[Electroacupuncture in the prevention and treatment of sore throat and nausea and vomiting after gastrointestinal surgery: a randomized controlled trial].

OBJECTIVE: To observe the effect of electroacupuncture (EA) intervention on postoperative sore throat (POST) and postoperative nausea and vomiting (PONV) after endotracheal intubation and general anesthesia. METHODS: According to the random number table, 60 patients of gastrointestinal surgery under general anesthesia with tracheal intubation were randomly divided into EA group (30 cases) and control group (30 cases). Patients in the EA group were given acupuncture at Shaoshang (LU11) 30 minutes before general anesthesia, and EA at Chize (LU5) and Hegu (LI4) continued until the operation was completed. The incidence and severity of POST and visual analogue scale (VAS) score at 12, 24, and 48 h after surgery, and the incidence and severity of PONV at 12, 24 h after surgery were analyzed, respectively. RESULTS: The incidence and severity of POST and PONV, and VAS score in the EA group were significantly lower than those in the control group 12 h and 24 h after surgery (P<0.05). Both groups had significant reductions in VAS score at 24 h and 48 h after surgery compared with that at 12 h (P<0.05). CONCLUSION: EA can significantly improve the prognosis of patients on sore throat and reduce the incidence of PONV.

Effect of bispectral index-guided anesthesia on consumption of anesthetics and early postoperative cognitive dysfunction after liver transplantation: An observational study.

The objective of this study was to summarize the incidence of postoperative cognitive dysfunction (POCD) after 7days following liver transplantation (LT), and to evaluate the effectiveness of bispectral index (BIS) guided anesthetic intervention in reducing POCD. Additional serum concentrations of S100ß and neuron-specific enolase (NSE) were detected during surgery to determine whether they were reliable predictors of POCD.Patients who underwent LT at Beijing YouAn Hospital Affiliated to Capital University of Medical Science from January 2014 to December 2015 were enrolled. BIS monitor was needed during surgery. Patients who underwent LT without BIS monitoring during August 2012 to December 2014 served as historical controls. A battery of 5 neuropsychological tests were performed and scored preoperatively and 7days after surgery. POCD was diagnosed by the method of one standard deviation (SD). The blood samples of BIS group were collected at 5 time points: just before induction of general anesthesia (T0), 60 minutes after skin incision (T1), 30 minutes after the start of the anhepatic phase (T2), 15 minutes after reperfusion of the new liver (T3), and at 24 hours after surgery (T4).A total of 33 patients were included in BIS group, and 27 in the control group. Mean arterial pressure was different between 2 groups at 30 minutes after the start of the anhepatic phase (P = .032). The dose of propofol using at anhepatic phase 30 min and new liver 15 min was lower in the BIS group than control group (0.042 ±â€Š0.021 vs. 0.069 ±â€Š0.030, P < .001; 0.053 ±â€Š0.022 vs. 0.072 ±â€Š0.020, P = .001). Five patients were diagnosed as having POCD after 7 days in the BIS group and the incidence of POCD was 15.15%. In the control group, 9 patients had POCD and the incidence of POCD was 33.33%. The incidence of POCD between 2 groups had no statistical difference (P = .089). S100ß increased at stage of anhepatic 30 minutes (T2) and new liver 15 minutes (T3) compared with the stage of before anesthesia (T0) (1.49 ±â€Š0.66 vs. 0.72 ±â€Š0.53, P < .001; 1.92 ±â€Š0.78 vs. 0.72 ±â€Š0.53, P < .001). NSE increased at stage of anhepatic 30 minutes (T2) and new liver 15 minutes (T3) compared with the stage of before anesthesia (T0) (5.80 ±â€Š3.03 vs. 3.58 ±â€Š3.24, P = .001; 10.04 ±â€Š5.65 vs. 3.58 ±â€Š3.24, P < .001). At 24 hours after surgery, S100ß had no difference compared to one before anesthesia (1.0 ±â€Š0.62 vs. 0.72 ±â€Š0.53, P = .075), but NSE still remained high (5.19 ±â€Š3.64 vs. 3.58 ±â€Š3.24, P = .043). There were no significant differences in the serum concentrations of S100ß between patients with and without POCD at 5 time points of operation (P > .05). But at 24 hours after surgery, NSE concentrations were still high of patients with POCD (8.14 ±â€Š3.25 vs. 4.81 ±â€Š3.50, P = .035).BIS-guided anesthesia can reduce consumption of propofol during anhepatic and new liver phase. Patients in BIS group seem to have a mild lower incidence of POCD compared to controls, but no statistical significant. The influence of BIS-guided anesthesia on POCD needs to be further confirmed by large-scale clinical study. S100ß protein and NSE are well correlative with neural injury, but NSE is more suitable for assessment of incidence of postoperative cognitive deficits after surgery.

[Determination of the concentration of ropivacaine in dog plasma by reversed-phase high performance liquid chromatography].

OBJECTIVE: To establish a Reversed-Phase high performance liquid chromatography method for determination of plasma ropivacaine in dog. METHODS: The concentration of ropivacaine was assayed on Intertsil C18 column (4.6 mm x 250 mm, 5 microm)with a mobile phase consisting of methanol: H2O (50:50), the detection wavelength was 215nm and the flow rate was 1.4 ml/min. the column temperature was 20 degrees C and the sensitivity was 0.02 AUFS respectively. the volume of sample for detection is 10 microl. RESULTS: the linear range was 0.1-25 microg/ml (r = 0.9982). The recovery of ropivacaine was 91.2%-93.6%, RSD were 2.10%-3.40% (n=6). The detection limit was 0.05 microg/ml. the intra-day and interday precisions of assay for ropivacaine was 1.35%-2.88% and 1.80%-3.76%. CONCLUSION: This method is simple, rapid, accurate and convenient for determination of the concentration of ropivacaine in dog plasma.