Objective To determine the respiratory depression effect-site concentration (Ce) of remifentanil when used in combination with different target concentrations of propofol in patients undergoing neurosurgical surgery. Method Eighty patients aged 18-64 yr weighing 45-90 kg scheduled for elective neurosurgical surgery were randomly divided into 4 groups (n = 20 each): remifentanil group (group R), remifentanil combined with propefol 1, 1.5, 2 μg/ml group (group RP1, RP1.5, RP2). In group R, RP1, RP1.5 or RP2, the patients received propofol by TCI at target plasma concentration (Cp) of 0, 1, 1.5 or 2 μg/ml respectively, when the preset concentration was reached, received remifentanil via TCI at the initial target Cp of 2 ng/ml, and the concentration was then increased in the increment of 2 ng/ml at 3 min intervals until respiratory depression was achieved. Respiratory depression was defined as one of the following end points: muscle rigidity, RR<6 bpm, MV < 3 L/min, PETCO_2> 55 mm Hg, SpO_2 < 90% or apnea > 15 s. The Ce of remifentanil, amount of remifentanil used and side effects were recorded during respiratory depression. Result The respiratory depression Ce of remifentanil were (5.2±2.1), (3.2±1.0), (2.9 ±1.3) and (2.2±1.0) ng/ml in group R, RP1, RP1,5 and RP2 respectively. Compared with group R, the respiratory depression Ce of remifentanil were significantly decreased in group RP1, RP1.5 and RP2 (P<0.01). Compared with group RP1 and RP1.5, the respiratory depression Ce of remifentanil was significantly decreased in group RP2(P<0.01). There was no significant difference in respiratory depression Ce of remifentanil between group RP1 and RP1.5 (P > 0.05). Conclusion The respiratory depression Ce of remifentanil is (5.2±2.1) μg/ml in patients without sedation. The respiratory depression Ces of remifentanil are (3.2 ±1.0), (2.9 ± 1.3) and (2.2 ±1.0) ng/ml in patients under sedation with propofoi at target Cps of 1, 1.5, 2 μg/ml during neurosurgical surgery.

Objective To observe the respiratory depression of sufentanil and remifentanil with target-controlled infusion under propofol sedation or not, and compare the effect of respiratory depression of the two drugs. Methods Eighty patients scheduled for elective neurosurgery were allocated into four groups by random digits table: the sufentanil group (group S), the remifentanil group (group R), the combination of sufentanil and propofol group (group SP) and the combination of remifentanil and propofol group (group RP),each group was 20 cases. The respiratory rate (RR), minute ventilation (MV),partial pressure of end-tidal carbondioxide ( PETCO2), pulse oxygen saturation (SpO2), mean arterial pressure ( MAP ), heart rate (HR), observer's assessment of alertness/sedation (OAA/S) were measured and respiratory depression was defined as one of the following end points were achieved: muscle rigidity, RR ＜ 6 beats/min, MV ＜ 3 L/min,PETCO2 ＞ 55 mm Hg ( 1 mm Hg = 0.133 kPa), SpO2 ＜ 0.90 or apnea ＞ 15 s. Results The calculated effect concentration (Ce) of sufentanil for respiratory depression were (0.46 ± 0.14) μ g/L in group S and (0.23 ±0.06) μ g/L in group SP, and Ce of remifentanil for respiratory depression were (5.22 ± 2.11 ) μ g/L in group R and (2.22 ± 1.02) μ g/L in group PP. Some respiratory parameters,such as RR,MV were decreased and PETCO2 was increased significantly as the increase of Ce. Conclusions Target-controlled infusion of equal analgesic plasma concentration of sufentanil and remifentanil can suppress spontaneous respiration significantly with the increase of plasma concentration. There will be a synergetic effect after combining with propofol, and respiratory depression will appear at lower concentration. But equal analgesic plasma concentration of the two drugs have no significant difference in the effect of respiratory depression.

Cricoid Cartilage ; surgery ; Humans ; Laryngectomy ; methods ; rehabilitation ; Larynx ; Recovery of Function

Adenoma ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Parathyroid Neoplasms ; diagnosis ; therapy

Humans ; Male ; Middle Aged ; Parathyroid Neoplasms

Adult ; Humans ; Male ; Maxillary Sinus ; Tooth Eruption, Ectopic

Humans ; Medicine, Chinese Traditional ; Respiratory Tract Diseases ; prevention & control ; therapy ; virology ; Virus Diseases ; prevention & control ; therapy

Endoscopy ; methods ; Humans ; Neck ; surgery

Objective To evaluate the diagnosis value of C-12 multiple tumor marker protein chip detective system for lung cancer. Methods The serum levels of 12 tumor makers were measured in 172 lung cancer patiens,52 pulmonary benign diseases patients. All lung cancer patients were definitly diagnosised by cytology or histology, including 89 squamous cell carcinoma patients, 72 bronchogenic adenocarcinoma patients, 11 small cell lung cancer patients; 12 patients in stage I, 28 patients in stageII, 65 patients in stage III, 67 patients in stage IV. The 12 common tumor markers in serum included CA199, NSE, CEA, CA242, CA125, CA153, AFP, Ferrtin, free-PSA, PSA, HGH, ?-HCG. Results At least one kind of tumor maker was found higher in 128 of the 172 lung cancer patients, the positive rate was 74.42%, and in 5 of the 52 pulmonary benign diseases patients, the positive rate was 9.62%,it is statistical significance between two the groups (P0.05) in different pathological types lung cancer patients .The positive rate was statistical significance in different stage lung cancer patients , the highest positive rate which in stage IV patients was 79.2% (P

Humans ; Tracheostomy ; methods