[The effect of surfentanyl and fentanyl at rhythmic spontaneous contraction on isolated rabbits uterine smooth muscles].

OBJECTIVE: To investigate the effects of surfentanyl and fentanyl on spontaneous contractions of isolated uterine smooth muscles of rabbits. METHODS: Thirty isolated uterine smooth muscles strips of rabbits with rhythmic spontaneous contraction were randomly divided into three groups: control group (n = 10) fentanyl group (n = 10) and surfentanyl group (n = 10). The effects of fentanyl and surfentanyl on spontaneous contractions intensity, frequency and duration of isolated uterine smooth muscles of rabbits in different concentrationswere monitored. RESULTS: There were no effect on the spontaneous contraction of isolated uterine muscles of rabbits at the concentration of 1 x 10(-8) mol/L in fentanyl group. The spontaneous contraction intensity was decreased significantly when the concentration of fentanyl more than 3 x 10(-8) mol/L (P < 0.05). The spontaneous contraction intensity, frequency and duration was inhibited more than 50% when the concentration of fentanyl more than 3 x 10(-7) mol/L (P < 0.05). And the spontaneous contraction duration was inhibited more than 50% when the concentration of surfentanyl more than 1 x 10(-7) mol/L (P < 0.05). Compared with surfentanyl group, there were significant difference on spontaneous contraction intensity when the concentration of fentanyl more than 3 x 10(-8) mol/L (P < 0.05). Difference on frequency, more than 3 x 10(-8) mol/L (P < 0.05) and difference on duration, at the concentration of 1 x 10(-7) and 1 x 10(-7) mol/L (P < 0.05). CONCLUSION: Fentanyl restrained the spontaneous contractions of isolated uterine smooth muscles of rabbits in concentration-dependent manner. Surfentanyl could reduce the spontaneous contractions duration on isolated uterine smooth muscles of rabbits. But there were no effect on frequency and duration.

[The application of nasopharyngeal airway in nurosurgery patients during anesthesia recovery].

OBJECTIVE: To evaluate safety and effectiveness of nasopharyngeal airway used for neurosurgery patients during the anesthesia recovery period. METHODS: A total of 60 patients (ASAI-II), aged between 25 to 67 years old, who were scheduled to undergo elective neurosurgery operation under general anesthesia, were randomly divided into the oropharyngeal airway group (group O) and the nasopharyngeal airway group (group N), with 30 cases in each group. After respiratory recovery was satisfactory at the end of operation, endotracheal tube was extubated under deep anesthesia. Afterwards, oropharyngeal airway was intubated in group O, and nasopharyngeal airway was intubated in group N. BP and HR before induction (T0), before airway intubation (T1), at 1 min (T2) and 5 min (T3) after airway intubation were recorded. Meanwhile, one-time success rate of airway intubation, the airway retention time, the times of airway regulation due to location change and the change of respiration and circulation in each groups during airway retention period were recorded. In addition, adverse reactions during airway retention period and tolerance scores of patients in both groups were recorded. RESULTS: BP and HR in group N at T1 and T2 increased significantly compared with T0 (P < 0.05), Compared with T1, BP and HR increased significantly at T2 in group N (P < 0.05). Compared with T1 and T2, the same index reduced significantly at T3 (P < 0.05). BP and HR in group N were significantly higher than those in group O at T2 (P < 0.05). Airway retention time in group N was significantly longer than that in group O [(137.4 +/- 18.32) min vs. (64.2 +/- 8.25) min, P < 0.053; the times of airway location regulation in group N was less than that in group O (0.34 +/- 0.21 vs. 2.80 +/- 0.54) (P < 0.05). During airway retention period the incidence of BP and HR exceeding the base value by 15% in group O was higher than that in group N (80.0% vs. 46.7%)(P < 0.01), and the incidence of SPO2 less than 95% in group O was higher than that in group N (26.7% vs. 6.7%) (P < 0.05). The incidence of nausea, upper airway obstruction and restlessness in group O was significantly higher than that in group N (P < 0.05). Moreover, airway tolerance score of patients in group N was significantly better than that in group O (P < 0.05). CONCLUSION: Nasopharyngeal airway could better maintain unobstructed upper airway in neurosurgery patients during the anesthesia recovery period with advantages such as small circulatory effect, good tolerance and fewer complications.

[Low-dose of furosemide to correct oliguria in gynecological surgery].

OBJECTIVE: To investigate the safety and efficay of low-dose furosemide in the correction of oliguria in the patients undergoing gynecologic surgery. METHODS: A total of 120 patients, aged between 20 to 50 years old, who were scheduled to receive elective gynecological open surgery under general anesthesia, were randomly divided into 3 groups: the control group, furosemide 0. 05 mg/kg (F0.5) group and furosemide 0. 1 mg/kg (F1) group (n=40). During surgery, blood volume and blood pressure was maintained in the normal range. The urine volume was recorded every 30 minutes. Oliguria was defined as the urine volume less than 0. 5 mL/(kg . h), When oliguria was observed, flurosemide or saline was given to the patients based on the enrollment status. If the patients were still oliguric 30 min later, the treatment was repeated. The total time of surgery, net fluid infusion volume, urine volume per unit time per body weight at the completion of surgery, the incidence of intraoperative oliguria, the total amount of furosemide and the average specific gravity of urine were recorded. RESULTS: There was no statistically significant difference in sex, age, fasting time, the total time of surgery and intraoperative net fluid infusion volume among the three groups (P>0. 05). The urine volume per unit time per body weight in control group was significantly lower than that of the other two groups (P<0. 01). The incidence of intraoperative oliguria in the three groups (control, low dose, high dose groups) were 52. 5%, 12. 5% and 0%, respectively (P<0. 01). CONCLUSION: Low-dose of furosemide could maintain normal urine volume and specific gravity of urine during gynecological surgery.

