Objective To determine the dose-response relationship of sufentanil inhibiting responses to tracheal intubation when combined with sevoflurane in pediatric patients.Methods Seventy-five pediatric patients of both sexes,aged 2-8 yr,weighing 11-28 kg,of ASA physical status Ⅰ,scheduled for elective operation on perineum or four extremity under general anesthesia,were randomly assigned into 5 groups (n =15 each) using a random number table:sevoflurane group (group S) and sevoflurane combined with sufentanil 0.15,0.30,0.45 and 0.60 μg/kg groups (SS14 groups).6％ sevoflurane was inhaled via a face mask.Mechanical ventilation was performed after spontaneous breathing weakened.The end-tidal sevoflurane concentration was maintained at 3％ after loss of consciousness.The corresponding doses of sufentanil were injected intravenously in SS14 groups,while the equal volume of normal saline was given in group S.The median effective dose (ED50),ED95 and 95 ％ confidence interval of sufentanil inhibiting responses to tracheal intubadon were calculated using Probit method.Results When combined with sevoflurane,the ED50 and ED95 (95 ％ confidence interval) of sufentanil inhibiting responses to tracheal intubation were 0.365 μg/kg (0.317-0.414μg/kg) and 0.513 μg/kg (0.454-0.647 μg/kg),respectively,in pediatric patients.Conclusion The ED50 of sufentanil required for inhibiting responses to tracheal intubation is 0.365 μg/kg and ED95 is 0.513 μg/kg when combined with sevoflurane in pediatric patients.

Objective To evaluate the effect of special rectification of clinical antimicrobial use in a hospital. Methods Medical records of patients receiving inguinal hernia repair before (in 2011)and after (in 2012)the per-formance of special rectification were reviewed,and the rationality of perioperative antimicrobial prophylaxis was compared.Results Prophylactic antimicrobial usage rate in patients receiving inguinal hernia repair decreased from 53.90%(76/114)in 2011 to 5.59%(10/179)in 2012,the difference was significant (χ2 =93.68,P <0.05);aver-age expense of antimicrobial use per patient decreased by 86.95% (from ￥ 624.73 in 2011 to ￥ 81 .52 in 2012);Combination use and single use was 93.42% and 80.00% respectively.Surgical site infection did not occur in both groups.Conclusion Through the special rectification activities of the clinical antimicrobial use,perioperative anti-microbial prophylaxis and expense of antimicrobial agents in patients receiving inguinal hernia repair is effectively re-duced.

Opioid-free anesthesia(OFA)is a multimodal analgesic strategy that combines multiple non-opioid drugs and/or techniques to obtain high-quality anesthesia.With the popularization of the concept of enhanced recovery after surgery(ERAS),OFA has become a common concern hot spot for perioperative phy-sicians.OFA is in line with the ERAS concept,and under multimodal anesthesia and pain management,it can reduce surgical stress,inflammation reaction and postoperative complications,significantly improve the prog-nosis of patients,promote postoperative rapid recovery and reduce the burden of medical and health resources.This article reviews the adverse reactions of opioids,OFA concept and indications,the clinical application of OFA in recent years,the existing controversies and problems to be solved.