Objective To investigate the effects of different concentrations of propofol on anoxia / reoxygenation injury to primary cultured rat hippocampal neurons. Methods Newborn (

Objective To investigate the protective effects of pharmacological preconditioning with diazoxide, an ATP-sensitive potassium channel opener, against anoxia/reoxygenation (A/R) injury to primarily cultured hippocampal neurons of newborn Wistar rats and the mechanism involved and the effects of diazoxide preconditioning on A/R-induced neuronal apoptosis. Methods Primarily cultured hippocampal neurons prepared by enzymatic digestion of hippocampus isolated from newborn (

Objective To investigate the effect of artifictal circadian rhythm of melatonin on the postoperative cellular immune function in patients undergoing gynecological operation Methods Eighteen ASA Ⅰ or Ⅱ patients,aged 25-50 yr,weighing 45-80 kg,scheduled for elective gynecological operation,were randomly divided into 3 groups (n =6 each):control group (group C),placebo control group (group P) and melatonin group (group M).In group M.melatonin 6 mg was given orally at 10 min before lights-out (21:00) on 1 day before operation,on the day of operation and on 1 day after operation,while placebo was given orally instead of melatonin in group P.The operation was performed under epidural anesthesia.Patient-controlled epidural analgesia with ropivacaine was used for postoperative analgesia.VAS score was maintained ＜ 5.Blood samples were collected from the peripheral vein at 1 day before operation (baseline),the end of operation and 1 day after operation to measure CD4+,CD8+ and CD3+ cell count by flow cytometry.The ratio of the number of CD4+ cells to the number of CD8+ cells was calculated.Results There were no significant differences in the number of CD4+,CD8+ and CD3 + cells and ratio of the number of CD4 + cells to the number of CD8 + cells between groups C,P and M (P ＞0.05).Conclusion Artificial circadian rhythm of melatonin exerts no influence on the postoperative cellular immune function in patients undergoing gynecological operation.

Objective In a randomized double blind study, we have compared the analgesic efficacy and safety of PCA with buprenorphine and PCA with morphine after abdominal hysterectomy. Methods One hundred and fifty-four patients aged 25-55 yr undergoing abdominal hysterectomy were included in this study. Patients with severe cardiac, cerebral, hepatic and renal disease and those who had recently taken monoamine oxidase inhibitor were excluded. Anesthesia was induced with propofol 1.5-2.0 mg?kg-1 and intubation was facilitated with succinylcholine 1.5 mg?kg-1 or vecuronium 0.1 mg?kg-1 . Anesthesia was maintained with inhalation of l%-2% isoflurane and 50% nitrous oxide in oxygen supplemented with intermittent iv boluses of vecuronium 1-2 mg, fentanyl 2?g?kg-1 and droperidol 1-2 mg. The patients were randomly divided into 2 groups: 1 buprenorphine group (B, n = 77 ) and 2 morphine group (M, n = 77) . In group B, patients received PCA with buprenorphine (bolus dose 0.03 mg, lockout interval 14 min, 24 h dose limit 1.2 mg); in group M patients received PCA with morphine (bolus dose 1 mg, lockout interval 5 min, 24 h dose limit 40 mg). Intensity of pain was assessed using VAS with 0 representing no pain and 10 representing the worst pain. Pain intensity difference before and after PCA and pain relief (PAR) (0 = not relieved, 4 = completely relieved) , patient satisfaction and adverse effects were recorded. Results The two groups were comparable with regard to age, body weight, duration of operation, the time when postoperative pain started and PCA was commenced, and the intensity of postoperative pain. There was no significant difference in pain intensity before and after PCA and PAR between the two groups. The incidence of nausea and vomiting was significantly higher in group B than in group M ( P

