Objective To evaluate the effect of propofol,sevoflurane,and dexmedetomidine on respiratory complications inchildren undergoing fiberoptic bronchoscopy(FOB).Methods This double-blind randomized clinical trial was cond...Objective To evaluate the effect of propofol,sevoflurane,and dexmedetomidine on respiratory complications inchildren undergoing fiberoptic bronchoscopy(FOB).Methods This double-blind randomized clinical trial was conductedamong 120 children aged 1 month to 3 years undergoing FOB.The patients were randomized into 3 groups(n=40)foranesthesia induction with sevoflurane inhalation,1 mg/kg propofol,or 1μg/kg dexmedetomidine before bronchoscopy,andthe changes in hemodynamic parameters,sedation level,and respiratory complications during and after the procedure wereassessed.Results The patients'heart rate during bronchoscopy was significantly lower and the mean arterial blood pressuresignificantly higher in dexmedetomidine group than in sevoflurane and propofol groups(P<0.05).Cough duringbronchoscopy did not occur in any of the cases in propofol group,while the highest frequency of cough was recorded indexmedetomidine group.The incidence of laryngospasm in the propofol group(12.5%)was significantly lower than those insevoflurane and dexmedetomidine groups(30%and 32.5%,respectively)(P<0.05).Conclusion Sevoflurane and propofol aresafe and suitable for anesthesia induction in children below 3 years of age undergoing diagnostic FOB and can achieve bettersedative effect and lower the incidences of cough and respiratory complications as compared with dexmedetomidine.展开更多
Aim: Propofol, a widely used alkyphenol intravenous anesthetic, has been proven to be a shortly acting, less toxic and high safe coefficient in clinic application. However, whether the drug has analgesic action is sti...Aim: Propofol, a widely used alkyphenol intravenous anesthetic, has been proven to be a shortly acting, less toxic and high safe coefficient in clinic application. However, whether the drug has analgesic action is still not clear. To further answer this question, the effects of i. t. propofol on persistent spontaneous nociception (PSN) and hyperalgesia induced by chemical tissue injury were examined.展开更多
目的观察和比较阿芬太尼、布托啡诺以及舒芬太尼复合丙泊酚用于宫腔镜手术的镇痛、镇静效果及对患者术后恢复的影响。方法选择择期行无痛宫腔镜手术女性患者150例,年龄18~55岁,BMI 18.5~28.0 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法将...目的观察和比较阿芬太尼、布托啡诺以及舒芬太尼复合丙泊酚用于宫腔镜手术的镇痛、镇静效果及对患者术后恢复的影响。方法选择择期行无痛宫腔镜手术女性患者150例,年龄18~55岁,BMI 18.5~28.0 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法将患者分为三组:阿芬太尼10μg/kg(A组)、布托啡诺20μg/kg(B组)和舒芬太尼0.1μg/kg(S组),每组50例。给予镇痛药物后,每组静脉注射丙泊酚2 mg/kg。待患者睫毛反射消失后开始宫腔镜操作。