ObjectiveTo investigate the effect of acute non-isovolemic hemodilution (ANIH) on spinal surgery. MethodsFrom January 2012 to July 2013, 80 patients scheduled for spinal surgery were enrolled. The patients were randomized into four groups, with 20 in each group. Patients in group A were infused with Ringer's injection and polygeline for fluid loss, physiological needs and blood loss. In group B, the patients were infused with acute hypervolemic hemodilution. In group C, patients were infused with acute nomovolemic hemodilution. In group D, patients were infused with ANIH. The hemodynamics and arterial blood gas indexes were detected in all the patients. ResultsThe mean blood pressure in group A and C was significantly more stable than that in group B and D. The central vein pressure in group B and D was significantly higher than that in group A and C after hemodilution (P<0.05), while the hematocrit in group B and D was significantly lower than that in group A and C (P<0.05). Allogeneic blood transfusion was performed in group A and B, while it was not performed in group C and D. ConclusionANIH can reduce the volume of blood loss during spinal surgery, and it is safe.
Objective To study the influence of low-tidal volume and positive end expiratory pressure (PEEP) protective ventilation on cardiac output volume in elderly patients under general anesthesia. Methods From August 2012 to July 2014, 60 elderly patients undergoing selective surgery were divided into three groups with 20 patients in each. Group A was treated with conventional ventilation: tidal volume at 8 mL/kg, PEEP at 0 cm H2O (1 cm H2O=0.098 kPa); group B was treated with a tidal volume of 6 mL/kg and a PEEP of 5 cm H2O; group C was treated with a tidal volume of 6 mL/kg and a PEEP of 8 cm H2O. We then observed and analyzed the blood pressure, heart rate, cardiac output, arterial blood gas and airway mean pressure before induction of anesthesia (T0), 15 minutes of mechanical ventilation after the induction of anesthesia (T1), 60 minutes after anesthesia induction (T2), and 15 minutes after tracheal extubation (T3). Results In all the three groups, the mean arterial pressure and cardiac output were stable. In group B and C, central venous pressure increased significantly, the mean airway pressure and lung compliance increased, and the arterial oxygen branch pressure also increased significantly (P < 0.05). Conclusion Low-tidal volume combined with 5-cm H2O or 8-cm H2O positive end expiratory pressure lung-protective ventilation had a small influence on the cardiac output of elderly patients under anesthesia, which can be safely used.
目的 觀察右美托咪啶復合丙泊酚靶控靜脈麻醉在纖維支氣管鏡檢查術中的麻醉效果。 方法 2010年12月－2012年4月，將60例行纖維支氣管鏡檢查術的患者隨機分為丙泊酚麻醉組（對照組）和右美托咪啶復合丙泊酚麻醉組（觀察組），每組各30例。觀察記錄不同時點平均動脈壓（MAP）、心率、呼吸次數（RR）、脈搏血氧飽和度（SpO2），鎮靜評分、手術時間、蘇醒時間、丙泊酚總用量、不良反應發生率及患者滿意度。 結果 所有患者均能順利完成操作，誘導入睡后觀察組MAP、心率下降（P＜0.05），丙泊酚總用量、不良反應發生率均少于對照組（P＜0.05），鎮靜評分優于對照組（P＜0.05）；兩組RR、SpO2、蘇醒時間、手術時間及患者滿意度差異無統計學意義（P＞0.05）。 結論 右美托咪定復合丙泊酚靶控輸注適用于纖維支氣管鏡檢查術麻醉，是一種更加安全有效的麻醉方法。