Objective To evaluate the efficacy and safety of China-made remifentanil in a randomized, controlled and double-blinded multi-center clinical study. Methods Two hundred and one patients were randomly divided into two groups: control group received intravenous fentanyl and study group received intravenous remifentanil. In both groups anesthesia was induced with propofol 1-2 mg ?kg-1 and fentanyl 2.5?g/kg or remifentanil 2 ?g/kg. Intubation was facilitated with succinylcholine 1.0-1.5 mg?kg-1. The patients were mechanically ventilated(VT 8-10 ml?kg-1 , RR 10 bpm) . Anesthesia was maintained with fentanyl at 0.03 ?g?kg-1?min-1 or 0.2?g?kg-1?min-1 supplemented with 66% N2O and intermittent iv boluses of vecuronium. The efficacy variables recorded were the changes in blood pressure(BP) and heart rate(HR) during surgical stimulation and the quality of anesthesia. The safety variables included BP and HR, the doses of ephedrine, atropine, urapidil and naloxone required during surgery, the volume of intraoperative blood loss, changes in EGG, and the pre- and post-operative liver and kidney function, extubation time, emergence time (opening eyes when the patient's name is being called), end-tidal CO2 before extubation, admission to PACU or ICU, and the unexpected events in postoperative period. Results The anesthetic efficacy of remifentanil was similar to that of fentanyl with better analgesic effect . Remifentanil wore off faster in comparable doses. Conclusion China-made remifentanil is a good and safe anesthetic with better analgesic effect.

Objective To assess the accuracy of cerebral oxygenation measured by near-infrared spectroscopy (NIRS) in predicting ischemic cerebral injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). Methods Seventeen patients undergoing cardiac valve replacement under CPB were enrolled in this study. During operation, NIRS was used to measure regional oxygen saturation (rScO2),tissue hemoglobin index ( THI ), changes in concentrations of oxyhemoglobin (△ O2 Hb ), deoxyhemoglobin (△ HHb) and total hemoglobin (△ cHb) of the frontal lobes. The parameters mentioned above and patients whose minimal rScO2 decreased to less than 50% were recorded after entering the operation room, immediately after tracheal intubation, aortic cannulation and superior and inferior vena cava cannula, at the beginning of CPB, at the lowest temperature during CPB, after rewarming to 36.5 ℃, immediately after termination of CPB, and at 1 h after termination of CPB. Blood samples were taken from right internal jugular vein immediately before anesthesia induction, before rewarming, after rewarming to 36.5 C, and at 1, 5 and 20 h after termination of CPB to detect plasma concentrations of S100 protein and neuron-specific enolase (NSE) by ELISA. The cognitive function of patients was assessed 1 day before surgery and 8 days after surgery, and postoperative cognitive dysfunction (POCD) was recorded. Results Nine patients presented with minimal rScO2 less than 50%. Among them,7 patients developed POCD. The plasma concentrations of S100 protein and NSE were significantly higher at 1 and 5 h after termination of CPB in patients whose minimal rScO2 decreased to ≤ 50% than in those whose rScO2 ＞50% .Conclusion Cerebral oxygenation measured by NIRS can accurately predict cerebral ischemic injury in patients undergoing cardiac valve replacement under CPB.

Objective To evaluate the effects of magnesium sulphate on the efficacy of postoperative patient-controlled intravenous analgesia (PCIA) with morphine. Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes aged 45-60 yr weighing 48-70 kg scheduled for elective upper abdominal surgery were randomly allocated into 2 groups ( n = 30 each) : morphine group (group M) and magnesium sulphate-morphine group (group MS) . If the VAS score=3, PCIA was started. Patients in group M received morphine in a 0.015 mg/kg bolus dose. Patients in group MS received morphine 0.015 mg/kg and magnesium sulphate 0.9 mg/kg. The consumption of analgesic drugs was recorded at 4, 8, 16, 24 and 48 h after 1st attempt. The gastrointestinal function recovery time was recorded. Venous blood samples were taken before anesthesia induction and at the end of operation and analgesia to determine the serum magnesium and calcium ion concentrations. Results Compared with group M, the consumption of analgesic drugs was significantly decreased, and the gastrointestinal function recovery time after operation was significantly shortened in group MS (P < 0.05). The serum magnesium ion concentration in both groups was significantly lower at the end of operation and analgesia than before anesthesia induction ( P < 0.05) . The serum magnesium ion concentration in group MS was significantly higher at the end of analgesia than at the end of operation ( P <0.05) .There was no significant difference in the serum calcium ion concentration between M and MS groups. Conclusion Magnesium sulphate can ameliorate the efficacy of postoperative PCIA with morphine.

