Objective: To study the influence of different anesthesia depths on the cerebral oxygen metabolism and stress response during general anesthesia surgery as well as the postoperative cognitive function in elderly patie...Objective: To study the influence of different anesthesia depths on the cerebral oxygen metabolism and stress response during general anesthesia surgery as well as the postoperative cognitive function in elderly patients. Method: Prospective study was designed, and the elderly patients undergone general anesthesia surgery in our hospital between March 2015 and March 2017 were selected and randomly divided into the three groups: group A with Narcotrend index 25-35;the group B with Narcotrend index 35-45;the group C with Narcotrend index 45-55. Before induction (T0), during surgery (T1), at extubation (T2) and 30 min after extubation (T3), cerebral oxygen metabolism indexes arterio-venous oxygen content difference (Da-jvO2) and cerebral oxygen extraction rate as well as stress indexes norepinephrine, epinephrine, cortisol and growth hormone were measured;1, 3, 5 and 7 d after surgery, mini-mental state examination was adopted to evaluate cognitive function, and the serum neuron-specific enolase, S100B and β amyloid 1-42 were measured. Results: At T1, T2 and T3, Da-jvO2 levels of group A and group B were obviously higher than those of group C whereas cerebral oxygen extraction rate levels as well as serum norepinephrine, norepinephrine, cortisol and growth hormone contents were lower than those of group C;1, 3, 5 and 7 d after surgery, mini-mental state examination scores of group B and group C were significantly higher than those of group A, while serum neuron-specific enolase, S100B and β amyloid 1-42 contents of group B and group C were significantly lower than those of group A. Conclusion: The anesthesia depth with Narcotrend index 35-45 can control cerebral oxygen metabolism, reduce stress response and improve postoperative cognitive function.展开更多
Objective: To study the effect of ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia on the pain and stress response after hip replacement. Methods: A total of 74 cases of elderly ...Objective: To study the effect of ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia on the pain and stress response after hip replacement. Methods: A total of 74 cases of elderly patients who received hip replacement in Mianyang Central Hospital between December 2015 and June 2017 were selected and randomly divided into multimodal analgesia group (MMA group), and patient-controlled intravenous analgesia group (PCIA group), MMA received ropivacaine fascia iliaca compartment block, dezocine preemptive analgesia combined with patient-controlled intravenous analgesia, and PCAI group received patient-controlled intravenous analgesia. The levels of pain-related molecules and stress-related hormones in serum as well as the levels of stress-related immune molecules in peripheral blood were detected immediately after surgery and 12 h after surgery. Results: 12 h after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of both groups of patients were significantly higher than those immediately after surgery, peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly lower than those immediately after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of MMA group 12 h after surgery were significantly lower than those of PCIA group, and peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly higher than those of PCIA group. Conclusion: Ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia can reduce the pain and stress response after hip replacement.展开更多
Objective:To study the effect of parecoxib sodium intervention before induction on incision pain and inflammatory stress response after orthopedic surgery.Methods: Patients who underwent orthopedic surgery under lumba...Objective:To study the effect of parecoxib sodium intervention before induction on incision pain and inflammatory stress response after orthopedic surgery.Methods: Patients who underwent orthopedic surgery under lumbar anesthesia combined with epidural block anesthesia in Mianyang Central Hospital between March 2015 and June 2017 were selected and divided into two groups by random number table method, Par group received parecoxib sodium intervention before induction combined with routine postoperative patient-controlled intravenous analgesia, and control group only accepted routine postoperative patient-controlled intravenous analgesia. The pain neurotransmitters, inflammatory molecules and stress molecules in serum and peripheral blood were measured before surgery as well as 1 day and 3 days after surgery.Results: Compared with pain neurotransmitters of same group before surgery, serum PGE2, 5-HT, SP, NPY levels of both groups were significantly lower whereas serum COR and GH levels and peripheral blood JAK2, STAT3, IL-1, IL-6, IFIT1, Nrf2 and HO-1 mRNA expression were significantly higher 1 day and 3 days after surgery, and serum PGE2, 5-HT, SP, NPY, COR and GH levels as well as peripheral blood JAK2, STAT3, IL-1, IL-6, IFIT1, Nrf2 and HO-1 mRNA expression of Par group 1 day and 3 days after surgery were lower than those of control group.Conclusions: Parecoxib sodium intervention before induction can reduce the incision pain and inflammatory stress response after orthopedic surgery.展开更多
