Intravenous remifentanil and propofol for gastroscopy.

STUDY OBJECTIVES: To evaluate the efficiency and safety of intravenous (i.v.) remifentanil and propofol for gastroscopy in healthy adults. DESIGN: Randomized, double-blinded study. SETTING: Endoscopy Center, West China Hospital, Sichuan University (Chengdu, People's Republic of China). PATIENTS: 199 adult ASA physical status I and II patients. INTERVENTIONS: Patients were randomly allocated to either the fentanyl group (n = 99) or the remifentanil group (n = 100). Patients received either fentanyl 0.5 microg/kg or remifentanil 0.5 microg/kg, followed by a bolus injection of one mg/kg of propofol. The subsequent doses of propofol were 0.5 mg/kg when the patient was conscious or body movement appeared. MEASUREMENTS: Noninvasive blood pressure, heart rate, arterial pulse oxygen saturation, and respiratory rate were recorded before gastroscopy and at two-minute intervals until the end of the gastroscopy procedure. Patients were asked to evaluate their level of cognition using the Digit-Symbol Substitution Test score before gastroscopy and at 10 minutes after discontinuation of the drug injection. MAIN RESULTS: Recovery time was significantly shorter in the remifentanil group than in the fentanyl group (P < 0.05). Postoperative Digit-Symbol Substitution Test scores were significantly higher in the remifentanil group than in the fentanyl group (P < 0.01). Total dosage of propofol given in the remifentanil group was significantly less than it was in the fentanyl group (P < 0.01). Frequency of apnea was significantly higher in the remifentanil group (P < 0.05). There were no significant differences in frequency of hypoxemia, bag ventilation, or body movement between the two groups (P > 0.05). CONCLUSIONS: Intravenous remifentanil and propofol were more efficient for gastroscopy than i.v. fentanyl and propofol.

Sentinel hospital surveillance for rotavirus diarrhea in the People's Republic of China, August 2001-July 2003.

China has the second largest birth cohort in the world and the second highest number of deaths due to rotavirus infection. It is also the only country with a licensed rotavirus vaccine. Chinese policy makers now need credible estimates of the burden of rotavirus disease, to decide about vaccine use. From August 2001 through July 2003, prospective hospital-based surveillance for rotavirus diarrhea among children <5 years of age was conducted in 6 sentinel hospitals. Rotavirus isolates were characterized to determine the G and P genotypes circulating during the study. Of 3149 children who were admitted to the hospitals for diarrhea and for whom screening for rotavirus was performed, 1590 (50%) had positive results of an antigen detection assay. Of all episodes of rotavirus diarrhea, 95% occurred during the first 2 years of life. The most common rotavirus strain was P[8]G3 (49% of episodes), and all the common strains were detected, including G9 strains (4% of episodes). Ongoing efforts are under way to more precisely define the burden of rotavirus diarrhea in urban and rural populations, to assess the proportion of episodes that may be due to unusual or emerging strains, and to estimate the economic burden of rotavirus disease.