Objective To investigate the effects of inhalation of isoflurane (Iso) on pulmonary and systemic inflammatory response through the changes in the plasma and pulmonary levels of IL-1β and IL-10 in rats. Methods Thirty-two adult male Wistar rats were randomly divided into 4 groups (n=8 each): group control (group C), group Iso-4 h, group Iso-8 h and group R. Group C inhaled air only. Group Iso-4 h and Iso-8 h inhaled in 40% O2 + 1.5% Iso for 4 and 8 h respectively. Group R inhaled 40% O2 + 1.5% Iso for 8 h and then withdrew and only inhaled 40 % O2 for 2 h. Blood samples were taken from femoral artery for measurement of plasma concentrations of IL-1β and IL-10 by ELISA. Then the rots were sacrificed to collect bronchoalveolar lavage fluid (BALF) for measurement of IL-1β and IL-10 concentrations. The right lung tissues were obtained for determination of the expression of IL-1β mRNA and IL-10 mRNA by RT-PCR. Results The BALF concentration of IL-1β and IL-1β mRNA expression in lung tissues were significantly higher in group Iso-4 h, and the concentrations of plasma and BALF IL-1β and IL-10, and the expression of IL-1β mRNA and IL-10 mRNA in lung tissues were significantly higher in group Iso-8 h than in group C (P<0.05), but there were no significant differences in the concentrations of plasma and BALF IL-1β and IL-10 and expression of IL-1β mRNA and IL-10 mRNA in lung tissues between group R and group C (P>0.05). The plasma and BALF IL-10 concentrations and IL-10 mRNA expression in lung tissues were significantly higher in group Iso-8 h than in group Iso-4 h (P<0.05). The concentrations of plasma and BALF IL-1β and IL-10 and expression of IL-1β mRNA and IL-10 mRNA in lung tissues were significantly lower in group R than in group Iso-8 h (P<0.05). Conclusion Isollurane inhalation can induce transient pulmonary and systemic inflammatory response in rats.

0.05).Conclusions Combined spinal and epidural anesthesia combined with target controlled infusion of midazolam has slight side effects and serum cortisol changes,suitable for gynecological operations.

Objective:To examine the effects of different concentrations of Isoflurane on the level of surfactant protein A(SP-A) and the expression of SP-A mRNA in the lung of rats.Methods: Thirty-two male Wistar rats were randomly divided into 4 groups: control group received 40%(volume fraction) O_2 inhalation(40% O_2,n=8);0.7% isoflurane group(n=8),1.5% isoflurane group(n=8).They and 2.0% isoflurane group(n=8).They were treated with 40%O_2 with 0.7%,1.5% and 2.0% isoflurane respectively.In each group,the rats inhaled experimental gas for 8 hours,and then were put to death immediately.Morphological changes of type Ⅱ pneumocytes were observed by transmission electron microscopy.Surfactant protein content in broncho-alveolar lavage fluid(BALF) was measured with Western Blotting.The level of intracellular SP-A was examined with immunohistochemistry(IHC).To assess the relative levels of SP-A mRNA in lung tissue,reverse transcriptase-polymerase chain reaction(RT-PCR) was used with the co-amplification of the "housekeeping" gene GAPDH as internal control.Results: Morphological changes of type Ⅱ pneumocytes were distinct in 1.5% isoflurane and 2.0% isoflurane groups.Isoflurane,after three doses,significantly reduced the SP-A content in BALF.Control group,(437 112)?25 654;0.7%Isoflurane group,355 789?28 116;1.5%Isoflurane group,238 554?31 531;(2.0%) Isoflurane group,223 632?25 710(P

Objective To investigate the effects of 1% ropivacaine injected epineurally or intraneurally on the recovery of sciatic nerve from acute injury in rats. Methods Seventy-two healthy male Wistar rats weighing 220-250 g were xandomly assigned into 4 groups ( n = 18 each): group Ⅰ epineural injection of normal saline(NS)(group C1); group Ⅱ intraneural injection of NS (group C2); group Ⅲ epineural injection of 1% ropivacaine (group Epi-R) and group Ⅳ intraneural injection of 1% ropivacaine (group Intra-R). The animals were anesthetized with intraperitoneal 3% pentobarbital 60 mg/kg. The sciatic nerve was exposed and crushed with blood vessel clamp for 2 min. NS or 1% ropivacaine 0.2 ml was injected epineurally or intraneurally after release of the clamp.Sciatic nerve function was measured and sciatic nerve function index (SFI) was calculated at day 1, 3, 7, 14, 21and 28 after operation. Six animals in each group were anesthetized on the 14th and 28th day after operation and the nerve conduction velocity (NCV) of the sciatic nerve was measured. The sciatic nerve was then removed for histologic examination. Results There was no significant difference in SFI and NCV at all time points among group C1 , C2 and Epi-R. SFI was almost normal on the 28th day after operation in the 3 groups. The NCV was significantly slower at day 14 and 28 after operation in intra-R group than in the other 3 groups. Conclusion Intra-neural injection of ropivacaine can significantly delay the recovery of sciatic nerve from acute injury.

