Objective To evaluate the clinical intubation of Bonfils intubation fiberscope in difficult airway of acromegaly patients.Methods Fifteen acromegaly patients who have one of the following criteria of preoperative airway assessment,Mallampati score ≥3,thyromental distance (≤6 cm),mouth opening(≤3.5 cm).After routine anesthetic induction the patients were intubated with Bonfils intubation fiberscope.Haemodynamic changes were observed and handling of the Bonfils intubation fiberscope was evaluated in terms of the ease of insertion into oropharynx,visualization of epiglottis,advancement into glottis aperture and slide down the tracheal tube.Intubating time and success rate were also recorded.Postoperatively,sore throat or hoarseness were followed up for all patients.Results After intubation systolic pressure and heart rate increased as compared with pre-intubation((P

Objective To investigate the effect of ketamine pretreatment on acute tolerance to morphine in rats with chronic inflammatory pain.Methods Twenty-four adult male SD rats weighing 180-200 g were randomly divided into 3 groups (n=8 each): group Ⅰ morphine (M) ,group Ⅱ ketamine (K) and group Ⅲ ketamine + morphine (KM). Chronic inflammatory pain was induced by subcutaneous injection of Freund's adjuvant 0.125 ml into the plantar surface of left hindpaw. Three days after Freund's adjuvant injection, the animals received intraperitoneal (IP) morphine 5 mg/kg in group M, IP ketamine 10 mg/kg in group K or IP ketamine 10 mg/kg 10 min before IP morphine 5 mg/kg in group KM once a day for 3 consecutive days respectively. The paw withdrawal threshold to yon Frey hair stimulation (PWT) and paw withdrawal latency to noxious thermal stimulation(PWLT) using the hot plate test were measured before Freund's adjuvant injection (T0, baseline), and every day before (T1) and at 15 (T2), 30 (T3), 60 (T4) and 120 min (T5) after medication for 3 days (D1,2,3).Results PWT was significantly increased after medication on D1,2,3 in group KM but only on D1,2 in group M. PWLT was significantly prolonged after medication on D1,2,3 in group KM but only on D1 in group M. Conclusion Ketamine 10 mg/kg pretreatment can decrease the acute tolerance to morphine in rats with chronic inflammatory pain.

Although there are a number of shortcomings with these animal models, they provide important clues in understanding the underlying pathophysiology of neuropathic pain in humans. In these models, cutaneous sensory threshold of the hindlimb ipsilateral to nerve injury is measured. The presence of neuropathic pain in experimental animal models is mainly measured as allodynia or hyperalgesia, in which the normally nonnoxious or mildly noxious stimuli induce a nociceptive behavioral response. This paper mainly discusses the recent findings from the peripheral nerve injury model of neuropathic pain, as well as the different characteristics of these animal models of neuropathic pain.

AIM: To investigate if pregabalin could depress the acute tolerance induced by morphine when curing the chronic inflammatory pain of rats.METHODS: 24 adult male Sprague-Dawley rats weighing 180-200 g were randomly divided into three groups(8 in each group).Freund's adjuvant was injected subcutaneously in left hind-paw of the rat to establish the chronic inflammatory pain model.3 days later,rats received 3 daily intragastrical(p.o.) morphine 8 mg/kg(M group),pregabalin 3 mg/kg(P group) or morphine 8 mg/kg+pregabalin 3 mg/kg(MP group) administrations respectively.The rats' pressure-withdrawal threshold(PWT) and paw withdrawal thermal latency(PWTL) were determined with Von-Frey hair test and rat hot-plate test respectively.The results of PWT and PWTL before and 15,30,60,120 min after medication were recorded.RESULTS: PWT and PWTL of the rats in M group increased after medication on all the time points of the first day and 15 min of the second day(P

Objective To investigate the safety and feasibility of anesthesia for patients with myasthenia gravis using target controlled infusion without muscle relaxant.Methods Thirty-one patients with myasthenia gravis were recruited into study.A target controlled infusion was started with targeting effect-site concentration of propofol 3 μg/mL and remifentanil 4 ng/mL.Intubation was performed when patients were unconsciousness and target concentrations of both drugs were reached.No muscle relaxant was used during anesthesia.Blood pressure,heart rate,performance of intubation and respiratory recovery including extubation and wake time were observed.Results All patients were intubated successfully in one attempt.38.7% patients had mild cough when the endotracheal tube past through the vocal cord during intubation.Blood pressure and heart rate at post-intubation increased significantly as compared with pre-intubation (P＜0.01).After cease of drugs,time of spontaneous breathing recovery was (6.5±2.9) min.Extubation and wakeup time were (9.8±3.6) and (7.4±3.1) min respectively.No adverse event was noted.Conclusion Target controlled infusion without muscle relaxant was safe and effective anesthesia for myasthenia gravis patients undergoing thymectomy.

