The effects of halothane anesthesia on the liver function were investigated in 78 male Sprague-Dawley rats pretreated with ethyl alcohol. Blood sampling was done before intravenous administration of ethyl alcohol(400 mg/kg, 5 ml/kg, 9.99 vol %) or saline(5 ml/kg)through tail vein of the rat. Twentyfour hours later, all rats were randomly assigned to receive one of two anesthetic managements for two hours; 1) halothane -N2O-O2 2)N2O-O2 Bood sample and hepatic tissue were obtained 24 or 96 hours after anestheia Measurements of hepatic function(protein, albumin, cholesterol, bilirubin, blood urea nitro- gen, creatinine) were made and hepatic tissue was examined with light microscopy. The results are as follows; 1) There was no siginificant difference in the laboratory findings between the alcohol and saline groups. 2) There was no significant difference in the laboratory findings between the halothane and nitrous oxide anesthesia. 3) No difference in histologic injury was found between alcohol and saline groups. 4) No difference in histologic injury was found between halothane-nitrous oxide-oxygen and nitrous oxide-oxygen ansthesia groups.
Administration, Intravenous ; Anesthesia* ; Animals ; Bilirubin ; Cholesterol ; Ethanol* ; Halothane* ; Humans ; Liver ; Male ; Microscopy ; Nitrous Oxide ; Rats* ; Rats, Sprague-Dawley ; Urea ; Veins

Adult ; Anesthetics, Inhalation ; administration & dosage ; Desflurane ; Electroencephalography ; methods ; Female ; Humans ; Isoflurane ; administration & dosage ; analogs & derivatives ; Male ; Middle Aged ; Monitoring, Intraoperative ; Nitrous Oxide ; administration & dosage

OBJECTIVETo investigate the analgesic and sedative effects of inhaling a mixture of nitrous oxide and oxygen on burn patient during and after dressing change.

METHODSA total of 240 burn patients hospitalized in the Institute of Burn Research of Changhai Hospital Affiliated to the Second Military Medical University, Department of Burns of the First People's Hospital in Zhengzhou, and Department of Burns and Plastic Surgery of General Hospital of Ningxia Medical University from October 2011 to September 2012 were enrolled in our study, and they were all in accordance with the inclusion criteria. The 240 patients were divided into control group (n = 60, treated with inhalation of oxygen during dressing change) and treatment group (n = 180, treated with inhalation of a mixture of 65% nitrous oxide and oxygen during dressing change) according to the computer-generated list of random number. The other treatments in control group and treatment group were the same. Before, during, and after dressing change, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation (SO2), and adverse effects were observed. The degree of pain and anxiety felt by the patients were respectively evaluated with the visual analogue scale (VAS) and Chinese version of the burn specific pain anxiety scale (C-BSPAS) at the same time points as above. Data were processed with analysis of covariance, chi-square test, analysis of variance, and rank sum test.

RESULTSThere were no significant differences between control group and treatment group in the levels of HR, SBP, DBP, and SO2 before dressing change (with F values respectively 0.76, 0.06, 1.11, 0.70, P values all above 0.05). Compared with those of control group, the levels of HR, SBP, DBP, and SO2 in treatment group were significantly ameliorated during dressing change (with F values respectively 81.78, 146.36, 226.44, 205.62, P values all below 0.01). After dressing change, the levels of DBP in the two groups were close (F = 0.31, P > 0.05), but the levels of HR, SBP, and SO2 showed statistical differences (with F values respectively 7.02, 8.69, 12.23, P < 0.05 or P < 0.01). Before dressing change, the VAS scores were approximate between control group and treatment group (Z = 0.21, P > 0.05). Compared with those in control group (9.4 ± 0.7, 1.7 ± 2.5), the VAS scores were significantly lowered in treatment group during and after dressing change (1.6 ± 1.3, 0.7 ± 1.1, with Z values respectively 11.84, 3.35, P values all below 0.01). There was no significant difference in C-BSPAS score between control group and treatment group before dressing change (Z = 0.62, P > 0.05). Compared with those in control group (75 ± 13, 73 ± 12), the C-BSPAS scores in treatment group were decreased during and after dressing change (9 ± 15, 9 ± 14, with Z values respectively 11.91, 12.28, P values all below 0.01). There were no obvious adverse effects in two groups before, during, and after dressing change.

CONCLUSIONSA mixture of nitrous oxide and oxygen seems to have obvious analgesic and sedative effects on burn patients during dressing change, and it can be widely used.

