To observe the effects of intraoperative application of radical scavenger edaravone in severe elderly cases.A total of 400 severe elderly patients scheduled for surgery were randomly assigned to receive edaravone 60 mg/40 ml (Group Y) or an equal volume of normal saline (Group C). The arterial blood samples were harvested at immediately after pricking, 1 hour after the beginning of surgery and before saturation to determine the levels of superoxide dismutase (SOD) and malondialdehyde (MDA). The operative duration, fluid volume, blood loss, blood transfusion volume, urine output, intraoperative adverse events, mortality rate, total hospital stay, intensive care unit (ICU) stay, postoperative mechanical ventilation time and complications were recorded. Patients undergoing off-pump coronary artery bypass graft (OPCABG) were evaluated for troponin I (cTnI) and left ventricular ejection fraction (LVEF) before and after 24 hours of surgery.SOD was higher and MDA lower in Group Y than those in Group C at 1 hour intraoperation and before saturation [SOD: (87 ± 14) U/ml vs (78 ± 14) U/ml, (83 ± 13) U/ml vs (77 ± 14) U/ml, P < 0.01, < 0.05; MDA: (11 ± 5) nmol/L vs (14 ± 7) nmol/L, (11 ± 5) nmol/L vs (14 ± 6) nmol/L, P < 0.05, < 0.01]. There were more intraoperative hypotension cases requiring a continuous application of vasoactive drugs in Group C (37 cases vs 19 cases), total hospital stay [(21 ± 9) d vs (23 ± 9) d, P < 0.05] and ICU stay [(10 ± 7) d vs (13 ± 9) d, P < 0.05] were also longer. Postoperative cTnI and LVEF of Group Y significantly improved in OPCABG cases (all P < 0.05).The intraoperative application of edaravone in severe elderly patients may prevent MDA increase and SOD decrease and reduce free radical damage. Especially in OPCABG patients, cTnIand LVEF improve significantly.
Objective To evaluate the sedative effect of dexmedetomidine and propofol and the correlation of the conscious condition and BIS in ophthalmic surgery.Methods Forty patients,ASA Ⅰ～Ⅱ,who underwent elective ophthalmic surgery,were randomly divided into two groups based on the medications used for sedation:the dexmedetomidine group(Group D) and the propofol group(Group P).In Group D,the loading dose was 0.8 μg/kg,followed by 0.3 μg/(kg·h).In Group P,the loading dose was 0.5 mg/kg,followed by 2.5 mg/(kg·h).BIS,HR,MAP and Ramsay score were observed and recorded before and during the operation.Results The Ramsay scores were same in the two groups and BIS were lower in Group D compared with Group P(P 0.05).HR in Group D was also lower than Group P(P 0.05).Side effects of hopoxemia were observed only in Group P.Conclusion Compared with propofol,dexmedetomidine appears to have more advantages in patients with ophthalmic surgery under local anesthesia.In addition,the BIS is lower with dexmedetomidine sedation than propofol at the same sedative level.
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