Objective:To investigate the effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation.Methods: A total of 218 patients receiving tracheal intubation general ane...Objective:To investigate the effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation.Methods: A total of 218 patients receiving tracheal intubation general anesthesia in the hospital between January 2017 and December 2017 were divided into the control group (n=109) and the dexmedetomidine group (n=109) by random number table method. Control group underwent routine propofol anesthesia induction and dexmedetomidine group underwent dexmedetomidine anesthesia induction on the basis of propofol. The differences in the severity of inflammatory response and stress response were compared between the two groups of patients after general anesthesia induction (T0), 1 min after endotracheal intubation (T1), 5 min after endotracheal intubation (T2) and 10 min after endotracheal intubation (T3).Results:At T0, there was no statistically significant difference in serum levels of inflammatory factors and stress hormones between the two groups. At T1, T2 and T3, serum inflammatory factors CRP, IL-1, IL-6, IL-8 and TNF-α levels of dexmedetomidine group were lower than those of control group;serum stress hormones ACTH, Cor, NE, AngⅠ and AngⅡ levels were lower than those of control group. Conclusion: Dexmedetomidine + propofol general anesthesia induction can effectively reduce the inflammatory stress response caused by endotracheal intubation.展开更多
Objective: To study the effect of nalbuphine preemptive analgesia combined with ropivacaine local infiltration on postoperative incision pain, stress response and immune function in children. Methods: Children who rec...Objective: To study the effect of nalbuphine preemptive analgesia combined with ropivacaine local infiltration on postoperative incision pain, stress response and immune function in children. Methods: Children who received selective laparotomy in Mianyang Central Hospital between August 2015 and August 2017 were selected and randomly divided into control group, nalbuphine group (N group), ropivacaine group (R group) and nalbuphine + ropivacaine group (N+R group). The levels of pain and stress-related mediators in serum and the levels of immune cells in peripheral blood were detected before operation and 24 h after operation. Results: 24 h after operation, serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of four groups of children were significantly higher than those before operation while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly lower than those before operation;serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of N group, R group and N+R group were significantly lower than those of control group while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly higher than those of control group;serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of N+R group were significantly lower than those of N group and R group while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly higher than those of N group and R group. Conclusion: Nalbuphine preemptive analgesia combined with ropivacaine local infiltration can reduce the postoperative incision pain and stress response and improve the immune function in children.展开更多
文摘Objective: To study the influence of different anesthesia depths on the cerebral oxygen metabolism and stress response during general anesthesia surgery as well as the postoperative cognitive function in elderly patients. Method: Prospective study was designed, and the elderly patients undergone general anesthesia surgery in our hospital between March 2015 and March 2017 were selected and randomly divided into the three groups: group A with Narcotrend index 25-35;the group B with Narcotrend index 35-45;the group C with Narcotrend index 45-55. Before induction (T0), during surgery (T1), at extubation (T2) and 30 min after extubation (T3), cerebral oxygen metabolism indexes arterio-venous oxygen content difference (Da-jvO2) and cerebral oxygen extraction rate as well as stress indexes norepinephrine, epinephrine, cortisol and growth hormone were measured;1, 3, 5 and 7 d after surgery, mini-mental state examination was adopted to evaluate cognitive function, and the serum neuron-specific enolase, S100B and β amyloid 1-42 were measured. Results: At T1, T2 and T3, Da-jvO2 levels of group A and group B were obviously higher than those of group C whereas cerebral oxygen extraction rate levels as well as serum norepinephrine, norepinephrine, cortisol and growth hormone contents were lower than those of group C;1, 3, 5 and 7 d after surgery, mini-mental state examination scores of group B and group C were significantly higher than those of group A, while serum neuron-specific enolase, S100B and β amyloid 1-42 contents of group B and group C were significantly lower than those of group A. Conclusion: The anesthesia depth with Narcotrend index 35-45 can control cerebral oxygen metabolism, reduce stress response and improve postoperative cognitive function.
