To determine the differences in analgesic, hemodynamic and ventilatory effects between epidural and intravenous midazolam (MID), 44 adult patients, ASA grade Ⅰ to Ⅱ, scheduled for elective upper abdominal surgery. were randomly allocated to receiving epidural MID 0.05 mg/kg (group E_1) or 0.1 mg/kg (group E_2). or intravenous MID 0.05 mg/kg (group V_1) or 0.1 mg/kg (group V_2), respectively, The analegic effect was evaluated by pin-prink test, following MID administration. The hemodynamie and ventilatory values were measured by impedance cardiogra phy and side stream spirometry, before and 1.3, 5, 10, 15 and 20 mins after MID administration. Tbe results showed that the segmental spinal analgesia occured with MID in group E_1 and E_2, but no analgesia was produced with WID in group V_1 and V_2. Following MID administration in four groups, HR increased during first 5 mins (P0.05); CI, SI. LVWI, MAP, RPP and indices of myocardial eonstraction, cardiae peak flow and blood ejection velocity decreased slightly(P0.05). After MID administration, SpO_2 and VT were reduced (P0.05), and the inspiratory end-tidal oxygen content difference was elevated transiently (P0.05) and went down in group E_2 and V2(P0.05).

Objective: To compare the clinical effects of postoperative patient controlled epidural analgesia (PCEA) with different combinations of tramadol and/or buprenorphine. Method:The 150 cases of surgical patients were ran domly divided into 6 groups: 0.6% tramadol (group T_1). mixture of 0.6% tramadol and 0.15% bupivacaine (group T_2), mixture of 0.0015% buprenorphine and bupivacaine (group B_1) , mixture of 0. 0015% buprenorphine, bupivacaine and 0.6% tramadol(group B_2). 0.15% bupivacaine(group C_1), 0.0015% buprenorphine(group C_2). With a Graseby- 9300 PCA pump in the loading-continuous-PCA model, the doses were 5mL-0.5ml-1ml respectively. Result: (1)In the first postoperative 24 hours the amount of drugs used in each group was similar; (2)1n these six groups, both visual analog scale scores and the ratios of tatol deliveries to demands were B_2

Objective:To evaluate the safety of patient controlled epidural analgesia (PCEA)for elderly patient. Method: Forty two adult patients after operation were divided into control group(44.4?7.8a)and old group(70.9?5.la) according to their ages. All patients reeeived epidural 0.125% bupivacaine and 0.01% morphine mixture for PCEA. BP,HR, RR and SpO_2 were monitored for the first 24 hours following PCEA. Result: The dosage of the mixture was 33.3?6.8ml in control group and 31.6?8.7ml in old group. BP,HR didn't alter markedly in both groups throughout the whole period. RR and SpO_2 remined normal levels. Conclusion: With adequate dosage PCEA can be used safely for elderly postoperative analgesia

1) in group R was shortest among the four groups Conclusions Combination of clonidine with local anesthetics in subarachnoid block is effetive and safe, 50?g clonidine can improve the effects of ropivacaine without significant change in hemodynamics

0.05 as compared with T3 ) . (3) 3 min after propofol injection OAA/S score dropped to 0 in all patients; AEP index and BIS decreased to 28.97?11 and 50? 11 respectively.Conclusions Induction of anesthesia with intravenous midazolam-fentanyl-propofol is smooth and effective with little circulatory disturbance.

Objective To compare auditory evoked potential index (AEPI) , BIS , heart rate variability (HRV) and spectral edge frequency (SEF) for monitoring the level of analgesia and sedation produced by different analgesic mixture of PCEA. Methods Thirty ASA Ⅰ-Ⅱ patients undergoing upper abdominal surgery under general anesthesia were enrolled in the study.Patients with mental or hearing disorders were excluded. The patients were randomly divided into three groups . The basic analgesic mixture for PCEA was 0.2% ropivacaine + 0.01% morphine in the 3 group and the PCEA regimen was : loading dose 5ml , background infusion 1ml?h-1, bolus dose 1ml and lock-out interval 10 min. The difference among the 3 groups was that the 5ml loading dose contained clonidine l00?g in group Ⅱ or midazolam 2mg in group Ⅲ. The patients were premedicated with phenobartital and scopolamine. Epidural catheter was placed at T9-10 , a test dose of 1 % lidocaine 3-5ml was given to confirm the correct placement of the epidural catheter. General anesthesia was induced with midazolam 0.06mg?kg-1, fentanyl 4?g?kg-1, propofol 0.5mg?kg-1 and vecuronium 0.1mg?kg-1. Anesthesia was maintained after tracheal intubation with isoflurane inhalation and propofol infusion. Patients were transported to PACU after operation.PCEA was started after extubation when the patients was awake and complained of pain. The AEPI, BIS , HRV and SEF values and VAS, OAA/S scores were recorded before induction of anesthesia (T0 ) at the end of surgery (T1), 5, 15, 30 , 60 , 90 min and 2h, 4h, 8h, 20h, 24h after loading dose (T2-12). Results (1) AEPI was significantly higher than the baseline value when the patient was awake and feel pain ( P

