Background and aim: Instability in the hemodynamic symptoms has been common at the time of extubation in patients and the cause to create the side effects. The aim of this research was to study the effect of injection...Background and aim: Instability in the hemodynamic symptoms has been common at the time of extubation in patients and the cause to create the side effects. The aim of this research was to study the effect of injection of Alfentanil, Lidocaine and their composition in reduction of side effects arising from extubation. Materials and methods: 172 patients (20 - 40 years old) that referred to Shahid Rajaee Hospital in 2014 and had been under the orthopedic surgery, were divided randomly and by using colored cards into four equal groups (43 patients in each group). Alfentanil (5 microgram/kilogram) was injected to the first group. The second group received Lidocaine (1 milligram/ kilogram). The composition of these two drugs was injected to the third group and the normal equal volume of Saline was injected to the fourth group which was the control group. The means of systolic and diastolic blood pressure, average arterial pressure and the number of heartbeat at the time of extubation were measured and registered 1, 5, 10, 15 and 20 minutes after extubation. Also, the amount of situation of bucking after extubation was registered in the groups. Results: The demographic results were similar in all groups. The mean of systolic blood pressure and number of heartbeats in the group of Alfentanil and composition of Alfentanil-Lidocaine had significant reduction (p 0.05). The situation of bucking in three treatment groups had significant reduction in comparison with control group. Conclusion: Alfentanil and composition of it with Lidocaine both had caused reducing the systolic blood pressure and heartbeats.展开更多
Background: Patient-controlled sedation (PCS) is increasingly used for moderate sedation. Detailed understanding is essential for maintaining safety and giving the most benefit. We wanted to explore the associations b...Background: Patient-controlled sedation (PCS) is increasingly used for moderate sedation. Detailed understanding is essential for maintaining safety and giving the most benefit. We wanted to explore the associations between patients’ characteristics, perioperative pain and anxiety, the procedure, and the calculated concentrations at the effect site (Ce) of propofol. We also wanted to analyse the pharmacokinetic profiles of propofol and alfentanil during PCS, and their association with respiratory complications. Methods: 155 patients were double-blinded and randomised to have propofol or propofol and alfentanil for PCS during gynaecological surgery. Pharmacokinetic simulation of Ce and multiple regressions aided the search for correlations between explanatory variables and concentrations of drugs. Results: In group propofol, treatment for incontinence, anterior repair, and the patient’s weight correlated the best (B-coef = 0.20, 0.20 and 0.01;r = 0.69;r² = 0.48). When alfentanil was added, alfentanil and the patient’s weight were associated with Ce of propofol (B-coef = ǂ.40 and 0.01;r = 0.70;r² = 0.43). Logistic regression indicated that age and Ce of drugs were related to ten cases of respiratory complications. Conclusions: Patients’ weights and the type of surgery performed were associated with the Ce of propofol;this knowledge could be used for refinement of the doses given during PCS. Because the pharmacokinetic profiles of propofol and alfentanil are different, the alfentanil effect becomes predominant during the time course of sedation. In order to reduce the risk of early and late respiratory depression, alfentanil should not be added to propofol in the same syringe.展开更多
目的探讨复合阿芬太尼时丙泊酚或环泊酚抑制人工流产术中体动反应的半数有效剂量。方法选择2021年10月-2022年4月在嘉兴市第二医院妇科手术中心行择期无痛人工流产术的患者,年龄18~35岁,体质量指数(body mass index,BMI)18~28kg/m^(2),...目的探讨复合阿芬太尼时丙泊酚或环泊酚抑制人工流产术中体动反应的半数有效剂量。方法选择2021年10月-2022年4月在嘉兴市第二医院妇科手术中心行择期无痛人工流产术的患者,年龄18~35岁,体质量指数(body mass index,BMI)18~28kg/m^(2),美国麻醉医师协会(American Society of Anesthesologists,ASA)分级为Ⅰ或Ⅱ级,胎儿年龄<10周,初次妊娠或无经阴道分娩史。采用随机数字表法将患者分为2组:丙泊酚组(P组)和环泊酚组(C组)。麻醉诱导时静脉注射阿芬太尼后给予改良序贯法设定剂量的丙泊酚或环泊酚,若术中患者出现肢体不自主运动并影响术者手术操作且需追加麻醉药物即判定为阳性反应,并且静脉追加丙泊酚或环泊酚0.5mg/kg或0.1mg/kg,下一例患者丙泊酚或环泊酚增加一个剂量梯度。反之则下一例患者丙泊酚或环泊酚减少一个剂量梯度,相邻患者的丙泊酚或环泊酚剂量梯度分别为0.5mg/kg和0.1mg/kg。采用Probit回归分析法计算丙泊酚和环泊酚的50%有效剂量(median effective dose,ED_(50))、95%有效剂量(95% effective dose,ED_(95))及相应的置信区间(confidence interval,CI)。结果P组丙泊酚抑制人工流产术中体动反应的ED_(50)(95%CI)为1.815(1.315~2.319)mg/kg,ED_(95)(95%CI)为2.901(2.368~6.447)mg/kg;C组环泊酚抑制体动反应的ED_(50)(95%CI)为0.381(0.279~0.484)mg/kg,ED_(95)(95%CI)为0.613(0.501~1.344)mg/kg,两者对应的等效比值为4.76(4.71~4.79)。结论复合阿芬太尼时环泊酚抑制人工流产术中体动反应的效价大于丙泊酚。展开更多