Administration, Inhalation ; Adolescent ; Adult ; Aged ; Analgesia ; methods ; Bandages ; Burns ; surgery ; Female ; Humans ; Hypnotics and Sedatives ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Nitrous Oxide ; administration & dosage ; therapeutic use ; Oxygen ; administration & dosage ; therapeutic use ; Young Adult

Increases in heart rate (HR) and blood pressure (BP) are common during light planes of anesthesia at the end of operation and just prior to extubation. This study was undertaken to investigate and compare HR and BP responses to endotracheal extubation during light general anesthesia with and without prior intravenous administration of clonidine. Eighty hypertensive patients aged 45-65 yr were undergoing a variety of operations. In this study, the BP of hypertensive patients was well controlled on antihypertensive regimens before anesthesia. Anesthesia was induced by the injection of thiopental sodium, diazepam, fentanyl and vecuronium, and maintained with enflurane (0.8-2.5 per cent) and nitrous oxide (50 per cent) in oxygen. Patients were randomly divided into two groups of 40 each with regard to management of endotracheal extubation at the end of operation. Patients in clonidine group received an izv injection of clonidine (0.75 ug/kg) 30 min. prior to extubation. One minute prior to extubation, baseline arterial BP and HR were recoreded. Single measurement of systolic and diastolic BP and HR were obtained during the study and were recorded at 30 seconds, 1 min., 2 min., 3 min., 4 min. and 5 min. after extubation, and upon entrance to the postanesthetic recovery room (6-10 min. after extubation). Patients in control group received no injection prior to extubation, but were otherwise treated similarly and had data recorded at the same times as those in clonidine group. The results were as follows ;1) No significant differences were noted in BP and HR prior to clonidine administration between patients in the two groups. 2) Thirty seconds after extubation, both BP and HR increased significantly in both group (p< 0.05) but the increasing rate in clonidine group was significantly less than in control group (p<0.05). 3) Patients in control and clonidine group sustained a significant elevation in both BP and HR which persisted for 3 and 1 min after extubation (p<0.05), respectively. 4) Changes in both BP and HR in patients of clonidine group became significantly less than control group every time intervals after extubation (p<0.05). In conclusion, the result of this study demonstrate that iv injection of clonidine (0.75 ug/kg) administered 30 min. before endotracheal extubation prevents increases in BP and HR before and after extubation and in the recovery room. The data suggest that iv clonidine injection prior to extubation should be of advantage to patients with hypertension who may not be able to tolerate the increased hemodynamics which usually accompany endotracheal extubation.
Administration, Intravenous ; Airway Extubation ; Anesthesia ; Anesthesia, General ; Blood Pressure ; Clonidine* ; Diazepam ; Enflurane ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Nitrous Oxide ; Oxygen ; Recovery Room ; Thiopental ; Vecuronium Bromide

BACKGROUND: Sevoflurane has a low blood-gas partition coefficient, resulting in rapid induction and recovery. We compared the effects of sevoflurane with those of enflurane anesthesia on parturients and neonates during and after elective cesarean section. METHODS: Ninety-six parturients were divided into two groups: E (enflurane, n = 47) and S (sevoflurane, n = 49). After endotracheal intubation with intravenous administration of thiopental 4 mg/kg and succinylcholine 1.5 mg/kg, anesthesia was maintained with 50% nitrous oxide in oxygen and enflurane 1 vol% or sevoflurane 1 vol%. Maternal hemodynamic parameters, blood loss, and recovery were monitored. Neonatal outcome was evaluated by Apgar scores, umblical artery blood gas analysis and acid-base status. RESULTS: Recovery times were faster with sevoflurane anesthesia (P < 0.05). All patients in two groups developed transient hypertension and tachycardia after intubation, which returned to baseline in approximately 5 minutes. Maternal blood loss did not differ significantly between the two groups, and one patient in S group developed postoperative recall. Neonatal outcome was equally good in the two groups. CONCLUSIONS: Parturients anesthetized with sevoflurane for cesarean section recovered more rapidly compared with enflurane without any differences in hemodynamic parameters and neonatal outcome.
Administration, Intravenous ; Anesthesia* ; Arteries ; Blood Gas Analysis ; Cesarean Section* ; Enflurane* ; Female ; Hemodynamics ; Humans ; Hypertension ; Infant, Newborn ; Intubation ; Intubation, Intratracheal ; Nitrous Oxide ; Oxygen ; Pregnancy ; Succinylcholine ; Tachycardia ; Thiopental

