Objective To introduce the clinical application of Tono-Pen tonometer.Methods The intraocular pressure was detected with Tono-Pen XL tonometer at different time points for sixteen patients went through laparoscopic gynecologic operation,then the statistical analysis of the results was performed.Results In processes of artificial pneumoperitoneum and low position,the intraocular pressure escalated gradually,and after artificial pneumoperitoneum,the intraocular pressure descended rapidly.Conclusion Tono-Pen tonometer is the only tonometer can be used for the patient of general anesthesia until now.

Objective To compare the influences of general anesthesia and intra spinal anesthesia on circulation, respiration, body temperature and anesthesia-related complications in patients undergoing percutaneous nephrolithotomy (PCNL), and assess the effectiveness and safety of both anesthesia. Methods Forty ASA Ⅰ - Ⅱ patients elective for PCNL surgery were divided into two groups by random digits table with 20 cases each:group Ⅰ (endotracheal general anesthesia) and group Ⅱ (intra spinal anesthesia). The temperature, heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2) values and postoperative shivering, nausea, vomiting, back discomfort and the incidence of sore throat were observed and recorded. Results The anesthesia was stable, there were no changes in MAP, HR at different time in group Ⅰ . The anesthesia in group Ⅱ was effective, MAP at 15 min after anesthesia,and HR,MAP after lithotomy position and prone position were obviously changed in group Ⅱ compared with those before anesthesia and group Ⅰ (P ＜ 0.05 ). The temperature at 30,60,90, 120 min after anesthesia decreased compared with that before anesthesia in two groups (P ＜ 0.05 ), and the temperature at 30,60 min after anesthesia in group Ⅰ [(35.8 ±0.6), (34.8 ± 0.5)℃] was lower than that in group Ⅱ [(36.2 ± 0.6),(35.6 ± 0.5)℃](P＜ 0.05).During recovery,complications such as shivering, nausea,sore throat, back discomfort occurred to some extent, of which the incidence of shivering was the highest. Conclusion Both of two anesthesia are applicable to PCNL. When intra spinal anesthesia is used,the life indicators of patients need to be observed and general anesthesia is preferable for the obesity,less physical and the old with poorly compensatory function.

Objective To evaluate the effects of total intravenous anesthesia without muscle relaxants on motor evoked potential (MEP) monitoring during scoliosis surgery.Methods Fifty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-25 yr,scheduled for posterior spinal fusion surgery,were randomly divided into 2 groups with 25 patients in each group: muscle relaxants combined with total intravenous anesthesia group (group Ⅰ) and total intravenous anesthesia without muscle relaxant group (group Ⅱ).In both groups,a loading dose of dexmedetomidine 1 μg/kg was infused over 20 min,followed by infusion at 0.2 μg· kg-1 · h-1.After the loading dose of dexmedetomidine was given,anesthesia was induced,the patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil 0.2μg· kg-1 · min-1 and propofol 80-120 μg· kg-1 · min-1.The bispectral index value was maintained at 40-60.Train of four stimulation of ulnar nerve was used to monitor the neuro-muscu-lar block.Cisatracurium was infused at 0.5-1.5 μg·kg-1 ·min-1,T1 was maintained at 45％-55％,and the infusion was stopped 30 min before the isolation of paraspinal muscles was completed in group Ⅱ.MEP were monitored and recorded during the period when the administration of the muscle relaxation was stopped,and the degree of muscle relaxation was assessed by the surgeon.The successful wake-up test was recorded.Results The incidence of successful MEP monitoring was significantly higher in group Ⅱ than in group Ⅰ (P ＜ 0.05).There was no significant difference in the degree of muscle relaxation between the two groups (P ＞ 0.05).All the patients were successfully woken up.Conclusion Total intravenous anesthesia without muscle relaxants can provide satisfactory muscle relaxation for scoliosis surgery and increase the probability of successful MEP monitoring simultaneously.

