Propofol/therapeutic use* ; Depression/drug therapy*

Endarterectomy, Carotid ; methods ; Female ; Humans ; Male ; Methyl Ethers ; therapeutic use ; Myocardium ; metabolism ; Propofol ; therapeutic use

BACKGROUNDSedation for the coblation-assisted upper airway procedure has lacked easy modulation between appropriate pain control and airway protection. This study aimed to compare the effectiveness of dexmedetomidine versus target controlled propofol infusion in providing sedation during a coblation-assisted upper airway procedure.

METHODSIn a prospective, randomized trial, 60 adult patients with obstructive sleep apnea syndrome due to undergoing a coblation-assisted upper airway procedure were enrolled and randomly allocated to receive dexmedetomidine, 1.0 µg/kg over 10 minutes and maintain dosage 0.7 µg×kg(-1)×h(-1) (n=30) or propofol target controlled infusion (n=30). Satisfaction with the analgesia and tolerance of the procedure by the patient, as assessed by a visual analogue scale, were evaluated as primary outcomes. Cardiopulmonary parameters and some side effects were monitored and recorded.

RESULTSBoth groups of 30 patients had comparable demographics and initial parameters. Patients in the propofol group reported more pain (P<0.05), tolerated the procedure less well (P<0.05), and were less satisfied with the different stages of procedure (P<0.05 or P<0.01). Changes in mean arterial pressure and heart rate were more dramatic in the propofol group (P<0.05). The dexmedetomidine group experienced fewer airway events and less respiratory depression than did the propofol group.

CONCLUSIONDexmedetomidine in conjunction with local anesthesia offered better analgesia and conscious sedation for a coblation-assisted upper airway procedure as well as less airway obstruction, apnea and greater haemodynamic stability.

Adult ; Conscious Sedation ; methods ; Dexmedetomidine ; therapeutic use ; Female ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Male ; Middle Aged ; Propofol ; therapeutic use

OBJECTIVE: To explore the application of the Dexmedetomidine utend drug induced sleep endoscopy. METHOD: Forty-four OSAHS patients diagnosed by PSG randomly were divided into group A (Dexmedetomidine group) and group B (Propofol group), each group of 22 cases. Group A: pump the Dexmedetomidine (1 microg/kg) over 15 minutes. Once the patient reached a satisfactory level of sedation, the electronic nasopharyngoscope was introduced into the nasal cavity group B: the propofol (2 mg/kg) was intravenous injected, use the same exmination after the object patients falling asleep. If not, double the injection dose of the two group. Observe and record the patient vital signs, EEG and sleep time, and handle the complications. RESULT: The study was successfully completed both in group A and B. Mean arterial pressure (MAP) in group B was lower than group A during the examination significantly (P < 0.05). The time falling to sleep in two groups were (13.4 +/- 2.5) min and (6.6 +/- 1.2) min, and the time in group A was much longer than that in group B. The lowest oxygen saturation during the examination in two groups were 0.835 +/- 0.096 and 0.691 +/- 0.095, and the difference was statistically significant. There was no incidence of adverse reactions in two groups. CONCLUSION Compared with propofol, Dexmedetomidine is a safer sleep-inducing drug, and it can be used for clinical sleep endoscopy.
Adult ; Dexmedetomidine ; therapeutic use ; Endoscopy ; Feasibility Studies ; Female ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Male ; Middle Aged ; Propofol ; therapeutic use ; Sleep

BACKGROUNDIn recent years, increasing numbers of patients are accepting neoadjuvant chemotherapy before their operation in order to get a better prognosis. But chemotherapy has many side-effects. We have observed that patients who accepted neoadjuvant chemotherapy are more sensitive to anesthetics. The aim of this study was to determine the median effective dose (EC(50)) of intravenous anesthetics for neoadjuvant chemotherapy patients to lose consciousness during target-controlled infusion.