记录术中低血压、心动过缓、呼吸抑制和呛咳及术后恶心呕吐、头晕、头痛等发生情况。记录入室时、扩张宫颈时、置入宫腔镜时、手术结束时的HR、MAP、SpO_(2)。记录术中丙泊酚的诱导剂量、单位时间追加剂量和总量、术后睁眼时间、清醒时间、术后15 min、2和6 h的VAS疼痛评分。结果与入室时比较,A、B组扩张宫颈时、置入宫腔镜时、手术结束时HR明显减慢、MAP、SpO_(2)均明显下降,S组扩张宫颈时、置入宫腔镜时、手术结束时HR明显减慢、MAP均明显下降,置入宫腔镜时以及手术结束时SpO_(2)明显下降(P<0.05)。与A组比较,B组和S组的术后恶心呕吐发生率明显升高,B组术后头晕和术后头痛发生率和术后15 min VAS疼痛评分明显升高,S组术后2和6 h VAS评分明显升高(P<0.05)。与B组比较,S组的术后恶心呕吐和术后头晕的发生率明显降低,术后6 h VAS疼痛评分明显升高,A组和S组睁眼时间和清醒时间明显缩短(P<0.05)。结论与布托啡诺和舒芬太尼复合丙泊酚比较,阿芬太尼复合丙泊酚用于宫腔镜手术对术中循环影响较小,且术后患者恢复清醒时间短,术后恶心呕吐等不良反应发生率更低。展开更多
目的比较地氟烷吸入麻醉与丙泊酚全凭静脉麻醉对经鼻内镜垂体腺瘤切除术患者术后恢复质量的影响,为优化该类手术的麻醉方案提供循证依据。方法采用单中心、前瞻性、随机对照研究设计,纳入112例拟行经鼻内镜垂体腺瘤切除术的患者,采用数...目的比较地氟烷吸入麻醉与丙泊酚全凭静脉麻醉对经鼻内镜垂体腺瘤切除术患者术后恢复质量的影响,为优化该类手术的麻醉方案提供循证依据。方法采用单中心、前瞻性、随机对照研究设计,纳入112例拟行经鼻内镜垂体腺瘤切除术的患者,采用数字表法随机分为地氟烷组(n=56)和丙泊酚组(n=56)。地氟烷组采用地氟烷[0.7~1.0肺泡最低有效浓度(minimum alveolar concentration,MAC]联合瑞芬太尼维持麻醉,丙泊酚组采用丙泊酚(4~6 mg·kg^(-1)·h^(-1))联合瑞芬太尼维持麻醉。主要结局指标为麻醉药物停用后至Aldrete评分达9分的时间,次要指标包括苏醒时间、拔管时间以及术后住院时间。结果地氟烷组Aldrete评分达9分的时间显著短于丙泊酚组(13.0 min vs 16.5 min,P=0.003),意识恢复时间(14.0 min vs 16.5 min,P=0.009)和拔管时间(13.0 min vs 16.5 min,P=0.003)亦明显缩短。然而,地氟烷组术后躁动(17.9%vs 3.6%,P=0.015)和呕吐发生率(19.6%vs 5.4%,P=0.022)较高,两组严重躁动发生率差异无统计学意义。术后24 h恢复质量[恢复质量15项量表(Quality of Recovery-15,QoR-15)]评分和住院时间组间差异无统计学意义。结论地氟烷麻醉可显著加速经鼻内镜垂体腺瘤切除术患者的术后恢复,但可能增加轻度躁动和呕吐风险。临床应用中需权衡不良反应,采取针对性预防措施。展开更多
文摘Objective To evaluate the effect of propofol,sevoflurane,and dexmedetomidine on respiratory complications inchildren undergoing fiberoptic bronchoscopy(FOB).Methods This double-blind randomized clinical trial was conductedamong 120 children aged 1 month to 3 years undergoing FOB.The patients were randomized into 3 groups(n=40)foranesthesia induction with sevoflurane inhalation,1 mg/kg propofol,or 1μg/kg dexmedetomidine before bronchoscopy,andthe changes in hemodynamic parameters,sedation level,and respiratory complications during and after the procedure wereassessed.Results The patients'heart rate during bronchoscopy was significantly lower and the mean arterial blood pressuresignificantly higher in dexmedetomidine group than in sevoflurane and propofol groups(P<0.05).Cough duringbronchoscopy did not occur in any of the cases in propofol group,while the highest frequency of cough was recorded indexmedetomidine group.The incidence of laryngospasm in the propofol group(12.5%)was significantly lower than those insevoflurane and dexmedetomidine groups(30%and 32.5%,respectively)(P<0.05).Conclusion Sevoflurane and propofol aresafe and suitable for anesthesia induction in children below 3 years of age undergoing diagnostic FOB and can achieve bettersedative effect and lower the incidences of cough and respiratory complications as compared with dexmedetomidine.
