It is often neglected that hypercapnia may occur during upper epidural anesthesia. To evaluate the necessity and accuracy of P_(ET)CO_2 monitoring through a nasotracheal oropharyngeal cathter during upper epidural anesthesia, 16 patients undergoing radical excision of mammary carcinoma, were investigated for the changes of PaCO_2 and PET CO_2, and the correlation between them. The results showed that the increases of PaCO_2 during the anesthesia were significant (P

Objective:To evaluate the safety of epidural Innovar during upper epidural anesthesia. Method: Fortyeighty patients of breast surgery were divided randomly into 3 groups. Epidural anesthesia was used in control group. Fentanyl 1?g/kg and droperidol 0.05mg/kg were administered intravenously 30 minutes after the epidural injection of local anesthetics in intravenous group. Fentanyl 1?g/kg and droperidol 0.05mg/kg were given epidurally combined with the local anesthetics in epidural group, Respiration,hemodynamic and blood analysis changes were observed in the three groups before and during anesthesia. Result:The decrease of respiratory rate and increase of PaCO_2 were more significant in intravenous group than those in control group. There was no significant change of respiratory rate,but increases of PaCO_2 in epidural group, which was higher than that in control group and lower than that in intravenous group. Conclusion: Small dose of Innovar used epidurally has less influence on the respiration than the same dose of Innovar used intravenously during the upper epidural anesthesia.

Objective To evaluate the feasibility of performing closed circuit ventilation with Ohmeda Excel 210 plus ventilator 7900 in the infant anesthesiaMethods Thirty lip cleft or palate cleft infants with body weight under 10 kg were enrolled into the studyIn a sequence of before and after, the parameters of respiratory dynamics were compared between closed circuit ventilation and Jackson-Rees circuit ventilation RR 22 frequency/min, I:E 1:15 and P ETCO 2 40mmHg were set as constant parameters, tidal volume (VT) was adjusted accordinglyThe total respiratory compliance (CT), airway peak pressure (Ppeak), positive end-expiratory pressure (PEEP), fractional concentration of CO 2 in inspiratory gas (FiCO 2), first second forced expiratory volume rate (FEV 10%) were measured during closed circuit and Jackson-Rees circuit ventilationsResults As compared with those during the Jackson-Rees circuit ventilation, PEEP increased significantly and FiCO 2 decreased markedly during the closed circuit ventilationThere were no significant differences in Ppeak, VT, CT, FEV 10%, MAC, SpO 2, HR and MAP between closed circuit ventilation and Jackson-Rees circuit ventilationConclusions It is feasible to perform closed circuit ventilation with Ohmeda Excel 210 plus ventilator 7900 in the infant anesthesia

Bepridil hydrochloride(Bep) hydrochloride is a new , long - acting antianginal and antiarrhythmic agent. Through the observation of ∑ST.NST.and NQ of ECG or nitro blue tetrazolium chloride staining, we studied the effect of Bep on liga-tion of the left coronary artery in rabbits and the myocardial ischemia induced by isopre-naline in rats. The results showed that in the groups treated with Hep andpropranolol theisoelectric level was facilitated. ∑ST.NST, NQ, thecreatine phosphokinase values and the weight percentage of infarcted myocardium were decreased. The myocardial ischemic injury was decreased by histopathological stud-