[Microsurgical treatment of gigantic dumbbell-shaped jugular foramen tumor].

OBJECTIVE: To discuss the method of microsurgical treatment for jugular foramen tumor (JFT). METHODS: Ten patients with dumbbell-shaped JFTs who were microsurgically treated by the same group were retrospectively studied, the surgical approaches includes infratemporal approach and modified far lateral approach according to tumors' size, blood feeding, hearing and growth manner. Cranial nerve function, pre- and postoperative complications, follow-up data were presented and discussed. RESULTS: Gross total tumor removal was achieved in 7 patients, subtotal removal in 2 cases, partial removal in 1 case, postoperative cerebrospinal fluid leaking in 1 cases, postoperative new cranial nerve defects in 1 cases, aggravation in 2 cases. Postoperative deficits of the cranial nerves improved in 80 percent of the patients. Favorable facial function in 6 months postoperatively (House-Brackmann grade system in Grade 1 and Grade 2) was noted in 7 of the 10 patients. The postoperative level of hearing was preserved in 3 of the 6 patients with residual hearing. Recurrence was noted in 1 case during the follow-up period. CONCLUSIONS: Surgical total removal of JFT is possible depends on microsurgical operation with the two approaches with lowly additional neurological deficits. The function of preoperative affected cranial nerves can be recovered.

Optimal dose of succinylcholine for tracheal intubation in patients during inhalation induction with sevoflurane: a randomized controlled trial.

STUDY OBJECTIVE: To determine the dose of succinylcholine during inhalation induction of a patient. DESIGNED: Prospective, double-blind, randomized study. SETTING: Operating room of a university hospital. PATIENTS: 180 adult, ASA physical status 1 and 2 patients with a suspected difficult airway, who were scheduled for surgery. INTERVENTIONS: Nonpremedicated patients were anesthetized with inhalation of 8% sevoflurane, followed by succinylcholine. Group 1 received intravenous (IV) succinylcholine 0.3 mg/kg, Group 2 had IV succinylcholine 0.6 mg/kg, and Group 3 was given IV succinylcholine 1.0 mg/kg. Direct laryngoscopy and tracheal intubation were performed after onset of succinylcholine. MEASUREMENTS: Intubation conditions were scored as excellent, good, or poor. The recovery time of spontaneous respiration, end-tidal carbon dioxide partial pressure (PETCO2), and pulse oxygen saturation (SpO2) were recorded. MAIN RESULTS: Acceptable conditions (excellent and good) for intubation were rated in 80% of Group 1 patients (0.3 mg/kg succhinylcholine), 91.7% of Group 2 patients (0.6 mg/kg), and 93.3% of Group 3 patients (1.0 mg/kg), respectively. Intubation scores were similar in Groups 2 and 3, and were significantly higher than in Group 1 patients (0.3 mg; P < 0.01). Time to recovery of spontaneous respiration in Group 3 was significantly prolonged compared with Groups 1 and 2 (238 ± 59 sec vs 132 ± 43 sec, P < 0.001; 238 ± 59 sec vs 151 ± 47 sec, P < 0.001, respectively). SpO2 in Group 3 did not differ significantly from Group 1 and 2 values. However, PETCO2 in Group 3 was significantly higher than in Groups 1 or 2. CONCLUSIONS: Succinylcholine at a dose of 0.6 mg/kg IV provided intubation conditions similar to succinylcholine at 1.0 mg/kg IV, and recovery of spontaneous respiration following a 0.6 mg/kg dose of succinylcholine was significantly shorter.

Effects of propofol on the minimum alveolar concentration of sevoflurane for immobility at skin incision in adult patients.

STUDY OBJECTIVE: To determine the effect of propofol on skin incision at target plasma concentrations of one to 6 µg/mL on the minimum alveolar concentration (MAC) of sevoflurane. DESIGN: Prospective, randomized, single-blinded study. SETTING: Operating room of a university hospital. PATIENTS: 122 adult, ASA physical status I and II patients with cholecystitis and gastric cancer, presenting for elective abdominal surgery. INTERVENTIONS: Each group received propofol at different target-controlled plasma concentrations of 0, 1, 2, 3, 4, 5 and 6 µg/mL, respectively. The end-tidal concentration of sevoflurane was stable at a predetermined value for at least 15 minutes. Skin incision was performed after return of neuromuscular function. MEASUREMENTS: Patients were observed for gross purposeful movement for one minute after skin incision. Heart rate and mean arterial pressure were recorded before induction of anesthesia, before incision, and after incision. MAIN RESULTS: The MAC of sevoflurane when used alone was 2.2% ± 0.11%. Propofol decreased the MAC of sevoflurane by 12.3% at one µg/mL, 30.5% at two µg/mL, 35% at three µg/mL, 46.8% at 4 µg/mL, 57.7% at 5 µg/mL, and 72.7% at 6 µg/mL. The linear regression equation of the interaction between sevoflurane and propofol was Y = 2.1679 - 0.256 X, R(2) = 0.9407, where X = plasma propofol concentration, Y = sevoflurane concentration, and R(2) = correlation coefficient. CONCLUSIONS: Propofol decreases the MAC of sevoflurane in a concentration-dependent manner in adult patients.