Propofol is a most widely used intravenous anesthetic, but there is a dispute constantly on its use in obstetric anesthesia. This paper reviewed the research progress in that issue, including the pharmacokinetics of propofol in obstetric patients, the effects of propofol on neonates and pregnant uterine muscle, conscious sedation, prophylactic effect of propofol on nausea, vomiting and pruritus in cesarean section with spinal anesthesia.

Objective To investigate the feasibility of different doses of dexmedetomidine required to prevent sufentanil-induced cough during anesthesia induction. Methods Two hundred and forty ASA Ⅰ or Ⅱ patients, aged 18-55 yr, weighing 45-78 kg, undergoing elective gynecological operations under general anaesthesia, were randomly divided into 4 groups ( n = 60 each) : Ⅰ -Ⅳ groups. Ⅱ -Ⅳ groups received iv infusion of dexmedetomidine 0.10, 0.25 and 0.50 fig/kg at a rate of 0.05 μg·kg-1·min-1 respectively before anesthesia induction. Anesthesia was induced with target-controlled infusion of propofol (target effect-site concentration 5 μg/ml) , when the BIS value reached 55, iv sufentanil 0.5 fig/kg was injected over 3 s. The occurrence and degree of cough were recorded within 1 min after sufentanil injection. Tracheal intubation was facilitated with succinylcholine 1-2 mg/kg after the observation. The adverse cardiovascular events (severe sinus bradycardia, hypotension) were also record ed from the start of dexmedetomidine infusion to 1 min after intubation. Results The incidences of cough were 25 % , 7 % , 7 % and 5 % , incidences of severe sinus bradycardia 0, 3 % , 15 % and 25 % , and incidences of hypotension 5% , 7% , 8% and 8% in Ⅰ - Ⅳ groups respectively. Compared with group Ⅰ , the incidences of cough were significantly decreased in Ⅱ - Ⅳ groups, while the incidences of severe sinus bradycardia increased in Ⅲ -Ⅳ groups (P ＜ 0.01) . There was no significant difference in the incidences of cough among Ⅱ - Ⅲ groups and in the degree of cough among the four groups (P ＞ 0.05). Conclusion Intravenous dexmedetomidine 0.10 μg/kg can be used to prevent sufentanil-induced cough during anesthesia induction.

Objective To evaluate the effect of hypophysin and oxytocin on QT interval of the patients undergoing myomectomy. Methods Forty ASAⅠ-Ⅱ female patients scheduled for laparoscopic operation were enrolled. All patients were randomized into hypophysin or oxytocin group, with 20 patients in each group. The blood pressure, heart rate and QT interval were recorded at following time points: before anesthesia (T_1), before injection of hypophysin or oxytocin (T_2), 2 min (T_3), 5 min (T_4), 10 min (T_5), 20 min (T_6), and 30 min (T_7) after injection of hypophysin or oxytocin. Results The QT interval at 2, 5 and 10 min post injection of hypophysin were significantly longer compared to oxytocin group (P<0.01). No significant changes of QT interval were detected in oxytocin group, though the trend of QT interval prolongation were recorded. Conclusions In hysteromyoma operation, injection of hypophysin could prolong the QT interval of patients.

Objective:To evaluate the effect and safety of penehyrclidine hydrochloride when it was applied preoperatively in outpatient.Method:240 patients were randomly divided into two groups.Group P(120 cases)was treated with penehyclidine hydrochloride 0.5mg before the anesthesia as Group A(120 cases)with Atropine 0.25 mg.Sedation scale was observed just 5 and 15 minutes after drug administration.Analge scale,the degree of the patient's dry-mouth and PONV were also recorded.Time of recovery and leaving were studied too.Result:Group P had significantly better analgesic efficacy than Group A(P0.05).The degree of the patients dry-mouth were statistical difference between 2 group both 15min and 4h postoperation(P

