Application of sedation-agitation scale in conscious sedation before bronchoscopy in children.

This retrospective study investigated the application of the sedation-agitation scale (SAS) in pediatric bronchoscopy by observing its effects on sedative dosages and adverse reactions.Children who underwent sedation before bronchoscopy, during the period from January 2014 to June 2017, were divided into control and SAS groups. Patients in the control group were administered a single dose of 0.1 to 0.3 mg/kg midazolam, based on physicians' clinical experience. The initial dose of midazolam in the SAS group was 0.1 mg/kg, and was adjusted based on the SAS score, as evaluated by physicians. Between-group comparisons were made of midazolam dose; adverse reactions of midazolam, such as agitation, delirium, excessive sedation, and respiratory depression; operating time of bronchoscopy; and number of participants.No statistically significant differences in gender, age distribution, weight, or disease composition were observed between the groups. The midazolam dose, operating time, and number of participants at different ages were all lower in the SAS group than in the control group. Fewer adverse drug reactions, such as intraoperative agitation and delirium, were noted in the SAS group. Moreover, the overall number of participants was reduced, and the overall operating time was less than that in the control group.Application of SAS for assessment of sedation during pediatric bronchoscopy can guide individualized administration of midazolam, reduce midazolam dose while achieving an ideal sedative effect, reduce adverse reactions, and improve operator experience. Hence, its use should be promoted for pediatric patients undergoing bronchoscopy under local anesthesia and conscious sedation.

The effects of baicalin on the TLR2/4 signaling pathway in the peripheral blood mononuclear cells of a lipopolysaccharide-induced rat fever model.

Baicalin, which is a flavonoid compound isolated from Scutellariae radix, has significant antipyretic effects. The aim of the present study was to evaluate the effects of baicalin on the Toll-like receptor 2/4 (TLR2/4) signaling pathway in the peripheral blood mononuclear cells (PBMCs) of a rat fever model induced by lipopolysaccharide (LPS). Sprague-Dawley rats were injected intraperitoneally with 100µg/kg LPS with or without a 160mg/kg baicalin treatment to induce fever. The results showed that baicalin significantly reduced the body temperatures of the fever-induced rats, inhibited the LPS-modulated upregulation of TLR4 mRNA and protein expression and TNF-α and IL-1ß mRNA expression in the rat PBMCs and downregulated nuclear factor-κB activation with simultaneous decreases in TNF-α and IL-1ß protein expression. The LPS and baicalin had no significant effect on TLR2 mRNA or protein expression in the PBMCs. These data suggest that baicalin can inhibit the TLR4 signaling pathway in the PBMCs of our animal model. Our findings may provide new mechanistic insights into the antipyretic effects of baicalin.