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Objective:To compare the efficacy of HES 130/0.4 and acetate Ringer′s solution (A-HES) and HES 130/0.4 and normal saline (NS-HES) for volume therapy in the patients undergoing non-cardiac surgery with general anesthesia.Methods:Two hundred and fifty American Society of Anesthesiologist physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18-32 kg/m 2, undergoing noncardiac surgery with general anesthesia, were divided into group A-HES and group NS-HES using the stratified block randomization technique.A-HES and NS-HES 15 ml/kg were intravenously infused over 1 h immediately after induction of anesthesia in A-HES and NS-HES groups, respectively.Mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP) were recorded before and after infusion, and the maximum changing rate of MAP and HR and the maximum change in CVP were calculated.The pH value, BE and HCO 3- were recorded before infusion and at 15 min after the end of infusion, and Hb, Hct, electrolytes, blood glucose, blood biochemical parameters and parameters of coagulation function were measured.The occurrence of abnormal blood biochemical parameters, blood glucose, and parameters of coagulation function, intraoperative requirement for vasoactive drugs, occurrence of HES-related adverse events, and intraoperative fluid intake and output were recorded. Results:A total of 251 cases were actually enrolled in this study, with 125 cases in group A-HES, and 126 cases in group NS-HES.Compared with group NS-HES, no significant change was found in the maximum changing rate of MAP and HR and the maximum change in CVP ( P>0.05) in group A-HES, and non-inferiority analysis showed that group A-HES was not inferior to group NS-HES.Compared with group NS-HES, the concentrations of BE and HCO 3-, K + , Ca 2+ and Mg 2+ were significantly increased, the concentrations of Na + and Cl - were decreased, the PT was shortened, the incidence of abnormal PT was decreased at 15 min after the end of infusion ( P< 0.05), and no significant change was found in the other parameters mentioned above in group A-HES ( P>0.05). Conclusion:The volume expanding effect of A-HES and its effect on liver and kidney function are not significantly different from those of NS-HES, however, A-HES has certain advantages in maintaining acid-base balance, electrolyte stability and coagulation function.
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Objective To evaluate the efficacy and safety of oxycodone hydrochloride injection for postoperative analgesia in patients undergoing the operation under general anesthesia in a prospective,randomized,blind,multicenter,positive-controlled,clinical trial.Methods Two hundred and forty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 40-95 kg,scheduled for elective abdominal operation or orthopedic surgeries under general anesthesia,were randomly divided into 2 groups (n =120 each):morphine sulfate injection group (group M) and oxycodone hydrochloride injection group (group O).Morphine or oxycodone 1 mg was injected intravenously when the patients complained of pain after tracheal extubation or removal of the laryngeal mask,and administration was repeated if necessary until VAS≤40 mm.Then patient-controlled intravenous analgesia (PCIA) (100 ml,0.5 mg/ml) with morphine or oxycodone was used for postoperative analgesia (lasting for 48 h).The PCIA pump was set up with a 1 ml bolus dose,a 5 min lockout interval and background infusion at a rate of 0.5 mg/h.Pain at rest and during movement was assessed using VAS score at 3,24 and 48 h after administration,and non-inferiority test was performed.Total morphine or oxycodone consumption,requirement for rescue analgesic,the number of unsuccessfully delivered dose,the number of attempts,and the level of patient' s satisfaction were recorded within 48 h after operation.The adverse events were recorded and laboratory examinations (blood and urine routine test,blood biochemical examination) were performed within 72 h after administration.Results There was no significant difference in the VAS scores at rest and during movement at different time points,requirement for rescue analgesic,the number of unsuccessfully delivered doses and attempts,level of patient' s satisfaction,total morphine or oxycodone consumption,and adverse events between the two groups (P ＞ 0.05).No serious adverse event occurred in the two groups.The most common adverse event was nausea,followed by vomiting.There was no significant difference in the incidences and degree of nausea and vomiting between the two groups (P ＞ 0.05).The incidences of nausea and vomiting in patients underwent orthopedic surgeries were significantly lower in group O than in group M (P ＜ 0.05).The other adverse events were fewer and abnormal laboratory examinations were rare in the two groups.95％ confidence interval of the difference between the mean VAS scores at rest and during movement at each time point was within 15 mm (boundary values of non-inferiority testing) in the two groups.Conclusion PCIA with oxycodone hydrochloride injection is safe and effective in reducing pain after moderate or major operation,and the analgesic efficacy is similar to that of morphine sulfate injection,however,the development of nausea and vomiting is reduced when PCIA with oxycodone hydrochloride injection is used for orthopedic surgeries as compared with that when morphine sulfate injection is used and the ratio between the analgesic efficacy of the two drugs is close to 1∶1.
