Objective To investigate the modulatory effect of different dosage of sufentanil on I GABA in rat dorsal root ganglion neurons. Methods The rat root ganglion neurons were enzymatically dissociated. The whole-cell patch clamp techniquewas applied to record the effect of 0.02 , 0.1, 0.5, 2.5 μmol/L sufentanil and 0.5 mol/L sufentanil + 1 nmol/L Naloxone, a non-specific ityopioid receptor antagonist on IGABA. Results 0.02, 0.1, 0.5, 2.5 μmol/L sufentanil potentiated IGABA to (108.7 ± 6.7)%,(122.0 ± 2.3)%, (146.7 ± 7.9)% and (130.1 ± 5.6)%, respectively (n = 10; *P < 0.05, **P < 0.01). The potentiation role of 0.1,0.5, 2.5 μmol/L sufentanil on IGABA lasted 10 to 20 min The potentiation could be blocked by Naloxone (n = 7; *P < 0.05, **P < 0.01). Conclusion Sufentanil activates μ opioid receptor and potentiates the action of GABAA receptor, and the potentiation could be blocked by Naloxone. The enhancement of currents by sufentanil may increase GABA A receptor-mediated presynaptic inhibition at the spinal cord level.

Objective To investigate the effects of epidural ropivacaine block combined with propofol intravenous anesthesia on CaMKⅡ and ERK1/2 total protein (T-CaMKⅡ and T-ERK1/2) and phosphorylation(p-CaMKⅡ and p-ERK1/2) levels in the hippocampus and cortex of rats.Methods Rats were randomly assigned to three groups: group P(control,propofol intravenous anesthesia),group PS(propofol and epidural normal saline) and group PR(propofol and epidural 0.5% ropivacaine).Anesthesia were performed in 72 h after epidural catheter placement.The rats in group PR received 70 μL of 0.5% ropivacaine to achieve epidural block.1% propofol was infused through rats caudal vein.Propofol dosage for anesthesia induction was 12 mg/kg,for anesthesia maintenance was 40 mg/(kg·h).Before the rats were decapitated,the depth of anaesthesia was assessed as either light anesthesia or deep anesthesia by checking of pinch withdrawalreflex,eyelid reflex and spontaneous rapid whisking of the vibrissae after propofol continuous infusion for 1 h.T-CaMKⅡ/T-ERK1/2 and p-CaMKⅡ/p-ERK1/2 in hippocampus and frontal cortex were examined by Western blot.Results 7 rats were assessed as light anesthesia and one rat as deep anesthesia in group P;6 rats were assessed as light anesthesia and 2 rats as deep anesthesia in group PS;in group PR,1 rat was assessed as light anesthesia and 7 rats as deep anesthesia.Significant differences were seen among three groups (P<0.05).In hippocampus of rats,p-CaMKⅡ(Thr286)43.7%±8.8% and p-ERK1/2 32.4%±7.9% in group PR were significantly lower than those in group P (100%,P<0.05).Conclusions Epidural ropivacaine block may strengthen the depth of anesthesia achieved with propofol intravenous anesthesia.The decrease of p-CaMKⅡ(Thr286) and p-ERK1/2 in hippocampus of rats may explain the effects of epidural block.

Objective To systcmatically rcvicw the effect of goal-directed fluid therapy (GDFT) on outcomes following abdominal surgery.Methods Pubmed,Embase,CINAHAL,Scopus and Cochrane Library were searched from 1980 to May 2016 to identify randomized controlled trials involving the effect of GDFT on outcomes following abdominal surgery in adults (aged＞ 18 yr).GDFT served as therapy group,and conventional fluid therapy served as control group.The major evaluation indexes included the postoperative mortality rate,incidence of postoperative complications and length of hospital stay.The secondary evaluation index was the recovery of postoperative gastrointestinal function.Meta-analysis was conducted using the RevMan 5.1 and Stata 12.0 softwares.Results Forty-five randomized controlled trials involving 6344 patients were included in our meta-analysis,and there were 3406 cases in therapy group and 2938 cases in control group.The results of mcta-analysis showed that compared with control group,the number of patients who developed postoperative complications was significantly decreased,the length of hospital stay was shortened,and the time to first flatus and time to first liquid diet were shortened in therapy group (P＜0.05).There was no significant difference in the mortality rate between the two groups (P＞0.05).Conclusion GDFT can promote outcones following abdominal surgery and exerts no effects on the survival rate in patients.