Objective To investigate the effects of inhalation of different concentrations of sevoflurane on pulmonary inflammatory response in rats. Methods One hundred and twenty adult Wistar rats of both sexes weighing 200-250 g were randomly divided into 4 groups: Ⅰ control group breathing room air (group C, n = 12);Ⅱ oxygen group breathing 40% O2(group O, n = 36);Ⅲ and Ⅳ sevoflurane groups breathing 1.5% and 3.0% sevoflurane in 40% O2 respectively (group S1, S2, n = 36). Group Ⅱ was further divided into 3 subgroups according to the duration of 40% O2 inhalation 4 h, 8 h and 10 h. Group Ⅲ and Ⅳ were further divided into 3 subgroups ( n = 12 each) breathing sevoflurane for 4 h, 8 h and 8 h followed by 2 h O2 (40%) inhalation. The animals were sacrificed at the end of O2 or/and sevoflurane inhalation. Broncho-alveolar lavage was performed in 6 animals in each subgroup. The TNF-α concentration in broncho-alveolar lavage fluid was determined. The TNF-α mRNA expression and MPO activity in the lung tissue were measured in the other 6 animals in each subgroup. Results Inhalation of 1.5% or 3.0% sevoflurane for 4 or 8 h did not induce inflammatory response in the lung as compared with animals breathing room air or 40% O2 . Conclusion Exposure to sevoflurane does not induce pulmonary inflammatory response in rats breathing spontaneously.

The latest advance of sedation for critically ill adult patients in intensive care unit (ICU) was reviewed in order to provide certain clinical information for the ICU physicians about sedation. Guidelines, clinical research, Meta-analysis, and reviews in recent years were collected using electronic data base. Discussions included: ① the definition of light sedation, and its effects on clinical outcome, stress, sleep and delirium; ② light sedation strategies included: the target population, the target sedation strategy and daily sedation interruption, clinical assessment and monitoring of sedation, selection of sedative drugs, light sedation extenuation; ③ light sedation strategies and pain, agitation, delirium control bundles; ④ the problems and prospects of light sedation. Light sedation is the main principle of currently ICU sedation strategy in critically ill adult patients. Goal-directed light sedation should be considered as a routine therapy in most clinical situation, and its goal should be achieved as early as possible in the early stage of sedation. Routine use of benzodiazepines should be avoided, especially in patients with or at a risk of delirium. Prevention and treatment of agitation with a combination of non-pharmacologic or pharmacologic methods; ICU specification rules for pain, agitation and delirium prevention and treatment should be made. Light sedation is the main ICU sedation strategy in adult patients now, but must be individualized for each patient.

0.05). Conclusions The effect of rocuronium can be potentiated by nitroglycerin-induced deliberate hypotension, while time for maximum depression is prolonged.However, the time course of recovery of rocuronium can not be affected markedly.

Objective To investigate the pharmacodynamics of rocuronium by targeted-controlled infusion(TCI)during laparoscopy in elderly and adult patients.Methods A total of 31 patients undergoing selective laparoscopy operation from the Department of Gynecology and Department of General Surgery were divided into elderly group(aged 65-81 years,n=17)and adults group(aged 18-55 years,n=14).Under general anesthesia,rocuronium was infused intravenously using a TCI system.The upper limb without intravenous infusion was employed for TOF.The target plasma concentration(Cpt)was started from 1.0 ?g/ml,and then increased to 1.3,1.6,1.9,2.2,and 2.5 ?g/ml successively according to the neuromuscular response to the TOF stimulation.The endpoint of Cpt was determined when the T1 was blocked by 90%-95%.After terminating the infusion,the time to recovery of T1 to 25%,TOF ratio to 0.7,and recovery of index were recorded.T1 scales with each Cpt and the rates of rocuronium infusion were also recorded.Results T1 scales with each Cpt were significantly lower in the elderly patients than those in the adults(P

