Objective To assess the anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing video-assisted thoracoscopic surgery(VATS).Methods Forty ASA Ⅰ-Ⅱpatients. undergoing VATS were randomly divided into remifentanil-propofol group(group P,n=20)and remifentanil-desflurance group (group D,n=20).MAP and HR were monitered during the entire procedures. Conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score were recorded and compared between two groups. Results During the operation, MAP was decreased significantly in group D (P＜0.05).There was no significant difference in conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score between two groups. Conclusions The anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing VATS were both with quick recovery, but the fronter has more stable hemodynamics.

OBJECTIVETo observe the effect of Shenmai injection on the value of vascular endothelial active factors nitric oxide (NO), endothelin-1 (ET-1) of patients undergoing heart valve rveplacement and cardiac pulmonary bypass (CPB).

METHODThirty patients of cardiac valve replacement undergoing open heart surgery under cardiopulmonary bypass (CPB) were randomized single-blind method divided into Shenmai injection group (SM) and control group (C) with 15 cases each. Shenmai injection group (SM) were injected Shenmai injection 0.6 mL x kg(-1) added to physiological saline 250 mL after anaesthesia before CPB, the control control group were injected only physiological saline 250 mL at the same time. Blood samples were taken before induction of anesthesia and at 0.5, 2, 6, 24 hours after terminating CPB. To calculate P(A-a) DO2 and respiratory indexs (RI) by blood gas analysis, nitric oxide (NO) and endothelin-1 (ET-1) ET-1 were measured. At the same time, the time of CPB and artery blockage were recorded.

RESULTThere was no statistical significance before operation between 2 groups to every blood index. After CPB, P(A-a) DO2 , RI and ET-1 was higher than pre-operation after CPB (P < 0.05). But P(A-a) DO2, RI and ET-I of Shenmai group were lower than control group evidently at every point after CPB (P < 0.05 or P < 0.01). The concentrations of NO were reduced obveiously after CPB (P < 0.05), but in shenmai group, the range of descent was lower than control group (P < 0.01 or P < 0.05).

CONCLUSIONThe concentrations of NO and ET-1 is connected with the lung injury after CPB. Through rise the level of NO and reduce the level of ET-1, Shenmai injection can alleviate the lung injury in some degree after CPB and improve pulmonary oxygenation function.

Adult ; Blood Gas Analysis ; Cardiopulmonary Bypass ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Endothelial Cells ; drug effects ; metabolism ; Endothelin-1 ; blood ; Female ; Heart Valve Prosthesis ; Humans ; Injections ; Male ; Middle Aged ; Nitric Oxide ; blood