Objective To investigate the change in neuromuscular blocking effect of rocuronium induced by liver dysfunction. Methods Forty patients undergoing elective liver and biliary tract operation under general anesthesia were divided into 2 groups : (A) control group included 20 patients with normal liver function and (B) liver dysfunction group included 20 patients with obstructive jaundice. The premedication consisted of phenobarbital 0.lg and atropine 0.5 mg. Anesthesia was induced with midazolam 0.1 mg?kg-1,fentanyl 6?g?kg-1 and etomidate 0.3 mg?kg-1.The neuromuscular function was monitored by TOF stimulation of the ulnar nerve using accelerograph (Biometer).Rocuronium 0.6 mg?kg-1 was administered iv via the vein in the upper arm.The patients were intubated when T1 was 95% depressed and mechanically ventilated.PETCO2 was maintained at 35-40 mm Hg.The onset time (from the end of injection to T1=0),clinical duration of action (from the end of injection to 25% recovery of T1) and recovery index (T1 from 25% to 95% ) were recorded.MAP, HR and SpO2 were recorded before and at 5 and 10 min after rocuronium injection.Results The demographic data including sex, age and weight were comparable between the two groups. The onset time was (63?19) s in group A and (70?21) s in group B.The difference was not statistically significant. The clinical duration of action was (41?16) min in group A and (67?29) min in group B (P0.05).Conclusion Liver dysfunction induced by obstructive jaundice prolongs the clinical duration of action,but does not significantly affect the onset time of and recovery from rocuronium.

ve To investigate the time course of potentiation of rocuronium produced by 1MAC of desflurane or isoflurane. Methods Twenty-four ASA I-II patients aged 18-60 years undergoing elective abdominal operation under general anesthesia were studied. Patients with neuromuscular, liver or kidney disease and those receiving any drug which may affect neuromuscular transmission were excluded. Premedication consisted of intramuscular phenobarbital 0.1 and atropine 0.5mg 30min before operation. Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1, fentanyl 6?g.kg-1 and etomidate 0.3mg?kg-1 .Tracheal intubation was facilitated with rocuronium 0.6mg?kg-1 iv. The degree of neuromuscular block was monitored by measuring muscle response to TOF using accelerography (Biometer) . For maintenance of anesthesia the patients were randomly assigned to receive either propofol + fentanyl (control group) or 1 MAC of desflurane + propofol + fentanyl (desflurane group) or 1 MAC of isoflurane + propofol + fentanyl(isoflurane group). Rocuronium was continuously infused during operation to maintain T1 at 5 % of the control and the infusion rate was recorded every 15 min. Results There were no significant differences among the three groups with respect to sex, age, body weight and duration of anesthesia. In Des and Iso groups the infusion rate of rocuronium was reduced in an exponential manner and maximal potentiation occurred at 90 min of isoflurane or desflurane inhalation. The maximal reduction in infusion rate was 42.7 % in Des group and 37.6% in Iso group. There was no significant difference between the two groups.Conclusions Desflurane and isoflurane can potentiate the muscle relaxation produced by rocuronium in a similar degree and the potentiation is time dependent.

Objective To compare the efficacy of sevoflurane inhalation and remifentanil-propofol anesthesia in patients undergoing total gastrectomy. Methods Forty ASA class Ⅰ or Ⅱ patients with gastric cancer were divided into sevoflurane inhalation anesthesia (group S) and remifentanil-propofol intravenous anesthesia(group P), with 20 cases each. Perioperative hemodynamic veriables, bispectral index (BIS) values and end-tidal concentration of sevoflurane were continuously monitored. The time of recovery from anesthesia and adverse reactions of anesthesia were recorded as well. Results Compared with those before anesthesia, BP and HR were significantly decreased (P< 0. 05). The depth of anesthesia in both groups was maintained well with BIS in 45-60 and vital signs were stable during operation. The recovery from anesthesia was quicker in group P than that in group S. The incidences of restlessness and couphing were obviously lower in group P than those in group S (P<0.05). Conclusion Either sevoflurane inhalation or remifentanil-propofol intravenous anesthesia can be used safely in total gastrectomy.