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The fluid status variate sharply in patients after operation. Appropriate fluid therapy is essential to reduce perioperative complications, shorten hospitalization days and improve prognosis of postoperative patients. In this article, we reviewed the relevant issues about fluid therapy strategy for postoperative patients such as the variation of body fluid in patients after operation, the assessment of fluid status, the establishment of the goal of fluid therapy and the selection of strategy or fluid for fluid therapy in patients after operation.
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Objective To observe the therapeutic effect of irradiation of the lumbar sympathetic ganglia by linear polarized light for the lower-limb neuropathie pain.Methods The lumbar sympathetic ganglia was irradiated by super liar therapeutic equipment focused on L_2 as the center,once a day,20 min each time for 30 days.Skin temperature on the lower limb,VAS score and pain threshold were evaluated.Results Compared to before,the skin temperature increased (P<0.01),VAS decreased (P<0.01),and pain threshold incresed(P<0.01).Conclusion The super lizer irradiation has a good therapeutic effect on lower extremity neuropathic pain
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Objective To investigate the pharmacodynamics of cis-atracurium after a single bolus injection in adults and children undergoing live donor liver transplantation during preanhepatic,anhepatic and neohepatic phase.Methods Twenty-six ASA Ⅲ or Ⅳ patients aged 7 months-64 yr,werghing 6-80 kg of beth sexes undergoing live donor liver transplantation were assigned to one of 2 groups:group A adults (n=16) and group B children(n=10).Anesthesia was induced with midazolam 0.05 mg/kg and fentanyl 3-5 μg/kg in both groups and propofol TCI (Cp 3μg/ml) in adults.As soon as the patients lost consciousness,tracheal intubation was facilitated with 2×ES95 of cis-atracurium (0.1 mg/kg).The intubation condition wag recorded.The response of the adductor pollicis to TOF stimulation of the ulnar nerve was recorded (TOF-Guard).An increment of cis-atracurium 0.03 mg/kg was given when T1 returned to 25% of baseline value or the four twitches appeared.Cis-atracurium administration and sevoflurane inhalation were stopped before the three phases and resumed when T1 reached 75% of baseline value.The onset time,mterval between the 2 cis-atracurium administrations,duration of clinical action and recovery of neuromuscular block were recorded.The intubation condition was evaluated.Results The onset time was significantly shorter in adults than in children.There was no significant difference in intubation condition between the 2 groups.The interval between the 2 cis-atracurium administrations and duration of clinical action were similar during the 3 phases in adults and significantly shorter during neohepatic phase than during anhepatic phase in children.The recovery was faster in children than in adults.Conclusion Cis-atracurium 2×ED95 (0.1 mg/kg)can be used for both adults and children undergoing live donor liver transplantation.The onset time is longer and recovery is faster in children than in adults.Cis-atracurium is suitable for patients of different ages and liver function.
