Objective To observe the effect of coenzyme complex on bispectral index(BIS)and recovery quality during recovery period of general anesthesia in elderly patients.Methods Ninety patients aged ≥ 65 years undergoing cholecystectomy under general anesthesia were equally randomized into three groups.The patients in groups of A and B were intravenously infused coenzyme complex 100 U and 200 U in 30 minutes after skin incision.The patients in group C were given equal volume of normal saline instead of coenzyme complex.HR and BIS were recorded before anesthesia induction,during sputum aspiration,during extubation and at 1,5,10 and 15 minutes after extubation. The operation time,extubation time,awakening time and Steward recovery scores at 1,5,10 and 15 minutes after extubation were recorded as well.The occurrence of arrhythmias in operation was observed.Results Compared with group C,BIS value during sputum aspiration,during extubation and at 1 and 5 minutes after extubation and Steward recovery scores at 1 and 5 minutes after extubation were increased(P<0.05),and extubation time and awakening time were shortened in groups of A and B(P<0.05).The incidence of arrhythmias in operation was higher in group C than those in groups of A and B(30.0% vs.13.3% and 3.3%)(P<0.05),which was higher in group A than that in group B (P<0.05).Conclusion Intravenous infusion of coenzyme complex 200 U in operation after skin incision is able to improve BIS value and recovery quality and reduce the occurrence of arrhythmia during recovery from general anesthesia in elderly patients.

Objective To study the effect of dexmedetomidine on ischemia‐reperfusion (I‐R ) injury of the legs .Methods Sixty patients undergoing knee joint debridement under spinal‐epidural anesthesia were equally randomized into two groups .The patients in group D were infused dexmedetomidine 1μg/kg in 10 minutes ,which was followed by indusion of dexmedetomidine 0.5μg · kg‐1 · h‐1 till 30 minutes before the end of surgery .The patients in group C were not given dexmedetomidine as the controls .The MAP and ECG were monitored .Plasma myeloperoxidase(MPO) and intercellular adhesion molecule‐1(ICAM‐1) were measured before (T1) and on the 1st (T2) and 5th (T3 ) day after operation .Results After deflation of tourniquet ,MAP of two groups was decreased ,but MAP was higher in group D than that in group C (P<0 .05) and the incidence of arrhythmias was lower in group D than that in group C(6.7% vs .13.3% )(P<0 .05) .At T2 and T3 , plasma concentrations of MPO were lower in group D than those in group C[(41.9 ± 12.2)μg/L vs . (50.1 ± 15.3)μg/L and (39.0 ± 11.1)μg/L vs .(48.1 ± 17.0)μg/L](P<0 .01) .So did serum levels of sICAM‐1[(380 ± 94) pg/L vs .(450 ± 120) pg/L and (360 ± 57) pg/L vs .(380 ± 85) pg/L] (P<0 .01) .Conclusion Dexmedetomidine has a certain protective effect on tourniquet‐induced I‐R injury of the legs .

肥胖患者通常伴随着一系列的机体生理变化,在其手术麻醉的过程中也有着和常人不同的指标以及一些注意事项.对于肥胖患者的麻醉管理一定要提高重视,加强术前评估和术中监测.同时麻醉医生应当加强对肥胖患者的病理生理特征的理论学习,更好地为肥胖患者提供麻醉服务.