Objective To investigate the effects,safety,controlling of controlled hypotension induced by remifentanil during endoscopic sinus surgery.Methods Forty patients with ASA grade Ⅰ～Ⅱ undergoing selective endoscopic sinus surgery,were randomly assigned into remifentanil group(A group)and nitroglycerin group(B group).After routine inducing,controlled hypotension was induced before the main procedure of surgery.A group was given remifentanil(1μg/kg)by intravenous injection,then remifentanil(0.3～0.8μg·kg~(-1)·min~(-1))was used in group A to keep mean arterial pressure between(MAP)60 and 80 mm Hg.B group was given fentanyl(0.03～0.08 μg·kg~(-1)·min~(-1))and nitroglycerin(2～5 μg·kg~(-1)·min~(-1))to keep mean arterial pressure(MAP)between 60 to 80 mm Hg till the main procedure of surgery was finished.Observing MAP and HR change before controlled hypotension,during controlled hypoteusion and after stopping controlled hypotension.Observing the time of opening-eyes,remove-tracheal tube and surgical field quality.Results The two groups were comparable with regard to the surgical field rating(P＞0.05).MAP in two groups during controlled hypotension were lower than those before controlled hypotension(P＜0.05),in A group,MAP were comparable with those in B group during controlled hypotension(P＞0.05).In B group there was rellexible tachycardia during controlled hypotension.HR in A group during controlled hypotension was lower than those before controlled hypotension(P＜0.05).HR during controlled hypotension in A group was lower than those in B group(P＜0.01).The time of opening-eyes,remove-tracheal tube in A group was less than those in B group(P＜0.01).ConclusionRemifentanil cound induce and sustain controlled hypoteusion.It was safe and feasible.It was better than nitroglycerin group for controlled hypotension in endoscopic sinus surgery.

ObjectiveTo study the anesthesia effect,safety and reliability of etomidate combined with remifentanil in elderly patients. Methods40 patients scheduled for abdominal operation were divided into two groups with 20 cases each: etomidate group(group A)and propofol group(group B).Anesthesia induction: midazolam 0.04mg/kg,remifentanil 1.5 μg/kg(time＞60s),atracurium 0.6mg/kg,group A to etomidate 0.2mg/kg(30 ～ 60s),(T1),1 min before trachea intubation(T2),1 min after trachea intubation(T3),5 min after cutting skin(T4),5 min after exploration(T5),5min after cutting ill focus(T6),3min after tracheal extubation(T7),30min after operation(T8).At the same time,observed analepsia condition. ResultsIn group B,SBP and DBP were lower than those in group A at T2,T3,T4 and T5(all P＜0.05).In group B,DBP was lower than those in group A at T6 and HR was lower than those in group A at T3 and T7(all P＜0.05).In group B,SBP and DBP were lower than before anesthesia at T2,T3,T4 and T5(all P＜0.05).In group B,DBP was lower than before anesthesia at T6 and HR was lower than before anesthesia at T2(all P＜0.05).In group A,HR was faster than before anesthesia at T7(P＜0.05).The time of openingeyes,remove-tracheal tube in B group was less than those in A group(all P＜0.05).Both groups without memory about operation,anesthesia was content. ConclusionEtomidate combined with remifentanil anesthesia was milder than propofol group to elderly patients ardiovascular effects.It was better than propofol group for elderly patients.

Objective To study the safety and efficacy of laryngeal mask airway(LMA) used in breast cancer general anesthesia. Methods Forty ASA Ⅰ or Ⅱ patients with breast cancer scheduled for selective radical mastectomy under general anesthesia were allocated randomly to either laryngeal mask airway group(group A,n =20) or tracheal tube group(group B, n = 20). SBP, DBP, HR, SpO2 of patients before anesthesia(To)/after intubation immediately (T1) and 5 minutes(T2) after intubation tracheal tube or laryngeal mask intubation/after extubation immediately (T3) and 5 minutes(T4) of after extubation tracheal tube or laryngeal mask were recorded. The different incidence of anesthetic complications and side effect were observed in both groups because intubation and extubation. Results In group B, SBP, DBP and HR were significantly higher than those in group A at T1 and T3 (P ＜ 0.05). Agitation, bucking and pharyngodynia incidence rate in group B were significantly higher than group A(P ＜ 0.05). Conclusion Ventilation with LMA in patients underwent breast cancer radical correction was better than endotracheal intubation general anesthesia in keeping stable hemodynamics and producing less anesthetic complications.