RESPONSE OF ANTARCTIC FUR SEALS TO IMMOBILIZATION WITH KETAMINE, A KETAMINE-DIAZEPAM OR KETAMINE-XYLAZINE MIXTURE, AND ZOLETIL®

Adult Antarctic fur seals (Arctocephalus gazella) were immobilized with Zoletil^® ( n = 172), ketamine ( n = 30), ketamine mixed with diazepam ( n = 23) and with ketamine mixed with xylazine ( n = 45). Response to all drugs was highly variable. There was a relationship between dose rate and level of immobilization in females given Zoletil^®. Males were slightly more sensitive to Zoletil^® than females but this could have been due to the greater body mass and lower mass-specific metabolic rate of males. The dose required to achieve a level of immobilization declined with greater body mass for Zoletil^® and ketamine but not for ketamine-diatepam. Ketamine and ketamine-sedative mixtures commonly caused mild tremoring and occasionally caused convulsions. Neither reaction was seen with Zoletil^®. Mean doses were, Zoletil^® 1.5 mg/ kg, ketamine 6.9 mg/kg, ketamine-diazepam 6.3 mg/kg ketamine and 6.3 μg/kg diazepam, and ketamine-xylazine 7.3 mg/kg ketamine and 0.62 mg/ kg xylazine. Zoletil^® performs at least as well on Antarctic fur seals as ketamine but it may cause respiratory depression. The dose of ketamine required for Antarctic fur seals was greater than for most other species of seals.     

Reversal of selenium and zinc deficiencies in chronic hemodialysis patients by intravenous sodium selenite and zinc gluconate supplementation

In six chronic dialyzed uremic patients, an intravenous sodium selenite (Se 50 μg during 5 wk and then 100 μg) and zinc gluconate (Zn 5 mg) supplementation was performed during 20 wk at each dialysis session three times weekly. Before supplementation, plasma Se and Zn, plasma and erythrocytes (RBC) antioxidant metalloenzymes glutathione peroxidase (GPX), and superoxide dismutase (SOD) were significantly decreased, whereas lipid peroxidation (as thiobarbituric acid reactants TBARs) was increased. To obtain a significative change in plasma selenium, we had to use an Se dose of 100 μg/dialysis session. Then, treatment-increased plasma Se (from 0.58 ±0.09 to 0.89±0.16 μmol/L) led to a repletion of RBC-GPX (from 29.6±6 to 43±5.8 U/g Hb) and increased plasma GPX levels (from 62±13 to 151±43 U/L). Plasma Zn and RBC-SOD did not vary significantly. The change of TBARs was not observed between wk 1 and 4. They decreased significantly between wk 4 (4.80±0.21μmol/L) and wk 20 (4.16±0.26 μmol/L). We noted a low correlation between TBARs and plasma GPX. A strong correlation was observed between Se and plasma GPX. The reversal of Se deficiencies should reduce oxidative damage observed in these patients.     

Long-term follow up of patients with common variable immunodeficiency treated with intravenous immunoglobulin: Reevaluation of intravenous immunoglobulin replacement therapy

Five patients with common variable immunodeficiency treated in our hospital between December 1979 and December 1990 were given six kinds of intravenous immunoglobulin preparations (pepsin treated, S-sulfonated, polyethylene glycol treated, pH4 treated, alkylated, and pH4.25 formulation preparation) for replacement therapy. Duration of the therapy ranged from 7.6 to 11 years. Incidences of fever and acute infections were variable among patients, but no significant differences were seen in the incidences among periods given each preparation. Three cases revealed abnormal pulmonary functions in tests. Adverse reactions were rarely seen in our study periods, and no severe reactions were observed. No significant differences were seen in incidences of adverse reactions. Postinfusion levels of serum complement slightly decreased from preinfusion levels. However, the decrease in complement was not related to any adverse reaction. No long-term complications such as transmission of hepatitis have been observed. Our data suggest that no obvious differences exist between the efficacy and safety of each IVIG preparation. Differences of efficacy of IVIG replacement therapy may be due to the variable pathophysiology of each patient.Abbreviations CVID common variable immunodeficiency - IVIG intravenous immunoglobulin     