Objective To assess the changes in blood coagulation induced by intraoperative blood salvage and reinfusion. Methods Thirty-six ASA I - II patients aged 15-63 yr undergoing elective major orthopedic surgery were paired according to their sex and type of surgery. The paired patients were randomly allocated to either autotransfusion group (study group) or homologous blood transfusion group (control group). Patients with malignant tumor were excluded. Anesthesia was induced with propofol, fentanyl and succinylcholine and maintained with isoflurane inhalation supplemented with intermittent iv boluses of fentanyl and vecuronium. During operation deliberate hypotension was induced with 0.01% sodium nitroprusside. Systolic blood pressure was maintained at (90?5) mm Hg or reduced by 30% of the baseline systolic blood pressure. During operation lactated Ringer' s solution was infused at a rate of 10 ml?kg-1?h-1 . In both groups, blood loss was replaced by equal volume of gelatine. Hct was maintained above 25% , CVP at 6 - 10 cmH2O and urine output above 50 ml? h-1 . In autotransfusion group, shed blood was collected and heparinized. Red cells were separated and washed for reinfusion. In control group red cell concentrate was infused. Hb, Hct, platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen concentration, and thrombin time (TT) were determined and thromboelastography (TEG) was performed before operation (T0 ), before blood transfusion (T1 ), 1 h after blood transfusion (T2) and 24 h after operation (T3) .Results The two groups were comparable with regard to age, sex, duration of operation, blood loss [ (1030 ?610) ml vs (989?586) ml] and the amount of crystalloid and colloid infused during operation. In autotransfusion group Hb decreased significantly after hemodilution. There was no significant difference in PT, APTT, FIB concentration and TT between the two groups. TEG showed that reaction time (r) increased significantly after hemodilution in autotransfusion group as compared with the preoperative baseline value (T0) but there was no significant difference in TEG parameters including r time between the two groups. Conclusion Intraoperative blood salvage and reinfusion induce no significant effects on blood coagulation as compared with allogenic blood transfusion.

Objective To compare the effects between epidural and general anesthesia for laparoscopic cholecystectomy. Methods A total of 500 cases scheduled for laparoscopic cholecystectomy (LC) were randomly divided into the epidural anesthesia group (Group E, n=250) and the general anesthesia group (Group G, n=250). Results (1) Hemodynamic parameters: in both groups the cardiac output (CO) decreased significantly after CO 2 pneumoperitoneum ( P 0 05), without significant differences between the two groups; the central venous pressure (CVP) was transiently elevated after pneumoperitoneum ( P 0 05), with significant differences between the two groups ( P 0 05), without significant differences between the two groups. (2) Ventilative parameters: the mean airway pressure (P AWM ) and the peak airway pressure (P peak ) were remarkably elevated during the course of pneumoperitoneum in the Group G ( P

Objective It has been shown that strong acute stress or long-term chronic stress significantly affects learning and memory. The aim of this study was to investigate the effects of chronic pain on learning and memory and morphological structure of hippocampus in neonatal rats.Methods Sixty SD rats aged 7 days were randomly divided into two groups : (A) chronic pain group ( n = 30) in which 0.5% formalin 0.1 ml was injected subcutaneously into plantar region of hind paw every day for two weeks and (B) control group (n = 30) in which the plantar region of hind paw was touched with cotton-tipped swab every day for 2 weeks instead of subcutaneous injection of formalin. Morris water maze performance was used to test learning and memory. The number of granule neurons in dentate gyrus and pyramidal neurons in CA3 were counted. Results The mean latency period in the Morris water maze intelligence test was significantly longer in chronic pain group than that in control group ( P

Objective To investigate the effects of chronic pain on spatial learning ability and the expression of neuronal cell adhesion molecules (NCAM) in hippocampus in neonatal rats.Methods Sixty newborn SD rats of both sexes were randomly divided into pain group ( n = 30) and control group ( n= 30). In pain group complete Freund' s adjuvant (CFA) 20 ?l was injected subcutaneously in the plantar surface of left hindpaw on the 2nd day after birth, whereas in control group normal saline 20 ?l was injected instead of CFA. The animals were weighed on the 3rd, 11th and 22nd day after birth. Ten animals in each group were anesthetized with intraperitoneal pentobarbital and killed on the 11th and 22nd day after birth respectively. The brains were immediately removed for determination of NCAM expression in CA3 and dentate gyms of hippocampus using immuno-histochemical staining technique. Morris water maze test was performed starting from the 21st day after birth for 8 consecutive days to assess the spatial learning ability ( n = 10 in each group) .Results The latent period before finding the hidden-plateform was significantly longer on the 1st and 4th day of the test (22nd and 25th day after birth) in pain group than in control group (P

