Objective It has been reported that nutritional status of the patients affects neuromuscular (N-M) blockade induced by succinylcholine, tubocurarine, atracurium and vecuronium. The purpose of this study was to investigate the effect of malnutrition on rocuronium induced N-M block. Methods Forty ASA Ⅰ -Ⅱ patients undergoing surgery under general anesthesia were divided into four groups of 12 patients each, based on body mass index (BMI): I normal group BMI = 18.5-25kg? m-2 ;Ⅱ mild malnutrition group BMI= 17-18.5 kg?m-2 ;Ⅲ moderate malnutrition groups BMI = 16-17 kg?m-2 and Ⅳ severe malnutrition group BMK90% the patient was intubated and mechanically ventilated. PETCO2 was maintained at 4.0-4.7kPa. Anesthesia was maintained with 0.5%-0.7% isoflurane +60% N2O. During operation when T1 returned to 25% of control rocuronium 0.15mg?kg-1 was supplemented. The onset time, degree of N-M block and duration of action of initial and supplemental dose were recorded.Results With initial dose the onset time was delayed in group Ⅲ [(184?58)s] and group Ⅳ [(252?62) s] as compared with that in group Ⅰ [(122?33 )s] (P0.05) .Conclusions The neuromuscular blockade induced by rocuronium is reduced in patients with moderate and severe malnutrition.

To identify the role of spinal cyclooxygenase (COX)-1 in the development and maintenance of postoperative pain, we examined the changes of COX-1 protein expression in lumbar spinal cord by immunohistochemistry and Western blot technique in rat plantar incision model at different time points (pre-incision or 2 h, 4 h, 6 h,12 h, 1 d, 2 d, 3 d, 5 d and 7 d after incision). We also studied the anti-allodynic effects of the COX inhibitors by intrathecal administration of non-selective COX inhibitors (ketorolac), selective COX-1 (SC-560) or COX-2 inhibitor (NS-398) immediately or 2 h, 24 h after incision. The mechanical allodynia was evaluated by using paw withdrawal threshold (PWT) response to mechanical stimulation on pre-incision, 2 h, 1 d, 2 d, 3 d, 5 d and 7 d after incision or 30 min after drug treatment. The result showed that COX-1 immunoreactive cells mainly focused in the superficial laminae of lumbar spinal dorsal horn and expression of spinal COX-1 protein increased after incision, peaked at 4 h (P＜0.01) and lasted for 12 h. Postoperative treatment with both SC-560 and ketorolac significantly alleviating the mechanical allodynia induced by skin incision, but NS-398 had no such effect. This study demonstrates that spinal COX-1 involves in the development and maintenance of postoperative hypersensitivity and intrathecal COX-1 inhibitor has anti-allodynic effect on incision pain in the rat.

Objective To investigate the changes of plasma carbon monoxide (CO) concentration in patients undergoing cardiac surgical procedures Methods Arterial blood samples were obtained via the radial artery catheter ,before incision, CPB30min, before cardioversion,before weaning from CPB, 20 min after weaning from CPB,4h,24h after surgery, respectively, to measure the plasma CO concentration with ultraviolet spectrophotometry Results Plasm CO concentration increased significantly after the commencement of CPB(P

Objective To study the effects of different doses of propofol on the changes in lung Ca content and pulmonary ultrastructure caused by intestinal ischemia-reperfusion (IIR) induced lung injury. Methods Forty male SD rats weighing 200-250g were randomly divided into 5 groups of 8 rats each: group I sham operation (control group): group II small intestinal ischemia-reperfusion; group III propofol 4 mg-kg-1-h-1; group IV propofol 8mg-kg-h-1; group V propofol 10 mg-kg-1-h-1. The rats were anesthetized with 3% pentobarbital 40mg-kg-1 ip. Right carotid artery and left internal jugular vein were cannulated for BP and pulmonary arteral pressure (PAP) monitoring and fluid and drug administration. The animals were tracheotomized and mechanically ventilated. PETCO2 was maintained at 4 .67- 5.60 kPa. Abdomen was opened. Superior mesenteric artery (SMA) was isolated and clamped for 60 min followed by 120min reperfusion. In group III , IV and V 10min before SMA occlusion was released different doses of propofol was continuously infused until the end of experiment. In group I and II isovolemic normal saline was infused instead of propofol. Lung Ca2+ content was measured and ultrastructure of the lung examined. Results The lung tissue Ca2+ content increased significantly after IIR in group II and III as compared with group I , IV and V ( P