Objective To explore the relationship between Bispectral index （BIS） values,Narcotrend index （NTI） values and the predicted effect-site concentration （EC）during target-controlled infusion of propofol. Methods In 30 patients during target-controlled infusion of propofol,the propofol infusion was set at an initial EC of 0.5 mg/L and increased by 0.5 mg/L steps every 5 min until 5 min after the modified observer＇s assessment of alertness/sedation scale（OAA/S） values reached zero. The predicted EC of propofol,the values of NTI,NTS and BIS were recorded,and the sedation level were examined by the modified OAA/S every 20 s. The predicted EC of propofol and the values of BIS and NTI at LVC and LOC in 5%,50% and 95% of patients were calculated. Results There were good linear correlations between BIS,NTI and the predicted EC of propofol （r2=0.787,0.792）.The predicted EC of propofol at LVC in 5%,50% and 95% of patients were 1.2,1.8 and 2.5 mg/L,respectively. The values of BIS and NTI at LVC in 5%,50% and 95% of patients were 78.2,68.2 and 58.2; 73.9,64.9 and 55.8,respectively.The predicted EC of propofol at LOC in 5%,50% and 95% of patients were 1.6,2.6 and 3.5 mg/L,The values of BIS and NTI at LOC in 5%,50% and 95% of patients were 74.6,58.2 and 41.5,66.2,55.8 and 45.3,respectively. Conclusion During target-controlled infusion of propofol,LVC and LOC occurred within a definite range of predicted effect-site concentrations.There were the good linear correlations between BIS,NTI and the predicted EC of propofol.NTI may be more useful than BIS in predicting LVC and LOC because of the smaller range of values for the two clinical end-points.

Objective To observe the effects of sulfentanil with various doses on the Bispectral index and Narcotrend index without nociceptive stimulus under the sevoflurane anesthesia.Methods Forty-eight ASA Ⅰ or Ⅱ patients undergoing gynecological operations were randomly divided into four groups（n=12）.All patients were induced with sevoflurane,the end-tidal concentrations of sevoflurane in all groups were adjusted to 1.0 MAC after tracheal intubation. Fifteen minutes later,sufentanil was injected in groups of B,C,D with the doses of 0.25,0.5,1.0 μg/kg respectively. The observations were finished when the values of Bispectral index and the Narcotrend index reached the minimum over 5 min. The values of Bispectral index and the Narcotrend index were recorded every minutes after the sufentanil injection. Results Among all groups,the BIS,Narcotrend values and tmax produced no statistical difference. Compared with the time when conscious lost,BIS and Narcotrend values were significantly lower when sevoflurane anesthesia reached steady state in all groups. The values of BIS and Narcotrend were significant lower after the injection of sufentanil in the groups of B,C and D（P0.05）. Conclusion Under the sevoflurane anesthesia with the steady end-tidal concentration of 1.0MAC,sufentanil could reduce the values of BIS and Narcotrend index without nociceptive stimulus without distinction among different doses.

Objective To observe the effects of polyglucose and sodium chloride injection on treating hypotension of patients in postanesthesia care unit (PACU).Methods Everyone of thirty-two patients with hypotension in PACU received 500ml polyglucose and sodium chloride injection by venous injection at the velocity of 12ml?kg -1 ?h -1 .The mean arterial pressure (MAP),heart rate (HR) were recorded before administration and 5, 15,30,60 min after administration, the urine volume was measured at 1 hour after administration ,and the blood gas analysis were measured before injection and an hour after injection.Results The MAP increased significantly at 5min after administration,and the effects could last 60 minutes, the urine volume increased and the Hb and K + reduced remarkable after injection.Conclusions The administration of polyglucose and sodium chloride injection can effectively increase blood volume and blood pressure,and reduce blood transfusion,so might reduce complications of blood transfusion. [

