International journal of clinical and experimental medicine
-
Penehyclidine hydrochloride (PH), a new anticholinerigic drug associated with few cardiovascular side effects, was used widely as premedication in China. There is no information on the pharmacodynamic interaction between PH and anesthetics for loss of consciousness (LOC). This study was designed to determine the effects of premedicated PH on the propofol dose requirement for LOC and Bispectral Index (BIS) during target-controlled infusion (TCI) of propofol. ⋯ The predicted propofol Ce and consumption based on body weight of each patient were lower in Group PH than Group NS (p < 0.05). BIS values were not significantly changed before propofol infusion, and decreased gradually as propofol Ce increased and were not significantly different when LOC was reached between two groups (p > 0.05). We conclude that premedicated PH reduces the propofol Ce and dose requirement for LOC, but has no effect on BIS.
-
To compare the different outcomes of dexmedetomidine (Dex) vs. propofol combined with sevoflurane in children's laparoscopic surgery by noninvasive continuous cardiac output monitoring (NICOM). ⋯ Compared with propofol, the combination of Dex in children undergoing laparoscopic surgery shows better inhibition on HR.
-
Case Reports
Life-threatening anaphylactic shock due to chlorhexidine on the central venous catheter: a case series.
In this article, we report two life-threatening anaphylactic shocks by an antiseptic coated central venous catheter (CVC) within a 6-month period in our cancer center. Anaphylactic shock was preceded immediately after insertion of a central venous catheter (CVC) coated with silver sulphadiazine and chlorhexidine acetate (Blue FlexTip(®) ARROWg(+)ard Blue(®), 14Ga, Arrow International, Inc. ⋯ Though antiseptic coated CVC anaphylaxis has been reported in Japan, Europe and America, to our knowledge, this is first reported in China. We present these rare cases to remind clinicians about hypersensitivity to chlorhexidine that could potentially be life-threatening.
-
Caudal block is the regional anesthetic technique that is used most frequently in pediatric surgery and bupivacaine and levobupivacaine are widely utilized in this technique. Opioid drugs have been added to local anesthetic solutions to prolong duration of analgesia but ideal combination were not found. We compared the postoperative analgesic efficacy of equal concentrations of bupivacaine or levobupivacaine plus tramadol in pediatric patients. ⋯ There were no significant differences between groups for arterial pressures and heart rate values after caudal block and during the operation. Caudal bupivacaine plus tramadol and levobupivacaine plus tramadol have similar postoperative analgesic efficacy. But the use of bupivacaine plus tramadol may cause a greater frequency of urinary retention.
-
Previous studies demonstrated that systemic administration of lidocaine could induce central nervous toxicities, including behavioral convulsion as well as cognitive and cellular injury. Ketamine, a general anesthetic, is commonly used as an adjuvant in regional anesthesia with combination of lidocaine. The present was designed to investigate the effects of ketamine in central nervous toxicities of lidocaine. ⋯ We conclude that both pre- and/or post-administration of ketamine could improve lidocaine induced convulsive behaviors. However, cognitive functions and pathology of neurons of these rats are further impaired, compared to the rats without ketamine. This result indicates that ketamine combined with lidocaine might be risky in regional anesthesia.