Objective To investigate the effects of nalbuphine combined with dexmedetomidine on postop-erative recovery quality and pain in patients who undergoing laparoscopic bariatric surgery.Methods A total of 169 patients who underwent laparoscopic bariatric surgery at our hospital were included and divided into control group(group C),nalbuphine group(group N),dexmedetomidine group(group D),and nalbuphine combined with dexme-detomidine group(group ND)using randomised numerical table method.Group C received intravenous injection of saline,group N and group ND received intravenous injection of nalbuphine before the end of the surgery,and group D and group ND received pumping of dexmedetomidine before anesthesia induction and during surgery.Compare the postoperative recovery quality score(QoR-40),hemodynamics at different time points,visual analogue scale score(VAS),sedation-agitation scale(SAS),first time out of bed activity and exhaust time,and incidence of nausea and vomiting among four groups.Results The postoperative QoR-40 scores of patients in group ND were better than those in group C and group N(P<0.05),and the QoR-40 scores in group D were better than those in group C(P<0.05).MAP and HR were more stable during the awakening period in group ND and group D(P<0.05).Compared with group C,patients in all three groups had lower VAS scores and SAS scores(P<0.05)and consumed less remedial analgesic medication(P<0.05).In terms of adverse reactions,the incidence of postoperative nausea,vomiting and coughing in the group ND was lower than that in the group C(P<0.05).Conclusion The combination of nalbuphine and dexmedetomidine could improve the quality of postoperative recovery and pain in patients under-going laparoscopic bariatric surgery,reduce hemodynamic fluctuations during the patients′ recovery period,reduce the incidence of nausea and vomiting,and improve the patients′ prognosis.

OBJECTIVETo assess the value of magnetic resonance (MR) myocardial perfusion imaging (MRMPI) in evaluating the myocardial viability in patients with myocardial infarction.

METHODSMRMPI was performed in 51 patients with myocardial infarction using a 1.5 T MR scanner. All the patients were examined using IR-turbo FLASH sequence during the first-pass and delayed phase 5-30 min after injection of 0.1 mmol/kg Gd-DTPA at the rate of 4 ml/s. The short axis images were acquired during the first-pass, and both the short axis and long axis images were obtained during the delayed phase. The left ventricular wall on the short-axis slice was divided into 8 segments. A correlative study of the results of the rest and stress (99m)Tc single photon emission computed tomography (SPECT) was carried out in 21 patients.

RESULTSIn the 51 patients with myocardial infarction, 42(82.3%) showed hypoperfusion during the first-pass imaging and 50(98%) had delayed hyperenhancement. In the 21 patients receiving SPECT, 48 nonviable segments was detected among the 168 segments scanned by (99m)TcSPECT, and MRMPI showed delayed hyperenhancement in all the infracted areas. Of the 120 viable segments detected by rest and stress (99m)Tc SPECT, 97 segments (80.8%) were found to be free of delayed hyperenhancement by MRMPI. With the rest and stress (99m)Tc SPECT as the reference, the sensitivity and the specificity of MRMPI were 100.0% and 80.8%, respectively.

CONCLUSIONMRMPI allows effective identification of the myocardial viability and nonviability as well as the severity and extent of the myocardial infraction.

Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Female ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; diagnostic imaging ; physiopathology ; Myocardial Perfusion Imaging ; methods ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon