Either tacrine (THA) with succinylcholine or alcuronium was used on a randomized basis for laparoscopic procedures in twenty young females. The technique using THA with succinylcholine was found to be more suitable and predictable for this procedure and gave a smoother anaesthetic course, brighter recovery and minimal postoperative complications.
Alcuronium - adverse effects ; Aminoacridines - adverse effects ; Anesthesia Recovery Period ; Laparoscopy - methods ; Postoperative Complications - prevention & ; control

OBJECTIVETo evaluate efficacy of dexmedetomidine in preventing shivering after general anesthesia in women undergoing laparoscopic surgery.

METHODSEighty patients scheduled for laparoscopic gynecological surgery were randomized into dexmedetomidine group (n=40) and control group (n=40) to receive 1.0 µg/kg dexmedetomidine or an equal volume of saline slowly injected (for over 10 min) at 30 min before the anticipated completion of surgery. The postoperative incidences of shivering and the side effects were recorded.

RESULTSThe patients in the control group showed a significantly higher postoperative incidence of shivering (37.5%) than those in dexmedetomidine group (P<0.05). Heart rate and mean arterial pressure showed significant variations postoperatively in dexmedetomidine group (P<0.05), which had a significantly greater sedation score (P<0.05), a higher incidence of dry mouth (P=0.000), but a significantly lower incidence of nausea and vomiting than the control group (P<0.05).

CONCLUSIONDexmedetomidine can lower the incidence of shivering after general anesthesia for laparoscopic gynecological surgery.

Adult ; Anesthesia, General ; adverse effects ; Dexmedetomidine ; therapeutic use ; Female ; Gynecologic Surgical Procedures ; adverse effects ; methods ; Humans ; Laparoscopy ; adverse effects ; methods ; Prospective Studies ; Shivering ; Single-Blind Method

The CobraPLA(TM) (CPLA) is a relatively new supraglottic airway device that has not been sufficiently investigated. Here, we performed a prospective observational study to evaluate the efficacy of the CPLA during controlled ventilation. In 50 anesthetized and paralyzed patients undergoing elective surgery a CPLA was inserted and inflated to an intracuff pressure of 60 cm H2O. The success rate of insertion upon the first attempt was 82% (41/50), with a mean insertion time of 16.3 +/- 4.5 seconds. The adequacy of ventilation was assessed by observing the end tidal CO2 waveform, movement of the chest wall, peak airway pressure (13.5 cm H2O), and leak fraction (4%). We documented the airway sealing pressure (22.5 cm H2O) and noted that the the site of gas leaks at that pressure were either at the neck (52%), the abdomen (46%), or both (2%). In 44 (88%) patients, the vocal cords were visible in the fiberoptic view through the CPLA. There was no gastric insufflation during the anesthesia. Respiratory and hemodynamic parameters remained stable during CPLA insertion. Postoperative blood staining of CPLA was minimal, occurring in 22% (11/50) of patients. Mild and moderate throat soreness was reported in 44% (22/50) and 4% (2/50) of patients, respectively. Lastly, mild dysphonia was observed in 6% (3/50) of patients and mild dysphagia in 10% (5/50) of patients. Our results indicated that the CPLA is both easy to place and allows adequate ventilation during controlled ventilation.
Respiration, Artificial/adverse effects/*instrumentation ; Middle Aged ; Male ; Intubation/adverse effects/*instrumentation ; Hypopharynx ; Humans ; Female ; Anesthesia/*methods ; Adult

The use of nitrous oxide-oxygen inhalation sedation to relieve anxiety and pain in dental outpatient treatment has been a very mature and safe technique in the world. This technology has been introduced into China for nearly 20 years, and many clinical cases have proved its safety, practicability and effectiveness, which can meet the clinical needs of patients. To further standardize and popularize this technique, the Society of Sedation and Analgesia, Chinese Stomatological Association formed the recommended application guidelines after many discussions and revisions on the basis of widely soliciting opinions and referring to relevant literatures. It covers indications, contraindications, standardized operation procedures, occupational protection, identification and treatment of adverse reactions, training and other aspects. This guideline can be used as a reference for the use of nitrous oxide-oxygen inhalation sedation techniques in the outpatient setting of dentistry.
Anesthesia, Dental ; Anesthetics, Inhalation/adverse effects* ; Conscious Sedation/methods* ; Dental Anxiety/prevention & control* ; Humans ; Nitrous Oxide/adverse effects* ; Outpatients ; Oxygen

