Objective To investigate change of bispectral index(BIS) and hemodynamic index during induction and orotracheal intubation of sevoflurane anesthesia. Methods This study was a prospective before-after study in the same patients. A total of 30 ASA physical status I and II adult patients without airway abnormalities were enrolled to receive inhalation induction of anesthesia with 8% sevoflurane. Mean arterial pressure(MAP),heart rate(HR) and BIS were recorded before anesthesia(T1),when patients loss of consciousness(T2), before intubation (T3),at 1 min(T4) and 3 min(T5) after intubation. Results BIS at T1-T5 were 96.8±1.7,70.4±8.8,39.2±8.4,43.6±12.9 and 41.6±9.3 respectively, the measurements at T2-T5 were all markedly lower than at T1(Plt;0.05). HR at T3-T5 were all markedly higher than at T1(Plt;0.05). MAP at T2 and T3 were markedly lower than at T1, but at T4 was higher than at T1(Plt;0.05), and recovered to the level at T1 at T5(Pgt;0.05).BIS,HR and MAP at T4 were all significantly higher than T3(Plt;0.05). Conclusion Anesthesia induction with sevoflurane and small dose of succinylchoiline we used can provide adequate depth of general anesthesia,but can not prevent cardiovascular adverse reactions to intubation.
ObjectiveTo systematically review the effectiveness of non-depolarizing neuromuscular blockers for the prevention of succinylcholine-induced myalgia in clinical practice. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 2, 2014), WanFang Data, CBM and CNKI were searched to collect the randomized controlled trails (RCTs) about non-depolarizing neuromuscular blockers for the prevention of succinylcholine-induced myalgia from inception to March 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was conducted using RevMan 5.2 software. ResultsA total of 11 RCTs involving 666 patients were included. The results of meta-analysis showed that:the pre-treatment of non-depolarizing neuromuscular blockers prevented succinylcholine-induced myalgia at 24 h after surgery (RR=0.46, 95%CI 0.39 to 0.55, P<0.000 01); however, the effectiveness of non-depolarizing neuromuscular blockers for prevention of succinylcholine-induced myalgia at 48 h after surgery was still unclear. ConclusionCurrent studies suggests that both rocuronium and atracurium are effective for the prevention of succinylcholine-induced myalgia. However, due to limited quantity and quality of the included studies, more high-quality studies are needed to verify the abovementioned conclusion.