Objective To investigate the effect of esmolol pretreatment on propofol injection pain..Methods Ninety patients undergoing breast cancer surgery under general anesthesia were ran-domly assigned into three groups (n=30 each).Group E were pretreated with 5 mg/ml(total 2 ml)es-molol group L with 20 mg/ml (total 2 ml)lidocaine and group N with 2 ml normal saline.After one minute,each group was administrated propofol intravenouly.The pain and hemodynamic data were re-corded.Results Compared with group N,propofol injection pain degree decreased obviously in groups E and L (P <0.05).propofol injection pain occurred in 25 (83.3%)in group N,was signifi-cantly higher than that of 12 (40.0%)in group E and 14 (46.7%)in group L (P <0.05),propofol injection pain had no significant difference between groups E and L.Compared with T1 ,SBP,DBP decreased in groups E and L at T2 ,SBP decreased in group N at T2 significantly (P <0.05).Com-pared with T2 ,DBP was significantly higher at T3 in group E (P <0.05).Conclusion Pretreatment with low dose esmolol was effective in attenuating pain during propofol injection.

Objective To investigate the serum therapeutic concentration of tramadol during intravenous analgesia for postoperative pain relief. Methods Twenty adult patients ASA Ⅰ-Ⅱ (10 male, 10 female) undergoing elective radical operation for cancer of stomach were treated with intravenous tramadol for postoperative pain relief. Patients addicted to any drug or tolerant to opioid and patients with epilepsy or liver and/or renal dysfunction were excluded. All patients were premedicated with intramuscular phenobarbital 0.1g and atropine 0.5mg. Anesthesia was induced with midazolam 0. 1mg/kg and fentanyl 5 μg/kg and intubation was facilitated with vecuronium 0.16mg/kg. Anesthesia was maintained with continuous intravenous infusion of propofol 4-6 mg@ kg 1 @ h 1, fentanyl 2-3 μg@ kg-1 @ h-1 and vecuronium 0.1mg@ kg-1@ h-1 combined with inhalation of 1% isoflurane. After surgery in ICU when patients felt slight pain (VAS 1-2), intravenous tramadol 1.5mg/kg was given as initial dose. Whenever patients felt slight pain (VAS 1-2) again, a bolus of tramadol 20 mg was given intravenously every 10 min until VAS was 0. The onset time (from the end of iv injection of initial dose of tramadol to VAS 0), the duration of action (from VAS 0 to VAS 1-2) and the time when accumulated dose of tramadol amounted to twice the initial dose were recorded. HR, MAP, respiratory rate (RR) and SpO2 were monitored and recorded before and 10, 20, 30 min after administration of tramadol. Venous blood samples were taken before each additional tramadol administration on demand for determination of serum tramadol concentration by high performance liquid chromatography. Results The mean serum therapeutic level of tramadol during period of analgesia was (370±148)ng/ml(248.6-615.7ng/ml). The mean onset time of the initial dose was (9.2± 2.1 )min. The mean duration of action was (2.3 ± 1.0)h. The time when accumulated dose of tramadol amounted to twice the initial dose was (6.4 ± 2.7)h on average. There were no significant changes in HR,MAP, RR and SpO2 after tramadol. Conclusions It is safe and effective to give intravenous tramadol for postoperative pain relief. Serum therapeutic concentration of tramadol varies greatly from patient to patient,so the dose of tramadol should be individulized.[Key Words] Pain, postoperative; Tramadol; Plasma concentration; Injections, intravenous

Objective To study the transfer of ropivacaine across the single cotyledon of the term human placenta and the effects of maternal hypoproteinemia and fetal acidemia on the transfer. Methods Eighteen placentas were obtained from healthy full term parturients within 5 min after vaginal or cesarean section delivery. The dual perfused human placental model was made. The placentas were randomly divided into three groups of 6 placentas : (A) control group in which 100% fresh frozen plasma was used in both maternal and fetal circulation with pH maintained at 7.4 on both sides; (B) fetal academia group in which 100% fresh frozen plasma was used in both circulations but fetal pH was reduced to 7.0; (C) maternal hypoproteinemia group in which 50% fresh frozen plasma used in maternal circulation and 100% fresh frozen plasma in fetal circulation, pH was maintained at 7.4 on both sides. Samples were taken from the perfusate in the reservoir at 15, 30, 60, 90, 120 min after ropivacaine (2?g?ml-1) and antipyrine (10 ?g?ml-1 ) were added in maternal circulation for determination of concentrations of ropivacaine, antipyrine, glucose and lactate. Glucose consumption rate, lactate generation rate and relative and absolute transfer ratio of ropivacaine were calculated. Results Absolute transfer ratio of ropivacaine was gradually increasing with perfusion time, reaching 8.7?1.0% (A) , 10.5 ?1.6% (B) and 11.8?1.1% respectively at 120 min. Relative transfer ratio of ropivacaine was relatively constant during 120 min perfusion and was significantly higher at each time point in group B and C than in group A ( P

