BACKGROUND Gastroscopy and colonoscopy are important and common endoscopic methods for the diagnosis and treatment of gastrointestinal and colorectal diseases.However,endoscopy is usually associated with adverse react...BACKGROUND Gastroscopy and colonoscopy are important and common endoscopic methods for the diagnosis and treatment of gastrointestinal and colorectal diseases.However,endoscopy is usually associated with adverse reactions such as nervousness,nausea,vomiting,choking cough,and pain.Severe discomfort,such as vomiting,coughing,or body movement,may lead to aggravation of a preexisting condition or even interruption of examination or treatment,especially in some critically ill patients with physiological dysfunction(e.g.,cardiovascular or respiratory disease).The optimal methods for inducing analgesia and sedation in endoscopy are areas of ongoing debate;nevertheless,determining an appropriate regimen of sedation and analgesia is important.AIM To evaluate the effects of propofol combined with dezocine,sufentanil,or fentanyl in painless gastroscopy and colonoscopy.METHODS Four hundred patients were randomly assigned to one of four groups for anesthesia:intravenous dezocine,sufentanil,fentanyl,or saline.Propofol was administered intravenously for induction and maintenance of anesthesia.RESULTS The dosage of propofol in the dezocine group was significantly lower than those in other groups(P<0.01).Bispectral index and Steward score(0-6 points,an unresponsive,immobile patient whose airway requires maintenance to a fully recovered patient)after eye opening in the dezocine group were significantly higher than those in other groups(P<0.01).Awakening time and postoperative pain score(0-10 points,no pain to unbearable pain)in the dezocine group were significantly lower than those in other groups(P<0.01).Mean arterial pressure and pulse oxygen saturation in the dezocine group were significantly more stable at various time points(before dosing,disappearance of eyelash reflex,and wakeup)than those in other groups(P<0.01).The rates of hypopnea,jaw thrust,body movements,and usage of vasoactive drugs in the dezocine group were significantly lower than those in other groups(P<0.01).Additionally,the rates of reflex coughing,nausea,and vomiting were not statistically different between the four groups(P>0.05).CONCLUSION The combination of propofol and dezocine can decrease propofol dosage,reduce the risk for the development of inhibitory effects on the respiratory and cardiovascular systems,increase analgesic effect,decrease body movement,shorten awakening time,and improve awakening quality.展开更多
INTRODUCTION Sepsis is defined as an infection associated with systemic manifestations of inflammation, which has become the most common complication in the perioperative period caused by severe burn/trauma and major ...INTRODUCTION Sepsis is defined as an infection associated with systemic manifestations of inflammation, which has become the most common complication in the perioperative period caused by severe burn/trauma and major surgical operation.[1,2] The incidence of sepsis in adults is estimated to be 149–240/100 000 per year, and that of severe sepsis and septic shock is 56–91/100 000 per year. In the last decade, the short-term mortality of sepsis has declined to around 20% in developed countries partly due to the international Surviving Sepsis Campaign （SSC）, while the mortality remains very high （50%–80%） in 1–5 years after discharge from hospitals.[3–7] Thus, sepsis and its subsequent severe sepsis and septic shock are currently major issues in the field of medical and health care.展开更多
文摘BACKGROUND Gastroscopy and colonoscopy are important and common endoscopic methods for the diagnosis and treatment of gastrointestinal and colorectal diseases.However,endoscopy is usually associated with adverse reactions such as nervousness,nausea,vomiting,choking cough,and pain.Severe discomfort,such as vomiting,coughing,or body movement,may lead to aggravation of a preexisting condition or even interruption of examination or treatment,especially in some critically ill patients with physiological dysfunction(e.g.,cardiovascular or respiratory disease).The optimal methods for inducing analgesia and sedation in endoscopy are areas of ongoing debate;nevertheless,determining an appropriate regimen of sedation and analgesia is important.AIM To evaluate the effects of propofol combined with dezocine,sufentanil,or fentanyl in painless gastroscopy and colonoscopy.METHODS Four hundred patients were randomly assigned to one of four groups for anesthesia:intravenous dezocine,sufentanil,fentanyl,or saline.Propofol was administered intravenously for induction and maintenance of anesthesia.RESULTS The dosage of propofol in the dezocine group was significantly lower than those in other groups(P<0.01).Bispectral index and Steward score(0-6 points,an unresponsive,immobile patient whose airway requires maintenance to a fully recovered patient)after eye opening in the dezocine group were significantly higher than those in other groups(P<0.01).Awakening time and postoperative pain score(0-10 points,no pain to unbearable pain)in the dezocine group were significantly lower than those in other groups(P<0.01).Mean arterial pressure and pulse oxygen saturation in the dezocine group were significantly more stable at various time points(before dosing,disappearance of eyelash reflex,and wakeup)than those in other groups(P<0.01).The rates of hypopnea,jaw thrust,body movements,and usage of vasoactive drugs in the dezocine group were significantly lower than those in other groups(P<0.01).Additionally,the rates of reflex coughing,nausea,and vomiting were not statistically different between the four groups(P>0.05).CONCLUSION The combination of propofol and dezocine can decrease propofol dosage,reduce the risk for the development of inhibitory effects on the respiratory and cardiovascular systems,increase analgesic effect,decrease body movement,shorten awakening time,and improve awakening quality.
文摘INTRODUCTION Sepsis is defined as an infection associated with systemic manifestations of inflammation, which has become the most common complication in the perioperative period caused by severe burn/trauma and major surgical operation.[1,2] The incidence of sepsis in adults is estimated to be 149–240/100 000 per year, and that of severe sepsis and septic shock is 56–91/100 000 per year. In the last decade, the short-term mortality of sepsis has declined to around 20% in developed countries partly due to the international Surviving Sepsis Campaign （SSC）, while the mortality remains very high （50%–80%） in 1–5 years after discharge from hospitals.[3–7] Thus, sepsis and its subsequent severe sepsis and septic shock are currently major issues in the field of medical and health care.
