Objective To evaluate the effects of epidural anesthesia by target controlled introduction (TCI) of 0.375% ropivacaine (Ropi) combined with propofol on the blood pressure (BP) and heart rate (HR) of the patients in different age during thoracotomy. Methods Seventy five ASA Ⅱ-Ⅲ patients undergoing elective resection of esophageal carcinoma were divided into 3 groups according to their age (25 each): groupⅠ (aged 40～59), group Ⅱ (aged 60～74) and group Ⅲ (aged ≥75). An epidural catheter was inserted at the T6～T8 interspace in all patients before induction, and then 5ml of 1% lidocaine was given to all the patients. For each patient, 6 ml of 0.375% Ropi was given epidurally. Anesthesia was induced with propofol TCI 3?g/ml, fentanyl 3?g/kg and atracurium 0.6mg/kg. Tracheal incubation was performed when bispectrum index (BIS) value was less than 50. The patients were mechanically ventilated. Anesthesia was maintained with propofol TCI and epidural anesthesia of 0.375% Ropi at 6ml/h. Propofol was subsequently adjusted to maintain BIS at 50～55 during operation. The concentrations of propofol TCI, mean arterial pressure (MAP), HR, and the amount of ephedrine were continuously monitored during anesthesia. Results MAP in group Ⅱ and Ⅲ was lower than that in groupⅠ (P0.05). The amount of ephedrine used in group Ⅱ and Ⅲ was higher than that in group Ⅰ (P

Objective To evaluate the efficacy of intermittent positive pressure ventilation (IPPV,1 ml/kg) of the operated lungs in preventing hypoxemia during one-lung ventilation (OLV) in elderly patients undergoing radical resection of esophageal cancer.Methods Sixty American Society of Anesthsiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 65-75 yr,with body mass index of 18.5-24.0 kg/m2,were divided into 2 groups (n =30 each) using a random number table method:convention group and IPPV group.In convention group,ventilator settings were adjusted with the tidal volume of 6-8 ml/kg,respiratory rate of 15 breaths/min,inspiratory/expiratory ratio of 1 ∶ 2,and fraction of inspired oxygen 70％ during OLV.In IPPV group,ventilator settings were adjusted with the tidal volume of 1 ml/kg,respiratory rate of 15 breaths/min,and fraction of inspired oxygen 70％ on the operated side during OLV,and the ventilator settings on the other side were consistent with those previously described in convention group.Before anesthesia induction (T0),at 10 min of two-lung ventilation (T1),at 15,30 and 45 min of OLV (T2,4) and at 10 min after the end of OLV (T5),blood samples were collected from the radial artery for blood gas analysis.The partial pressure of arterial oxygen (PaO2) and alveolar to arterial partial pressure of oxygen were recorded.Respiratory index (RI) and oxygenation index (OI) were calculated.The occurrence of PaO2 ＜ 60 mmHg,RI＞ 1.0 and OI＜ 200 mmHg was recorded during OLV.Results Compared with convention group,the RI was significantly decreased at T4,the PaO2 and OI were increased,and the incidence of PaO2＜60 mmHg,RI＞ 1.0 and OI ＜ 200 mmHg was decreased in IPPV group (P＜ 0.05).Conclusion IPPV (1 ml/kg) of the operated lungs can prevent the occurrence of hypoxemia during OLV in elderly patients undergoing radical resection of esophageal cancer.

Objective:To evaluate the effects of transcutaneous electrical acupoint stimulation (TEAS) on sedation in healthy volunteers.Methods:Forty-six healthy volunteers of both sexes, with the Sleep Self-Rating Scale score 10-30, aged 22-28 yr, with the body mass index 18.5-23.0 kg/m 2, were selected and divided into 2 groups ( n=23 each) using a random number table method: TEAS group (E group) and control group (C group). Bilateral Neiguan and Shenmen acupoints were stimulated for 30 min in group E, while the stimulator was only connected, and no current was given in group C. The bispectral index (BIS)value, heart rate, oxygen saturation and mean arterial pressure were recorded at 10 min in the supine position (T 0) during the quiet period, at 10 min intervals during stimulation (T 1, 2) and at 5 min intervals within 15 min after the end of electrical stimulation (T 3-5). Then the condition whether the patient had fallen asleep was observed, and the patients were followed up on the second day for sleep status and related complications. Results:Compared with the baseline at T 0, the BIS value was significantly decreased at T 2-5 in group E ( P<0.05). The BIS value was significantly lower at T 3, 4 in group E than in group C ( P<0.05). There was no significant difference in sleep status during stimulation and at the night of the trial between the two groups ( P>0.05). Heart rate, oxygen saturation and mean arterial pressure were in the normal range at each time point, and no trial-related complications occurred in the two groups ( P>0.05). Conclusion:TEAS can produce certain sedative effect on healthy volunteers.