Intraspinal narcotic anesthesia was performed in 180 open heart surgery patients. 0.1 mg/Kg of morphine or 1.5 mg/Kg of meperidine was administered as the primary anesthetic in the subarachnoid space using the barbotage technique. Of the 180 patients scheduled for open heart surgery, morphine was administered to 95 patients, meperidine to 55 and a mixture of morphine and meperidine to 30 patients. From a clinical point of view, there were no significant cardiovascular problems, however, respiratory depression seemed to be most serious after morphine administration. Mild complications such as pruritus (11.1%), voiding difficulty (10.6%), intraoperative awareness (4.4%) and spinal headache were observed, however these were mild, not major clinical problems and were acceptable. Postoperative analgesic effect and respiratory controllability were excellent.
Anesthesia, Spinal/adverse effects/*methods ; *Cardiac Surgical Procedures ; Humans ; Meperidine/*administration & dosage/adverse effects ; Morphine/*administration & dosage/adverse effects ; Respiratory Insufficiency/chemically induced

Aged ; Anesthesia, General ; adverse effects ; Echocardiography ; methods ; Humans ; Male ; Pulmonary Embolism ; diagnosis ; therapy

OBJECTIVETo initially observe the effect of classical endotracheal intubation on endotracheal bacterial contamination and evaluate the validity of protective endotracheal intubation on reducing endotracheal bacterial contamination.

METHODSNinety elective patients undergoing general anesthesia for hysterectomy were randomly assigned to two equal groups. Group II received endotracheal intubation protected by sterilized transparent sleeve while group I correspondingly adopted unprotective classical endotracheal intubation. Endotracheal swab sampling and bacterial counting were performed on the principle of aseptic processing before endotracheal intubation and extubation, respectively.

RESULTSBacteria were found in 62 of 180 samples. The difference of bacterial counting between before extubation and before intubation was (-0.3 +/- 35.6) 100 CFU/ ml in group II, lower than that in group I, which was (21.4 +/- 56.7) 100 CFU/ml (P<0.05).

CONCLUSIONEndotracheal bacterial contamination may be caused by unprotective classical endotracheal intubation and could be reduced by protective endotracheal intubation.

Anesthesia, General ; Bacteria ; isolation & purification ; Female ; Humans ; Hysterectomy ; Intubation, Intratracheal ; adverse effects ; methods ; Trachea ; microbiology

BACKGROUNDSpinal anesthesia was considered as a reasonable anesthetic option in severe preeclampsia when cesarean delivery is indicated, and there is no indwelling epidural catheter or contraindication to spinal anesthesia. However, the ideal dose of intrathecal bupivacaine has not been quantified for cesarean delivery for severe preeclamptic patients. This study aimed to determine the ED 50 and ED 95 of intrathecal bupivacaine for severely preeclamptic patients undergoing elective cesarean delivery.

METHODSTwo hundred severely preeclamptic patients are undergoing elective cesarean delivery under combined spinal-epidural anesthesia enrolled in this randomized, double-blinded, dose-ranging study. Patients received 4 mg, 6 mg, 8 mg, or 10 mg intrathecal hyperbaric bupivacaine with 2.5 μg sufentanil. Successful spinal anesthesia was defined as a T6 sensory level achieved within 10 minutes after intrathecal drug administration and/or no epidural supplement was required during the cesarean section. The ED 50 and ED 95 were calculated with a logistic regression model.

RESULTSED 50 and ED 95 of intrathecal bupivacaine for successful spinal anesthesia were 5.67 mg (95% confidence interval [CI]: 5.20-6.10 mg) and 8.82 mg (95% CI: 8.14-9.87 mg) respectively. The incidence of hypotension in Group 8 mg and Group 10 mg was higher than that in Group 4 mg and Group 6 mg (P < 0.05). The sensory block was significantly different among groups 10 minutes after intrathecal injection (P < 0.05). The use of lidocaine in Group 4 mg was higher than that in other groups (P < 0.05). The use of phenylephrine in Group 8 mg and Group 10 mg was higher than that in the other two groups (P < 0.05). The lowest systolic blood pressure before the infant delivery of Group 8 mg and Group 10 mg was lower than the other two groups (P < 0.05). The satisfaction of muscle relaxation in Group 4 mg was lower than other groups (P < 0.05). There was no significant difference in patients' satisfaction and the newborns' Apgar score and the blood gas analysis of umbilical artery serum (P > 0.05).

