Objective To evaluate the effects of low-dose epinephrine on cerebral oxygen saturation (rScO2) and awakening time during one-lung ventilation (OLV) for thoracic surgery. Methods Thirty consecutive patients undergoing lobectomy from March to July 2016 in our hospital were randomly divided into an epinephrine group (n=15, 8 males and 7 females at an average age of 58.70±11.40 years) or a saline group (n=15, 7 males and 8 females at an average age of 57.00±11.40 years). They were continuously infused with 0.01 μg/(kg·min) epinephrine or saline after general induction. Hemodynamics was maintained ±20% of the baseline value. All patients were ventilated by a pressure control mode during OLV with tidal volume of 5-8 ml/kg and end-tidal carbon dioxide tension (EtCO2) of 35-45 mm Hg. Regional cerebral oxygen saturation (rScO2) was monitored using near-infrared spectroscopy (NIRS) continuously. Results Compared with the saline group, the epinephrine group had a high rScO2 during OLV, with a statisitical significance at OLV 40 min and 50 min (67.76%±4.64% vs. 64.08%±3.07%, P=0.016; 67.25%±4.34% vs. 64.20%±3.37%, P=0.040). In addition, the awakening time of patients in the epinephrine group was shorter than that of the saline group (P=0.004), and the awakening time was associated with the duration of low-dose rScO2 (r=0.374). Conclusion Continuous infusion of 0.01 μg/(kg·min) could improve the rScO2 during OLV and shorten awakening time in thoracic surgery.
Objective To explore the emergence agitation resulting from postoperative indwelling urethral catheters in patients of thoracic surgery. Methods In this prospective cohort study, we recruited 140 patients who were scheduled for thoracic surgery under general anesthesia in West China Hospital from January through April 2014. These patients were divided into two groups including a control group and a trial group with 70 patients in each group. The patients in the control group had indwelled urethral catheter routinely. The catheter removed after the surgery at operation room in the trial group. Intraoperative urinary volume, emergence agitation (EA) occurrence, postoperative urinary retention, and urethral irritation were recorded. Results There was no statistical difference in postoperative urinary retention rate between the control group and the trial group (1.43% vs. 2.86%, P=0.230). However, the urethral irritation rate in the control group was significantly higher than that in the trial group (12.86% vs. 0.00%, P=0.012) . And there was a statistical difference in adverse event rate (2.86% vs. 0.00%, P=0.039) between the two groups. There was a significantly higher incidence of urethral irritation in male patients (20.51%, 8/39) than female patients (3.23%, 1/31, P=0.033).The rate of EA in the control group was significantly higher than that in the trial group (28.57% vs. 12.86%, P=0.010). There was a significantly higher EA rate in the patients who had urethral irritation by postoperative indwelling catheters compared with those without indwelling catheters (45.00% vs. 12.86%, P=0.043). Conclusion This study suggests that postoperative EA is a result from urethral irritation than local pain, and the EA rate can be decreased by removal of catheter before anaesthetic recovery.
ObjectiveTo observe the incidence of hypotension in general anesthesia patients in post anesthesia care unit (PACU), compare the blood pressure before and after treatment, and analyze hypotension causes. MethodBetween September 2012 and July 2013, data of 18 931 patients in PACU after general anesthesia were retrospectively analyzed for the incidence of hypotension. At the same time, the change of blood pressure was also detected before and after treatment. ResultsSixty-two patients had hypotension during the anesthesia recovery period after general anesthesia. The incidence was 0.33%. The proportion was the highest among patients who underwent abdominal surgery, reaching 41.9%. Systolic pressure and diastolic pressure improved significantly after treatment (P<0.05). ConclusionsIt is important to perform comprehensive evaluation of vital signs, closely observe disease conditions and vital sign changes, find out and manage low blood pressure for patients in PACU, which secure their safety.
ObjectiveTo analyze the occurrence of arrhythmia in patients during the recovery period of anesthesia, in order to take appropriate measures in nursing care to ensure the safety of patients. Method We carried out a retrospective analysis of 18 931 general anesthesia post-operative patients (aged 16-84 years old) transferred to anesthesia recovery from September 2012 to July 2013, and we observed the incidence rate of arrhythmia, and documented the clinical manifestations of the patients. ResultsDuring the anesthesia recovery, out of 18 931 general anesthesia postoperative patients, 269 cases of arrhythmia occurred, and the incidence rate was 1.42%. Twenty minutes after nursing intervention and use of medication, the difference of systolic blood pressure, bradycardic heart rate, and tachycardic heart rate of the patients were statistically better than those beofre the treatment (P＜ 0.05) . ConclusionEarly discovery and analysis of arrhythmia in patients during anesthesia recovery, along with timely provision of analgesic and antiarrhythmic treatment can effectively improve the circulation status of the patients, thus ensure the safety of the patients during anesthesia recovery.