METHODSTwo hundred and forty breast cancer patients undergoing elective operations were assigned to six groups according to treatment received before their operation and the use of intravenous anesthetics during anesthesia; non-adjuvant chemotherapy + propofol group (group NP, n = 40), Taxol + propofol group (group TP, n = 40), adriamycin + cyclophosphamide + 5-Fu + propofol group (group CP, n = 40), non-adjuvant chemotherapy + etomidate group (group NE, n = 40), taxol + etomidate group (group TE, n = 40), adriamycin + cyclophosphamide + 5-Fu + etomidate group (group CE, n = 40). We set the beginning effect-site concentration (Ce) of propofol as 3.0 µg/ml and etomidate as 0.2 µg/ml. The concentration was increased by steps until the patient was asleep, (OAAS class I-II), then gave fentanyl 3 µg/kg and rocuronium 0.6 mg/kg and intubated three minutes later. The patients' age, height, and weight were recorded. BIS was recorded before induction, at the initial effect-site concentration and at loss of consciousness. The effect-site concentration was recorded when patient lost consciousness.

RESULTSThere were no significant differences between groups in general conditions before treatment; such as BIS of consciousness, age, sex and body mass index. The EC(50) of propofol in the NP, TP and CP groups was 4.11 µg/ml (95%CI: 3.96 - 4.26), 2.94 µg/ml (95%CI: 3.36 - 3.47) and 2.91 µg/ml (95%CI: 3.35 - 3.86), respectively. The EC50 of etomidate in the NE, TE and CE groups was 0.61 µg/ml (95%CI: 0.55 - 0.67), 0.38 µg/ml (95%CI: 0.33 - 0.44), and 0.35 µg/ml (95%CI: 0.34 - 0.36), respectively. There was no significant difference of BIS level before induction or in BIS50 level in any group when patients lost consciousness.

CONCLUSIONSThe EC(50) of intravenous anesthetics to cause loss of consciousness in neoadjuvant chemotherapy groups is lower than in the control group. There was no significant difference of BIS level at which patients lost consciousness.

Adult ; Anesthetics, Intravenous ; therapeutic use ; Breast Neoplasms ; drug therapy ; surgery ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Etomidate ; therapeutic use ; Female ; Fluorouracil ; therapeutic use ; Humans ; Middle Aged ; Neoadjuvant Therapy ; adverse effects ; Paclitaxel ; therapeutic use ; Propofol ; therapeutic use ; Unconsciousness ; chemically induced

Acute Lung Injury ; chemically induced ; drug therapy ; Animals ; Endotoxins ; Glycoproteins ; therapeutic use ; Male ; Propofol ; therapeutic use ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo assess the effects of dexmedetomidine (Dex) on propofol dosage in target-controlled infusion (TCI) and hemodynamics in patients undergoing laparoscopic surgery under general anesthesia.

METHODSSixty patients undergoing laparoscopic surgery under general anesthesia were randomly divided into control group (n=30) and the Dex group (n=30). The patients in Dex group received a loading dose of Dex (1 µg/kg, infused within 10 min) before the surgery followed by continuous infusion at the rate of 0.3 µg·kg(-1)·h(-1) till the end of the surgery, and the control patients received saline infusion in the same manner. Heart rate, blood pressure, bispectral index (BIS), and propofol dose in TCI were recorded during induction and maintenance of anesthesia. The incidence of hypotension and bradycardia were observed during and after the surgery.

RESULTSNo difference was found in the incidence of hypotension and bradycardia between the control group and Dex group (P>0.05), but heart rate and blood pressure were lower in Dex group during extubation (P<0.05). The dose of propofol in TCI was significantly less in Dex group than in the control group (P<0.05).

CONCLUSIONDex can reduce hemodynamic abnormalities caused by extubation and decrease the dosage of propofol in TCI, and may serve as an ideal adjuvant drug for general anesthesia.

