Gender Affects the Median Effective Dose and 95% Effective Dose of Oxycodone for Blunting the Hemodynamic Response to Tracheal Intubation in Narcotic-Naive Adult Patients

Background： Intravenous （IV） oxycodone has been used at induction to prevent an intubation reaction. The aims of the current study were to calculate the median effective dose （ED50） and the 95% effective dose （ED95） of an IV bolus ofoxycodone that blunts the hemodynamic response to tracheal intubation with propofol according to gender and to observe the adverse events of induction-dose oxycodone. Methods： Adult patients who required general anesthesia and tracheal intubation were enrolled. Tracheal intubation was performed using unified TD-C-IV video laryngoscopy and an ordinary common endotracheal tube. Dixon＇s up-and-down method was used to obtain ED50, data for women and men separately. The initial dose of oxycodone was 0.2 mg/kg for women and 0.3 mg/kg for men （step size was 0.01 mg/kg）. Next, a dose-response curve from the probit analysis was generated to determine the ED50 and ED95 to blunt the intubation reaction in female and male patients. Adverse events following oxycodone injection were observed for 5 ,in before propofol injection. Results： Sixty-three patients were analyzed, including 29 females and 34 males. According to the probit analysis, the ED50, and ED95 of oxycodone required to blunt the intubation reaction in women were 0.254 mg/kg （95% confidence interval [CI], 0.220-0.328 mg/kg） and 0.357 mg/kg （95% （21, 0.297-2.563 mg/kg）, respectively. In men, the ED50 and ED95 were 0.324 mg/kg （95% CL 0.274-0.381 mg/kg） and 0.454 mg/kg （95% CI, 0.384-2.862 mg/kg）, respectively. Men required 28% more oxycodone than women for induction （P 〈 0.01 ）. The most common adverse events were dizziness （87.3%）, vertigo （66.7%）, sedation （74.6%）, and respiratory depression （66.7%）. Conclusions： Oxycodone can be used for induction to prevent intubation reactions. Gender affected the ED50 and ED95 ofoxycodone for blunting the tracheal intuhation reaction.

Clinical observation on prevention of chemotherapy infection in gastric cancer by moxa-stick moxibustion plus rhG-CSF and its effect on immune function

Objective:To observe the effect of moxa-stick moxibustion plus recombinant human granulocyte-colony stimulating factor(rhG-CSF)in preventing chemotherapy infection in gastric cancer and its effect on immune function.Methods:A total of 70 patients with gastric cancer treated by chemotherapy were randomly divided into an observation group and a control group,with 35 cases in each group.The control group was given rhG-CSF,and the observation group was given additional moxa-stick moxibustion on the basis of rhG-CSF.Both groups were treated for 2 chemotherapy cycles,totally 6 weeks.The number of patients with infection,the duration of infection and the duration of continuous use of antibiotics were observed.The leukocytes and granulocytes counts,the levels of tumor necrosis factor-a(TNF-a)and interferon-γ(IFN-γ)were measured before and after treatment,and the levels of CD4,CD8 and natural killer(NK)cells were analyzed.Results:The infection rate of the observation group was significantly lower than that of the control group(P<0.05),and the duration of infection and the duration of continuous use of antibiotics were also shorter(P<0.05).After treatment,the leukocytes and granulocytes counts in the two groups were higher than those before treatment(all P<0.05).After treatment,the levels of TNF-α and IFN-γ of the patients in the two groups were improved(all P<0.05),and there were significant differences between the observation group and the control group(P<0.05).After treatment,the numbers of CD4,CD8,and NK cells in the observation group increased significantly(all P<0.05);but the changes in the control group were not significant(P>0.05).Conclusion:Moxa-stick moxibustion plus rhG-CSF can significantly reduce the incidence and severity of chemotherapy infection in gastric cancer,increase the leukocytes and granulocytes counts,and regulate the levels of inflammatory factors,which may be related to the improvement of the immune function of the patients.

Effects of electroacupuncture plus drug anesthesia on pain and stress response in patients after radical surgery for stomach cancer

Objective:To observe the effect of electroacupuncture plus drug anesthesia on pain and stress response in patients after radical surgery for stomach cancer.Methods:A total of 60 patients were randomized into a control group and an observation group by the random number table,with 30 cases in each group.The control group was given conventional drug anesthesia.The observation group was given additional electroacupuncture intervention.Before anesthesia and 2 h,12 h and 24 h after surgery,the visual analog scale(VAS)was scored,the heart rate,the mean arterial pressure,and the levels of serumβ-endorphin(β-EP)and adrenocorticotrophic hormone(ACTH)were measured.Results:Two hours,12 h and 24 h after surgery,the VAS scores of both groups were higher than those before anesthesia(all P<0.05),and the VAS scores in the observation group were lower than those in the control group at the same time points(all P<0.05).Two hours,12 h and 24 h after surgery,the heart rates and mean arterial pressures in the control group were significantly higher than those before anesthesia(all P<0.05),while there were no significant intra-group differences in the observation group(all P>0.05),and the indicators were lower than those in the control group at the same time points(all P<0.05).Two hours,12 h and 24 h after surgery,the serumβ-EP levels in the observation group were significantly higher than those before anesthesia(all P<0.05),and significantly higher than those in the control group at the same time points(all P<0.05).Two hours,12 h and 24 h after surgery,the serum ACTH levels in the control group were significantly higher than those before anesthesia(all P<0.05),and were significantly higher than those in the observation group at the same time points(all P<0.05).Conclusion:Electroacupuncture plus drug anesthesia can significantly relieve pain and stress response in patients after radical surgery for stomach cancer.