Objective To investigate the effects of intrathecal morphine on cell-mediated immunity. Methods Forty male SD rats weighing 250-300 g were randomly divided into 5 groups ( n = 8 in each group) : sham-operated group (F); saline group (NS) and 3 morphine groups (M1, M2, M3). The animals were anesthetized with intraperitoneal chloral hydrate 300-350 mg?kg-1 . Microspinal catheter was inserted into the subarachnoid space at the lumbar region according to modified Yaksh technique. Correct implantation of the spinal catheter was confirmed by aspiration of CSF. In the morphine groups, after 5 days morphine was continuously infused through the spinal catheter at 2.5 (Ml), 5.0 (M2) and 10 ?g?h-1(M3) for 7 days. In NS group normal saline was continuously infused instead of morphine. On the 7th day 5% formalin 50 fd was injected into the plantar surface of left hindpaw. The number of flinches, lickings and total time of licking were recorded for 60 min. Pain intensity scoring (PIS) (0-3, 0 = no pain, 3 = severe pain) was used to assess the antinociceptive effect of intrathecal morphine. The animals were killed after evaluation of pain intensity. Body weight and spleen weight were measured. Spleen index (spleen weight/body weight) was calculated. T-lymphocyte function was evaluated based on Concanavalin-A (Con A) induced splenocyte proliferation. Modified lactic acid dehydrogenase (LDH) release assay was used to assess NK cell activity. Results The PIS scores were significantly lower in group M1 , M2 and M3 than in F and NS group. The spleen index, splenocyte proliferation induced by Con A and NK cell activity were significantly suppressed in the 3 morphine groups Conclusion Intrathecal morphine has significant antinociceptive effect and suppresses T-lymphocyte proliferation and NK cell activity in a dose-dependent manner

Objective To investigate the effects of continuous spinal anesthesia with different concentrations and doses of ropivacaine on the ultrastructure of the spinal cord and nerve roots. Methods Twenty-four male SD rats weighing 220-280 g were anesthetized with intraperitoneal 10% chloral hydrate 300-350 mg/kg. A polyurethane microcatheter was inserted into the lumbar subarachnoid space according to the technique described by Yaksh. An 8-cm catheter segment was left in the subarachnoid space. The animals were randomized to receive normal saline, 0.5%, 0.75% or 1.0% ropivacaine 40 ? 1 intrathecally 3 times at 1.5 h interval. Six hours after the first intrathecal administration the animals were decapitated and L1 ,2 segment of the spinal cord and nerve roots were immediately removed for electron microscopic examination. Results Electron microscopic examination revealed that in animals which received intrathecal (i.t.) normal saline, 0.5% or 0.75% ropivacaine the neurolemma of the nerve roots and the mitochondria and endoplasmic reticulum of the neurons in the spinal cord were intact, while in animals which received i.t. 1.0% ropivacaine the neurolemma was stratified and partly disrupted and there were swelling of endoplasmic reticulum and vacuole degeneration. Conclusion Six hours continuous spinal anesthesia with 1.0% ropivacaine may be injurious to the spinal cord and nerve roots.

Objective: To evaluate the efficacy of the bispectral index (BI) in predicting patient movement on skin incision under sevoflurane anesthesia with the PK statistic. Method: Twenty-nine adult patients. scheduled for elective upper abdominal surgery, were selected. Anesthesia was induced with propofol and 4%-5% sevoflurane in oxygen and maintained with one of four randomized sevoflurane concentrations (0.6MAC, 1.0MAC. 1.5MAC and 2.0MAC) for fifteen minutes, then skin incision was performed by the surgeon at the planned site of the surgery, and each patient was observed carefully about 2 minutes to detect purposeful movement. The data of BI, 95% SEF, MAP, SABP and HR in one minute before skin incision were applied to statistically analysis. Result: The P_K was significantly greater than 0.5 for the sevoflurane level and the BI. The PK of 95% SEF. SABP and MAP were less than that of the level of sevoflu or Bl. but was significantly greater than 0.5 The P_K of HR was close to 0.5. Conclusion: These indicators of B, BP and 95% SEF may predict patient movement to skin incision under sevoflurane anesthesia. of which the BI is the most sensi tive.

Objective To investigate the relation between the expression of Bcl-2 protein and protection against ischemic neuronal damage by preconditioning with sublethal ischemia .Methods The cerebral ischemia was induced by occlusion of bilateral common carotid arteries .Sixty-three gerbils were divided randomly into four groups:sham operative control group (group A,n=5),ischemic preconditioning control group (group B ;n=6) with a single 2-min cerebral ischemia; ischemia preconditioning group (group PC,n=26) and ischemic control group (group IR,n=26) with 5-min ischemia being induced following 3 days of reperfusion with or without 2-min ischemic preconditioning,then with reperfusion lasting 4 hours (group PC1,n=5;group IR1,n=5),24 hours (group PC2,n=7;group IR2,n=7),72 hours (group PC3,n=7;group IR3,n=7)or 7 days (group PC4,n=7;group IR4 ,n=7) respectively.Paraffin sections of hippocampus were used for Bcl-2 protein immunohistochemical staining.Results In group B,Bcl-2 protein immunoreactivity (the intensity of staining) significantly increased as compared with that in group A(P