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The Minimum Alveolar Concentration of Desflurane is Varied in Patients with End-Stage Renal Disease

Author: JiangXingHua
Tutor: WangYaPing
School: Central South University
Course: Anesthesiology
Keywords: ESRD Inhalation anesthetics MAC-awake Neuron-specific enolase
CLC: R692.5
Type: Master's thesis
Year: 2008
Downloads: 11
Quote: 0
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Abstract


Purpose This project intends to ESRD patients by observing whether inhaled anesthetics ( desflurane ) half awake alveolar concentration (MAC-awake) and neuron -specific enolase (NSE) changes and correlation . Methods ESRD group (I group ) and urinary stone disease group (C ) of the 22 patients , two groups of patients were performed using desflurane inhalation induction of anesthesia , each patient determination of the MAC-awake patients able to voice commands to make the right response. Measured during spontaneous breathing patients to maintain , and by regulating the flow of oxygen vaporizer first make the end-tidal concentration of desflurane quickly reach 1.4% and to maintain this concentration within 15min to make alveolar anesthetic gas partial pressure and brain anesthetic gas partial pressure reaches equilibrium , then the observer with a medium level sound require patients eyes open , if the patient is able to react correctly , then the elevated end-tidal desflurane concentration of 0.1% , and then to maintain 15min, and then continue to repeat the command . When the end-tidal desflurane concentration to make the voice of the patient is no longer able to make the correct response , MAC-awake the end of the determination . In patients with normal voice commands can not open eyes on the lowest end-tidal concentration and the highest when the patient can open eyes as the average end-tidal concentration of desflurane in patients with MAC-awake values. Two groups of patients MAC-awake values ??measured after peripheral venous blood samples were taken 5ml, double sterile gauze 3000r/min centrifugal filtration after 15 minutes , specimens were frozen at -20 ° C under test . All specimens Riuzzi later immunoassay neuron-specific enolase NSE concentration values ??. Results ESRD patients desflurane MAC-awake value (1.26 ± 0.62)% was significantly lower than the control group (2.28 ± 0.32)%; p <0.001. Which reflects brain damage neuron-specific enolase NSE was significantly higher (22.4 ± 16 vs11.32 ± 3.8; p <0.001). MAC-awake and neuron-specific enolase NSE showed a significant negative correlation . Conclusion ESRD patients desflurane MAC-awake values ??than non- ESRD patients is reduced . MAC-awake and neuron-specific enolase NSE showed a significant negative correlation .

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CLC: > Medicine, health > Surgery > Urology ( urinary and reproductive system diseases) > Kidney disease > Renal failure
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