0.05], but BTV measured at 60 min was significantly faster in propofol group than that in the enflurane group [(14.7 ? 1.5) mm?min-1 vs (9.9 ? 2.0) mm?min-1 P

25%, TCI of vecuronium was started at a target blood concentration of 0.3 ?g.ml-1 .Vecuronium was administrated by a specific TCI system incorporating the pharmacokinetic parameter set of Ruppy. Vecuronium target blood concentration was titrated to maintain T1/T2. at 25% .Results The average degree of NMB was 14.0%?2.2% in control group and 22.9%? 1.8% in TCI group. The difference was statistically significant ( P

Objective To evaluate the effects of curcumin on matrix metalloproteinase-9 (MMP-9)/tissure inhibitor of metalloproteinase-1 (TIMP-1) balance during limb ischemia-reperfusion (I/R)-induced lung injury in rats.Methods Twenty-four adult male Sprague-Dawley rats,aged 6-8 months,weighing 250-300 g,were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (group S) ; group I/R; curcumin + I/R group (group C + I/R).Limb ischemia was induced by occlusion of bilateral femoral arteries for 2 h followed by reperfusion for 3 h in I/R and C + I/R groups.At 2 h before ischemia,curcumin 200 mg/kg was injected intraperitoneally in group C + I/R,while the equal volume of normal saline was given instead in the other groups.Arterial blood samples were taken at 3 h of reperfusion for blood gas analysis and PaO2 was recorded.The animals were then sacrificed and the lungs were removed immediately for determination of wet/dry lung weight (W/D) ratio,myeloperoxidase (MPO) activity and MMP-9 and TIMP-1 contents.The ratio of MMP-9/ TIMP-1 was calculated.Results Compared with group S,PaO2 was significantly decreased,and W/D ratio,MPO activity,MMP-9 content and the ratio of MMP-9/TIMP-1 were significantly increased (P ＜ 0.05),while no significant change was found in TIMP-1 content in group I/R (P ＞ 0.05).Compared with group I/R,PaO2 and TIMP-1 content were significantly increased,and W/D ratio,MPO activity,MMP-9 content and the ratio of MMP-9/TIMP-1 were significantly decreased in group C + I/R (P ＜ 0.05).Conclusion The mechanism by which curcumin attenuates lung injury induced by limb I/R is related to decreased MMP-9 content,elevated TIMP-1 content and regulated balance between MMP-9 and TIMP-1 in the lung tissues of rats.

ve To evaluate the effects of desflurane and sevoflurane on postoperative cognitive function in the elderly to see if there is any difference. Methods Seventy ASA Ⅰ-Ⅱ patients agedl≥65yr undergoing total knee or hip replacement were randomly assigned to one of the two anesthetic groups of thirty-five patients each:desflurane group and sevoflurane group. All patients were premedicated with midazolam 1 mg iv. Anesthesia was induced with fentanyl 1.0-1.5?g?kg-1, propofol 1.0-2.0 mg?kg-1 and succinylcholine 1 mg?kg-1 and maintained with either 2%-4% desflurane or 1.0%-1.5% sevoflurane combined with N2 O in O2 (1:1) and intermittent iv boluses of vecuronium. MAP, HR, ECG, SpO2, PETCO2 and end-tidal concentration of desflurane or sevoflurane were monitored continuously during operation. After tracheal intubation the patients were mechanically ventilated and PETCO2 was maintained at 30-40 mm Hg. The Mini-Mental State (MMS) test was used to assess cognitive function before and at 1, 3, 6 and 24h after surgery. Results Compared with the baseline values the MMS scores decreased significantly at 1h after operation in both groups. However the MMS scores returned to preoperative baseline levels within 6h after surgery in both groups. There were no significant differences in MMS scores between the two groups before and after operation. At 1h after operation 51% of the patients in desflurane and 57% in sevoflurane group experienced cognitive impairment. But at 3h after surgery the percentage of the patients with cognitive dysfunction decreased to 11% in desflurane group and 9% in sevoflurane group. Conclusions In the elderly the postoperative cognitive dysfunction is temporary lasting only a few hours and the effects of desflurane and sevoflurane are similar.