超声引导下神经阻滞麻醉联合全身麻醉对股骨头置换老年患者麻醉效果及术后认知功能的影响

摘要 目的：研究超声引导神经阻滞麻醉联合全身麻醉对股骨头置换老年患者的麻醉效果及对术后认知功能的影响。方法：选取2019年1月至2021年12月期间我院收治的150例拟行股骨头置换术的老年患者,随机分为对照组和观察组,各75例。对照组患者行常规全身麻醉,观察组在对照组的基础上行超声引导下神经阻滞麻醉,比较两组患者的血流动力学指标,拔管时间、苏醒时间和复苏室停留时间,苏醒后疼痛,术后认知功能及不良反应的发生率。结果：观察组患者各时间点的心率（HR）和平均动脉压（MAP）均较对照组低（P＜0.05）。观察组拔管时间、苏醒时间和复苏室停留时间均较对照组短（P＜0.05）。观察组患者术后视觉模拟评分（VAS）均低于同一时间点的对照组（P＜0.05）。与对照组相比,观察组患者术后1 h、12 h和24 h的简易智力状态检查（MMSE）评分均较高（P＜0.05）,观察组术后1 h、12 h和24 h术后认知功能障碍（POCD）发生率较对照组低（P＜0.05）。两组患者不良反应发生率无差异（P＞0.05）。结论：超声引导神经阻滞麻醉可稳定血流动力学,缩短拔管、苏醒及复苏室停留时间,减轻术后疼痛,改善术后认知功能,减少POCD的发生,值得临床推广。     

丙泊酚联合七氟醚麻醉在先天性心脏病介入手术患儿中的心肌保护作用及对苏醒质量和应激反应的影响

摘要 目的：研究丙泊酚联合七氟醚麻醉在先天性心脏病介入手术患儿中的心肌保护作用及对苏醒质量和应激反应的影响。方法：选择2020年1月~2022年4月期间在苏州大学附属儿童医院接受先天性心脏病介入手术患儿96例,按照双色球法将患儿分为对照组（n=48,接受瑞芬太尼、丙泊酚麻醉）和观察组（n=48,接受丙泊酚、七氟醚麻醉）。对比两组患儿心率、呼吸频率、平均动脉压、苏醒质量、心肌损伤指标、应激反应指标和不良反应发生率。结果：两组置喉罩时（T1）~拔除喉罩（T4）时间点心率、呼吸频率、平均动脉压下降后升高,观察组高于对照组同时间点（P<0.05）。观察组的苏醒时间、拔管时间均短于对照组（P<0.05）。两组术毕、术后24 h肌酸磷酸激酶同工酶（CK-MB）、心肌肌钙蛋白（cTnI）升高后下降,观察组低于对照组同时间点（P<0.05）。两组术毕、术后24 h血糖、皮质醇升高后下降,观察组低于对照组同时间点（P<0.05）。两组不良反应发生率组间对比,差异不显著（P>0.05）。结论：丙泊酚联合七氟醚麻醉应用于先天性心脏病介入手术中,可减轻患儿的应激反应,稳定机体血流动力学波动,同时还可发挥心肌保护作用,提高苏醒质量。     

USE OF A PETHIDINE AND MIDAZOLAM COMBINATION FOR THE REVERSIBLE SEDATION OF CRABEATER SEALS (LOBODON CARCINOPHAGUS)

Between October and December of 1996–1999, off eastern Antarctica (60°-150°E), we darted 31 crabeater seals with midazolam and pethidine at estimated dose rates of 0.15–0.4 mg/kg and 1–3 mg/kg, respectively. Maximum sedation was reached at 23 ± 9 min (n = 18) and first signs of recovery were noted at 54 ± 24 min (n = 4). Seals greater than 250 kg body-mass were sedated by administration of approximately 90–100 mg midazolam and 600 mg pethidine, but the degree of sedation was unpredictable and did not permit invasive procedures in some cases. Behavior of the seal and adjacent conspecifics affected the success of procedures and our ability to monitor vital signs. Naloxone and flumazenil reversed sedation, making this combination attractive for use in animals adjacent to water. Additional ketamine was administered to two seals, resulting in improved restraint.     

