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
Objective:To observe the effects of different anesthesia depths on the level of plasma cortisol during operation and the score of postoperative MMSE in elderly patients underwent radical gastrectomy.Methods: A total o...Objective:To observe the effects of different anesthesia depths on the level of plasma cortisol during operation and the score of postoperative MMSE in elderly patients underwent radical gastrectomy.Methods: A total of eighty seven elderly patients undergoing radical gastrectomy were enrolled in this study. Continuous infusion of propofol and remifentanil for anesthesia and maintenance of propofol were divided into two groups: BIS-I (BIS: 45-55) and BIS-II (BIS: 55-65) by adusting the doses of propofol. The data were recorded as following, thewhole dosage of propofol, the time of extubation and the score of VAS. The level of plasma cortisol was finished at the time of incision and tracheal intubation. MMSE scores were recorded on the day before operation and follow-up at 3 and 7 d postoperatively. Record the patient's operation to discharge time, postoperative complications.Results: The concentration of cortisol in BIS-I group was higher than that in BIS-II group. There was no significant difference in extubation time, extubation VAS score and MMSE score after operation.Conclusion:There were no significant differences in the BIS values between 45 and 65 for the elderly patients undergoing upper abdominal surgery, and there were no significant differences in the patients' postoperative stress, wake, extubation, early postoperative pain scores and postoperative cognitive function. BIS values in 45-55 compared to 55-65 patients with low plasma cortisol levels may be associated with better control of stress levels, to maintain the BIS value between 45-55 anesthesia depths is more reasonable.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Objective:To observe the effects of different anesthesia depths on the level of plasma cortisol during operation and the score of postoperative MMSE in elderly patients underwent radical gastrectomy.Methods: A total of eighty seven elderly patients undergoing radical gastrectomy were enrolled in this study. Continuous infusion of propofol and remifentanil for anesthesia and maintenance of propofol were divided into two groups: BIS-I (BIS: 45-55) and BIS-II (BIS: 55-65) by adusting the doses of propofol. The data were recorded as following, thewhole dosage of propofol, the time of extubation and the score of VAS. The level of plasma cortisol was finished at the time of incision and tracheal intubation. MMSE scores were recorded on the day before operation and follow-up at 3 and 7 d postoperatively. Record the patient's operation to discharge time, postoperative complications.Results: The concentration of cortisol in BIS-I group was higher than that in BIS-II group. There was no significant difference in extubation time, extubation VAS score and MMSE score after operation.Conclusion:There were no significant differences in the BIS values between 45 and 65 for the elderly patients undergoing upper abdominal surgery, and there were no significant differences in the patients' postoperative stress, wake, extubation, early postoperative pain scores and postoperative cognitive function. BIS values in 45-55 compared to 55-65 patients with low plasma cortisol levels may be associated with better control of stress levels, to maintain the BIS value between 45-55 anesthesia depths is more reasonable.
