Effect of preoperative visiting operation room on emergence agitation in preschool children under sevoflurane anesthesia.

BACKGROUND: Emergence agitation (EA) is a common complication in children during recovery from sevoflurane anesthesia with an high incidence. The main objective of this study was to compare the effects of preoperative visiting operation room (PVOR) to administration of propofol at the end of anesthesia on EA in preschool children under sevoflurane anesthesia. METHODS: Sixty-nine preschool children aged from 3 to 6 years scheduled for tonsillectomy under sevoflurane anesthesia were randomly allocated to one of the three groups to receive either PVOR (Group PV), routine preoperative visit (Group RV) or routine preoperative visit plus propofol (Group RP), 23 patients were included in each group. General anesthesia was induced and maintained with sevoflurane. Parental separation status score, mask acceptance score, Aono's four point score and pediatric anesthesia emergence delirium (PAED) score and incidence of EA were recorded. PAED score >10 were regarded as EA. Recovery profile and adverse events were also recorded. RESULT: Parental separation status score and mask acceptance score in group PV was significantly lower than that in group RV and group RP (P < 0.05); Aono's four point score, PAED score and incidence of EA in group PV and group RP was significantly lower than that in group RV (P < 0.05); Time to extubation and time to interaction in group PV and group RV was significantly shorter than that in group RP (P < 0.05); POV and rescue by fentanyl in group PV and group RP was significantly lower than that in group RV(P < 0.05). CONCLUSION: PVOR can effectively reduce the incidence of EA as well as administration of propofol without additional medical expenses and other adverse effects.

Expression of transforming growth factor beta 1 in lung tissue during cardiopulmonary bypass-induced lung injury in dogs.

BACKGROUND: Cardiopulmonary bypass (CPB) is a necessary technique for cardiac surgery and usually induces acute lung injury. Transforming growth factor ß1 (TGFß1) has been found to play a crucial role in the pathogenesis of inflammatory diseases; however, whether TGFß1 is also involved in CPB-induced lung injury has yet to be determined. Therefore, we aimed to investigate the TGFß1 expression in the lungs of dogs after CPB. METHODS: A total of 36 healthy mongrel dogs were randomly assigned to control and CPB groups. Six dogs in each group were killed before, 30 min after the operation, and 60 min after the operation (T0, T1, and T2). Lung injury was evaluated by hematoxylin and eosin staining. Respiratory index (RI), oxygenation index (OI), malondialdehyde (MDA) content in the lung, and pulmonary permeability index (PPI) were determined at each time point. TGFß1 expression was determined using real-time reverse transcription polymerase chain reaction and immunohistochemistry. RESULTS: There was a serious lung injury observed after CPB in dogs. RI increased and OI decreased in the dogs after CPB. The MDA content significantly increased after CPB; however, no significant change of MDA occurred in the control group. A significant increase of PPI was detected in CPB group at the T1 and T2 time points compared with that at the T0 time point. TGFß1 expression in the lung was increased after CPB on both the mRNA and protein levels. Positive correlations between TGFß1 mRNA level and MDA (r = 0.867, p < 0.01) and between TGFß1 mRNA and PPI (r = 0.821, p < 0.01) were detected by linear correlation. CONCLUSION: The upregulation of TGFß1 expression plays an important role in the development and progression of CPB-induced acute lung injury.