瑞芬太尼复合丙泊酚麻醉对结肠癌手术患者血流动力学、炎症反应及免疫球蛋白的影响

目的:探讨瑞芬太尼复合丙泊酚麻醉对结肠癌手术患者血流动力学、炎症反应及免疫球蛋白的影响。方法:选取2017年1月～2018年12月期间于新疆医科大学附属第一医院行腹腔镜下结肠癌根治术患者189例,根据随机数字表法将患者分成对照组(n=94,丙泊酚麻醉)和研究组(n=95,瑞芬太尼复合丙泊酚麻醉),比较两组患者围术期指标、血流动力学、炎症反应及免疫球蛋白水平,记录两组术中不良反应发生情况。结果:研究组患者苏醒时间、拔管时间、自主呼吸恢复时间、定向力恢复时间均短于对照组(P0.05)。对照组麻醉诱导10 min(T2)、术毕拔管后10 min(T3)时间点心率(HR)、平均动脉压(MAP)较T1时间点降低,T3时间点高于T2时间点(P0.05),研究组T2时间点HR、MAP较T1时间点降低(P0.05);研究组T2、T3时间点HR、MAP高于对照组同时间点(P0.05)。研究组术后1h(T4)、术后1d(T5)时间点白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)低于对照组同时间点(P0.05)。研究组T4、T5时间点免疫球蛋白A(Ig A)、免疫球蛋白M(Ig M)、免疫球蛋白G(Ig G)高于对照组同时间点(P0.05)。两组不良反应发生率比较差异无统计学意义(P0.05)。结论:结肠癌手术中使用瑞芬太尼复合丙泊酚麻醉,可有效改善围术期各项指标,维持机体血流动力学稳定,减少机体炎症反应、免疫抑制,安全可靠。     

不同浓度罗哌卡因腰硬联合麻醉用于人工髋关节置换手术对患者麻醉效果和术后运动功能的影响

摘要 目的：探讨不同浓度罗哌卡因腰硬联合麻醉用于人工髋关节置换手术对患者麻醉效果和术后运动功能的影响。方法：2017年2月至2019年12月选择在本院进行人工髋关节置换手术的患者84例,根据随机数字表法把患者分为观察组与对照组各42例。两组都给予腰硬联合麻醉,对照组采用常规浓度0.5 %罗哌卡因麻醉观察组采用低浓度0.375 %罗哌卡因麻醉,记录患者麻醉效果和术后运动功能变化情况。结果：观察组的麻醉持续时间、运动恢复时间和感觉运动时间都显著短于对照组(P<0.05)。观察组麻醉后10 min、30 min、60 min的Bromage评分都低于对照组(P<0.05)。观察组术后7 d的低血压、恶心呕吐、头晕头痛、尿潴留等不良反应发生率为7.1 %,显著低于对照组的19.0 %(P<0.05)。两组所有患者在术后2 h、术后4 h、术后24 h的呼吸、心率均在正常范围内波动,组间与组内对比都无统计学意义(P>0.05)。结论：低浓度罗哌卡因腰硬联合麻醉用于人工髋关节置换手术能改善患者的麻醉效果和运动功能,提高麻醉效果,并不影响患者的生命体征,且能减少术后不良反应的发生。     

利多卡因经气管内给药和静脉给药对全麻苏醒期患者镇静镇痛效果、血流动力学和呛咳反应的影响

摘要 目的：探讨利多卡因经气管内给药和静脉给药对全麻苏醒期患者镇静镇痛效果、血流动力学和呛咳反应的影响。方法：选取2018年3月~2019年8月于我院在气管内全麻下完成泌尿外科、腹部外科并预计于术后可以迅速拔除气管导管的患者63例,上述患者根据随机数字表法分为A组（n=31）和B组（n=32）,A组患者给予利多卡因静脉给药,B组患者给予利多卡因经气管内给药,比较两组患者苏醒时间、拔管时间、镇静镇痛效果、血流动力学及呛咳反应。结果：两组苏醒时间、拔管时间组间比较差异无统计学意义（P>0.05）。两组插管时、拔管时、拔管后10 min心率（HR）、收缩压（SBP）、舒张压（DBP）均呈先升高后降低趋势,且B组插管时、拔管时、拔管后10 min的HR、SBP、DBP均低于A组（P<0.05）。两组拔管时、拔管后10 min组内及组间镇静-躁动评分(SAS)比较差异无统计学意义（P>0.05）;两组拔管后10 min疼痛视觉模拟量表(VAS)评分高于拔管时,但B组低于A组（P<0.05）。B组患者插管时、拔管时呛咳反应发生率均低于A组（P<0.05）。结论：与静脉给药相比,全麻苏醒期患者给予利多卡因经气管内给药,镇静镇痛效果确切,可减轻血流波动,降低插管时、拔管时呛咳反应发生率。