1.Efficacy of remifentanil and propofol combined with local anesthesia for coblation-assisted upper-airway procedures
Dachan ZHOU ; Yunlong ZHANG ; Tiening HOU
Chinese Journal of Anesthesiology 2008;28(8):695-697
Objective To evaluate the efficacy and safety of remifentanil and propefol combined with local anesthesia for cobiation-assisted upper-airway procedure (CAUP). Methods Eighty ASAⅠorⅡpatients aged 25-60 yr body mass index ≤ 35 kg/m2 with sleep apnea hypopnea syndrome scheduled for CAUP were randomly divided into 4 groups (n=20 each): normal saline group (S), propefol group (P), remifentanil group (R) and propoful + remifentanil group (PR). After topical anesthesia with 1% decicaine, the patients in group S, P, R or PR received iv infusion of normal saline 0.15 ml·kg-1·h-1 , propofol 25 μg·kg-1·min-1 , remifentanil 0.05 μg·kg-1·min-1, or propefol + remifentanil at the same rate respectively. Ten minutes later local infiltration anesthesia was performed in operative field with lidocaine containing epinephrine 1:200 000. Ramsay sedation score and verbal rating scale (VRS) were assessed every 5 min. VRS Ⅲwas defined as anesthesia failure in group S. It was also defined as anesthesia failure that Ramsay sedation score > 3 or occurrence of respiratory depression during increment of propofol or remifentanil in patients with VRS Ⅲ in the other 3 groups. BP and HR were recorded before coblation and 5 rain after coblation. Airway obstruction and apnea were also observed. Results Anesthesia achievement ratio was significantly higher in group R and PR (90% and 100% respectively) than in group S and P (40% and 65% respectively) (P<0.05). SP, DP and HR were significantly lower 5 rain after coblation in group R and PR than in group S (P < 0.05). There was no significant difference in incidence of adverse effects between the 4 groups(P>0.05). Conclusion Remifentanil or propofol-remifentanil combined with local anesthesia is safe and effective for CAUP.
2.Application of coblation assisted upper-airway procedure to obstructive sleep apnea-hypopnea syndrome.
Weihong XIN ; Tiening HOU ; Degui SHU ; Zhanquan YANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2007;21(3):107-109
OBJECTIVE:
To investigate the efficacy and the value of CAUP in treatment of OSAHS.
METHOD:
CAUP and the dissection of palatopharyngeus muscle were performed by RFVTR . One hundred and sixty-eight patients with OSAHS treated by CAUP from July 2001 to July 2004 were summarized. Among them, 52 patients were analyzed by PSG after 1 year of the operation.
RESULT:
All the operative procedure were carried out smoothly with excellent patient tolerance. Post-operation complications were foreign body feeling in oral cavity. No velopalatal insufficiency occurred. The efficient rate was 94.2% after 1 year of the operation according to the PSG results.
CONCLUSION
CAUP is a simple, safe,repeatable and acceptable surgical procedure and it was developing with excellent value in the treatment of OSAHS on the basic of accurate X-ray imaging.
Adult
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Aged
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Catheter Ablation
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methods
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Female
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Humans
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Male
;
Middle Aged
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Palate, Soft
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surgery
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Palatine Tonsil
;
surgery
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Sleep Apnea, Obstructive
;
surgery
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Tongue
;
surgery
;
Turbinates
;
surgery
;
Uvula
;
surgery
;
Young Adult