Objective To evaluate the efficacy of ultrasound-guided great auricular nerve block with different concentrations of ropivacaine for postoperative analgesia in patients undergoing tympanic and mastoid surgery.Methods Ninety American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 18-60 yr,with body mass index of 19-25 kg/m2,undergoing elective tympanic and mastoid surgery under general anesthesia,were divided into 3 groups (n=30 each) using a random number table:control group (group C),0.25％ ropivacaine group (group R1) and 0.50％ ropivacaine group (group R2).In R1 and R2 groups,great auricular nerve block was performed under ultrasound guidance before anesthesia induction,0.25％ and 0.50％ ropivacaine 2 ml were injected,respectively,10 min later the block in the area innervated by great auricular nerve was evaluated using the method of acupuncture in comparison with the contralateral area.After successful block was confirmed,the patients were ventilated using the laryngeal mask airway under general anesthesia.Flurbiprofen axetil was given as rescue analgesic,sufentanil was used when the efficacy was not satisfactory,and visual analog scale score was maintained less than or equal to 3 points.The number of patients requiring rescue analgesic was recorded within 48 h after surgery.Results The great auricular nerve was successfully blocked in 60 patients of R1 and R2groups.Compared with group C,the requirement for rescue analgesic was significantly decreased within 48 h after surgery in R1and R2 groups (P＜0.01).There was no significant difference in the requirement for rescue analgesic within 48 h after surgery between group R1 and group R2 (P＞0.05).Conclusion Ultrasoundguided great auricular nerve block with 0.25％ ropivacaine provides better efficacy for postoperative analgesia in the patients undergoing tympanic and mastoid surgery.

Objective To evaluate the efficacy of ultrasound-guided great auricular nerve (GAN)block combined with general anesthesia for middle ear microsurgery in adult patients.Methods Sixty-four adult patients of both sexes,aged 18-60 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective middle ear microsurgery,were assigned into 2 groups (n =32 each) using a random number tabte:GAN block combined with general anesthesia group (group GANB+G) and general anesthesia group (group G).Patients received GAN block with 0.25％ ropivacaine 2 ml using ultrasoundguided in-plane technique before anesthesia induction in group GANB+G.Anesthesia induction and maintenance protocols (IV infusion of propofol and target-controlled infusion of remifentanil) were similar in two groups.Analgesia was performed with sufentanil,flurbiprofen axetil or parecoxib sodium after operation to maintain visual analog scale score ＜4 within 48 h after operation.The infusion duration and consumption of propofol and remifentanil,requirement for postoperative analgesia and occurrence of postoperative nausea and vomiting were recorded.Results Compared with group G,the consumption of remifentanil was significantly reduced,and the requirement for postoperative analgesia and incidence of postoperative nausea and vomiting were decreased in group GANB + G (P ＜ 0.05 or 0.01).Conclusion Ultrasound-guided GAN block combined with general anesthesia provides better analgesic efficacy in the the perioperative period in adult patients undergoing middle ear microsurgery.

Objective To determine the median effective dose(ED50)of dezocine inhibiting re-sponses to insertion of laryngeal mask airway(LMA)when combined with propofol in the elderly pa-tients.Methods American Society of Anesthesiologists physical statusⅠorⅡ patients, aged 66-75 yr, with body mass index of 20-25 kg∕m2, were included in this study.Anesthesia was induced with dezocine at the initial dose of 0.2 mg∕kg and propofol which was simultaneously administered by target-controlled infu-sion.The initial target plasma concentration of propofol was 1 μg∕ml, and the concentration was increased in increments of 0.5 μg∕ml every 3 min until the target concentration 3 μg∕ml was achieved.LMA was inserted when bispectral index value reached 50-60.The dose of dezocine was determined using the up-and-down method.The response to insertion of LMA was defined as positive when patients developed coughing, laryn-gospasm and∕or body movement during insertion or within 3 min after insertion.The dose of dezocine was in-creased∕decreased in the next patient if the insertion response was positive or negative.The ratio between the two successive doses was 0.8.The ED50and 95% confidence interval of dezocine inhibiting responses to in-sertion of LMA were calculated.Results When combined with propofol, the ED50of dezocine inhibiting re-sponses to insertion of LMA was 0.126 mg∕kg, and the 95% confidence interval was 0.110-0.143 mg∕kg.Conclusion The ED50of dezocine inhibiting responses to insertion of LMA is 0.126 mg∕kg when combined with propofol in the elderly patients.

Isolation rearing (IR) enhances aggressive behavior, and the central serotonin (5-hydroxytryptamine, 5-HT) system has been linked to IR-induced aggression. However, whether the alteration of central serotonin is the cause or consequence of enhanced aggression is still unknown. In the present study, using mice deficient in central serotonin Tph2 and Lmx1b, we examined the association between central serotonin and aggression with or without social isolation. We demonstrated that central serotonergic neurons are critical for the enhanced aggression after IR. 5-HT depletion in wild-type mice increased aggression. On the other hand, application of 5-HT in Lmx1b mice inhibited the enhancement of aggression under social isolation conditions. Dopamine was downregulated in Lmx1b mice. Similar to 5-HT, L-DOPA decreased aggression in Lmx1b mice. Our results link the serotoninergic system directly to aggression and this may have clinical implications for aggression-related human conditions.