1.Induction and recovery of propofol and etomidate in pediatric anesthesia
Yong JIANG ; Xiaohui TANG ; Dewei HOU
Chinese Journal of Biochemical Pharmaceutics 2017;37(6):278-279
Objective To explore the effect of propofol and etomidate on anesthesia induction in pediatric surgery, and to provide evidence for the future use of anesthesia in pediatric surgery.Methods120 cases of pediatric surgery patients were prospectively selected pediatric in our hospital from May 2013 to January 2015 as the research object, randomly divided into 2 group respectively, control group and observation group, 60 cases in each group;the control group anesthesia was induced with etomidate, observation group anesthesia was induced with propofol, and the anesthetic effect were observed in the two groups, recovery and adverse reaction in the induction period of anesthesia.ResultsThe patients in the observation group anesthesia satisfaction scores were significantly higher than the control group (P<0.05) and the observation group;the recovery time and the time of leaving room were significantly shorter than the control group (P<0.05);in the observation group, respiratory depression, restlessness, throat and bronchial spasm, adverse reactions such as nausea and vomiting were significantly lower than the control group (P<0.05).ConclusionPropofol is more suitable for pediatric surgery than etomidate, and anesthesia effect is remarkable, fast recovery, worthy of clinical application and promotion.
2.Application of sufentanil in pediatric surgery and postoperative analgesia
Yong JIANG ; Xiaohui TANG ; Dewei HOU
Chinese Journal of Biochemical Pharmaceutics 2017;37(5):290-291
Objective To investigate the safety and efficacy of sufentanil in pediatric surgery.Methods80 cases of pediatric surgery were prospectively selected pediatric methods in The Third People's Hospital of Xining from July 2013 to January 2015 as the research object, the patients were divided into two groups, control group and observation group, 40 cases in each group.The control group received remifentanil,observation group were given sufentanil, mean arterial pressure(MAP)and heart rate(HR)30min and 5min at each time point after extubation and 5min based value children after entering the operation room after induction were compared.The sedation scores of 5min, 15min and 30min after tracheal intubationwere recorded..ResultsThe pain scores in the observation grouppostoperative T4, T5, T6 each time were significantly higher than the control group (P<0.05);MAP and HRin the observation group at T0, T1, T2, T3 had no significant differencecompared with control group, MAP during T4 in the observation group was significantly higher than the control group (P<0.05);and HR in the observation group in the period of T4 was significantly lower than the control group (P<0.05).ConclusionThe application of sufentanil in pediatric surgery is effective and safe.
3.Quantitative Estimation of Blood Concentration of Lamotrigine in Chinese Han Pediatric Patients with Epi-lepsy Based on UGT1A4142T>G Polymorphism and Blood Concentration of Valproic Acid
Yanling HE ; Fan HE ; Xiaolan MO ; Jiali LI ; Xueding WANG ; Jie ZHANG ; Juan CHEN ; Yuguan WEN ; Dewei SHANG ; Yechun YANG ; Lianbing HOU
China Pharmacy 2017;28(20):2737-2742
OBJECTIVE:To investigate the effects of UGT1A4142T>G polymorphism and blood concentration of valproic ac-id(VPA)on blood concentration of lamotrigine(LTG)in southern Chinese Han children with epilepsy,and to establish the predic-tion equation for quantitatively estimating blood concentration of LTG. METHODS:A total of 72 southern Chinese Han children with epilepsy selected from Guangzhou Women and Children's Medical Center during Jan. 2010-Sept. 2016 were given LTG+VPA. LC-MS/MS and enzyme amplified immunoassay were adopted to determine the blood concentration of LTG and VPA. RFLP-PCR was adopted to determine UGT1A4142T>G polymorphism. The relationships of age, gender, blood concentration of VPA, UGT1A4142T>G polymorphism and LTG concentration-to-dose-ratio (CDR) were also investigate. The prediction equation for blood concentration of LTG was established by multiple linear regression analysis. RESULTS:Age and blood concentration of VPA were positively related to CDR of LTG(r=0.225,0.300,P<0.05);there was no statistical significance in the influence of gender on CDR of LTG(P>0.05). UGT1A4 TT,TG and GG genotypes were detected in 39,29,and 4 cases respectively;the frequencies of each genotype were in line with the Har-dy-Weinberg balance(P>0.05). CDR of LTG of TT genotype was significantly lower than those of TG and GG genotype,with sta-tistical significance(P<0.05). Results of multiple linear regression analysis showed that the dose of LTG(x1),body weight(x2), blood concentration of VPA(x3)and UGT1A4142T>G polymorphism(x4)were all related to blood concentration of LTG(P<0.05). Using blood concentration of LTG(c)as dependent variable,above factors as independent variable,the regression equation was c=0.794+0.032x1-0.057x2+0.010x3+0.532x4(R2=0.616,P<0.05;UGT1A4 TT genotype was equal to 0,TG and GG genotype was equal to 1). There was a strong positive correlation between predicted blood concentration and measured ones(r=0.785,P=0.001). CONCLUSIONS:The dose of LTG,body weight,blood concentration of VPA and UGT1A4142T>G polymorphism may associated with blood concentration of LTG. Established prediction equation can provide reference for precise medication in south-ern Chinese Han children with epilepsy.
4.Relationship between the genetic factors and lamotrigine efficacy in epileptic children received valproic ac-id therapy in south China
Yanling HE ; Fan HE ; Xiaolan MO ; Jiali LI ; Xueding WANG ; Jie ZHANG ; Juan CHEN ; Yuguan WEN ; Dewei SHANG ; Lianbing YECHUN ; HOU YANG
The Journal of Practical Medicine 2017;33(19):3280-3283
Objective To investigate the effect of age,gender,weight and UGT1A4142T>G gene poly-morphism on the efficacy of LTG in epileptic children treated with valproic acid ,and to determine the effective se-rum concentration of LTG in children with epilepsy in south China. Methods A total of 72 pediatric patients with epilepsy received LTG and VPA treatments were enrolled in this study. Patients were treated from January 2010 to September 2016 in Guangzhou women and childrens′medical center. Serum concentration of LTG was measured by using the liquid chromatography-tandem mass spectrometry. UGT1A4142T > G was genotyped by the polymerase chain reaction-restriction fragment length polymorphism method. The correlations between the efficacy of LTG and age,gender,weight were analyzed by chi-square test,non-parametric test and logistic regression analysis,respec-tively. Results The curative effect of patients who were younger and with lighter weight were relatively poor ,and men were better than women in the curative effect. UGT1A4142T > G was not related with LTG efficacy. When combined with VPA,the effective serum concentration of LTG in children with epilepsy was more than 2 g/mL. Conclusion There is a good correlation between age and LTG curative effect. The effective serum concentration of LTG in children with epilepsy,who were co-treated with VPA,was more than 2 g/mL. This study provides a refer-ence for the individual administration of children with epilepsy in south China.