Objective To evaluate the safety and effectiveness of oral midazolam sedation combined nitrous oxide sedation for reducing dental fear in children.Methods Totally 77 children with a Frankl's Behavior Rating Scale score of 1 were included in this study,among whom 41 received a total of 78 person-times of oral midazolam sedation (0.50-0.75 mg·kg ) (midazolam group) and 36 children were treated with the combination of 0.4 mg/kg oral midazolam with 30%-40% nitrous oxide (totally 73 person-times)(combination group). At each visit,heart rate,arterial oxygen saturation,and treatments were recorded. The behaviors of children during the treatment were assessed by Frankl's Behavior Rating Scale,the completion of treatment was assessed by Houpt Scale,and the sedation status was assessed by Ramsay Scale. Telephone follow-up was performed to record the side effects 24 hours after treatment. Results The vital signs were stable among all the 77 subjects,with a Ramsay score of 2 or 3. In the midazolam group, the behaviors were cooperative in 52 person-times (66.7%) and not cooperative in 26 person-times (33.3%);the planned treatments were completed in 62 person-times (79.5%) and partially completed in 16 person-times(20.5%). In the combination group,the behaviors were cooperative in 56 person-times (76.7%) and not cooperative in 17 person-times (23.3%);64 person-times (87.7%) completed the planned treatments and 9 person-times (12.3%) partially completed the treatments. The success rates of sedation (χ =1.87,P= 0.17) and treatment (χ =1.83,P= 0.18) were not significantly different between these two groups. The median Frankl scale score was significantly higher in the combination group [3 (3,4)] than in the midazolam group [3 (2,4)] (Z=2.647,P=0.008]. The median score of Houpt scale in the combination group [5(4,6)] was also significantly higher than in midazolam group [5(3,5)] (Z=2.236,P=0.026]. In midazolam group,there were 7 person-times of dysphoria,3 person-times of diplopia,and 2 person-times of hiccough among 78 person-times;in the combination group,there were 5 person-times of dysphoria,5 person-times of diplopia,1 person-time of hiccough,and 2 person-times of vomit among 73 person-times of treatment. Thus,there was no significant difference in the incidence of side effects (15.4% vs.17.8%,χ =0.160,P=0.689). Logistic regression analysis showed that the success rate of treatment was not associated with sex (OR=1.704,P=0.174),dose (OR=1.289,P=0.516),and treatment types (OR=0.555,P=0.143). Children over 3 years old had a significantly high success rate than those under 3 years old (OR=3.372,P=0.011). Conclusions Oral midazolam is safe and effective for reducing dental fear in children. The combination of oral midazolam with 30%-40% nitrous oxide can improve the behaviors of children during the dental treatment,especially in children over 3 years old.
Administration, Oral ; Anesthesia, Dental ; Child ; Child, Preschool ; Conscious Sedation ; Cross-Over Studies ; Dental Anxiety ; Humans ; Hypnotics and Sedatives ; Midazolam ; therapeutic use ; Nitrous Oxide

The neuromuscular and hem+odynamic effects of mivacurium 0.15 mg/kg and succinylcholine 1 mg/kg were compared in 26 adult patients (ASA I and II) during nitrous oxide-oxygen-propofol-fentanyl anesthesia. Neuromuscular block was monitored by recording the compound electromyogram of the hypothenar muscle resulting from supramaximal train-of-four stimuli applied to the ulnar nerve. Time to onset of over 95% block and duration to 25% recovery of control twitch after injection of mivacurium were significantly longer than for succinylcholine (201 +/- 37.6 vs 54 +/- 5.2 sec and 13.0 +/- 2.2 vs 8.4 +/- 2.1 min; mean +/- SD). Onset of mivacurium with priming technique was shortened (125 +/- 20.7 sec), but was also slower than that of succinylcholine. Although the recovery index during spontaneous recovery was significantly longer for mivacurium than for succinylcholine (6.9 +/- 1.3 vs 5.1 +/- 0.9 min), antagonism with neostigmine at 25% recovery of twitch height sufficiently facilitated the recovery index of mivacurium (4.5 +/- 1.0 min) to a level similar to that of succinylcholine with no statistical difference. The hemodynamic effects of mivacurium were few as compared to those of succinylcholine. In conclusion, mivacurium is considered to have additional advantages for short procedures when succinylcholine is undesirable.
Adult ; Anesthesia ; Female ; Fentanyl/administration & dosage ; Hemodynamics/*drug effects ; Humans ; Isoquinolines/*pharmacology ; Male ; Neuromuscular Junction/*drug effects ; Neuromuscular Nondepolarizing Agents/*pharmacology ; Nitrous Oxide/administration & dosage ; Propofol/administration & dosage ; Succinylcholine/*pharmacology