文摘Objective: To study the effect of ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia on the pain and stress response after hip replacement. Methods: A total of 74 cases of elderly patients who received hip replacement in Mianyang Central Hospital between December 2015 and June 2017 were selected and randomly divided into multimodal analgesia group (MMA group), and patient-controlled intravenous analgesia group (PCIA group), MMA received ropivacaine fascia iliaca compartment block, dezocine preemptive analgesia combined with patient-controlled intravenous analgesia, and PCAI group received patient-controlled intravenous analgesia. The levels of pain-related molecules and stress-related hormones in serum as well as the levels of stress-related immune molecules in peripheral blood were detected immediately after surgery and 12 h after surgery. Results: 12 h after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of both groups of patients were significantly higher than those immediately after surgery, peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly lower than those immediately after surgery, serum SP, PGE2, TNF-α, IL-1β, IL-10, FC, NE, E and GH levels and peripheral blood Foxp3+ cell fluorescence intensity of MMA group 12 h after surgery were significantly lower than those of PCIA group, and peripheral blood CD3+, CD4+, CD8+ cell fluorescence intensity were significantly higher than those of PCIA group. Conclusion: Ropivacaine fascia iliaca compartment block combined with dezocine multimodal analgesia can reduce the pain and stress response after hip replacement.
文摘Objective:To study the effect of parecoxib sodium intervention before induction on incision pain and inflammatory stress response after orthopedic surgery.Methods: Patients who underwent orthopedic surgery under lumbar anesthesia combined with epidural block anesthesia in Mianyang Central Hospital between March 2015 and June 2017 were selected and divided into two groups by random number table method, Par group received parecoxib sodium intervention before induction combined with routine postoperative patient-controlled intravenous analgesia, and control group only accepted routine postoperative patient-controlled intravenous analgesia. The pain neurotransmitters, inflammatory molecules and stress molecules in serum and peripheral blood were measured before surgery as well as 1 day and 3 days after surgery.Results: Compared with pain neurotransmitters of same group before surgery, serum PGE2, 5-HT, SP, NPY levels of both groups were significantly lower whereas serum COR and GH levels and peripheral blood JAK2, STAT3, IL-1, IL-6, IFIT1, Nrf2 and HO-1 mRNA expression were significantly higher 1 day and 3 days after surgery, and serum PGE2, 5-HT, SP, NPY, COR and GH levels as well as peripheral blood JAK2, STAT3, IL-1, IL-6, IFIT1, Nrf2 and HO-1 mRNA expression of Par group 1 day and 3 days after surgery were lower than those of control group.Conclusions: Parecoxib sodium intervention before induction can reduce the incision pain and inflammatory stress response after orthopedic surgery.
文摘Objective:To investigate the effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation.Methods: A total of 218 patients receiving tracheal intubation general anesthesia in the hospital between January 2017 and December 2017 were divided into the control group (n=109) and the dexmedetomidine group (n=109) by random number table method. Control group underwent routine propofol anesthesia induction and dexmedetomidine group underwent dexmedetomidine anesthesia induction on the basis of propofol. The differences in the severity of inflammatory response and stress response were compared between the two groups of patients after general anesthesia induction (T0), 1 min after endotracheal intubation (T1), 5 min after endotracheal intubation (T2) and 10 min after endotracheal intubation (T3).Results:At T0, there was no statistically significant difference in serum levels of inflammatory factors and stress hormones between the two groups. At T1, T2 and T3, serum inflammatory factors CRP, IL-1, IL-6, IL-8 and TNF-α levels of dexmedetomidine group were lower than those of control group;serum stress hormones ACTH, Cor, NE, AngⅠ and AngⅡ levels were lower than those of control group. Conclusion: Dexmedetomidine + propofol general anesthesia induction can effectively reduce the inflammatory stress response caused by endotracheal intubation.
文摘Objective: To study the effect of nalbuphine preemptive analgesia combined with ropivacaine local infiltration on postoperative incision pain, stress response and immune function in children. Methods: Children who received selective laparotomy in Mianyang Central Hospital between August 2015 and August 2017 were selected and randomly divided into control group, nalbuphine group (N group), ropivacaine group (R group) and nalbuphine + ropivacaine group (N+R group). The levels of pain and stress-related mediators in serum and the levels of immune cells in peripheral blood were detected before operation and 24 h after operation. Results: 24 h after operation, serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of four groups of children were significantly higher than those before operation while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly lower than those before operation;serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of N group, R group and N+R group were significantly lower than those of control group while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly higher than those of control group;serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of N+R group were significantly lower than those of N group and R group while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly higher than those of N group and R group. Conclusion: Nalbuphine preemptive analgesia combined with ropivacaine local infiltration can reduce the postoperative incision pain and stress response and improve the immune function in children.