Objective To observe the effects of propofol or sevoflurane combined with remifentanil on cerebral blood flow (CBF) and cerebral autoregulation in patients undergoing gynecologic laparoscopic surgery. Methods Forty patients were randomly divided into two groups: the propofol group (group P, n=20) and the sevoflurane group (group S, n=20). Anaesthesia was induced with target-controlled infusion (TCI) of propofol and remifentanil in group P, with an inhaled induction of sevoflurane and TCI of remifentanil in group S, respectively. The depth of anesthesia was regulated according to bispectral index (BIS). The pressure of end-tidal carbon dioxide (P_(ET)CO_2) was kept at 35-40 mmHg by mechanical ventilation. The mean arterial pressure (MAP), heart rate (HR), pressure of arterial carbon dioxide (PaCO_2), P_(ET)CO_2, time-averaged peak flow velocity (TAP) and the transient hyperaemic response ratio (THRR) were recorded at 7 different time points: supine position (T_1) and supine lithotomy position before induction (T_2), the instant and 5 min after tracheal intubation (T_3,T_4), the instant and 15 min after abdominal CO_2 insufflation and trendelenburg-lithotomy position (T_5,T_6), and 10 min after the deflation abdomen (T_7), respectively. Results Compared with the baseline values at T_1, TAP was not significantly changed at T_2, T_5, or T_6 in group P, but was markedly decreased at T_3, T_4 and T_7. TAP in group S only decreased at T_4 and T_7, while it was much higher than that in group P at T_3. In group S, THRR was markedly lowered at T_3 compared with that at T_1; but in group P, it showed a significant increase at T_3. Conclusions Combined with remifentanil, propofol decreased CBF, but has no effect on the brain self-regulation. When inhaled in high concentrations, sevoflurane significantly reduces the brain self-regulation. Intraoperation pneumoperitoneum and postural factor significantly increase CBF, playing a stronger role than the narcotic drugs in clinical dosage (propofol, sevoflurane), without any influence on the brain self-regulation.

Objective To evaluate the effect of chronic anemia on duration of non-hypoxic apnea during tracheal intubation after induction of general anesthesia in female patients.Methods Seventy-five ASA physical status Ⅰ or Ⅱ patients,aged 20-40 yr,of Mallampati class Ⅰ or Ⅱ,with body mass index ＜ 25 kg/m2,were enrolled in the study.According to the test results of hemoglobin (Hb),the patients were allocated into 3 groups (n =25 each):Hb ＞ 110 g/L group (group A),Hb 90-110 g/L group (group B),and 70 g/L ＜ Hb ＜ 90 g/L group (group C).Each patient inhaled 100％ oxygen through a mask with oxygen flow of 8 L/min and 3 min later anesthesia was induced with general anesthesia.Assisted ventilation was not performed during induction.After tracheal intubation,artificial ventilation was performed with pure oxygen when SpO2 decreased to 90％.The time from beginning of apnea to SpO2 of 90％ (duration of non-hypoxic apnea),and the minimum SpO2 and the maximum PET CO2 during the period of observation were recorded.Immediately before oxygen inhalation via a mask,immediately after beginning of apnea,and at the time for SpO2 decreasing to 90％,arterial blood samples were taken from 10 patients randomly chosen from each group for blood gas analysis.Results Compared with group A,the duration of non-hypoxic apnea was significantly shortened,and no significant change was found in the minimum SpO2 in B and C groups,and the maximum PET CO2 and PaCO2 while SpO2 decreasing to 90％ were decreased in group C.Compared with group B,the duration of non-hypoxic apnea was signifi.cantly shortened,PaCO2 while SpO2 decreasing to 90％ was decreased,and no significant change was found in the minimum SpO2 and the maximum PET CO2 in group C.Conclusion Mild and moderate chronic anemia shortens the duration of non-hypoxic apnoea to about 6.0 and 3.5 min,respectively,during tracheal intubation after induction of general anesthesia in female patients.

Objective To study the feasibility and reliability of median nerve somatosensory evoked potential monitoring in neurosurgery around the brain stem. Methods in selected 43 patients SEP N20, waveforms were recorded after stimulation of left and right median nerves respectively. Anesthesia was maintained with intravenous anesthetics throughout the operation. As soon as N20 waveform changed significantly, the surgeon was informed and the operative procedure was modified whenever possible. Results SEP waveforms were almost stable during maintaining with total intravenous anesthesia (TIVA). Within 43 cases, SEP waveform of & patients significantly changed. In these cases, SEP of 5 patients returned to normal gradually and no further neurologic dysfunction happened postoperatively. The other 3 cases did not recover, and postoperative neurologic complications happened. There was no false-negative or false-positive result. The correlation between intraoperative SEP changes and postoperative neurologic alterations was significant statistically. Conclusions SEP recording is a reliable technique for intraoperative monitoring during neurosurgery around the brain stem. TIVA is helpful for SEP monitoring.

