Objective To compare the laryngeal mask insertion conditions at different plasma target concentrations (Cp) during the induction of anesthesia with target-controlled infusion (TCI) of propofol.Methods Forty-five ASA I - II patients of both sexes aged 18-60 yr, weighing 50-80 kg undergoing minor surgery in which the use of laryngeal mask (LM) was indicated were randomly divided into 3 groups ( n = 15) according to Cp of propofol set during induction of anesthesia: 4, 6 and 8 ?g ? ml-1 . The patients were premedicated with intramuscular scopolamine 0.3 mg. Fentanyl 3 ?g?kg-1 was given i.v. . TCI of propofol was started 3 min later with Diprifusor (Graseby 3500 infusion pump). LM was inserted when the effect-site concentration (EC) of propofol reached 2.5 ?g ? ml -1 as displayed on the infusion pump. LM insertion conditions (mouth opening, gagling, coughing, head and limb movement, overall ease of insertion) were assessed. The total dose of propofol, insertion time, the time needed to reach EC 2.5 ?g?ml-1 were recorded. SP, DP, HR and BIS value were recorded at 6 time points: baseline before induction (T1 ) , at the loss of consciousness (T2), at EC 2.5 ?g ? ml-1 (T3), immediately (T4), 3 min (T5) after insertion of LM. Results The SP, DP, HR and BIS value were decreasing with increasing depth of anesthesia in the 3 groups. The decrease in BP and BIS value after insertion of LM was significantly larger in group 3 (8 ?g ?ml-1) than in group 1 and 2 (P

Objective To assess the accuracy of mixed venous oxygen saturation ( S(-v)O2 ) in reflecting the change in CO during off-pump coronary artery bypass grafting (OPCABG) .Methods Twenty-five NYHA Ⅰ -Ⅲ patients of both sexes, aged 50-75 yr, weighing 55-85 kg, undergoing OPCABG, were studied. Anesthesia was induced with midazolam, fentanyl, etomidate and pipecuronium and maintained with propofol infusion and intermittent iv boluses of fentanyl and pipecuronium supplemented with isoflurane if necessary. The patients were mechanically ventilated (VT 8-10 ml/kg, RR 8-10 bpm, I:E 1:2). PETCO2 was maintained at 35-45 mm Hg.Radial artery was cannulated and pulmonary catheter was placed. CI, S(-v)O2 and Hb were monitored and recorded before skin incision, during anastomosis with left anterior descending artery (LAD), right coronary artery (RCA)and left circumflex coronary artery (LCX), when the chest was closed, when the patients' body position was changed and the heart was manipulated. S(-v)O2 and CI were scaled immediately after the pulmonary artery catheter was placed and before anastomosing LAD. Results The CO change in S(-v)O2 was real-time and accurate in reflecting the body positioning and elevation of hearts. There was no simultaneous significant change in CI.Conclusion The CO change in S(-v)O2 is real-time and accurate in reflecting the body positioning and elevation of hearts during OPCABG.

Postoperative nausea and vomiting (PONV) is one of the common complications in gynecological surgery which seriously affects the postoperative recovery, and elderly women are the high-risk group of PONV. Prevention and treatment of PONV is not only a part of anesthesia management, but is also important for enhance recovery after surgery, which gynecological surgeons need to focus on. This article discusses the inducement, occurrence mechanism, risk assessment, preventive and treatment measures of PONV, in order to provide clinical reference for the standardized management of PONV in gynecological surgery.