Objective To observe the effects of ventilation with low tidal volume and positive end-expiratory pressure (PEEP)in different periods on the postoperative pulmonary function and short-term prognosis in aged patients undergoing abdominal surgery.Methods Sixty aged patients undergoing selective open abdominal surgery scheduled for general anesthesia,21 males and 39 fe-males,were randomized into 3 groups (n =20).Patients in group A received PEEP 1 h after the be-ginning of surgery;patients in group B received PEEP 1 h before tracheal extubation;patients in group C received PEEP intraoperatively.The secretion score in preoperative,postoperative 24 h and 72 h respectively,and the arterial blood gas analysis indexes (PaCO 2 ,PaO 2 ,A-aDO 2 ,PaO 2/FiO 2 calculation)in postoperative 1 h and 24 h were recorded.Results Compared with preoperative,in postoperative 1 h,PaCO 2 increased obviously in all groups,PaO 2 decreased in group B,A-aDO 2 in-creased in group A (P <0.05);in postoperative 24 h,PaCO 2 was significantly increased in group B and C,PaO 2/FiO 2 decreased in group B (P <0.05).Compared with postoperative 1 h,in postopera-tive 24 h,PaCO 2 and A-aDO 2 decreased obviously in group A (P <0.05).There were no differences in postoperative secretions score in between the 3 groups.Conclusion Low tidal volume combined short-range PEEP in different periods of surgery may improve postoperative pulmonary oxygenation. But they had no obvious help with postoperative pulmonary complications.

Objective To investigate the effect of anesthesia management of patients with laparoscopic cholecystectomy(LC) based on fast track surgery(FTS). Methods A randomized controlled clinical trial was carried out, 38 patients were randomly divided into test group(n=19,epidural block anesthesia and general anesthesia) and control group (n=19,general anesthesia). The blood glucose(Glu)and serum cortisol were tested at the following four time pointsbefore anesthesia, at pneumoperitoneum, 15 min after surgery and completing operation. Awakening time, evacuation time post operation and adverse events were observed and compared. Results Compared with before anesthesia, serum cor-tisol and Glu were increased at various time point in control group (P<0.05), there were statistical differences in two groups (P<0.05). Awakening time and evacuation time post operation of test group were earlier than control group (P<0.05). There were statistical differences in adverse events post operation in two groups(P<0.05). Conclusion Anesthesia management based on FTS can decrease stress reaction and accelerate rapid rehabilitation for patients of LC.