Background Awareness is a serious complication of general anesthesia. In China, the incidence of intraoperative awareness was 1% in patients undergoing total intravenous anesthesia （TIVA）. In this study, we compared...Background Awareness is a serious complication of general anesthesia. In China, the incidence of intraoperative awareness was 1% in patients undergoing total intravenous anesthesia （TIVA）. In this study, we compared the incidence of awareness between Bispectral index （BIS）-guided and routine TIVA protocol and evaluated the effect of BIS on preventing awareness. Methods A prospective, randomized, double-blinded, multicenter controlled trial was performed. Patients （〉18 years of age） undergoing TIVA were randomly divided into BIS-guided group （Group A, BIS was monitored and recommended to maintain between 40-60） and control group （Group B, BIS was monitored but the screen was covered）. The intraoperative BIS values were downloaded and the BIS trends of confirmed awareness cases were analyzed to determine whether light anesthesia existed. Results Of the total 5228 patients, 2919 patients were assigned to Group A and 2309 to Group B. Four cases of confirmed awareness （0.14%） were reported in the BIS-guided group and 15 （0.65%） in the control group （P=-0.002, OR=0.21, 95% confidence intervals： 0.07-0.63）. The incidence of possible awareness （0.14% vs. 0.26%, P=0.485） and dreaming （3.1% vs. 3.1%, P=0.986） was comparable between BIS-guided group and the control group. Among the 19 confirmed awareness cases, intraoperative BIS trends of six cases were downloaded and identified. Five of them showed signs of light anesthesia as BIS 〉60 and lasted 19-106 minutes, whereas one case had a stable BIS trend and the values were within 60 during the operation. Another five awareness cases were reviewed for anesthesia procedures, of which improper light anesthesia were confirmed. Conclusions BIS-guided TIVA （BIS was recommended to maintain between 40-60） decreased the risk of awareness compared with routine TIVA. The main reason for awareness was light anesthesia.展开更多
<b>Objective:</b> The purpose of this study was to investigate the effect of right supine endotracheal intubation on respiratory complications and airway pressure of general anesthesia, and to provide guid...<b>Objective:</b> The purpose of this study was to investigate the effect of right supine endotracheal intubation on respiratory complications and airway pressure of general anesthesia, and to provide guidance for clinical application. <b>Methods:</b> Seventy-two children who received oral treatment under general anesthesia from November 2020 to November 2021 in Yantai Stomatological Hospital were randomly divided into three groups, 24 cases in each group. All three groups of children entered the PACU after the surgery. The children in Group I were extubated in the supine position, the children in Group II were immediately changed to the right decubitus after extubation in the horizontal position, and the children in Group III were extubated in the right decubitus. HR, MAP and SpO<sub>2</sub> of T1 (the time point at the beginning of surgery), T2 (the time point at 1 hour after surgery), T3 (the time point after extubation), T4 (the time point at 1 minute after extubation), T5 (the time point at 3 minutes after extubation) in the three groups were observed, t1 (operation time) and t2 (the time of leaving the PACU) were recorded. The airway pressure (P1) in the recumbent position and the airway pressure (P2) in the right decubitus position before extubation were recorded in Group III. The number of sputum suction and complications after extubation were counted. <b>Results:</b> The t2 in Group III was shorter than that in Groups I and II, and the number of sputum suction in Group III was less than that in Groups I and II (P < 0.05). The HR at T3, T4 and T5 in Group III was lower than that in Group I, and the HR at T4 and T5 was lower than that in Group II (P < 0.05). There were significant differences in the incidence of respiratory complications among the three groups (P < 0.05). The incidence of asphyxia, bucking and glossocoma postoperative agitation in Group III was significantly lower than that in Group I, and the incidence of asphyxia and choking was lower than that in Group II (P < 0.05). The incidence of gl展开更多
文摘Background Awareness is a serious complication of general anesthesia. In China, the incidence of intraoperative awareness was 1% in patients undergoing total intravenous anesthesia （TIVA）. In this study, we compared the incidence of awareness between Bispectral index （BIS）-guided and routine TIVA protocol and evaluated the effect of BIS on preventing awareness. Methods A prospective, randomized, double-blinded, multicenter controlled trial was performed. Patients （〉18 years of age） undergoing TIVA were randomly divided into BIS-guided group （Group A, BIS was monitored and recommended to maintain between 40-60） and control group （Group B, BIS was monitored but the screen was covered）. The intraoperative BIS values were downloaded and the BIS trends of confirmed awareness cases were analyzed to determine whether light anesthesia existed. Results Of the total 5228 patients, 2919 patients were assigned to Group A and 2309 to Group B. Four cases of confirmed awareness （0.14%） were reported in the BIS-guided group and 15 （0.65%） in the control group （P=-0.002, OR=0.21, 95% confidence intervals： 0.07-0.63）. The incidence of possible awareness （0.14% vs. 0.26%, P=0.485） and dreaming （3.1% vs. 3.1%, P=0.986） was comparable between BIS-guided group and the control group. Among the 19 confirmed awareness cases, intraoperative BIS trends of six cases were downloaded and identified. Five of them showed signs of light anesthesia as BIS 〉60 and lasted 19-106 minutes, whereas one case had a stable BIS trend and the values were within 60 during the operation. Another five awareness cases were reviewed for anesthesia procedures, of which improper light anesthesia were confirmed. Conclusions BIS-guided TIVA （BIS was recommended to maintain between 40-60） decreased the risk of awareness compared with routine TIVA. The main reason for awareness was light anesthesia.
文摘<b>Objective:</b> The purpose of this study was to investigate the effect of right supine endotracheal intubation on respiratory complications and airway pressure of general anesthesia, and to provide guidance for clinical application. <b>Methods:</b> Seventy-two children who received oral treatment under general anesthesia from November 2020 to November 2021 in Yantai Stomatological Hospital were randomly divided into three groups, 24 cases in each group. All three groups of children entered the PACU after the surgery. The children in Group I were extubated in the supine position, the children in Group II were immediately changed to the right decubitus after extubation in the horizontal position, and the children in Group III were extubated in the right decubitus. HR, MAP and SpO<sub>2</sub> of T1 (the time point at the beginning of surgery), T2 (the time point at 1 hour after surgery), T3 (the time point after extubation), T4 (the time point at 1 minute after extubation), T5 (the time point at 3 minutes after extubation) in the three groups were observed, t1 (operation time) and t2 (the time of leaving the PACU) were recorded. The airway pressure (P1) in the recumbent position and the airway pressure (P2) in the right decubitus position before extubation were recorded in Group III. The number of sputum suction and complications after extubation were counted. <b>Results:</b> The t2 in Group III was shorter than that in Groups I and II, and the number of sputum suction in Group III was less than that in Groups I and II (P < 0.05). The HR at T3, T4 and T5 in Group III was lower than that in Group I, and the HR at T4 and T5 was lower than that in Group II (P < 0.05). There were significant differences in the incidence of respiratory complications among the three groups (P < 0.05). The incidence of asphyxia, bucking and glossocoma postoperative agitation in Group III was significantly lower than that in Group I, and the incidence of asphyxia and choking was lower than that in Group II (P < 0.05). The incidence of gl
