Objective To investigate the effect of intmopemtive intravenous penehyclidine hydrochloride on pulmonary function in patients undergoning thoracotomy.Methods Sixty ASA Ⅰ or Ⅱ patients aged 30-64 yr scheduled for elective radical esophagectomy for cancer were randomly divided into 2 group(n=30 each):penehyclidinc hydrochloride group and control group.Penehychdine hydrochloride 0.01 mg/kg(in nolmal saline 2 ml)was injected iv 20 min after opening the thoracic cavity in penehyclidine hydrochloride group.The equal vohlme of normal saline was injected iv in control group.Anesthesia was induced with fentanyl 2μg/kg,propofol 0.4μG/ml and rocuronium 0.6 mg/kg.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remlfentanyl 0.1μg·min-1,propofol 2.0-2.5 μg/ml and intermittent iv injecfion of rocuronium.The use of remifentanyl and pmpofol was stopped 5 min before operation.Dynamic lung compliance (Cd) and peak airway pressure were monitored and recorded immediately before penehychdine hydrechlofide administration (T0) and at 3 min(T1),5 min(T2),10 min(T3),30 min(T4),1 h(T5),2 h (T6)after penehyclidine hydrochloride administration.Results There was no significant difference in Cd and peak airway pressure among different time points in control group(P>0.05).Cd was significantly higher,while peak airway pressure lower at T1-6 than at T0 in penehychdine hydrochlofide group(P<0.05).Cd wag significantly higher,while peak airway pressure lower at T1-6 in penehyclidine hydrochloride group than in control group(P<0.05) .Conclusion Intraoperative intravenous penehyclidine hydrochloride can improve the pneumodynamics and is helpful for ventilation in patients undergoing thoracotomy.

Objective To evaluate the feasibility of blind intubation via Cookgas intubating laryngeal airway (CILA) in patients under general anesthesia. Methods Sixty ASA Ⅰ or Ⅱ patients aged 11-65 yrs scheduled for elective plastic surgery under general anesthesia were randomly allocated into 2 groups ( n = 30 each): blind intubation group (B) and fiberoptic bronchoscope group (FOB) . All patients were evaluated before operation to identify patients with difficult airway. Anesthesia was induced with midazolam 0.05 mg?kg-1 , fentanyl 2 ?g?kg-1 , propofol 2 mg?kg-1 and vecuronium 0.1 mg?kg-1 . CILA was inserted in all patients. The patients in group B were blindly intubated via CILA, while in group FOB tracheal intubation was guided with fiberoptic bronchoscope via CILA. The time spent in intubation and the success rate of tracheal intubation were recorded. SBP, DBP, HR and SpO2 were recorded immediately before and after induction of anesthesia, immediately after insertion of CILA, immediately after tracheal intubation and immediately after CILA was withdrawn. Results CILA was inserted successfully in all patients. In group B tracheal intubation was accomplished at first attempt in 26 patients, at 2nd or 3rd attempt in 2 patients and failed in 2 patients. In group FOB tracheal intubation was much easier and accomplished at 1st attempt in 29 patients and at 2nd attempt in 1 patient. Twenty four of 25 patients expected to be difficult intubation were intubated successfully. The two groups were comparable with respect to hemodynamic changes during intubation. Conclusion It is possible to intubate via CILA. The success rate is high with minimal cardiovascular response.

Objective To analyze of the relationship between level of anxiety and depression before surgery and anus exhausting time for patients after gynecological abdominal surgery.Methods A descriptive study was conducted with a survey of 100 cases of patients with gynecological abdominal surgery where the level of anxiety and depression before surgery and post-anus exhausting time were analyzed to explore the correlation between them.Results In the 88 valid questionnaires,the incidences of stress and anxiety before surgery were respectively 38.64％(34/84) and 19.32％(17/88) and the average anus exhausting time after surgery was (44.55 ± 13.90) hours;the anus exhausting time of anxious patients was significantly longer than that of non-anxious patients [(48.35±12.84) hours vs.(42.50±14.13) hours,t=-2.12,P＜0.05] and bivariate Logistic regression analysis suggested that preoperative level of anxiety had a significant effect on anus exhausting time after surgery.Conclusions Stress,anxiety and other negative emotions can affect anus exhausting time after surgery and level of anxiety could be used as one predictor of the delay of anus exhausting time after surgery.

Objective To compare the intubating conditions between dexmedetomidine and remifentanil when combined with sevoflurane-nitrous oxide (N2O) for anesthesia induction in the pediatric patients.Methods A total of 122 pediatric patients,aged 4-10 yr,of American Society of Anesthesiologists physical status Ⅰ,undergoing elective plastic surgery,were randomly divided into dexmedetomidine group (group D,n =61) and remifentanil group (group R,n=61).Eight percent sevoflurane and 60％ N2O were inhaled for induction of anesthesia,and the fresh gas flow was set at 6 L/min.After disappearance of eyelash reflex,dexmedetomidine 1 μg/kg and remifentanil 1 μg/kg were intravenously injected over 50-60 s in D and R groups,respectively,and 1 min later tracheal intubation was performed.The intubating conditions were graded,and the satisfactory intubating conditions and successful intubation were recorded.The development of adverse cardiovascular reactions and complications such as hyoxemia and laryngospasm before and after intubation and postoperative pharyngodynia was recorded.Results Compared with group D,no significant change was found in the success rate of intubation,rate of satisfactory intubation,intubating condition grade or incidence of postoperative pharyngodynia (P＞ 0.05),and the incidence of hypertension and sinus tachycardia after intubation was significantly increased in group R (P＜0.05).No pediatric patients developed hyoxemia,laryngospasn or sinus tachycardia in two groups.Conclusion When 8％ sevoflurane and 60％ N2O are inhaled for anesthesia induction,combing with dexmedetomidine 1 μg/kg produces better clinical efficacy than combing with remifentanil 1 μg/kg in improving the intubating conditions for pediatric patients.

With the development of our economy and the progress of science and technology,the comfort medicine of children in the perioperative period is gradually promoted.Comfort medicine not only eliminates the physical pain of children,but also avoids the permanent psychological trauma caused by oper-ation and anesthesia.The incidence of preoperative anxiety in children is higher than that in adults,which may have adverse effects on perioperative period and prognosis of children.The characteristics of parents of different children,such as parental anxiety level,parental education level,parental socioeconomic back-ground,family composition,ethnicity,language,and other factors will affect the preoperative anxiety level of children.Intervention measures such as parents'participation in guiding children's preparation for anesthe-sia,management of children's fasting and drinking,and presence at the induction of anesthesia can alleviate children's preoperative anxiety level.For children with disabilities,communication between parents and medical staff in the perioperative period and intervention management of children is important.Compared with the traditional preoperative preparation program,the internet-based family preoperative preparation plat-form provides a comprehensive,effective and personalized information guidance for the families of children,ensuring the comfortable perioperative medical treatment of children.