Objective To investigate the analgesic effects of intrathecal dexamethasone injection on pain induced by chronic compression of dorsal root ganglion in mouse.Methods Using rat model of radicular pain induced by chronic compression of dorsal root ganglion ( CCD), 40 male SD rats successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into 5 groups:Sham-operation group ( Sham group, n = 8 ), Control group ( CCD group, n = 8), Dexamethasone group ( D group, n = 8), Akt inhibitor V group (A group, n = 8 ) and Dexamethasone plus Akt inhibitor Ⅳ group (DA group, n = 8 ).Rats in D group, A group or DA group were intrathecally treated with dexamethasone (100μg/kg) ,Akt inhibitor Ⅳ (0.6μg/10μl) or dexamethasone ( 100 μg/kg) plus Akt inhibitor Ⅳ (0.6 μg/10 μl) on Day 3,13 after CCD respectively, while rats in C and Sham group received Vehicle (10% DMSO).Paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were tested on 3 d before and 3 d,4 d,7 d,10 d,13 d,14 d and 15 d after operation.Results Compared with Sham group,both PWMT (P＜0.01) and PWTL (P＜0.01) were significantly decreased after CCD surgery on the ipsilateral side.After dexamethasone and Akt inhibitor were respectively intrathecally injected at 3 postoperative day,PWMT (7.33 ± 1.03 ) g, (5.67 ± 1.03 ) g, (2.67 ± 1.03 ) g (P ＜0.01 ) ,PWTL( 16.47 ±0.46)s, ( 14.48 ±0.84) s, ( 10.82 ±2.21 ) s(P＜0.01 ) ,then decreased gradually,and intrathecally injected again at 13 postoperative day, PWMT ( 7.33 ± 1.03 ) g, ( 5.67 ± 1.03 ) g, (2.33 ± 0.81 ) g (P ＜0.01 ), PWTL( 16.44 ±0.90) s, ( 14.01 ±0.82)s, ( 10.22 ± 1.28)s (P＜0.01).Coadministration dexamethasone and Akt inhibitor exhibit significant synergies, postoperative 4 d PWMT( 10.83 ± 2.04)g, (2.67 ± 1.03 )g (P ＜0.01),PWTL(19.11 ±2.01)s,(10.82 ±2.21)s (P＜0.01);14 d PWMT (7 ±0.82)g,(2.33 ±0.81)g (P ＜ 0.01 ), PWTL( 17.16 ± 1.14)s, ( 10.22 ± 1.28 ) s (P ＜ 0.01 ).Conclusion Intrathecal high-dose dexamethas one or PKB / Akt inhibitors can effectively improve pain behavior response induced by chronic compression of dorsal root ganglia,combination of these two drugs could generate significant synergies, and the effection is more obvious, more durable.

Objective To compare the effects of sevoflurane and isoflurane on ventilation function during laparoscopic cholecystectomy by monitoring side stream spirometry(SSS).Methods Totally 40 adult patients(ASA grade Ⅰ-Ⅱ),who were to undergo laparoscopic cholecystectomy,were randomly divided into sevoflurane group(group Ⅰ) and isoflurane group(group Ⅱ),with 20 cases in each.The two groups were given same preoperative medication and induction of anesthesia.Anesthesia maintenance was performed with inhaling of 1% sevoflurane or 1% isoflurane,combined with continuous intravenous infusion of propofol [3 to 5 mg/(kg?h)] and atracurium [0.3 to 0.5 mg/(kg?h)].The changes of the lung compliance and Airway resistance of the two groups,as well as dead space ratio,were observed in the two groups.Results ① Compared with the patients received intubation at the supine position,the two groups showed reduced pulmonary compliance(Cdyn) and significantly increased airway pressure(Paw,P

Objective To evaluate the effect of dexmedetomidine on quality of wake-up test in the patients undergoing posterior osteotomy correction surgery.Methods Ninety-seven patients of both sexes,aged 17-59 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index 18.5-25.0 kg/m2 and global kyphosis angle＞60°,scheduled for elective posterior osteotomy correction surgery under general anesthesia,were randomly divided into 2 groups using a random number table:control group C (n=46) and group D (n =51).In group D,dexmedetomidine 1.0 μg/kg was infused over 15 min before induction of anesthesia,and group C received the equal volume of normal saline instead.Anesthesia was induced with iv midazolam,propofol,fentanyl,vecuronium and dexamethasone in C and D groups.Mechanical ventilation was performed after tracheal intubation.Anesthesia was maintained with infusion of cisstracurium,propofol and remifentanil.Dexmedetomidine 0.3 μg · kg-1 · h-1 was infused throughout the surgery in group D,and meanwhile normal saline was given throughout the surgery in group C.The anesthetic drugs for maintenance except dexmedetomidine were discontinued at the beginning of the wake-up test.The wake-up time was recorded and the wake-up quality was assessed.Ramsay sedation scores and Riker sedation-agitation scale scores were also recorded when all the patients were successfully awakened.The development of cardiovascular events during wake-up test and intraoperative awareness was recorded.Results The wake-up quality was significantly higher,Riker sedation-agitation scale scores were lower,Ramsay sedation scores were higher,the incidence of nausea and vomiting was lower,and no significant change was found in wake-up time in group D.No intraoperative awareness was observed in the two groups.Conclusion Dexmedetomidine can raise wake-up quality without prolonging wake-up time and with stable hemodynamics and fewer side effects in the patients undergoing posterior osteotomy correction surgery.