文摘Aim: Propofol, a widely used alkyphenol intravenous anesthetic, has been proven to be a shortly acting, less toxic and high safe coefficient in clinic application. However, whether the drug has analgesic action is still not clear. To further answer this question, the effects of i. t. propofol on persistent spontaneous nociception (PSN) and hyperalgesia induced by chemical tissue injury were examined.
文摘目的观察和比较阿芬太尼、布托啡诺以及舒芬太尼复合丙泊酚用于宫腔镜手术的镇痛、镇静效果及对患者术后恢复的影响。方法选择择期行无痛宫腔镜手术女性患者150例,年龄18~55岁,BMI 18.5~28.0 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法将患者分为三组:阿芬太尼10μg/kg(A组)、布托啡诺20μg/kg(B组)和舒芬太尼0.1μg/kg(S组),每组50例。给予镇痛药物后,每组静脉注射丙泊酚2 mg/kg。待患者睫毛反射消失后开始宫腔镜操作。记录术中低血压、心动过缓、呼吸抑制和呛咳及术后恶心呕吐、头晕、头痛等发生情况。记录入室时、扩张宫颈时、置入宫腔镜时、手术结束时的HR、MAP、SpO_(2)。记录术中丙泊酚的诱导剂量、单位时间追加剂量和总量、术后睁眼时间、清醒时间、术后15 min、2和6 h的VAS疼痛评分。结果与入室时比较,A、B组扩张宫颈时、置入宫腔镜时、手术结束时HR明显减慢、MAP、SpO_(2)均明显下降,S组扩张宫颈时、置入宫腔镜时、手术结束时HR明显减慢、MAP均明显下降,置入宫腔镜时以及手术结束时SpO_(2)明显下降(P<0.05)。与A组比较,B组和S组的术后恶心呕吐发生率明显升高,B组术后头晕和术后头痛发生率和术后15 min VAS疼痛评分明显升高,S组术后2和6 h VAS评分明显升高(P<0.05)。与B组比较,S组的术后恶心呕吐和术后头晕的发生率明显降低,术后6 h VAS疼痛评分明显升高,A组和S组睁眼时间和清醒时间明显缩短(P<0.05)。结论与布托啡诺和舒芬太尼复合丙泊酚比较,阿芬太尼复合丙泊酚用于宫腔镜手术对术中循环影响较小,且术后患者恢复清醒时间短,术后恶心呕吐等不良反应发生率更低。
文摘目的比较地氟烷吸入麻醉与丙泊酚全凭静脉麻醉对经鼻内镜垂体腺瘤切除术患者术后恢复质量的影响,为优化该类手术的麻醉方案提供循证依据。方法采用单中心、前瞻性、随机对照研究设计,纳入112例拟行经鼻内镜垂体腺瘤切除术的患者,采用数字表法随机分为地氟烷组(n=56)和丙泊酚组(n=56)。地氟烷组采用地氟烷[0.7~1.0肺泡最低有效浓度(minimum alveolar concentration,MAC]联合瑞芬太尼维持麻醉,丙泊酚组采用丙泊酚(4~6 mg·kg^(-1)·h^(-1))联合瑞芬太尼维持麻醉。主要结局指标为麻醉药物停用后至Aldrete评分达9分的时间,次要指标包括苏醒时间、拔管时间以及术后住院时间。结果地氟烷组Aldrete评分达9分的时间显著短于丙泊酚组(13.0 min vs 16.5 min,P=0.003),意识恢复时间(14.0 min vs 16.5 min,P=0.009)和拔管时间(13.0 min vs 16.5 min,P=0.003)亦明显缩短。然而,地氟烷组术后躁动(17.9%vs 3.6%,P=0.015)和呕吐发生率(19.6%vs 5.4%,P=0.022)较高,两组严重躁动发生率差异无统计学意义。术后24 h恢复质量[恢复质量15项量表(Quality of Recovery-15,QoR-15)]评分和住院时间组间差异无统计学意义。结论地氟烷麻醉可显著加速经鼻内镜垂体腺瘤切除术患者的术后恢复,但可能增加轻度躁动和呕吐风险。临床应用中需权衡不良反应,采取针对性预防措施。
