Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare...Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.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: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
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
Objective:To investigate the effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation.Methods: A total of 218 patients receiving tracheal intubation general ane...Objective:To investigate the effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation.Methods: A total of 218 patients receiving tracheal intubation general anesthesia in the hospital between January 2017 and December 2017 were divided into the control group (n=109) and the dexmedetomidine group (n=109) by random number table method. Control group underwent routine propofol anesthesia induction and dexmedetomidine group underwent dexmedetomidine anesthesia induction on the basis of propofol. The differences in the severity of inflammatory response and stress response were compared between the two groups of patients after general anesthesia induction (T0), 1 min after endotracheal intubation (T1), 5 min after endotracheal intubation (T2) and 10 min after endotracheal intubation (T3).Results:At T0, there was no statistically significant difference in serum levels of inflammatory factors and stress hormones between the two groups. At T1, T2 and T3, serum inflammatory factors CRP, IL-1, IL-6, IL-8 and TNF-α levels of dexmedetomidine group were lower than those of control group;serum stress hormones ACTH, Cor, NE, AngⅠ and AngⅡ levels were lower than those of control group. Conclusion: Dexmedetomidine + propofol general anesthesia induction can effectively reduce the inflammatory stress response caused by endotracheal intubation.展开更多
AIM: To compare the effect of propofol versus urapidil on hemodynamics and intraocular pressure during anesthesia and extubation for ophthalmic patients. METHODS: Eighty-two surgical patients (Class: ASA I-II) were ra...AIM: To compare the effect of propofol versus urapidil on hemodynamics and intraocular pressure during anesthesia and extubation for ophthalmic patients. METHODS: Eighty-two surgical patients (Class: ASA I-II) were randomly assigned to propofol (n = 41) and urapidil groups (n = 41). Their gender, age, body mass, operation time and dosage of anesthetics had no significant difference between the two groups (P > 0.05). The patients of propofol and urapidil groups were given propofol (1.5mg/kg) and urapidil (2.5mg/kg) respectively; and two drugs were all diluted with normal saline to 8mL. Then the drugs were given to patients by slow intravenous injection. After treatment, the patients were conducted immediate suction, tracheal extubation, and then patients wore oxygen masks for 10 minutes. By double-blind methods, before the induction medication, at the suction, and 5, 10 minutes after the extubation, we recorded the systolic and diastolic blood pressure (BP), heart rate (HR), pH, PaO2, PaCO2, SaO(2) and intraocular pressure (TOP) respectively. The complete recovery time of the patients with restlessness (on the command they could open eyes and shaking hands) was also recorded during the extubation. The data were analyzed by using a professional SPSS 15.0 statistical software. RESULTS: The incidence of cough, restlessness and glossocoma was significantly lower in the propofol group than that in the urapidil group after extubation (P < 0.05). There were no episodes of hypotension, laryngospasm, or severe respiratory depression. There was no statistical difference in recovery time between two groups (P > 0.05). In propofol group, the BP and HR during extubation and thereafter had no significant difference compared with those before induction, while they were significantly lower than those before giving propofol (P < 0.05), and had significant difference compared with those in urapidil group (P < 0.05). Compared to preinduction, the BP of urapidil group showed no obvious increase during aspiration and extubation. The HR of urapidil group had little changes after being given urapidil, and it was obviously increased compared with that before induction. The stimulation of aspiration and extubation caused less cough and agitation in propofol group than that in urapidil group (P < 0.05). The IOP of propofol group showed no obvious increase during extubation compared with that in preinduction, while in the urpidil group, extubation caused IOP significantly increased (P < 0.05). The changes in these indicators between the two groups had no significant difference (P > 0.05). CONCLUSION: Compared to urapidil, propofol is superior for preventing the cardiovascular and stress responses and IOP increases during emergence and extubation for the ophthalmic patients. Moreover, it has no effects on patient's recovery.展开更多
文摘Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.
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: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Objective:To investigate the effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation.Methods: A total of 218 patients receiving tracheal intubation general anesthesia in the hospital between January 2017 and December 2017 were divided into the control group (n=109) and the dexmedetomidine group (n=109) by random number table method. Control group underwent routine propofol anesthesia induction and dexmedetomidine group underwent dexmedetomidine anesthesia induction on the basis of propofol. The differences in the severity of inflammatory response and stress response were compared between the two groups of patients after general anesthesia induction (T0), 1 min after endotracheal intubation (T1), 5 min after endotracheal intubation (T2) and 10 min after endotracheal intubation (T3).Results:At T0, there was no statistically significant difference in serum levels of inflammatory factors and stress hormones between the two groups. At T1, T2 and T3, serum inflammatory factors CRP, IL-1, IL-6, IL-8 and TNF-α levels of dexmedetomidine group were lower than those of control group;serum stress hormones ACTH, Cor, NE, AngⅠ and AngⅡ levels were lower than those of control group. Conclusion: Dexmedetomidine + propofol general anesthesia induction can effectively reduce the inflammatory stress response caused by endotracheal intubation.
基金National Natural Science Foundation of China (No.39580683)
文摘AIM: To compare the effect of propofol versus urapidil on hemodynamics and intraocular pressure during anesthesia and extubation for ophthalmic patients. METHODS: Eighty-two surgical patients (Class: ASA I-II) were randomly assigned to propofol (n = 41) and urapidil groups (n = 41). Their gender, age, body mass, operation time and dosage of anesthetics had no significant difference between the two groups (P > 0.05). The patients of propofol and urapidil groups were given propofol (1.5mg/kg) and urapidil (2.5mg/kg) respectively; and two drugs were all diluted with normal saline to 8mL. Then the drugs were given to patients by slow intravenous injection. After treatment, the patients were conducted immediate suction, tracheal extubation, and then patients wore oxygen masks for 10 minutes. By double-blind methods, before the induction medication, at the suction, and 5, 10 minutes after the extubation, we recorded the systolic and diastolic blood pressure (BP), heart rate (HR), pH, PaO2, PaCO2, SaO(2) and intraocular pressure (TOP) respectively. The complete recovery time of the patients with restlessness (on the command they could open eyes and shaking hands) was also recorded during the extubation. The data were analyzed by using a professional SPSS 15.0 statistical software. RESULTS: The incidence of cough, restlessness and glossocoma was significantly lower in the propofol group than that in the urapidil group after extubation (P < 0.05). There were no episodes of hypotension, laryngospasm, or severe respiratory depression. There was no statistical difference in recovery time between two groups (P > 0.05). In propofol group, the BP and HR during extubation and thereafter had no significant difference compared with those before induction, while they were significantly lower than those before giving propofol (P < 0.05), and had significant difference compared with those in urapidil group (P < 0.05). Compared to preinduction, the BP of urapidil group showed no obvious increase during aspiration and extubation. The HR of urapidil group had little changes after being given urapidil, and it was obviously increased compared with that before induction. The stimulation of aspiration and extubation caused less cough and agitation in propofol group than that in urapidil group (P < 0.05). The IOP of propofol group showed no obvious increase during extubation compared with that in preinduction, while in the urpidil group, extubation caused IOP significantly increased (P < 0.05). The changes in these indicators between the two groups had no significant difference (P > 0.05). CONCLUSION: Compared to urapidil, propofol is superior for preventing the cardiovascular and stress responses and IOP increases during emergence and extubation for the ophthalmic patients. Moreover, it has no effects on patient's recovery.