A randomized prospective study was performed on the anesthetic induction, maintenance, and recovery characteristics of sevoflurane-nitrous oxide, compaired to that of target- controlled propofol and fentanyl anesthesia, for forty day-case hysteroscopic surgery. The patients in the sevoflurane group (n = 20) received sevoflurane-nitrous oxide for both induction (8%) and maintenance (1 - 2%) of anesthesia, while the patients in the propofol group (n = 20) received target-controlled propofol (4 microgram/ml, 3-6 microgram/ml as occasion demanded) with fentanyl (1 microgram/kg). In both groups, the airway was maintained by a facemask with the patient breathing spontaneously during the surgery. The mean times to unconsciousness and readiness for surgery were similar in both groups, with those for the sevoflurane group, compared to the propofol group being 80.4 18.9 vs. 83.6 38.8 sec, and 220.1 76.9 vs. 231.0 95.4 sec, respectively. Propofol was associated with significantly higher incidences of involuntary movement (30% vs. 5%) and apnea (35% vs. 0%) during the induction period than with sevoflurane. Hemodynamic variables were similar with the exception of significantly lower blood pressures during the first 5 minutes of induction with propofol. Emergence times to eye opening, hand squeezing and orientation for sevoflurane compared to propofol were: 316.6 79.3 vs. 507.4 218.8 sec, 390.0 69.3 vs. 653.1 201.6 sec and 380.6 80.8 vs. 666.3 208.7 sec, respectively, all of these being significantly faster for sevoflurane than propofol. The postanesthetic Aldrete's recovery scores of the patients immediately after surgery were higher in the sevoflurane group. Propofol was associated with more drowsiness, with sevoflurane being associated with more nausea, in the recovery period; however, neither delayed the time to discharge (103.7 28.1 vs. 99.0 36.2 min). In conclusion, sevoflurane-nitrous oxide appears to be superior for day-case hysteroscopic surgery, than target-controlled propofol with fentanyl, with regards to the speed of recovery from anesthesia and the return to hemodynamic stability.
Adult ; Anesthesia ; Anesthetics/*pharmacology ; Comparative Study ; Female ; Fentanyl/*pharmacology ; Hemodynamics/drug effects ; Human ; *Hysteroscopy ; Methyl Ethers/administration & dosage/*pharmacology ; Nitrous Oxide/administration & dosage/*pharmacology ; Pain Measurement ; Propofol/administration & dosage/*pharmacology ; Prospective Studies

OBJECTIVETo study the effects of cardiovascular function in dental extraction on hypertensive patients by inhalation 50% nitrous oxide.

METHODSThe 30 hypertensive patients were randomly allocated into two groups: A group inhalation the 50% nitrous oxide and oxygen, B group inhalation the air and O(2). To measured the HR, BP, and SpO(2) in dental extraction.

RESULTSIn a group the changes of blood pressure and heart rate are more smoother than B group. Two groups were significant in HR, BP and SpO(2) (P < 0.01).

CONCLUSIONSInhalation with 50% nitrous oxide can keep the stability of cardiovascular system and it is a valid method in dental extraction on hypertensive patients.

Administration, Inhalation ; Aged ; Anesthetics, Inhalation ; administration & dosage ; pharmacology ; Blood Pressure ; drug effects ; Female ; Heart Rate ; drug effects ; Hemodynamics ; drug effects ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged ; Nitrous Oxide ; administration & dosage ; pharmacology ; Oxygen ; blood ; Partial Pressure ; Time Factors ; Tooth Extraction

BACKGREOUND: The magnitude of neuromuscular blockade is related to plasma concentration of muscle relaxants. This study was designed to compare the maximal depression of twitch height by blood flow occlusion using a tourniquet at various time interval after intravenous administration of muscle relaxants. METHOD: We studied 127 healthy male adult patients who underwent elective surgery under the general anesthesia with propofol infusion and 50% nitrous oxide. The single supramaximal twitch stimulation applied to the ulnar nerve at the wrist at 1 Hz. The twitch response of adductor pollicis muscles were measured by a 2 kg Load Cell strain gauge with a thumb piece modification and recorded by a Gould TA 240 recorder. After occlusion of blood flow by the tourniquet in the upper arm, in which the neuromuscular monitoring was applied on the wrist, we administered the equipotent dose (ED95) of succinylcholine (S group), mivacurium (M group), and vecuronium (V group) intravenously on the contralateral arm respectively. We measured the maximal depression (%) of twitch height after the releasing tourniquet at 30, 60, 90, 120, 150, and 240 second intervals after the injection of each drug. RESULTS: The depression of twitch height was not found from 90 seconds of tourniquet time in the M group, and 120 seconds of tourniquet time in the S group. However, in the V group, the depression of twitch height was maintained to 240 seconds of tourniquet time. CONCLUSIONS: It is suggested that the plasma concentration of mivacurium declined faster than that of succinylcholine, and that of vecuronium decreased slowest among the groups after intravenous administration of equipotent dose (ED95).
Administration, Intravenous ; Adult ; Anesthesia, General ; Arm ; Depression ; Forearm* ; Humans ; Male ; Muscles ; Neuromuscular Agents* ; Neuromuscular Blockade ; Neuromuscular Monitoring ; Nitrous Oxide ; Plasma ; Propofol ; Succinylcholine* ; Thumb ; Tourniquets ; Ulnar Nerve ; Vecuronium Bromide* ; Wrist