Objective: To investigate perioperative changes of gastrointramucosal pH (pHi) in major operative patients. Method: Six patients underwent major abdominopelvie operation with radial artery and internal jugular vein catheters, and nasogastric tonometries in place. The phi and hemodynamic, oxygen, and metabolic variables were measured simutaneously before anesthesia, 30 minutes after anesthetic induction, during intraoperation, at the end of operation, and the first 24 hours postoperatively. Result: There was significant decrease in mean pHi(P

Objective The double-blinded, randomly study was designed to determine the clinical efficacy and safety of ropivacaine for combined spinal-epidural anesthesia (CSE). Methods Sixty patients, ASA class Ⅰ-Ⅱ , 18 to 75 years, undergoing elective lower limb or perineum surgery, were randomly allocated to receiving spinally hyperbaric mixture 1.5-2ml of 1% ropivacaine (group R, n=20), 0.75% bupivacaine(group B,n=20), or 1% tetracaine (group T,n=20), combined with 10% glucose 1ml and 3% ephidrine 1ml respectively,and the anesthesia was maintained with epidural administration with 2% lidocaine if necessary during the operation ,after the B-D DurasafeTM combined spinal epidural anesthesia kit was applied at the L 3-4 interspace.Results The time to maximum spread of anesthesia in group R was longer, but the recovery time was shorter than those in group T(P0.05). Additionally, as compared with ones in group B and T, the onset of motor block and the time to peak motor block were prolonged significantly (P

Objective To compare the effects of propofol with thiopentone on preventing riskiness of tracheal intubation. Methods In 224 elective surgical patients under general anesthesia, the riskiness of tracheal intubation was evaluated following the administration of fentanyl 2?g/kg combined with propofol 2.0mg/kg (group P) or thiopentone 5.0 mg/kg (group T) respectively, with multivariate analysis. Results Risk rate was 36. 04 % in group T and 17. 70 % in group P (P 0 .05). Conclusions There is certainly clinical advantage of propofol compared to thiopentone in terms of preventing riskiness of tracheal intubation if hypotension of propofol is unconcerned.

Gabapentin may bind the ? 2? subunit of the voltage -dependent calcium ion channels at the postsynaptic dorsal horn and interrupt t he series of events possibly leading to the experience of a neuropathic pain sen sation. Many clinical studies have clearly demonstrated the efficacy of gabapent in in the treatment of diabetic neuropathy and postherpetic neuralgia. Gabapenti n is considered an effective drug with its minimal side effects and drug interac tions in the management of neuropathic pain syndromes.

Objective To determine the changes in perioperative plasma melatonin, cortisol and neuron-specific enolase (NSE) and neuropsychological function in patients who developed CNS complications after coronary artery bypass grafting (CABG) .Methods Three patients developed CNS complications (cerebral infarction, motor aphasia, motor and sensory aphasia) after CABG performed under hypothermic cardiopulmonary bypass (CPB) were studied. Blood samples were taken before induction of anesthesia (T1) , 10 min after tracheal intubation (T2), 10 min after heparinization (T3), at 30 min of CPB (T4) , immediately after discontinuation of CPB (T5), at closure of chest (T6), immediately after returning to ICU (T7) and every 3 h in ICU for 24 h (T8-15) for determination of plasma concentrations of NSE, cortisol and melatonin using enzyme-linked immunosorbent assay and radioimmunoassay. Cognitive function was measured before and 10 to 20 days after operation using a battery of tests, while depression and anxiety were assessed by self-rating depression scale and state-trait anxiety inventory respectively. Results The plasma NSE concentration was increased after operation in all 3 patients. The circadian rhythms of melatonin and cortisol were disturbed in patient 1 and 2 during the 24h after operation but were retained in patient 3. In patient 1 and 3 the performance of the trailing making test, the digit symbol subtest of WAIS-R and the stroop color word interference test were poor, meanwhile they became more depressed and less anxious. Conclusion In patients who develop CNS complication after CABG, there are cognitive decline, sentimental disorders and disrupted circadian rhythm of melatonin and cortisol secretion.