Objective:To observe the effects of remimazolam benzenesulfonate combined with alfentanil during painless gastroenteroscopy in elderly patients.Methods:This study analyzes patients aged 60–85 years old undergoing pai...Objective:To observe the effects of remimazolam benzenesulfonate combined with alfentanil during painless gastroenteroscopy in elderly patients.Methods:This study analyzes patients aged 60–85 years old undergoing painless gastroenteroscopy.A total of 140 patients,examined between February 2023 and February 2024,voluntarily participated and were randomly divided into an experimental group and a control group.The control group received alfentanil combined with propofol for anesthesia,while the experimental group received alfentanil combined with remimazolam benzenesulfonate.The relevant indices of both groups were separately analyzed.Results:Patients in the experimental group had a shorter awakening time,a faster discharge rate(P<0.05),and a shorter examination duration;however,the difference in examination time between the two groups was not statistically significant(P>0.05).Before anesthesia,there was no significant difference in the basic information and vital signs of the two groups(P>0.05).Two minutes after anesthesia,both groups showed a decline in vital signs,but the vital signs of the experimental group remained more stable after the procedure,with the group’s indices showing improvement over the control group(P<0.05).Additionally,the incidence of adverse reactions in the experimental group was lower than in the control group(P<0.05).Conclusion:In painless gastroenteroscopy for elderly patients,anesthesia using a combination of remimazolam benzenesulfonate and alfentanil improves anesthesia effectiveness,hastens patient recovery,enhances the stability of vital signs,and effectively controls adverse reactions,thereby improving patient comfort.展开更多
This study explores a novel noninvasive method for monitoring blood alfentanil concentrations using a dog model. Alfentanil which 'back', permeated across the oral mucosa from the systemic circulation was coll...This study explores a novel noninvasive method for monitoring blood alfentanil concentrations using a dog model. Alfentanil which 'back', permeated across the oral mucosa from the systemic circulation was collected from the oral mucosal surface and quantitated. The levels of the 'back' permeated alfentanil were found to closely reflect real time serum alfentanil concentrations. With further work, this finding may lead to a novel noninvasive method for monitoring real time serum alfentanil concentrations in its clinical applications.展开更多
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
Objective.To compare the effects of alfentanil and esmolol on hemodynamic and catecholamine response to tracheal intubation. Methods.Thirty five adult patients were randomly allocated to on...Objective.To compare the effects of alfentanil and esmolol on hemodynamic and catecholamine response to tracheal intubation. Methods.Thirty five adult patients were randomly allocated to one of three groups,Group A(control group),Group B(esmolol group)and Group C(alfentanil group).The patients received either 2 mg/kg esmolol(in Group B)or 30 μg/kg alfentanil(in Group C)before intubation.Tracheal intubation was performed with 4 mg/kg thiopental and 0 1 mg/kg vecuronium and 3% isoflurane.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean blood pressure(MBP),heart rate(HR),norepinephrine(NE),epinephrine(E)and dopamine(DA)were measured before and after intubation. Results.The control group had a baseline SBP of 149±23 mmHg while Groups B,C had a baseline SBP of 148±23,and 150±21mmHg,respectively(P>0 05).Three min after tracheal intubation,the control group SBP increased to 160±30 mmHg and Group B remained at the baseline level,147±5 mmHg,and Group C significantly decreased to 91±22 mmHg(P<0 01).Two min after intubation HR in Group B increased significantly but 3 min after intubation HR in Groups B and C were significantly lower than that of control group(P<0 05).NE in Groups A and B increased significantly to 5 75±3 51 and 6 75±3 30 nmol/L 3 min after intubation(P<0 01).In Group C,3 min after intubation NE was not significantly different from the baseline but E decreased significantly(P<0 01). Conclusion.2 mg/kg esmolol can moderate the hemodynamic response to tracheal intubation to a certain extent and 30μg/kg alfentanil can completely attenuate the hemodynamic and catecholamine responses.展开更多
目的:比较瑞马唑仑或丙泊酚复合阿芬太尼静脉麻醉无痛胃肠镜检查患者术后精神运动功能恢复的情况。方法:选择无痛胃肠镜检查患者78例,随机分为瑞马唑仑组(RA组)和丙泊酚组(PA组),两组分别给予瑞马唑仑或丙泊酚复合阿芬太尼静脉麻醉,记...目的:比较瑞马唑仑或丙泊酚复合阿芬太尼静脉麻醉无痛胃肠镜检查患者术后精神运动功能恢复的情况。方法:选择无痛胃肠镜检查患者78例,随机分为瑞马唑仑组(RA组)和丙泊酚组(PA组),两组分别给予瑞马唑仑或丙泊酚复合阿芬太尼静脉麻醉,记录术前(T1)、开始检查时(T2)、苏醒时(T3)和离室时(T4)的血压、心率、呼吸和指脉氧饱和度;应用Trieger点测试(trieger dot test,TDT)和数字符号替换测试(digit symbol substitution test,DSST)评估术前(T1)、离室时(T4)和术后1 h(T5)、术后2 h(T6)时精神运动功能情况。结果:与T1相比,两组T4、T5时TDT试验中遗漏点数(number of dots missed,NDM)、遗漏点最远距离(maximum distance of dots missed,MDDM)和遗漏点平均距离(average distance of dots missed,ADDM)均增加,比较差异有统计学意义(P<0.05);与T1相比,两组T4、T5时DSST的完成率和正确率均降低,比较差异有统计学意义(P<0.05)。两组患者T6时TDT和DSST结果与T1比较差异无统计学意义(P>0.05)。与PA组相比,RA组T4、T5时NDM、MDDM和ADDM均降低,比较差异有统计学意义(P<0.05);RA组T4、T5时DSST完成率和正确率均增加,比较差异有统计学意义(P<0.05)。与PA组相比,RA组T2时低血压发生率降低,比较差异有统计学意义(P<0.05)。两组呼吸抑制发生率比较差异无统计学意义(P>0.05)。结论:瑞马唑仑复合阿芬太尼用于无痛胃肠镜检查,术后2 h精神运动功能完全恢复;瑞马唑仑组患者精神运动功能恢复快于较丙泊酚组,且不良反应少。展开更多