Objective To evaluate the feasibility and safety of using continuous spinal anesthesia (CSA) in high risk elderly patients undergoing lower abdominal or lower extremity surgery. Methods Sixty-four ASA III or IV patients aged 70-101 yr weighing 38-55 kg undergoing lower abdominal or lower extremity surgery were randomized to receive epidural anesthesia (EA) (n = 32) or CSA ( n = 32). The patients were complicated with cerebral embolism and/or hypertension, coronary artery disease and/or COPD and/or diabetes mellitus. The patients were unpremedicated. EA was performed at I2.3 or L1.2. A test dose of 2 ml of 2% lidocaine was given. When no signs of spinal block was observed, 1 % ropivacaine was given in small increments until the block height reached T6-8 . CSA was performed at L3,4 using Spinocath (B. Braun). A 2-cm catheter segment was left in subarachnoid space. 0.5% bupivacaine was given in 0.5 ml increments every 3 min until satisfactory block level was reached. The onset time of anesthesia was recorded. The degree of motor block was assessed using modified Bromage scale. Arterial blood samples were obtained before anesthesia (T0 , baseline), when satisfactory block level was reached ( T1), 1 h after skin incision (T2) and at the end of operation (T3) for determination of lactate concentration. The amount of ephedrine and innovar ( droperidol-fentanyl mixture) used during operation and the recovery of motor function of lower extremities were also recorded. Results The demographic data including sex, age, height, body weight, ASA physical status and types of operation were not significantly different between the two groups. BP and HR were significantly decreased after anesthesia as compared to the baseline values at T0 in group EA, whereas in CSA group there were no significant changes in BP and HR after anesthesia. Significantly more patients received ephedrine in EA group (98% ) than in CSA group (15%) and the mean dose of ephedrine was significantly higher in EA group [(34.5?3.1) mg] than in CSA group [(4.3?0.5) mg ]. The onset of block was significantly faster in CSA group than in EA group. Motor blockade was less intense in EA group as assessed by modified Bromage scale. Analgesia was more satisfactory in CSA group and less patients received innovar during operation in CSA group (20% ) than in EA group (51% ). The recovery of motor function of lower extremities was faster in CSA group than in EA group. Blood lactate was significantly higher at T1 , T2 , T3 in EA group than in CSA group. No late complications related to CSA was observed. Conclusion CSA is safe and effective and provides better analgesia with better hemodynamic stability and faster onset of block than EA in elderly patients.

Objective To investigate the effects of chronic inflammatory pain induced by injection of complete Freund' s adjuvant (CFA) into the plantar surface of hindpaw on the development of learning and memory and proenkephalin mRNA expression in hippocampus of neonatal rats. Methods sixty neonatal SD rats (6 rats from each of 10 litters) were randomly divided into control and chronic pain group ( n = 30; 3 rats from each of the 10 litters). In chronic pain group CFA 20 ? l was injected subcutaneously into plantar surface of left hindpaw on the 2nd day after birth whereas in control group normal saline 20 ? l was injected instead of CFA. Ten animals (1 rat from each of the 10 litters) in each group were killed on the 10th and 21st day after birth respectively. Hippocampi were removed for determination of proenkephalin mRNA expression by RT-PCR. Ten animals (1 rat from each of the 10 litters) in each group underwent Morris water maze test 3 times a day for 8 days starting from the 21st day after birth. Results The mean latent period before the rats found the hidden platform was significantly longer in chronic pain group than in control group. When the platform was removed the swimming time and distance of the rats in chronic pain group were significantly shorter than those in control group. There was no significant difference in the latent period before the rats found the visible platform between the two groups. The proenkephalin mRNA expression in hippocampus on the 10th and 21st day after birth was significantly lower in chronic pain group than in control group ( P