Objective To explore a kind of comfortable medical for ervical plexus anesthesia auxiliary anesthesia .Methods 80 thyroidectomy female patients were randomly divided into normal saline group (group A) ,droperidol-fentanyl group (group B) ,bu-torphanol group (group C) ,dex group (group D) ,20 cases in each group .The change of systolic blood pressure (SBP) ,diastolic blood pressure (DBP) ,heart rate (HR) ,blood oxygen saturation (SpO2 ) ,narcotrend index (NTI) were monitored .The above pa-rameters were recorded at 10 min before cervical plexus(T0 ) ,cervical plexus operation(T1 ) ,skin incision(T2 ) ,separation of thyroid upper extreme(T3 )and suture(T4 ) .Results There was no significant difference between the groups A and B at the same time point (P>0 .05) .In group C ,the SBP、DBP、HR at T3 and T4 were significant higher than at T0 ,and at the same point the A and B group decreased statistically significant (P<0 .05) .In group D ,the SBP、DBP、HR at T2 、T3 、T4 were significant lower than at T1 ,espe-cially at T4 compared to at T0 (P<0 .05) .Compared to group A ,B ,C ,the SBP、DBP、HR in group D were lower at T3 and T4(P<0 .05) .NTI in group D at T1 、T2 had significant difference compared with group A and B (P<0 .05) ,especially at T3 、T4 were sta-tistically significant than the other three groups(P<0 .05) ,sedation was better than the other groups .Conclusion Cervical plexus block supplemented by dex can reduce the patient′s stress response and reach moderate sedation analgesia to comfortable medical purposes .

Objective To explore the effects and the underlying mechanisms by which paired associative stimulation ( PAS) of tibial nerve electrostimulation and M1 cortex transcranial magnetic stimulation ( TMS) in pro-moting the recovery of forelimb dysfunction in rats with cerebral ischemic stroke. Methods Resting motor thresholds of left extensor carpi radialis muscle ( ECR) were determined 5 min before and 5 min, 30 min, 60 min after PAS,respectively, in 8 male Sprague-Dawley ( SD) rats. Then 48 male SD rats were divided into a sham group ( n=16) subject to sham surgery, an experimental group (n=32) which was further divided into a MCAO group (n=16) and a PAS group (n=16) after cerebral ischemic stroke model was established successfully by occluding the right middle cerebral artery. 24 hours after surgery, PAS consisting of left tibial nerve stimulation and right M1 cortex area TMS was applied to PAS group once daily for 7 consecutive days. The corner tests and grip strength tests were per-formed before and after 7 days of PAS treatment in each group. The RMTs of left ECR were determined, metabolites of the left area tissue of cervical spinal cord were measured by nuclear magnetic resonance spectrum, and expressions of Bcl-2 and Bax of left and right area tissue of cervical spinal cord enlargement were detected by Western Blot tech-nique after 7 days of intervention. Results The average RMTs of left ECR at 5 min, 30 min, 60 min after PAS were significantly lower than those at 5 min before PAS ( P<0.05) . All rats in experimental group showed significant higher turning scores and lower grip strength when compared with sham group (P<0.001 or P<0.01). After PAS interven-tion, PAS group demonstrated lower turning scores, higher grip strength and lower RMT of left ECR as compared with MCAO group ( P<0.05 or P<0.01) . The expression of GABA of left cervical enlargment was significantly decreased in MCAO group when compared with the sham group ( P<0.05) , and there was no significant difference between MCAO group and PAS group. Meanwhile, other metabolites showed no significant difference among the three groups. The av-erage expression level of Bcl-2 and Bax proteins in both sides of cervical spinal cord enlargment showed no significant difference among three groups either. Conclusions Tibial nerve-M1 cortex area PAS may increase the excitability of motor cortical representation of forelimbs in rats, by which PAS promotes the recovery of forelimb dysfunction in rats with cerebral ischemic stroke.