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Objective To investigate the effect of electro-acupuncture (EA) on vascular permeability in patients undergoing open-heart surgery with CPB. Methods Thirty-two NYHA class Ⅰ or Ⅱ and ASA class Ⅱ or Ⅲ patients with BMI of 19-28 kg/m2 undergoing open heart surgery with CPB were randomly divided into 2 groups ( n = 16 each): Ⅰ control group and Ⅱ acupuncture group . The patients were premedicated with intramuscular phenobarbital 0.1 g, pethidine 50 mg and scopolamine 0.3 mg. Anesthesia was induced with midazolam, propofol, fentanyl and vecuronium and maintained with TCI of propofol and fentanyl in both groups. The patients were acupuncture points (neiguan, lieque, yunmen) were selected for stimulation with stimulator. Acupuncture stimulation was started from 30 min before anesthesia induction and continued until the end of operation. The level of sedation was monitored by BIS and maintained at 40-60 during operation. Urinary microalbumin concentration was used as a parameter of vascular permeability, and was measured before and at the end of operation. Blood samples were taken 24 h before and 24 h after operation for measurement of ALT, AST, total bilirubin, BUN and Cr. Results The two groups were comparable with respect to sex ratio, age, body weight, ASA physical status, and preoperative ejection fraction. There was no significant difference in renal and liver function between the 2 groups.Postoperative urinary microalbumin concentration was significantly lower in acupuncture group than in control group. Conclusion Acupuncture can reduce the effect of open heart surgery performed under CPB on vascular permeability.
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Objective To investigate the changes in the dose requirements of rocuronium after right hemihepatectomy in donor of living donor liver transplantation. Methods Sixteen ASA Ⅰ patients of living donor liver transplantation, aged 21-49 yr, weighing 51-86 kg, scheduled for right hemihepatectomy, were enrolled in this study. Anesthesia was induced with iv midazolam and fentanyl, and TCI of propofol and rocuronium. Changes in adductor pollicis muscle were monitored by the train of four (TOF) stimulation. The patients were mechaincally ventilated after tracheal intubation when T1/Tc = 0. The target plasma concentration of rocuroniurn was reduced to 1.0 μg/ml after tracheal intubation and the concentration was regulated to maintain 0 < T1 ≤ 10%. Anesthesia was maintained with sevoflurane inhalation, TCI of propofol, intermittent iv injection of fentanyl. The infusion of rocuronium and inhalation of sevoflurane were stopped before the second time of cholangiography, the total time and amount of rocuronium administered and the recovery of muscle relaxation were recorded at this time (before hemihepatectomy). The infusion of rocuronium and inhalation of sevoflurune were rests-ted after right hemibepatectomy. After the peritoneum was closed, the infusion of rocuroniurn and inhalation of sevoflurane were stopped again, the total time and amount of rocuronium administered and the recovery of muscle relaxation were also recorded at this time (after hemihepatectomy). Results The amount of rocuronium administered was significantly reduced after hemihepatectomy compared with that before hernihepatectomy (P < 0.05). The amount of rocurunium administered after hemihepatectomy was (67 ± 13) % of that before hemihepatectomy. Conclusion Right hemihepatectomy can affect the metabolism of rocuronium in the donor of living donor liver transplantation.
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We have developed a mini acupuncture manipulator, which can simulate the traditional needling therapy and can inquired about the acu-related physical parameters which could not be quantitatively studied in the past. For example, we can control the depth, velocity, angle, angular velocity, frequency and interval time of acupuncture. The experimental study on Sprague-Dawley rat's acute hemorrhagic shock model was conducted to compare the curative effect of acupuncture manipulator versus that of electroacupuncture. This experiment demonstrated that the acupuncture manipulator can imitate hand acupuncture in security and can produce the effect similar to that of electroacupuncture. So this mini acupuncture manipulator can be of applications in research, teaching and clinical treatment.