Objective To evaluate the effect of mild hypothermia on the recovery from cisatracurium blockade during the recovery from anesthesia in patients .Methods Thirty ASA physical status Ⅰ or Ⅱ patients , aged 18-64 yr , with body mass index 18-25 kg/m2 , scheduled for elective abdominal surgery under general anesthesia ,were enrolled in the study .The patients were divided into 2 groups according to the body temperature recorded when cisatracurium infusion was stopped at the end of surgery .The body temperature 36.0-36.9 ℃served as normothermia group (group N , n=14 ) and 34.0-35.9 ℃ served as mild hypothermia group (group H , n= 16 ) . The body temperature was measured by a thermocouple placed in the nasopharynx . Neuromuscular function was monitored by measuring the evoked mechanical response of the adductor pollicis muscle to supramaximal train-of-four (TOF) stimulation (frequency 2 Hz ,wave length 0.2 ms ,intensity 50 mA ,interval 15 s) of the ulnar nerve at the wrist using TOF-Watch SX? .Cisatracurium was intravenously infused at 1-3μg·kg-1 ·min-1 during surgery to maintain neuromuscular block with 1%

Objective To investigate the changes in oxygenation and intrapulmonary shunt duringprolonged one-lung ventilation (OLV) and compare the effects of four different anesthetic techniques. MethodsForty ASAⅠ -Ⅱ patients (27 male, 13 female) aged 36-74 yr undergoing prolonged OLV during elective thoracicsurgery were randomly allocated to one of four groups: (1) isoflurane (GI, n = 10); (2) isoflurane + epidural(GIE, n =10); (3) propofol (GP, n = 10); (4) propofol + epidural (GPE, n = 10). Radial artery wascannulated and Swan-Ganz catheter was placed via right internal jugular vein before induction of general anesthesia.In group 2 and 4 an epidural catheter was inserted at T_(7-8) or T_(8-9) and advanced 3 .5-4.0 cm in the epidural spacecephalad. Epidural block was produced by a bolus of 0.5 % ropivacaine 7-9 ml followed by continuous infusion of0. 5 % ropivacaine at 3-5 ml?h~(-1). Anesthesia was induced with propofol 1 .0-1. 5 mg?kg~(-1), fentanyl 3?g?kg~(-1) andvecuronium 0. 1 mg?kg~(-1). A left-sided double-lumen tube was inserted and correct position was confirmed. Thepatients were mechenically ventilated. The ventilation collditions were FiO_2 = 100 %, V_T = 8-10 ml?kg~(-1), I: E =1: 5 and respiratory rate was adjusted to maintained P_(ET) CO_2 at 35-45 mm Hg during both two-lung ventilation(TLV) and OLV. Anesthesia was maintained with isoflurane inhalation in group 1 and 2 or continuous infusion ofpropofol in group 3 and 4 supplemented with intermittent i. v. boluses of fentanyl. MAP, HR, ECG, MPAP,CVP, continuous cardiac output (CCO), BIS and TOF were continuously monitored during anesthesia. BIS was maintained at 45-55. Arterial and pulmonary blood gases were analyzed before induction of anesthesia (T_1), 30min after TLV was started (T_2 ), and 5, 15, 30, 60, 120 and 180 min after OLV was started (T_(3-8)) and 30 minafter TLV was resumed (T_9 ). The Qs/Qt (shunt fraction) was calculated at T_(1-9) Results Qs/Qt was significantlyincreased after induction of general anesthesia and mechanical ventilation and increased further during OLVcompared with the baseline value (T_1) in all four groups. The calculated Qs/Qt values were highest at 15 min (T_4)or 30 min (T_5) of OLV and remained high for 30-60 min and then gradually decreasing. During OLV QS/Qt washigher in group 1 than in the other three groups (P0.05). Cardiac output was significantly higher in group 1 and 2 than thatin group 3 and 4 during OLV. Conclusion During prolonged OLV intrapulmonary shunt tends to decrease withincreasing oxygenation with time, regardless of anesthetic techniques employed. Isoflurane inhalation is associatedwith a signifficant increase in shunt fraction. Combined general and epidural anesthesia may induce greaterhemodynamic changes.