）] were similar with those in previous reports. Volume of distribution （ Vd = 65. 766 ± 29. 100 L） was about two times greater than that reported in previous studies of other ethnics. Conclusion In the present study, the volume of distribution is significantly greater than thai reported in previous studies of other ethnics, indicating that there are some differences in the pharmacokinetics of remifentanil among different ethnics.展开更多
基金supported by the National Natural Science Foundation of China,No.81671891
文摘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）.
文摘Objective:To investigate the anesthetic effect of dezocine and remifentanil combined with propofol in painless artificial abortion.Methods:90 cases in total of painlessinduced abortion 1n our hospital from May 2017to May 2020 were retrospectively analyzed,29cases of propofol anesthesia(group A),29cases of dezocine combined with propofol anesthesia(group B),and 32 cases of remifentanil combined with propofol anesthesia(group C)were compared the anesthesia situation.Resuits:Compared with the cases in group A,the incidence of pain,body movement and sPo,90oat the injection site were lower in group B and group C,the use of propofol was reduced,and the VAS scores were lower when the patients begin to awake,and the efficiency was higher than that in group A(P<0.05);there was no statistic difference in the changes of SBP,DBP and HR index data in the operation time,postoperative awake time,and preoperative,intraoperative and postoperative time points of the three groups(P<0.05).Conclusion:Dezocine and remifentamil combined with propofol for painless artificial abortion anesthesia has more significant effect than propofol anesthesia alone,which can relieve patients'pain and reduce the chance of respiratory depression.
文摘BACKGROUND Although propofol generally reduces blood pressure,rarely,it causes hypertension.However,the mechanism by which propofol increases blood pressure has not been established,and so far,there are only a few reported cases.CASE SUMMARY A 46-year-old woman,diagnosed with thyroid cancer,was administered general anesthesia with propofol and remifentanil for a thyroid lobectomy.An increase in the concentrations of intravenous anesthetics further increased her blood pressure.The blood pressure remained stable when anesthesia was maintained with sevoflurane and remifentanil after the interruption of propofol administration.CONCLUSION We concluded that propofol administration was the cause of increased blood pressure.
文摘Objective:In this study, the effects of combined anesthesia with Remifentanil and Propofol on the hemodynamics and stress state indexes at different times in patients undergoing craniotomy were studied, and the effects of combined anesthesia with Remifentanil and Propofol on neurological function and inflammatory response in patients undergoing craniotomy were explored.Methods:A total of 92 patients who underwent craniotomy in our hospital from January 2017 to February 2019 were collected and divided into observation group and control group according to their anesthesia methods. 45 patients in the control group received propofol to maintain anesthesia. In the observation group, 47 cases were treated with remifentanil combined with propofol to maintain anesthesia. Changes in hemodynamics (HR, SpO2, MAP) of the two groups were monitored at different times throughout the operation. At the same time by ria method detection in patients with two groups of T0, T1, T2, T3, T4 in serum stress state index (AngⅡ, NE, ALD) changes. The changes of nerve function indexes (NSE, S100) and inflammatory factors (CRP, TNF-α) before and after surgery were compared between the two groups.Results:There were no significant differences in hemodynamics and stress state indicators of T0 between the two groups, and there were no significant differences in preoperative inflammatory reaction and neurological function indicators between the two groups. In the observation group, the changes of HR, SpO2 and MAP at each time point during the operation were less than those in the control group, and the hemodynamic state of the observation group was more stable than that of the control group. The level of AngⅡ, NE, ALD in Control patients in T1, T2, T3, T4 were higher than T0. The level of AngⅡ, NE, ALD of the two groups in T1, T2, T3, T4 are higher than T0. Observation group of patients with T1, T2, T3, T4 AngⅡ level obviously is higher than the control group with time. In the observation group, the levels of NE and ALD were higher at T2, T3 and T4 than at T0. The levels of NE and ALD in T3 and T4 were lower in the observation group than in the control group. Postoperative neurological function (NSE, S100) and inflammatory factors (CRP, TNF-α) were significantly higher in the two groups than in the control group.Conclusion: Combined anesthesia with Remifentanil and Propofol can stabilize the hemodynamic state of patients undergoing craniotomy, reduce cardiovascular stress response and inflammatory response, reduce nerve damage, and play a role in brain protection.
文摘Aim To study the pharmacokinetics of remifentanil in Chinese aduh patients undergoing elective surgery and compare the results with the data already published. Methods The pharmacokinetics of remifentanil was determined in 10 aduh patients undergoing elective surgery. Remifentanil 5 - 6 μg·kg^-1 was administered within 1 min after the induction of anesthesia. One point five millilitre of arterial blood samples were collected at 0 （baseline）, 1,2, 3, 5,7, 10, 15, 20, 25, 30, 45, 60, and 90 min after drug administration. Remifentanil concentration was assayed by HPLC/MS/MS. Resuits The concentration-time course of remifentanil was best described by a two-compartment model. Total clearance （CL = 2. 149 ± 0. 431 L·min^-1） of remifentanil was greater than the normal hepatic blood flow. The distribution half-life （t1/2α） [ 1.56 ± 0. 52 min （0.73 - 2.31 ） ] and the elimination half-life （t1/2β） [22.07 ± 10.30 min （9, 71 -36.07）] were similar with those in previous reports. Volume of distribution （ Vd = 65. 766 ± 29. 100 L） was about two times greater than that reported in previous studies of other ethnics. Conclusion In the present study, the volume of distribution is significantly greater than thai reported in previous studies of other ethnics, indicating that there are some differences in the pharmacokinetics of remifentanil among different ethnics.