Anesthesia, General ; Blood Pressure ; Bradycardia ; Dexmedetomidine ; therapeutic use ; Heart Rate ; Hemodynamics ; Humans ; Hypotension ; Laparoscopy ; Propofol ; administration & dosage ; therapeutic use

BACKGROUNDPerioperative disorder of magnesium, an important cation in the human body, may affect clinical anesthesia. The pharmacological data of propofol use, which is popularly used in the anesthesiology department and intensive care unit, is incomplete in Chinese patients. This study aimed to assess the effect of magnesium sulfate on the calculated plasma medial effective concentration (Cp50cal) of propofol at loss of response to command in Chinese females.

METHODSFifty patients undergoing gynecological laparoscopic surgery were randomly divided into the control group and the magnesium group. Before induction, magnesium sulfate (30 mg/kg) or placebo (equal volume of 0.9% saline) was given to patients in the magnesium group or the control group, respectively. Propofol was infused using a target-controlled infusion system, with a target concentration for each patient decided by up-and-down sequential allocation. After the equilibration between target plasma concentration and effective-site concentration, the state of consciousness was assessed. For determination of serum magnesium and calcium concentration, blood samples were taken before induction, after induction and at the end of surgery.

RESULTSThe Cp50cal was 2.52 µg/ml (2.47 - 2.57 µg/ml) for patients in the control group, and 2.46 µg/ml (2.41 - 2.51 µg/ml) for those in the magnesium group. A significant reduction of Cp50cal was observed (P = 0.021). There was a significant difference between the serum magnesium concentrations after induction and at the end of the surgery (P < 0.05). In the magnesium group, there was a trend toward decreasing after surgery, while in the control group, Cp50cal decreased significantly (P < 0.01).

CONCLUSIONSCp50cal of propofol at loss of response to command was 2.52 µg/ml (2.47 - 2.57 µg/ml) for Chinese female adults in this study. Infusion of 30 mg/kg magnesium sulfate may reduce the Cp50cal of propofol at loss of consciousness, which implies that magnesium may enhance the pharmacological effects of propofol.

Adolescent ; Adult ; Anesthetics ; therapeutic use ; Female ; Humans ; Magnesium Sulfate ; therapeutic use ; Middle Aged ; Propofol ; blood ; pharmacokinetics ; therapeutic use ; Unconsciousness ; chemically induced ; Young Adult

OBJECTIVETo evaluate the feasibility and safety of patient controlled analgesia (PCA) technology during double balloon endoscopy(DBE) inspection.

METHODSAccording to the anesthesia, 120 patients with suspected intestinal disease were randomized into non-anaesthesia(Group A), propofol infusion with TCI vein pump(Group B), and remifentanil vein infusion with PCA pump(Group C), with 40 patients in each group. The feasibility and safety of the three methods in double balloon endoscopy(DBE) inspection were evaluated.

RESULTSThe tolerance in groups B and C was good and the procedure success rate was 100%, significantly higher than Group A(80%, 12/40, P<0.01). The fluctuation of blood pressure, heart rate, and oxygen saturation was significantly greater in groups A and B, while patients in Group C remained stable. The detection rate was 67.5%(27/40) in Group B and 72.5%(29/40) in Group C, significantly higher than that in Group A(37.5%, 15/40, all P<0.01). The depth of endoscope was longer and the length of hospital stay shorter in Group C as compared to Group B(both P<0.05).

CONCLUSIONThe application of PCA technology in the double-balloon endoscopy inspection can meet the individualized analgesic needs of patients in different period, increase the tolerance and compliance of patients to the inspection, facilitate patient-operator communication and positions change, reduce the operation risk, and increase the success rate of double balloon endoscopy.

Adolescent ; Adult ; Aged ; Analgesia, Patient-Controlled ; Analgesics ; therapeutic use ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Piperidines ; therapeutic use ; Propofol ; therapeutic use ; Prospective Studies ; Young Adult

Female ; Humans ; Middle Aged ; Propofol ; therapeutic use ; Pulmonary Embolism ; complications ; Ventricular Fibrillation ; drug therapy ; etiology