AIM: To investigate whether hepatocyte apoptosis is contributed to liver ischemia-reperfusion (I/R) injury and the relationship between liver caspase-3 activity and hepatocyte apoptosis in cirrhotic rats. METHODS: Liver ischemia-reperfusion is induced by Pringle maneuver. The cirrhotic rats were randomized into two groups: Group A: simple hepatic blood inflow occlusion (HBIO); Group B: HBIO + inhibitor, before HBIO, ZVAD-fmk 15 mg/kg was injected via dorsal penis vein; Group C: healthy rat, simple HBIO. The ischemia time was 30 min in these groups. Serum aspartate aminotransferase(AST), liver caspase-3 activity, and apoptotic hepatocytes were examined in the three groups. RESULTS: After 6 h of reperfusion, the liver caspase-3 activity was markedly elevated and reached its peak, which was statistically higher than that of before I/R [(18.1?1.8 ) ?mol?h -1 ?g -1 (tissue) vs (6.6?2.0) ?mol?h -1 ?g -1 (tissue), P

AIM: To investigate the protective effect of ischemic preconditioning (IPC) on hepatic ischemia reperfusion(I/R) injury in cirrhotic rats and its possible mechanism. METHODS: Hepatic I/R was induced by Pringle maneuver. The cirrhotic rats were randomized into three groups: Group A: before 30 min of ischemia, a short period of 5 min ischemia and 5 min reperfusion were given; Group B: before 30 min of ischemia, a short period of 10 min ischemia and 10 min of reperfusion were given; Group C: 30 min ischemia only. The serum alanine transferase (ALT), hepatic Fas mRNA, caspase 3 activity and hepatocyte apoptosis were analyzed. RESULTS: The 7 day survival rate in the group A and B were 100%, respectively. However, it was only 62.5% in the group C. After 6 h of reperfusion, the ALT levels in both group A and B were significantly lower than that of in group C, P

Objective To evaluate the efficacy of dexmedetomidine combined with sufentanil for patientcontrolled intravenous analgesia (PCIA) after caeserean section. Methods One hundred and twenty parturients aged 18-40 yr undergoing caeserean section under spinal-epidural anesthesia were randomly assigned to one of 3 groups( n=40 each):group Ⅰ , group Ⅱ and group Ⅲ . During operation as soon as the baby was bom a bolus of dexmedetomidine 0.5 μg/kg was given iv in Ⅱ and Ⅲ groups while in group Ⅰ normal saline (NS) was given instead. Ⅰ and Ⅱ groups received PCIA with sufentanil (background infusion 0.015 μg·kg-1·h-1;bolus dose 0.023 μg/kg;lockout interval 8 min). Group Ⅲ received PCIA with sufentanil + dexmedetomidine (background infusion sufentanil 0.015 μg·kg-1 ·h-1 + dexmedetomidine 0.045 μg·kg· h-1;bolus dose sufentanil 0.023 μg/kg + dexmedetomidine 0.07 μg/kg;lockout interval 8 min) . Pain threshold and pain tolerance threshold were measured before caeserean section and 1 h after bolus dose of dexmedetomidine or NS. VAS, OAA/S and satisfaction scores and sufentanil consumption were recorded at 4, 8 and 24 h after operation.Blood samples were obtained before anesthesia,1 h after bolus injection of dexmedetomidine, and 24 h after operation for determination of serumcortisol concentration. Results Pain threshold and pain tolerance threshold at 1 h after bolus injection of dexmedetomidine were significantly increased as compared with the baseline before anesthesia in Ⅱ and Ⅲ groups and were significantly higher in Ⅱ and Ⅲ groups than in group Ⅰ . VAS scores and the consumption of sufentanil were significantly lower while the satisfactory score was significantly higher in group Ⅲ than in Ⅰ and Ⅱ groups. Serum cortisol concentrations were significantly increased at 1 h after iv dexmedetomidine or NS injection as compared with the baseline before anesthesia in all 3 groups, but there was no significant difference in serum cortisol levels among the 3 groups. Conclusion Addition of dexmedetomidine to sufentanil for PCIA can significantly reduce the consumption of sufentanil and improve parturient's satisfaction.