Objective To examine pharmacodynamics and serum concentration of tramadol during continuous intravenous infusion for postoperative pain relief Methods 500 ASA Ⅰ Ⅱ patients undergoing operation on extremities, spine or abdomen under anesthesia were studied Premedication included phenobarbital 0 1g and atropine 0 5mg im Anesthesia was induced with midazolam 0 08 0 12mg?kg -1 , fentanyl 5 6?g?kg -1 and vecuronium 0 12 0 14 mg?kg -1 and maintained with continuous intravenous infusion of propofol 3 0 4 5 mg?kg -1 ?h -1 , fentanyl 2 8 3 4?g?kg -1 ?h -1 and vecuronium 0 06 0 08 mg?kg -1 ?h -1 supplemented with inhalation of 0 8% 1 0% isoflurane At the end of operation a loading dose of tramadol 1 5 mg?kg -1 was given intravenously over 2 min, followed by continuous intravenous infusion of tramadol for 72h The patients were divided into two groups: group Ⅰ (n=246) received tramadol intravenous infusion at a rate of 8mg h -1 and group Ⅱ (n=254) received tramadol infusion at a rate of 10mg h -1 Venous blood samples were taken from 10 patients in group Ⅱ at 0, 0 5, 1, 3, 6, 12, 24, 30, 42, 48, 54, 60, 72h during postoperative tramadol infusion for determination of serum concentration of tramadol by high performance liquid chromatography (HPLC) Efficacy of analgesia was assessed by VAS score and side effects were recorded Results The two groups were comparable with regard to age, sex, weight, types of operation and the amount of fentanyl used during operation There was significant difference in the mean VAS scores between group Ⅰ (1 16?1 15) and group Ⅱ (0 83?1 33) (P

Objective To provide reference basis for clinical ,it is necessary to analyse the distribution and drug resistance of pathogenic bacteria isolated from intensive care unit .Methods The bacterial specimens from patients that treated in intensive care unit from January to December in 2013 ,had been collected and cultivated .The VITEK automatic bacterial identification system was performed to identify pathogens and drug susceptibility test .The software of Whonet5 .6 was used for statistically analysis .Results 1261strainsofpathogenicbacteriawereisolated,including900strainsofgramnegativebacilli,348strainsofgrampositivebac‐teria and 13 of fungi .Conclusion Gram negative bacillus is the main pathogenic bacteria in the critical patients .In order to improve the clinical efficacy ,clinical treatment should be based on the pathogenic bacteria culture and drug sensitivity test results to reasona‐bly apply antibacterial drugs .

Phospholipase A_2 (PLA_2) inhibitor quinacrine was used to explore protective effect on multiple organ dysfunction (MOD) caused by intestinal ischemia-reperfusion (I/R) in rats. Gut I/R caused the increase of gut PLA_2 activity and induced endotoxemia and bacteriemia. Pretreatment with intravenous quinacrine 10mg?kg~(-1) attenuated bacteria and endotoxin translocation,markedly lowered the levels of thromboxane A_2 and prostacyclin I_2 in blood,and provided protection from the development of vital organs dysfunction. As a result,the survival rate in pretreatment group increased by 25%. The results demonstrate that gut I/R promotes gut barrier failure,then contributes to the development of MOD by allowing bacteria or endotoxin reaching the circulation. PLA_2 and PLA_2-dependent lipid mediators play an important role in the development of gut I/R injury and MOD. Intravenous quinacrine has protection against MOD resulting from gut I/R.

Objective: We investigated experimentally the changes of intestinal immunity following shock and resuscitation after trauma. Method:The experimental model was made in rats, which underwent laparotomy, then bleeding and reinfusing through the right fetmoral artery. Result: The concentration of IgA following shock and resuscitation were significantly higher than that before shock.. The concentration of IgA 24 h following resuscitation was the lowest, and was significantly lower than that at the end of shock.. The endotoxin in portal vein following shock and resuscitation were higher than that before shock.. The endotoxin level 24 h following resuscitation was the highest, and markedly higher than that at the end of shock. Conclusion: The traumatic shock and resuscitation are capable of causing intestinal immunosuppression and endotoxemia.

Objective: To investigate the effects of pentoxifylline (PTX) on oxygen free radicals induced myocardial injury. Method: An in vivo myocardial impairment model was developed in SD rat with exogenous oxygen free radicals. The changes cardiac performance and serum malonylaldehyde (MDA), lactic acid, cretine phosphokinase (CK) levels were tested before and at different interval after I. V. administration of oxygen free redieal. Result: Myocardial performance after oxygen free radicals administration was significantly depressed compared to the baseline values (P

0.05 ),the O- 2 production increased significantly (P

Objective To evaluate the efficacy of PTX on the global cerebral ischemia reperfusion injuryMethods The global cerebral ischemia of gerbils was induced by clamping bilateral carotid arteries for 30 min , then declamping with the reperfusion lasting 90 min At the beginning of ischemia , PTX 25mg?kg -1 or 50mg?kg -1 was administered intravenously by mini infusion pump In another group , PTX 25mg?kg -1 was infused at the beginning of reperfusion In sham operated and control groups the same volume of 0 9% NaCl were infused 0 2% Even's blue 1ml?100g -1 was injected intraperitoneally At the end of experiment , The gerbils were decapitated to be preserved at -70℃ for measurement of water contents of whole hemispheres , cerebral superoxide dimutase (SOD) activity, malonyldialdehyde (MDA) content and Even's blue content Results As compared with those in control group, at the beginning of ischemia or reperfusion ,the administration with PTX 25mg?kg -1 significantly reduced the cerebral water content (P