ve When a new drug is introduced for intrathecal (IT) administration, its effect on spinal cord should be studied for safety reason. The aim of this study was to determine the ultra-microstructure of spinal cord and Ca2+ content in spinal cord after IT administration of ropivacaine in dogs. Methods Eighteen mongrel dogs of either sex weighing about 10kg were randomly assigned to one of three groups according to the dose of ropivacaine administered IT: group A received normal saline 2ml IT and served as control; group B received 0.5% ropivacaine 2ml(10mg) IT; group C received 1% ropivacaine 2ml(20mg) IT. Anesthesia was induced with intramuscular ketamine 20mg.kg-1 and atropine 0.05mg?kg-1 and maintained with intermittent iv boluses of ketamine 3mg?kg-1 and fentanyl 5?g?kg-1 Left internal jugular artery was cannulated for intra-arterial pressure monitoring. An incision was made in the back at L3-4 and lumbar puncture was confirmed by aspiration of cerebral-spinal fluid (CSF). Normal saline or ropivacaine was then injected over 20 seconds. 3 hours after IT administration the animals were sacrificed and L1-2 segment of spinal cord and nerve roots were immediately removed for Ca content determination and electron microscopic examination. Results The Ca2+ content of spinal cord was significantly higher in group C than that in group A and B. Electron microscope revealed that in group A and B neurolemma of the nerve root and mitochondria and endoplasmic reticulum of the neurons in spinal cord were intact, while in group C neurolemma was stratified and partly disrupted and mitochondria and endoplasmic reticulum underwent swelling and there was vacuole degeneration. Conclusions Ropivacaine of high concentration or at high dose may be injurious to spinal cord.

Aim To investigate the effect of sevoflurane pretreatment on the nuclear factor kappa B(NF-?B)-DNA binding activity of leukocyte in peripheral blood of the patients undergoing cardiac valve replacement under cardiopulmonary bypass(CPB).Methods Twenty patients undergoing cardiac valve replacement under CPB were divided randomly into two groups:control group(group C)and sevoflurane pretreatment group(group S).All patients were induced with midazolam 0.08~0.12 mg?kg-1,fentanyl 5~10 ?g?kg-1 and vecuronium 0.1 mg?kg-1.After endotracheal intubation,mechanical ventilation was conducted with 100% oxygen.Anesthesia in group C was maintained with intermittent intravenous fentanyl and midazolam,while in group S maintained with 2MAC sevoflurane besides fentanyl and midazolam intermittently before CPB.The anesthesia depth was kept to maintain the systolic pressure within 90~120 mmHg in both groups.Sevoflurane was discontinued at the initiation of CPB,and the following anesthetic regimen was the same as that in group C.To examine the NF-?B-DNA binding activity,the arterial blood samples were withdrawn at the following time point:after endotracheal intubation and before inhaling sevoflurane(T0),30 min(T1),1 h(T2),2 h(T3),6 h(T4)after aortic de-clamping.Electrophoretic mobility shift assay(EMSA)was used to measure the NF-?B-DNA binding activity of leukocyte.The dosage of fentanyl,midazolam,dopamine,sodium nitroprusside and the rate of spontaneous heart resuscitation in both groups were recorded.Results The NF-?B-DNA binding activity in group C was increased significantly after aortic de-clamping,and it reached to maximum at T1,but it was not changed significantly in group S from T0 to T4.The value of EMSA at all time points was lower in group S except T0 than that in group C(P