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Animals , Female , Male , Rats , Acupuncture Therapy , Biosensing Techniques , Equipment Design , Random Allocation , Rats, Sprague-Dawley , Shock, Hemorrhagic , Therapeutics , SoftwareABSTRACT
OBJECTIVE: To sum up the advantages and disadvantages as well as application prospects of several kinds of new devices in airway management, including the laryngeal mask airway (LMA), esophageal-tracheal combitubes (ETC),fribreoptic stylet laryngoscope (FOS), video Macintosh intubating laryngoscope system (VMS) and GlideScope(R) videolaryngoscope(GSVL).DATA SOURCES: Using the terms "airway management", we searched Medline for airway management device-related articles, which were published during January 1990 to February 2006 in English.STUDY SELECTION: The materials were firstly selected. Successful rate of intubation, intubation-related complications and incidence in studying tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen. Inclusive .criteria: ① Randomized and controlled study of adult cases. ② Clinical studies or case report. ③ Including the studies of general airway or difficult airway. Exclusive criteria: ① Study of intubation in children. ② Repetitive study.DATA EXTRACTION: Eighty-six articles about tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen, among which, 36 were included in this study, and 50 were excluded due to study on intubation in children or repetitive study.DATA SYNTHESIS: Correct placement does not affect vocal cord movement, so patients may vocalize while an LMA is in place. Its successful rate is over 90%. Its most attractive advantages are increased speed and ease of placement by both inexperienced personal and experienced anesthesiologists, low frequency of cough and low incidence. The esophageal tracheal combrtube is a supraglottic airway device that functions as an effective alternative to ventilization via mask and tracheal intubation in both the esophageal and tracheal position. It is successful when emergency occurs, but it is only suitable for adults. The flexibility of FOS allows for intubation of patients, without the need for head and neck manipulation. The main disadvantages of FOS are their limited field of view and the high cost of purchase and maintenance. Observation and manipulation in using VMS can be performed in one axis. GSVL provides a clear view of larynx on the monitor instead of directly viewed by the operator.CONCLUSION: These new devices of airway management can relatively decrease the intubation difficulty, increase the successful rate and lead to lower complication incidence. The skills of these new airway management devices should be included in the modern anesthesia residency program.
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Objective To observe the protective effects of hypoxic preconditioning(HPC) on the improvement of the cognitive dysfunction(learning and memory) and the damage in hippocampus induced by global cerebral ischemia/reperfusion(I/R) in CA1 and CA3 for 5 days in rats,and on the regulation of expression of erythropoietin(EPO) protein to approach the mechanism of the protection.Methods One hundred and twenty adult male Sprague-Dawley(SD) rats were divided into four groups randomly: sham group,I/R group,HPC24 group(hypoxia for 24 hours before I/R) and HPC48 group(hypoxia for 48 hours before I/R).Hang(motor function),passive avoidance and Morris water maze tests were carried out on the 5th day after I/R to measure the motor and cognition functions;hematoxylin-eosin(HE) staining was used to detected histopathological changes in hippocampus tissues;and the contents of EPO were tested by immunohistochemistry at 1 hour and 4 hours after I/R from hippocampus CA1 and CA3 regions.Results Hang,passive avoidance and Morris water maze tests showed that I/R can injure rat cognition;the improvement of cognition was marked in HPC groups, and it was shown that the effects were more significant in HPC48 group than those in the HPC24 group(P
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Objective To investigate the changes in mechanics of respiration during perioperative period in patients undergoing orthotopic liver transplantation (OLT) without venovenous bypass. Methods Thirty patients of grade Ⅱ～Ⅲ according to the American Society of Anesthesiologists (ASA) classification, undergoing orthotopic liver transplantation without venovenous bypass, were included in this study. The respiratory parameters measured perioperatively included average airway resistance, peak inspiratory pressure, peak expiratory flow rate, dynamic compliance, work of breathing and respiratory drive. The complications of respiratory system during postoperative period were observed. Results Average airway resistance was decreased after abdominal cavity opening, decreased significantly at 5 min new hepatic phase and increased postoperatively. Peak expiratory flow rate and dynamic compliance were increased gradually after induction and increased significantly at anhepatic phase and new hepatic phase but decreased significantly on the first day postoperatively. Work of breathing was decreased after induction and decreased significantly at anhepatic phase and postoperative period. There was no significant difference in peak inspiratory pressure during operation. Compared with the values preoperation, the respiratory drive was decreased significantly during anhepatic phase and new hepatic phase. Total 35 times of postoperative respiratory complications occurred, which included pleural effusion, atelectasis, pulmonary artery hypertension, pulmonary interstitial edema and pnermonia. Conclusions There are obvious changes in respiratory mechanics during perioperative period of OLT, especially in postoperative period. Mechanical respiratory support is essential for patients until respiratory function recovers.