CONCLUSIONOur study showed that the ED 50 and ED 95 of intrathecal bupivacaine for severely preeclamptic patients undergoing elective cesarean delivery were 5.67 mg and 8.82 mg, respectively. In addition, decreasing the dose of intrathecal bupivacaine could reduce the incidence of maternal hypotension.

Adult ; Anesthesia, Epidural ; Anesthesia, Spinal ; adverse effects ; methods ; Blood Pressure ; physiology ; Bupivacaine ; administration & dosage ; adverse effects ; therapeutic use ; Cesarean Section ; Double-Blind Method ; Female ; Humans ; Male ; Sufentanil ; administration & dosage ; adverse effects ; therapeutic use

OBJECTIVE: To conclude the correlation between the alternatives of anesthesia--general and local anesthesia--and the complications of nasal endoscopic surgeries. METHOD: Summing up the occurrence rates of the complications from 176 cases (321 sides) of patients with sinusitis(some were air crew); comparing and calculating these complications according to the ways of anesthesia which were adopted in the surgeries. RESULT: The occurrence rates of the complications from nasal endoscopic surgeries were 6.9% (22/321) and rates of major complications were 1.6% (5/321). Rates of 1.9% (4/210) occurred after surgeries with local anesthesia, 16.2% (18/111) with general anesthesia, which indicated the striking differences between them (chi2 = 21.11, P < 0.01). There were no differences between the types of diseases resulted from the choice of anesthesia (Type I and Type II, Type I and Type II, Type II and Type III chi2 = 0.06, 2.56, 3.82; P > 0.05). However, the incidences of various types of complications with local anesthesia were less than those with general anesthesia, which differed significantly within two groups (P < 0.05). No cases of obvious complications occurred to air crew. CONCLUSION The occurrence rates of complications of endoscopic surgeries with local anesthesia are lower than that of those with general anesthesia, which is worth promoting in ground crew and sing for reference to elevate rate of resuming flight in aircrew.
Adolescent ; Adult ; Aged ; Anesthesia, General ; adverse effects ; Anesthesia, Local ; adverse effects ; Child ; Chronic Disease ; Endoscopy ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Sinusitis ; surgery ; Young Adult

OBJECTIVETo investigate the effects of acupuncture on the morphine-related side effects (nausea, vomiting, itchiness and gastrointestinal disorders) in patients undergoing anesthesia and analgesia and try to find the clinical mechanism of acupuncture.

METHODSPatients scheduled to have transurethral prostatic resection: enrolled in the study (69 patients), characterized as Grade II or III by the American Society of Anesthesiologists physical status classification, were randomly assigned to three groups, 23 patients in each group: the placebo group (control group), non-anesthesia area (NAA) group, and the anesthesia area (AA) group. After spinal anesthesia, all patients received Patients Controlled Epidural Analgesia. The vital signs, bowel sounds, visual analogue scales, itchiness, nausea and vomiting, and time for first exhaust post operation were observed.

RESULTSAltogether, nine cases were eliminated, three in each group. Finally, sixty cases completed this study,: twenty in each group. There was a significant decrease of bowel sounds after morphine spinal anesthesia in the three groups. Compared with the control or AA group, the bowel sound recovered after acupuncture, the incidences of nausea and vomiting, itchiness, and time for first exhaust after operation decreased in the NAA group (P<0.05). There was a significant decrease of the incidence for itchiness in the NAA group compared with

CONCLUSIONSOn the basis of this study, it is obviously seen that acupuncture could: decrease the incidence of morphine-related side effects (nausea and vomiting, itchiness and gastrointestinal disorders) when the spinal cord conduct is normal. However, it decreases only the incidence of itchiness but not for gastrointestinal dysfunction when the spinal cord is blocked.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Analgesia ; adverse effects ; Analgesia, Epidural ; adverse effects ; Anesthesia, Epidural ; adverse effects ; methods ; Anesthesia, Spinal ; adverse effects ; methods ; Humans ; Intestines ; physiopathology ; Male ; Middle Aged ; Morphine ; administration & dosage ; adverse effects ; Postoperative Complications ; prevention & control ; Postoperative Nausea and Vomiting ; prevention & control ; therapy ; Prostatic Hyperplasia ; physiopathology ; surgery ; Pruritus ; therapy ; Transurethral Resection of Prostate ; rehabilitation ; Treatment Outcome