OBJECTIVETo evaluate target-controlled infusion (TCI) of remifentail-propofol and the balanced anesthesia of fentanyl-isoflurane during the operation with suspension laryngscope.

METHODSSixty ASA I-II patients scheduled for the surgery through suspension laryngoscopy were randomly divided into two groups: TCI group and control group. In TCI group, anesthesia was maintained with TCI remifentanil-propofol which was stopped at the end of operation. The target plasma concentration of remifentanil was set at 6 microg/L and propofol at 3 mg/L. In control group, anesthesia was induced with intravenous fentanl 2.5 microg/kg and propofol 1-2 mg/kg, maintained with fentanl 0.03 microg.kg(-1). min(-1) and 1% isoflurane which was stopped at the end of surgery. Intubation was facilitated with succinylcholine 1-1.5 mg/kg.MAP, HR, ECG, S(p)O(2) and P(ET)CO(2) were monitored during anesthesia. The following parameters were recorded and compared between two groups: (1) the changes in blood pressure (BP), heart rate(HR) and S(p)O(2) at different time point; (2) recovery profile including the time of response to verbal commands, autonomous breathing, tracheal extubation, orientation recovery, discharging from PACU after operation; (3) OAAS scores after operation; (4) postoperative complications; (5) unexpected events and awareness during operation.

RESULT(1) The hemodynamics were stable while the target plasma concentration of remifentanil was set at 6 microg/L and propofol at 3 mg/L. (2) During tracheal intubation, suspension laryngoscope was inserted, and extubation MAP was significantly lower in TCI group than that in control group; (3) There were no significant differences in hemodynamic values and S(p)O(2) of different time points between two groups. Study group was faster than control group on recovery profile including the time of response to verbal commands, autonomous breathing, tracheal extubation, orientation recovery and discharging from PACU. There was respectively one unexpected event in both groups.

CONCLUSIONRemifentanil supplemented with isoflurane anesthesia can achieve the optimal hemodynamic stability during the operation with suspension laryngoscopy and better recovery profile from anesthesia than fentanyl.

Adolescent ; Adult ; Anesthetics, Combined ; administration & dosage ; Anesthetics, Intravenous ; administration & dosage ; Blood Pressure ; Female ; Heart Rate ; Humans ; Laryngoscopy ; methods ; Male ; Middle Aged ; Piperidines ; administration & dosage ; Propofol ; administration & dosage

OBJECTIVETo compare the efficacy and safety of midazolam combined with fentanyl and propofol combined with fentanyl as conscious sedation in oocyte retrieval of in vitro fertilization and embryo transplantation (IVF-ET).

METHODSEighty patients receiving IVE-ET were randomly divided into midazolam combined with fentanyl group (midazolam group) and propofol combined with fentanyl group (propofol group). Antalgic effects, circulation status (blood pressure, heart rate), respiration status (rate, oxygen saturation and respiration depression) during operation, nausea and vomiting, and amnestic effects after operation were compared.

RESULTNo differences of antalgic effects and circulation status between two groups were observed. Percentages of respiration depression,vomiting and amnesia of midazolam group were 5.0 %, 10.0 % and 25%, respectively, and those of propofol group were 25%, 27.5% and 7.5%, respectively, which had statistical significance.

CONCLUSIONAs conscious sedation, midazolam combined with fentanyl is better than propofol combined with fentanyl in oocyte retrieval of IVF-ET.

Adult ; Anesthetics, Combined ; administration & dosage ; Anesthetics, Intravenous ; administration & dosage ; Female ; Fentanyl ; administration & dosage ; Fertilization in Vitro ; Humans ; Midazolam ; administration & dosage ; Oocyte Retrieval ; methods ; Propofol ; administration & dosage

OBJECTIVETo observe the impacts of doxapram on anesthetic efficacy and respiratory and circulatory functions during anesthesia with remifentanil given by target-controlled infusion (TCI) combined with propofol in painless artificial abortion.

METHODSA total of 120 ASA I women requiring voluntarily painless artificial abortion were randomized into two equal groups. One group was given remifentanil by TCI at 2 ng/ml and propofol 1mg/kg (group I), and the other given remifentanil by TCI, propofol, and doxapram 0.6 mg/kg (group II). The anesthetic efficacy and respiratory and circulatory suppression during anesthesia were observed.