文摘Background and aim: Instability in the hemodynamic symptoms has been common at the time of extubation in patients and the cause to create the side effects. The aim of this research was to study the effect of injection of Alfentanil, Lidocaine and their composition in reduction of side effects arising from extubation. Materials and methods: 172 patients (20 - 40 years old) that referred to Shahid Rajaee Hospital in 2014 and had been under the orthopedic surgery, were divided randomly and by using colored cards into four equal groups (43 patients in each group). Alfentanil (5 microgram/kilogram) was injected to the first group. The second group received Lidocaine (1 milligram/ kilogram). The composition of these two drugs was injected to the third group and the normal equal volume of Saline was injected to the fourth group which was the control group. The means of systolic and diastolic blood pressure, average arterial pressure and the number of heartbeat at the time of extubation were measured and registered 1, 5, 10, 15 and 20 minutes after extubation. Also, the amount of situation of bucking after extubation was registered in the groups. Results: The demographic results were similar in all groups. The mean of systolic blood pressure and number of heartbeats in the group of Alfentanil and composition of Alfentanil-Lidocaine had significant reduction (p 0.05). The situation of bucking in three treatment groups had significant reduction in comparison with control group. Conclusion: Alfentanil and composition of it with Lidocaine both had caused reducing the systolic blood pressure and heartbeats.
基金the Department of Anaesthesiology and Intensive Care, Linkoping UniversityHospital
文摘Background: Patient-controlled sedation (PCS) is increasingly used for moderate sedation. Detailed understanding is essential for maintaining safety and giving the most benefit. We wanted to explore the associations between patients’ characteristics, perioperative pain and anxiety, the procedure, and the calculated concentrations at the effect site (Ce) of propofol. We also wanted to analyse the pharmacokinetic profiles of propofol and alfentanil during PCS, and their association with respiratory complications. Methods: 155 patients were double-blinded and randomised to have propofol or propofol and alfentanil for PCS during gynaecological surgery. Pharmacokinetic simulation of Ce and multiple regressions aided the search for correlations between explanatory variables and concentrations of drugs. Results: In group propofol, treatment for incontinence, anterior repair, and the patient’s weight correlated the best (B-coef = 0.20, 0.20 and 0.01;r = 0.69;r² = 0.48). When alfentanil was added, alfentanil and the patient’s weight were associated with Ce of propofol (B-coef = ǂ.40 and 0.01;r = 0.70;r² = 0.43). Logistic regression indicated that age and Ce of drugs were related to ten cases of respiratory complications. Conclusions: Patients’ weights and the type of surgery performed were associated with the Ce of propofol;this knowledge could be used for refinement of the doses given during PCS. Because the pharmacokinetic profiles of propofol and alfentanil are different, the alfentanil effect becomes predominant during the time course of sedation. In order to reduce the risk of early and late respiratory depression, alfentanil should not be added to propofol in the same syringe.
文摘目的探讨复合阿芬太尼时丙泊酚或环泊酚抑制人工流产术中体动反应的半数有效剂量。方法选择2021年10月-2022年4月在嘉兴市第二医院妇科手术中心行择期无痛人工流产术的患者,年龄18~35岁,体质量指数(body mass index,BMI)18~28kg/m^(2),美国麻醉医师协会(American Society of Anesthesologists,ASA)分级为Ⅰ或Ⅱ级,胎儿年龄<10周,初次妊娠或无经阴道分娩史。采用随机数字表法将患者分为2组:丙泊酚组(P组)和环泊酚组(C组)。麻醉诱导时静脉注射阿芬太尼后给予改良序贯法设定剂量的丙泊酚或环泊酚,若术中患者出现肢体不自主运动并影响术者手术操作且需追加麻醉药物即判定为阳性反应,并且静脉追加丙泊酚或环泊酚0.5mg/kg或0.1mg/kg,下一例患者丙泊酚或环泊酚增加一个剂量梯度。反之则下一例患者丙泊酚或环泊酚减少一个剂量梯度,相邻患者的丙泊酚或环泊酚剂量梯度分别为0.5mg/kg和0.1mg/kg。采用Probit回归分析法计算丙泊酚和环泊酚的50%有效剂量(median effective dose,ED_(50))、95%有效剂量(95% effective dose,ED_(95))及相应的置信区间(confidence interval,CI)。结果P组丙泊酚抑制人工流产术中体动反应的ED_(50)(95%CI)为1.815(1.315~2.319)mg/kg,ED_(95)(95%CI)为2.901(2.368~6.447)mg/kg;C组环泊酚抑制体动反应的ED_(50)(95%CI)为0.381(0.279~0.484)mg/kg,ED_(95)(95%CI)为0.613(0.501~1.344)mg/kg,两者对应的等效比值为4.76(4.71~4.79)。结论复合阿芬太尼时环泊酚抑制人工流产术中体动反应的效价大于丙泊酚。