文摘Objective:To observe the effects of remimazolam benzenesulfonate combined with alfentanil during painless gastroenteroscopy in elderly patients.Methods:This study analyzes patients aged 60–85 years old undergoing painless gastroenteroscopy.A total of 140 patients,examined between February 2023 and February 2024,voluntarily participated and were randomly divided into an experimental group and a control group.The control group received alfentanil combined with propofol for anesthesia,while the experimental group received alfentanil combined with remimazolam benzenesulfonate.The relevant indices of both groups were separately analyzed.Results:Patients in the experimental group had a shorter awakening time,a faster discharge rate(P<0.05),and a shorter examination duration;however,the difference in examination time between the two groups was not statistically significant(P>0.05).Before anesthesia,there was no significant difference in the basic information and vital signs of the two groups(P>0.05).Two minutes after anesthesia,both groups showed a decline in vital signs,but the vital signs of the experimental group remained more stable after the procedure,with the group’s indices showing improvement over the control group(P<0.05).Additionally,the incidence of adverse reactions in the experimental group was lower than in the control group(P<0.05).Conclusion:In painless gastroenteroscopy for elderly patients,anesthesia using a combination of remimazolam benzenesulfonate and alfentanil improves anesthesia effectiveness,hastens patient recovery,enhances the stability of vital signs,and effectively controls adverse reactions,thereby improving patient comfort.
文摘This study explores a novel noninvasive method for monitoring blood alfentanil concentrations using a dog model. Alfentanil which 'back', permeated across the oral mucosa from the systemic circulation was collected from the oral mucosal surface and quantitated. The levels of the 'back' permeated alfentanil were found to closely reflect real time serum alfentanil concentrations. With further work, this finding may lead to a novel noninvasive method for monitoring real time serum alfentanil concentrations in its clinical applications.
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Objective.To compare the effects of alfentanil and esmolol on hemodynamic and catecholamine response to tracheal intubation. Methods.Thirty five adult patients were randomly allocated to one of three groups,Group A(control group),Group B(esmolol group)and Group C(alfentanil group).The patients received either 2 mg/kg esmolol(in Group B)or 30 μg/kg alfentanil(in Group C)before intubation.Tracheal intubation was performed with 4 mg/kg thiopental and 0 1 mg/kg vecuronium and 3% isoflurane.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean blood pressure(MBP),heart rate(HR),norepinephrine(NE),epinephrine(E)and dopamine(DA)were measured before and after intubation. Results.The control group had a baseline SBP of 149±23 mmHg while Groups B,C had a baseline SBP of 148±23,and 150±21mmHg,respectively(P>0 05).Three min after tracheal intubation,the control group SBP increased to 160±30 mmHg and Group B remained at the baseline level,147±5 mmHg,and Group C significantly decreased to 91±22 mmHg(P<0 01).Two min after intubation HR in Group B increased significantly but 3 min after intubation HR in Groups B and C were significantly lower than that of control group(P<0 05).NE in Groups A and B increased significantly to 5 75±3 51 and 6 75±3 30 nmol/L 3 min after intubation(P<0 01).In Group C,3 min after intubation NE was not significantly different from the baseline but E decreased significantly(P<0 01). Conclusion.2 mg/kg esmolol can moderate the hemodynamic response to tracheal intubation to a certain extent and 30μg/kg alfentanil can completely attenuate the hemodynamic and catecholamine responses.
文摘目的:比较瑞马唑仑或丙泊酚复合阿芬太尼静脉麻醉无痛胃肠镜检查患者术后精神运动功能恢复的情况。方法:选择无痛胃肠镜检查患者78例,随机分为瑞马唑仑组(RA组)和丙泊酚组(PA组),两组分别给予瑞马唑仑或丙泊酚复合阿芬太尼静脉麻醉,记录术前(T1)、开始检查时(T2)、苏醒时(T3)和离室时(T4)的血压、心率、呼吸和指脉氧饱和度;应用Trieger点测试(trieger dot test,TDT)和数字符号替换测试(digit symbol substitution test,DSST)评估术前(T1)、离室时(T4)和术后1 h(T5)、术后2 h(T6)时精神运动功能情况。结果:与T1相比,两组T4、T5时TDT试验中遗漏点数(number of dots missed,NDM)、遗漏点最远距离(maximum distance of dots missed,MDDM)和遗漏点平均距离(average distance of dots missed,ADDM)均增加,比较差异有统计学意义(P<0.05);与T1相比,两组T4、T5时DSST的完成率和正确率均降低,比较差异有统计学意义(P<0.05)。两组患者T6时TDT和DSST结果与T1比较差异无统计学意义(P>0.05)。与PA组相比,RA组T4、T5时NDM、MDDM和ADDM均降低,比较差异有统计学意义(P<0.05);RA组T4、T5时DSST完成率和正确率均增加,比较差异有统计学意义(P<0.05)。与PA组相比,RA组T2时低血压发生率降低,比较差异有统计学意义(P<0.05)。两组呼吸抑制发生率比较差异无统计学意义(P>0.05)。结论:瑞马唑仑复合阿芬太尼用于无痛胃肠镜检查,术后2 h精神运动功能完全恢复;瑞马唑仑组患者精神运动功能恢复快于较丙泊酚组,且不良反应少。
