Objective lo explore the analgesic effect of low-dose ketamine combined with remifentanil after laparoscopic cholecystectomy(LC).Methods This study was a prospective study.A total of 114 patients who underwent LC in hospital from June 2022 to June 2023 were selected and randomly divided into two groups by computer-generated random number table method:low-dose group and conventional-dose group,with 57 cases in each group,they were treated with esketamine 0.5 and 1 mg/kg combined with remifentanil for patient controlled intravenous analgesia(PCIA),respectively.The PCIA press times,the pain after surgery,adverse reactions were compared between the two groups.Results The comparison of PCIA press times,the visual analogue scale(VAS)pain scores at 2,8,12,24,and 48 hours after surgery between the low-dose group and the conventional-dose group[(3.16±0.63)times vs(3.14±0.65)times,(2.65±0.67)vs(2.63±0.69),(3.01±0.56)vs(3.05±0.70),(3.58±0.67)vs(3.60±0.69),(2.93±0.37)vs(2.95±0.30),(2.04±0.52)vs(2.06±0.59)]showed no statistically significant difference(P＞0.05).The incidence of hallucinations and increased heart rate in the low-dose group was lower than that in the conventional-dose group(0 vs 10.53％,1.75％vs 14.04％)(P＜0.05).Conclusion The analgesic effect of small dose esketamine combined with remifentanil after LC are comparable to those of conventional dose,but the former is safer.

Objective lo explore the analgesic effect of low-dose ketamine combined with remifentanil after laparoscopic cholecystectomy(LC).Methods This study was a prospective study.A total of 114 patients who underwent LC in hospital from June 2022 to June 2023 were selected and randomly divided into two groups by computer-generated random number table method:low-dose group and conventional-dose group,with 57 cases in each group,they were treated with esketamine 0.5 and 1 mg/kg combined with remifentanil for patient controlled intravenous analgesia(PCIA),respectively.The PCIA press times,the pain after surgery,adverse reactions were compared between the two groups.Results The comparison of PCIA press times,the visual analogue scale(VAS)pain scores at 2,8,12,24,and 48 hours after surgery between the low-dose group and the conventional-dose group[(3.16±0.63)times vs(3.14±0.65)times,(2.65±0.67)vs(2.63±0.69),(3.01±0.56)vs(3.05±0.70),(3.58±0.67)vs(3.60±0.69),(2.93±0.37)vs(2.95±0.30),(2.04±0.52)vs(2.06±0.59)]showed no statistically significant difference(P＞0.05).The incidence of hallucinations and increased heart rate in the low-dose group was lower than that in the conventional-dose group(0 vs 10.53％,1.75％vs 14.04％)(P＜0.05).Conclusion The analgesic effect of small dose esketamine combined with remifentanil after LC are comparable to those of conventional dose,but the former is safer.

Objective To investigate the effect of acute super volume blood dilution on cardiac output and blood coagulation function in senile patients.Methods Sixty patients with large joint operation were randomly divided into experimental group and control group,30 cases in each group.The experimental group was given 6％ hydroxyethyl starch and lactated Ringer's solution 15 mL/kg for AHH,while the control group was given routine infusion.Cardiac output and blood coagulation were compared between two groups.Results In the experimental group,cardiac output (CO) increased and blood coagulation function decreased after AHH (P ＞ 0.05).There were no significant differences in hematocrit (HCT),prothrombin time (PT),activated partial prothrombin time (APTT) and plasma fibrinogen (Fib) ateach time point between two groups (P ＞ 0.05).Conclusion Acute super volume blood dilution has small influence on cardiac output andblood coagulation function in senile patients.

Objective To investigate the effect of acute super volume blood dilution on cardiac output and blood coagulation function in senile patients.Methods Sixty patients with large joint operation were randomly divided into experimental group and control group,30 cases in each group.The experimental group was given 6％ hydroxyethyl starch and lactated Ringer's solution 15 mL/kg for AHH,while the control group was given routine infusion.Cardiac output and blood coagulation were compared between two groups.Results In the experimental group,cardiac output (CO) increased and blood coagulation function decreased after AHH (P ＞ 0.05).There were no significant differences in hematocrit (HCT),prothrombin time (PT),activated partial prothrombin time (APTT) and plasma fibrinogen (Fib) ateach time point between two groups (P ＞ 0.05).Conclusion Acute super volume blood dilution has small influence on cardiac output andblood coagulation function in senile patients.