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Aim To investigate the protective effects of high concentration fentanyl on the brain slice injury induced by oxygen glucose deprivation(OGD).Methods Rat brain slices were made and randomly assigned to four groups:control(n=10),OGD(n=10),fentanyl 50 ?g?L~(-1)(F_(50),n=10) and fentanyl 500 ?g?L~(-1)(F_(500),n=10).Changes of the neuron injury and apoptosis were observed with TTC staining,LDH releases,TUNEL staining,immunohistochemistry and electromicroscope.In addition,changes of intracellular calcium were measured with confocal laser-scanning microscopy.Results F_(50) and F_(500) attenuated the decrease of TTC staining and the increase of LDH release induced by OGD in brain slices.Neuronal apoptosis and changes of neuronal ultrastructures were attenuated by F_(50) and F_(500).Bcl-2 and Bax protein expressions were increased after OGD.Bax protein expression was decreased by F_(50) and F_(500),while Bcl-2 protein expression was increased by F_(50)and F_(500).Intracellular calcium concentration was increased by OGD and then it was lowered by F_(50) and F_(500).The protective effects of F_(50) were more obvious than that of F_(500).Conclusions High concentrations of fentanyl have neuron protective effects against OGD injury in rat brain slices,and fentanyl 50 ?g?L~(-1) has more obvious protective effects than fentanyl 500 ?g?L~(-1).
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OBJECTIVE:To build up a method for the determination of propofol in plasma by RP-HPLC with fluores?cence detection.METHODS:The separation was performed on a reversed-phase Zorbax Eclipse XDB-C 18 column(150mm?4.6mm,5?m)with a mobile phase consisting of methanol-acetonitrile-0.005mol/L sodium acetate buffer(pH4.0)(55∶20∶25,V/V).Propofol was extracted from plasma and dissolved in the mobile phase then detected at276/310nm.RESULTS:The calibration curve had the fine linearity in the concentration range of0.015625～8?g/ml(r=0.9998).The limit of detection(LOD)was1ng/ml(S/N ratio=3),the limit of quantification(LOQ)was10ng/ml.The absolute recovery was89.33%～93.37%,the relative recovery was97.75%～103.31%.The within-day and between-day precision(RSD%)was1.38%～5.02%and4.45%～9.056%respectively.CONCLUSION:The method is simple,stable and highly sensitive and can meet with the research of clinical pharmacokinetics.
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Objective To investigate the characteristics of pharmacodynamics of rocuronium in elderly patients. Methods Ninety-four ASA Ⅰ - Ⅱ patients aged between 32-97 yr were divided into 4 age groups : groupⅠ 32-59 yr(n=28);group Ⅱ 60-69 yr (n = 29);group Ⅲ 70-89 yr (n=27);group Ⅳ 90-97 yr (n=10).The patients were premedieated with intramuscular phenobarbital 0.lg and atropine 0.5 mg. Anesthesia was induced with midazolam, propofol and fentanyl. Tracheal intubation was facilitated with rocuronium 0.6 mg?kg-1.The patients were mechanically ventilated and PET CO2 was maintained between 35-45 mm Hg. Anesthesia was maintained with isoflurane 1 MAC and intermittent iv boluses of fentanyl. Rocuronium was continuously infused during operation to maintain T1 at 10%-20% control.Neuromuscular (N-M) function was monitored using TOF response measured by accelerography.(1) Onset time (time from end of rocuronium injection to 100% block of T4 ),(2) maximal effect (time from end of injection to 100% block of T1 ),(3) clinical duration (time from end of injection to 10% recovery of T1 ) ,(4) intubating condition,(5) the amount of rocuronium consumed every 30 min and (6) recovery time (time from termination of rocuronium infusion to recovery of T1 to 25% control)Results (1) The onset time and the time of maximal effect were significantly longer in group Ⅰ than those in other three groups.(2) The time of maximal effect in group Ⅳ was significantly shorter than that in group Ⅱ and Ⅲ (3)The recovery time in group Ⅰ and Ⅱ was significantly shorter than that in group Ⅲ and Ⅳ.(4) The amount of rocuronium consumed per 30 min was decreasing with increasing duration of infusion and age. Conclusion The duration of action of rocuronium is longer and less amount of rocuronium is needed when it is given to elderly patients.
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Objective To evaluate the accuracy of a new generation bioimpedance cardiac output monitor as compared with thermodilution and end expiratory CO 2 techniques Methods Sixteen patients (14 males, 2 females) aged (58?12) years undergoing elective coronary artery bypass (CAB) surgery were studied Cardiac output was measured after CAB surgery in ICU using a new generation bioimpedance cardiac output monitor(Rheo Bioimpedance Hemodynamic monitor) and conventional thermodilution technique in 16 patients and end expiratory CO 2 technique in 10 patients Cardiac output was also measured with Rheo Bioimpedance Hemodynamic monitor in 200 healthy volunteers consisting of equal numbers of male and female The volunteers of each sex were further divided into 5 equal groups of 20 each: (1)20 29 years, (2)30 39 years, (3)40 49 years, (4)50 59 years and (5)60 70 years Results Cardiac outputs measured by bioimpedance and thermodilution techniques were well correlated (r=0 83) and there was also a good correlation between cardiac outputs measured by bioimpedance and end expiratory CO 2 techniques(r=0 88) Cardiac out measured with Rheo Bioimpedance Hemodynamic monitor in 200 healthy volunteers showed that there was a significant difference in cardiac output between 60 70 years age group and the other age groups in both male and female Conclusions Cardiac output and other hemodynamic parameters measured with the new generation bioimpedance hemodynamic monitor are accurate and can be used for preoperative cardiovascular function evaluation and postoperative monitoring of dynamic changes in circulatory function
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Objective Since rocuronium (R) is excreted unchanged in the urine and bile, thus the duration of action may be increased in patients with liver dysfunction. The purpose of this study was to evaluate the neuromuscular blocking effect of R in patients with portal hypertension. Methods Seventy ASAⅠ-Ⅱ patients (36 males, 34 females) aged 30-60 yrs were divided into 2 groups : portal hypertension group (n=36) (PH) and control group (C) (n = 34). The liver function of the patients in PH group was classified as Child-Turcottee grade Ⅱ while those in C group had no liver dysfunction. The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg. Anesthesia was induced with midazolam 0.02 mg?kg-1 , propofol 1.0 mg?kg-1 , fentanyl 5 ?g?kg-1 and R 0.6 mg?kg-1 and maintained with isoflurane and intermittent i.v. boluses of fentanyl. R was continuously infused. The patients were mechanically ventilated after tracheal intubation. PETCO2 was maintained at 35-45 mm Hg . The N-M function was monitored by accelerography using TOF stimulation. (1) The onset time (from the end of R injection to maximal paralysis (T1=0). (2) Maximum depression time (the duration of completely no response to TOF stimulation. (3) Maintenance time (T1 returned to 10% ) . (4) recovery time (T1 returned to 25% after R infusion was stopped) and (5) recovery index (T1 returned from 25%-75%) were recorded. The amount of R infused every 30 min was also recorded. Results The two groups were comparable with respect to sex and age. The onset time and maximum depression time were significantly longer in PH group than in group C ( P
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To assess the concentration-responses relationships of propofol, 16 adult patient,ASA grade Ⅰ-Ⅱ,scheduled for upper abdominal operation, were randomly allocated to undergoing epidural block (group Ⅰ, n = 8)or combined anesthesia (group Ⅱ, n = 8) respectively. After a bolus injection of propofol 2.5mg ?kg, blood pressure (BP), heart rate (HR) and tidal volume (TV) were recorded, and drowsiness,amnesia,cooperation and orientation were evaluated by scorring scales in both groups. The venous samples were taken before and after the administration to measure the propofol plasma concentration by spectrofluorophotometric detector. The results revealed that there were no significant differences in pharmacokinetic parameters between two groups;the plasma concentration of propofol at 2. 5rag. L~(-1) was required for adequate anesthesia,and 1.5 to 1.9rag. L~(-1) for hypnosis,the patients were fully awake at 0.94?0.3mg. L~(-1); BP,HR and TV were significantly depressed at more than 2.0rag. L~(-1), and recovered to baseline at less than 1.5mg. L~(-1). It is suggested that there are good relationships between propofol plasma concentrations and its pharmacodynamic responses.