Objective To compare the efficacy and safety of anesthetizing patients with propofol-remifentanil given by TCI targeting effect-site vs plasma. Methods Forty-four ASA Ⅰ - Ⅱ patients aged 20 -65 yr undergoing laparascopic cholecystectomy were randomly divided into two groups : group P targeting plasma concentration (n = 22) and group E targeting effect-site concentration ( n - 22) . The patients were given midazolam 1 mg and scopolamine 0.3 nig i. v. in the operating room before anesthesia. Auditory evoked potential, BP, HR and SpO2 monitoring were started before induction of anesthesia. Anesthesia was induced with propofol and remifentanil given by TCL using two Graseby 3500 infusion pumps. The target concentration of propofol was set at 4 ?g ? ml-1 and remifentanii at 2 ng ? ml -1 . Remifentanil infusion was started 2 min before propofol infusion. When the patients lost consciousness (no response to patting and request for eye-opening), succinylcholine 2 mg?kg-1 was given i. v. to facilitate intubation. Intubation score was assessed. The time required for loss of consciousness after TCI of propofol was started (TLOC), the amount of propofol and remifentanil infused and auditory evoked potential index (AAIs) when the patients lost consciousness were recorded. The patients were mechanically ventilated (VT 8-10 ml, RR 10 bpm) and PETCO2 was maintained at 30-40 mm Hg. Anesthesia was maintained with N2O inhalation, TCI of propofol - remifentanil and intermittent i.v. boluses of vecuronium. Propofol -remifentanil target concentrations were titrated against AAIs value below 20 during maintenance of anesthesia. At the end of operation quality of anesthesia was evaluated. The total amount of propofol and remifentanil consumed were recorded. Aldrate post anesthetic recovery score and postoperative pain score were also assessed. Results TLOC was significantly shorter in group E [(0.45 ?0.1) min] than that in group P (0.86 ? 0.3 min) ( P

Objective To compare the effects of desflurane, enflurane and isoflurane on onset time,duration of action and recovery time of pipecuronium. Methods Thirty ASA Ⅰ-Ⅱ patients aged 18-60yr weighing40-80 kg were randomly divided into 3 groups: (1) desflurane group (n = 10); (2) enflurane group(n = 10) and(3) isoflurane group (n = 10). The patients were premedicated with intramuscular pethidine 1 mg?kg~(-1) andatropine 0 .01 mg?kg. Anesthesia was induced with midazolam 0. 03 mg?kg~(-1), propofol 0.5-1 .0 mg?kg~(-1)andfentanyl 2?g?kg~(-1) .When the patients fell asleep neuromuscular function was monitored by accelerography usingTOF stimulation. Pipecuronium 0.045 mg?kg~(-1) was given i. v. as soon as T_1 was 100 % blocked (T_1= 0), anotherdose of propofol was given, making the total dose of propofol amount to 2.5 mg' kg?kg~(-1).Tracheal intubation wasperformed. The patients were mechanically ventilated and P_(ET) CO_2 was maintained at 35-45 mm Hg. Desflurane oreaflurane or isoflurane was inhaled with N_2O-O_2(2: 1) .The end-tidal desflurane, enflurane or isofluraneconcentration was maintained at 0. 65 MAC(desflurane= 3. 9 %, enflurane = 1. 1 %, isoflurane = 0. 75 % ). Duringoperation when deeper anesthesia was needed intermittent i. v. blouses of fentanyl were given. The onset time, thetime needed for T_1 to return to 5 %, 10 %,25 %, 50 %,75 % of control and recovery index were recouled andcompared among the three groups.Results The demographic data including age, weight, sex and types ofoperation were not significantly different among the 3 groups. Three were no significant differences in onset time,recovery time (time for T_1 to return to 5 %, 10 %,25 %,50 % and 75 % of control) and recovery index amongthe 3 groups. Conclusion Desflurane can prolong the duration of action and recovery time of pipecuronium justlike enflurane and isoflurane but there were no significant differences among the 3 groups.

0.05) . The sensory block reached T7 in levobupivacaine group and T6 in bupivacaine group respectively. The motor blocked was somewhat more intense in bupivacaine group. Conclusion The efficacy and safety of epidural anesthesia with levobupivacaine and bupivacaine are comparable.