Objective To evaluate the effect of oral tramadol controlled release tablets premedication on the efficacy of anesthesia with target-controlled infusion (TCI)of propofol and remifentanil for painless colonoscopy in elderly patients.Methods Sixty ASA Ⅰ or Ⅱ patients,aged≥ 65 yr,undergoing painless colonoscopy,were randomly divided into 2 groups ( n =30 each): control group (group C) and tramadol group(group T).In group T tramadol controlled-release tablet 100 mg was administered orally at 2 h before operation.Anesthesia was induced and maintained with TCI of propofol and remifentanil.SP,DP,HR and SpO2 were recorded before induction,at the time to reach the ileocecal valve and at the end of operation.The induction time,duration of operation,emergence time,recovery time,adverse events and the amount of propofol and remifentanil consumed were recorded.Results There was no significant difference in hemodynamics parameters,induction time,duration of operation,emergence time,recovery time,adverse events and the amount of propofol and remifentanil consumed between the two groups (P ＞ 0.05 ).Conclusion Oral tramadol controlled release tablets 100 mg premedication can be safely used in painless colonoscopy in elderly patients,however,tramadol can not enhance the efficacy of anesthesia with TCI of propofol and remifentanil.

Objective To compare the effects of different anesthesia on immunologic function during perioperative radical mastectomy in patients having undergone preoperative chemotherapy. Methods Sixty ASA Ⅰ or Ⅱ patients, aged 28-64 yr, weighing 55-70 kg, scheduled for radical mastectomy, were studied. Thirty patients received preoperative chemical therapy for 3-4 weeks were randomly divided into CP group and CS group ( n = 15 each); thirty patients received no chemical therapy were also randomly divided into NCP group and NCS group (n=15 each).Propofol at a rate of 4-6 mg·kg-1·h-1 was infused in group CP and CS and sevoflurane with the end-tidal concentration of 1.5%-2.5% inhaled in group NPC and NCS to maintain anesthesia. Peripheral venous blood samples were taken before chemical therapy, before anesthesia, immediately after operation and at 72 h after operation for determination of the levels of T lymphocyte subsets and NK cells and plasma CK19 mRNA expression (by RT-PCR). CD4+/CD8+ ratio and the micrometastatic rate of the tumor cells were calculated. Results The CD3+ , CD8+ and NK cell level were significantly lower before anesthesia, immediately after operation and at 72 h after operation than before chemical therapy ( P < 0.05). The CD8+ immediately after operation and NK cell level at 72 h after operation in group CP, and CD4+ and NK cell levels immediately and at 72 h after operation in group CS were significantly lower than those before anesthesia ( P < 0.05). CD4+ and NK cell levels immediately and at 72 h after operation were significantly lower in group CS than in group CP, and in group NCS than in group NCP (P < 0.05). The CD4+/CD8+ ratio was significantly lower immediately after operation in group CS than in group CP ( P < 0.05) .There was no significant difference in the micrometastatic rate of the tumor cells among all groups (P > 0.05). Conclusion Sevoflurane combined anesthesia has a stronger inhibitory effect on immunologic function in radical mastectomy patients with preoperative chemotherapy than propofol combined anesthesia.