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0 05), while the difference between RBco and TDco was significant before CPB was started and 60min after termination of CPB (P
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Objective To observe the effects of desflurane, sevoflurane and isoflurane on hepatic oxygen balance and hepatic blood flow Methods Fifteen pigs were randomly divided into three groups: A desflurane group(n=5), B sevoflurane group(n=5), C isoflurane group(n=5) This study observed the effects of desflurane, sevoflurane and isoflurane on systemic and hepatic blood flow and oxygen balance with different concentrations using continuous thermodilution cardiac output monitor and ultrasonic Doppler blood flow monitorResults ①Hepatic blood flow: total hepatic blood flow(THBF) decreased dose-dependently in three groups without significant differences between groups The effects of desflurnae and sevoflurane on THBF were same as those on cardiac output(CO), while the effect of sevoflurane on THBF was larger than that on CO ②Oxygen balance: both systemic oxygen delivery(DO_2) and hepatic oxygen delivery(HDO_2) decreased significantly with the increasing of inhalation concentrations, systemic oxygen delivery(VO_2) and hepatic oxygen consumption(HVO_2) decreased significantly only at high concentration The effects of desflurnae and sevoflurane on HVO_2 and HDO_2 were same as those on VO_2 and DO_2, while the effect of sevoflurane on HDO_2 was larger than that on DO_2, but the effect of sevoflurane on HVO_2 was still same as that on VO_2Conclusions Because of the dose-dependently decreased hepatic blood flow, hepatic oxygen delivery decreases significantly, but hepatic oxygen consumption can be maintained well by self-regulation of hepatic oxygen extraction ratio,indicating that there is almost no influence on hepatic intracellular respiration and metabolism
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Objective To investigate the preventive effect of midazolam pretreatment against neurotoxicity of ropivacaine and the underlying mechanism. Methods Thirty male SD rats aged 4-6 months weighing 250-300 g were randomly divided into 3 groups with 10 animals in each group: group Ⅰ blank control; group Ⅱ ropivacaine (R) and group Ⅲ midazolam-ropivacaine (M-R). In group R and M-R 0.75% ropivacaine was infused i.v. at a rate of 0.5 ml?min-1 until the animal developed convulsion. The animals were killed and brains were immediately removed for detennination of glutamate, aspartate, glycine and GABA content in the brain. Venous blood samples were taken for determination of pH and plasma concentration of lactate. The total amount of ropivacaine infused was calculated.Results The plasma lactate concentration was significantly higher and pH was significantly lower in group R than in blank control group. The concentrations of the 4 amino acids in the brain were significantly increased in group R and M-R as compared with the blank control group. The aspartate, glycine and GABA contents in the brain were significantly lower in M-R group than in R group. The total amount of ropivacaine infused i.v. was significant larger in group M-R than in group R.Conclusion Midazolam pretreatment can prevent the neurotoxicity of ropivacaine by modulating the balance between excitatory and inhibitory amino acids.