Objective To investigate the effects of sodium hydroxybutyrate (?-OH) on neuronal apoptosis in neonatal rat cortex induced by hypoxic-ischemic (HI) insult. Methods One-hundred and fifty 7-day old newborn SD rats were randomly assigned to one of S groups ( n = 30 each): sham operation group (A); HI + normal saline (NS) group (B) and three HI + ?-OH groups (C, D, E) . HI was induced by ligation of left common carotid artery followed by 2 h inhalation of hypoxic air (8% O2 92% N2). In sham operation group (A) left common carotid artery was exposed but not ligated and no hypoxic air was inhaled after operation. In group B (HI + NS) NS 0.2 ml?10 g-1 was injected intraperitoneally (IP) t.i.d immediately after HI until the animals were killed; whereas in HI +?-OH groups ?-OH 50 (C) or 100 (D) or 200 (E) mg?kg-1 was injected IP instead of NS. Six animals were killed at 1 h, 3 h, 1 d, 3 d and 7 d in each group and brains were removed. The number of apoptotic neurons in the left cortex was detected using TUNEL staining technique. Results The number of apoptotic neurons at 1 h-7 d after HI was significantly greater in group B, C, D and E than in group A ( sham operation) . The expression of apoptosis positive neurons reached the peak at 1 day after HI. The number of apoptotic neurons at 3 h-3 d was significantly greater in group E (?-OH 200 mg?kg-1) than in group C and D (?-OH 50 and 100 mg?kg-1) . There was no significant difference in the number of apoptotic neurons between group B (HI + NS) and E (HI +?-OH 200 mg?kg-1). Conclusion Sodium hydroxybutyrate 50 and 100 mg?kg-1 can attenuate neuronal apoptosis in neonatal rat cortex induced by hypoxic-ischemic insult.

Objective To evaluate the effects of lateral position on fiberoptic bronchoscope (FOB)-guided orotracheal intubation under general anesthesia in the patients with ankylosing spondylitis.Methods Forty-five patients with ankylosing spondylitis, aged 19-63 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, were divided into 2 groups using the random number table: group supine position (group S, n=22) and group lateral position (group L, n=23).After induction of general anesthesia, orotracheal intubation was performed under the guidance of FOB.Intubation time, catheterization time, intubation condition and intubation-related complications were recorded.Mean arterial pressure (MAP) and heart rate (HR) were also recorded before anesthesia induction, immediately before intubation, immediately after onset of intubation, and at 2 and 4 min after intubation.Results The success rates of intubation were both 100％ in the two groups.Compared with group S, the intubation time and catheterization time were significantly shortened, the success rates of intubation and catheterization at first attempt were increased, MAP and HR were decreased immediately after onset of intubation, and no significant change was found in intubation-related complications in group L.Conclusion Lateral position can raise the success rate of FOB-guided orotracheal intubation under general anesthesia with shorter operation time, it is helpful in stabilizing hemodynamics during intubation, and intubation-related complications are fewer in the patients with ankylosing spondylitis.

To compare the efficacy and side effects of bupivaeaine(Bup)at two concentrations and fentanyl for caudal analgesia in children. Method:One hundred-fifty children undergoing hernia repair procedures under caudal anesthesia, were randomly assigned to five groups. Group A: 1% lidocaine (Lid), group B: 10% Lid+0.1% Bup, group C: 1% Lid+0.25% Baeup, group D: 1%Lid+0.15%Bup with 2?g?kg~(-1) fentanyl, group E: 1%Lid+0. 25%Bup with 2?g?kg~(-1) fentanyl for caudal analgesia, The degree of pain(LPS), nausea and vomiting (NV) were as sessed at 4, 8, 12 and 24 h after operation. Result: The numbers of LPS

Objective To evaluate the postoperative analgesic effects of parecoxib for laparoscopic urological surgery.Methods Forty patients with ASA scale ofⅠto Ⅲ underwent laparoscopic urological surgery were randomly divided into two groups: the flurbiprofen group(group Ⅰ,n=20) with IV flurbiprofen 100 mg at 2 hours after operation,and 100 mg twice a day during 3 days after operation;and the parecoxib group(group Ⅱ,n=20)with IV parecoxib 40 mg at 2 hours after operation,and 40 mg twice a day during 3 days after operation.The VAS score at 2,4,16,24 and 48 hours after operation and the adverse effects were recorded.Results The average VAS score of the two groups was 4 to 5 at 2 hours after operation,and was 0~3 at other time points.There was no significant difference among two groups in the VAS score.Conclusion Parecoxib can provid effective postoperative analgesia for patients underwent laparoscopic urological surgery as flurbiprofen.