RESULTSBoth of the two groups showed satisfactory anesthetic efficacy with comparable the BIS values (P>0.05). No significant difference was noted in the induction time and awaking time between the two groups (P>0.05), but group I had more serious respiratory and circulatory depression than group II (P<0.05).

CONCLUSIONDoxapram may attenuate respiratory and circulatory depression during anesthesia with remifentanil given by TCI combined with propofol in painless artificial abortion, and provide comparable anesthetic efficacy.

Abortion, Induced ; Adolescent ; Adult ; Anesthetics, Combined ; Doxapram ; administration & dosage ; Female ; Humans ; Infusions, Intravenous ; Middle Aged ; Piperidines ; administration & dosage ; Propofol ; administration & dosage ; Treatment Outcome

PURPOSE: Anesthesia and surgery commonly cause hypothermia, and this caused by a combination of anesthetic-induced impairment of thermoregulatory control, a cold operation room environment and other factors that promote heat loss. All the general anesthetics markedly impair normal autonomic thermoregulatory control. The aim of this study is to evaluate the effect of two different types of propofol versus inhalation anesthetic on the body temperature. MATERIALS AND METHODS: In this randomized controlled study, 36 patients scheduled for elective laparoscopic gastrectomy were allocated into three groups; group S (sevoflurane, n=12), group L (lipid-emulsion propofol, n=12) and group M (micro-emulsion propofol, n=12). Anesthesia was maintained with typical doses of the study drugs and all the groups received continuous remifentanil infusion. The body temperature was continuously monitored after the induction of general anesthesia until the end of surgery. RESULTS: The body temperature was decreased in all the groups. The temperature gradient of each group (group S, group L and group M) at 180 minutes from induction of anesthesia was 2.5+/-0.6degrees C, 1.6+/-0.5degrees C and 2.3+/-0.6degrees C, respectively. The body temperature of group L was significantly higher than that of group S and group M at 30 minutes and 75 minute after induction of anesthesia, respectively. There were no temperature differences between group S and group M. CONCLUSION: The body temperature is maintained at a higher level in elderly patients anesthetized with lipid-emulsion propofol.
Aged ; Aging ; Anesthesia, General/*methods ; Anesthetics, Combined/administration & dosage ; Anesthetics, Inhalation/*administration & dosage ; Anesthetics, Intravenous/*administration & dosage ; Body Temperature/*drug effects ; Body Temperature Regulation/drug effects ; Fat Emulsions, Intravenous ; Female ; Humans ; Male ; Methyl Ethers/*administration & dosage ; Middle Aged ; Propofol/*administration & dosage

OBJECTIVETo investigate the effect of epidural ropivacaine in combination with fentanyl for labor analgesia on the clinical outcome of labor.

METHODSA retrospective study was conducted involving 281 healthy primiparas, including 106 undergoing spontaneous labor who received epidural 0.15% ropivacaine in combination with fentany (1microg/ml) and 175 without epidural analgesia. The active phase duration, durations of each labor stages, delivery modes, management of labor, postpartum hemorrhage, incidence of fetal distress and asphyxia neonatorum were recorded in the two groups. The visual analogue scale (VAS) was used to assess the pain of uterine contraction, and modified Bromage scoring system applied to evaluate the lower limb motor block.

RESULTSThere were no significant differences in the duration of the first, third or the total labor stages between the two groups, but the second labor stage was prolonged in the labor analgesia group. The ratio of spontaneous labor, assisted vaginal delivery, and incidence of asphyxia neonatorum were higher, whereas the duration of the active stage was shortened in the analgesia group.

CONCLUSIONEpidural ropivacaine in combination with fentanyl in labor can decrease the incidence of cesarean section, and the duration of the active stage can be shortened with application of ocytocin.

Adult ; Amides ; administration & dosage ; therapeutic use ; Analgesia, Epidural ; methods ; Analgesia, Obstetrical ; methods ; Anesthetics, Combined ; Anesthetics, Intravenous ; administration & dosage ; therapeutic use ; Anesthetics, Local ; administration & dosage ; therapeutic use ; Female ; Fentanyl ; administration & dosage ; therapeutic use ; Humans ; Labor Pain ; drug therapy ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies

OBJECTIVE: To evaluate the effects of bispectral index(BIS) and auditory evoked potentials index(AEPindex) monitoring on the depth of anesthesia in inhalation of isoflurane and target-controlled infusion(TCI) of propofol, and to observe the changes of BIS and AEPindex. METHODS: Fourty ASA physical status I - II patients undergoing selective abdominal operations were divided into 2 groups randomly: Group I1(the end-tidal isoflurane concentration was 0.6 MAC, n=20) and Group I2(the end-tidal isoflurane concentration was 1.0 MAC, n=20). Anesthesia was induced with proprofol and vecuroninm. After the tracheal intubation, the patients were ventilated with 0.6/1.0 MAC isoflurane in pure oxygen, and after 20 minutes, propofol was administered with TCI according to the different target plasma concentrations from 1.0 g/mL to 3.0 g/mL(increasing 0.5 g/mL each time). The changes of MAP, HR, BIS and AEPindex were recorded simultaneously. RESULTS: There was no close correlation between MAP, HR and the end-tidal isoflurane concentration, target plasma concentration of propofol. The correlation coefficiencies between BIS, AEPindex and the end-tidal isoflurane concentration were -0.757, -0.819 and -0.832, -0.878 (P<0.001), respectively; those between BIS, AEPindex and the target plasma concentration of propofol were -0.932, -0.888 and -0.920, -0.923 (P<0.001). The correlation coefficiencies between BIS, AEPindex and the stimulation of endotracheal intubation were -0.728 and 0.544, respectively; however, there was no close correlation between BIS , AEPindex and the stimulation of skin incision, and exploration. CONCLUSION BIS and AEPindex are reliable parameters to monitor the depth of anesthesia of isoflurane and propofol combined anesthesia; and in response to the stimulation of tracheal intubation, AEPindex is better than BIS, but BIS and AEPindex can not be used to predict the cardiovascular reaction of skin incision and exploration.
Abdomen ; surgery ; Anesthesia ; methods ; Anesthetics, Combined ; administration & dosage ; Anesthetics, Inhalation ; administration & dosage ; Anesthetics, Intravenous ; administration & dosage ; Blood Pressure ; drug effects ; Electroencephalography ; Evoked Potentials, Auditory ; drug effects ; Female ; Heart Rate ; drug effects ; Humans ; Isoflurane ; administration & dosage ; Male ; Propofol ; administration & dosage ; Vecuronium Bromide ; administration & dosage

Acupuncture Therapy ; Adult ; Aged ; Anesthetics ; administration & dosage ; Combined Modality Therapy ; Female ; Humans ; Intervertebral Disc Displacement ; drug therapy ; physiopathology ; therapy ; Male ; Middle Aged ; Nerve Block ; Spinal Nerve Roots ; drug effects ; physiopathology

OBJECTIVETo compare the clinical efficacy difference in dysantonomia between transcutaneous electrical stimulation at Renying(ST 9) combined with stellate ganglion block(SGB) and simple SGB.

METHODSSixty patients in accord with the diagnostic criteria of dysantonomia were randomly divided into two groups,30 cases in each group. In the observation group,transcutaneous electrical stimulation at Renying(ST 9) combined with SGB were adopted; in the control group,simple SGB was applied. In the two groups, treatment was used three times a week,and nine treatments were considered as one course. There was an interval of one week between courses,and two courses were treated. Total seven weeks were required. Scores were evaluated according to subjective symptoms before treatment,one month and three months after treatment in the two groups.

RESULTSThe scores of subjective symptoms were not statistically different before treatment in the two groups(P>0. 05). The scores of subjective symptoms one month and three months after treatment were all lower than those before treatment(all P< 0. 01), and subjective symptoms scores in the observation group were lower than those in the control group(both P<0. 01).

CONCLUSIONTranscutaneous electrical stimulation at Renying(ST 9) combined with SGB could obviously enhance the clinical effects for dysantonomia, and the control and improvement for clinical symptoms are apparently superior to simple SGB.

Acupuncture Points ; Adult ; Anesthetics ; administration & dosage ; Autonomic Nerve Block ; Autonomic Nervous System Diseases ; drug therapy ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Stellate Ganglion ; drug effects ; physiopathology ; Transcutaneous Electric Nerve Stimulation ; Young Adult

OBJECTIVETo evaluate the effect of dexmedetomidine (Dex) on bispectral index (BIS) and auditory evoked potential index (AAI) during anesthesia with target controlled infusion (TCI) of propofol and remifentanyl.

METHODSThirty adult patients (ASA I approximate, equalsII) who were scheduled for elective thyroidectomy were monitored with BIS, AAI, ECG, blood pressure, end-tidal CO(2), and pulse oximeter before and during anesthesia. Anesthesia was induced by TCI with propofol 4 mg/L and remifentanyl 1 mu g/kg. After loss of consciousness the patients were intubated after rocuronium 0.6 mg/kg intravenous injection, remifentanyl was then infused at 0.2 microg/(kg x min)(-1) and propofol infusion (Ct) was titrated to maintain a BIS value at 50 +/- 3. At 10 min after stabilization of anesthesia the patients were randomly and double-blindly divided into 2 groups: Group D (n=15) received Dex 0.4 mu g/kg iv administered over 5 min and Group C (n=15) received equal volume of normal saline. Values of BIS, AAI, MAP, HR were recorded every 2 min within 20 min after the administration of the drugs.

RESULTSBefore anesthesia the BIS index was 90 +/- 2 in Group D and 92 +/- 2 in Group C, AAI was 81 +/- 1 in Group D and 78 +/- 1 in Group C. In anesthesia with target controlled infusion of propofol, BIS index showed a significant decrease with the i.v. administration of Dex 0.4 microg/kg, while AAI remained unchanged. In Group C, both of BIS and AAI remained unchanged after saline injection.

CONCLUSIONDuring propofol and remifentanyl anesthesia, after the administration of Dex, BIS value demonstrates a predominant decrease, whereas AAI shows no changes.

Adrenergic alpha-Agonists ; administration & dosage ; Adult ; Androstanols ; administration & dosage ; Anesthetics, Combined ; administration & dosage ; Anesthetics, Intravenous ; administration & dosage ; Dexmedetomidine ; administration & dosage ; pharmacology ; Double-Blind Method ; Evoked Potentials, Auditory ; drug effects ; Female ; Humans ; Infusions, Intravenous ; methods ; Male ; Medetomidine ; pharmacology ; Middle Aged ; Monitoring, Intraoperative ; methods ; Neuromuscular Nondepolarizing Agents ; administration & dosage ; Piperidines ; administration & dosage ; pharmacology ; Propofol ; administration & dosage ; pharmacology ; Thyroidectomy

This study was performed to compare the effect of intratesticular (IT) injection of xylazine/ketamine combination for canine castration with those of intramuscular (IM) or intravenous (IV) injection. Xylazine and ketamine was administered simultaneously via intratesticularly (IT group), intramuscularly (IM group) or intravenously (IV group) at doses of 2 and 10 mg/kg, respectively. Pain response at the time of injection, mean induction time, mean arousal time, mean walking time and cardiopulmonary function during anesthesia were monitored after the xylazine and ketamine administration. In IV and IM groups, heart rates were significantly decreased 30 and 45 min after xylazine and ketamine administration, respectively (p < 0.05). Respiratory rates were significantly decreased in the IV group (p < 0.05). In the IT group, there was no significant changes in heart and respiratory rates. The occurrence of cardiac arrhythmias was less severe in IT group compared with those in IM and IV groups. The route of administration did not affect rectal temperature. Mean induction time was significantly (p < 0.05) longer in IT group than in IM and IV groups. On the contrary, mean arousal time and mean walking time were shortened in IT group. Clinical signs related to pain response at the time of injection and vomiting were less observed in IT group than in IM group, and head shaking was less shown in IT group than in IM and IV groups during recovery period. These results indicated that intratesticular injection of xylazine/ketamine for castration has several advantages such as less inhibition of cardiopulmonary function and fast recovery from anesthesia without severe complications, and would be an effective anesthetic method for castration in small animal practice.
Anesthesia, Intravenous/veterinary ; Anesthetics, Combined/adverse effects/*therapeutic use ; Anesthetics, Dissociative/adverse effects/*therapeutic use ; Animals ; Body Temperature/drug effects ; Castration/*veterinary ; Dogs ; Drug Administration Routes/veterinary ; Electrocardiography/drug effects/veterinary ; Heart Rate/drug effects ; Injections/veterinary ; Injections, Intramuscular/veterinary ; Ketamine/adverse effects/*therapeutic use ; Male ; Pain, Postoperative/prevention&control/veterinary ; Pulmonary Ventilation/drug effects ; Testis/*drug effects ; Vomiting/chemically induced/veterinary ; Xylazine/adverse effects/*therapeutic use