Objective Uterine artery embolization (UAE) is a new but well accepted technique for uterine myoma but patients feel severe pain and cramp during and after operation. The purpose of this study was to determine the effectiveness and safety of PCEA with ropivacaine during and after UAE. Methods Eighty ASA 1 - D patients undergoing UAE were randomly divided into four equal groups with twenty patients in each group: group C received oral nimesulide and/or intramuscular pethidine; in group RD0, RD1 and RD2 patients received PCEA with a mixture of 0.2% ropivacaine + 0.004% morphine. An additional 0.005% (RD1 ) or 0.01 % droperidol (RD2 ) was added to the mixture in group RD1 and RD2 . The PCEA regimen consisted of loading dose 6ml, background infusion 2ml/h, bolus dose 2ml and lockout time 10 min. The VAS pain score, Ramsay score, Bruggman comfort score (BCS) and side effects like nausea, vomiting and pruritus were recorded and compared among the 4 groups. Results Pain and cramp in pelvis were common (90% ) during UAE in group C while the patients in groups RD0, RD1 and RD2 felt no pain and cramp. The patients were quiet and cooperative (Ramsay score 2) in group RD0, RD1 and RD2 while the patients in group C were anxious and agitated. The rate of nausea and vomiting was lower in group RD1 and RD2 than that in group C and RD0. No respiratory depression, hypotension and bradyarrliythmia were observed in the four groups. Conclusion PCEA with ropivacaine and morphine can affectively relieve pain during and after UAE with faster recovery and less side effects. PCEA with moderate droperidol (0.005% ) can reduce the rate of natisea and vomiting.

Objective To compare the analgesic and side effects of patient-controlled intravenous analgesia(PCIA) with lornoxicam and morphine supplemented by continuous epidural infusion of 0.2% ropivacaine. Methods Sixty ASA I - II patients undergoing elective hysterectomy under epidural anesthesia were randomly divided into two groups: lornoxicam group (L, n = 30) and morphine group (M, n=30). For postoperative analgesia both groups received continuous epidural infusion of 0.2% ropivacaine 4 ml'h . In group L the patients received PICA with 0.008% lornoxicam and in group M 0.001% morphine. The bolus dose was 1 ml, lock-out interval 5 min and maximal amount within 1 h was 12 ml in both groups. If the patient still felt pain after pressing PCA pump 12 times, an additional epidural bolus of 0.2% ropivacaine 5 ml and morphine 0. 5mg was given. The clinical effects were assessed by (1) VAS score of pain( 0 = no pain, 10 = severe pain), (2) Bruggrmann comfort score (0 = persistent pain, 4 = no pain at coughing), (3) modified Bromage score, (4)patients satisfaction, (5) the number of pressing of PCIA pump by the patient (D1 ) at 30 min, 1,4,8,12,16,20,24h and the number of bolus dose delivered (D2), (5) the time when the patient passed gas and (7) complications such as nausea and vomiting and respiratory depression.Results The demographic data were comparable between the two groups. The amount of ropivacaine consumed was 192 mg in both groups.The amount of lornoxicam consumed was (3.4 +2.8) mg in group L and the amount of morphine consumed was (4.7 + 3.5) mg in group M. There was no statistically significant difference in VAS and Bruggrmann comfort score between the two groups. There were less side-effects in group L which were also milder as compared with those in group M.Conclusion The results suggest that continuous epidural infusion of 0.2% ropivacaine combined with lornoxicam in PCIA can provide better analgesia and reduce drug consumption in PICA. The efficacy of analgesia providedby lornoxicam is similar to morphine but lornoxicam causes less side-effects than morphine.

Objective To assess the analgesic effect of continuous infusion of 0.2% ropivacaine with epidural catheter placed at T11-12 or L2-3 after abdominal hysterectomy. Methods Eighty ASA Ⅰ -Ⅱ patients undergoing elective abdominal hysterectomy were randomly divided into 4 groups with 20 patients in each group : in group Al and A2 the epidural catheter was placed at T11-12 and in group Bl and B2 at L2-3 . After surgery two infusion pumps were used. The first pump was used for continuous epidural infusion of 0.2% ropivacaine in the 4 groups. The second pump was used for patient controlled intravenous analgesia (PCIA) with 0.08% lornoxicam in group Al and Bl or with 0.1% morphine in group A2 and B2. The PCIA bolus dose was 1 ml with a lockout time of 5 min. The analgesic effect (assessed using VAS) and the consumption of lomoxicam / morphine were compared among the four groups. Results The ropivacaine consumption was 192 mg during the 24 h after operation in the 4 groups. The lornoxicam and morphine consumption were (3.9?2.8) mg and (4.6?3.5) mg in group Al and A2 with the epidural catheter placed at T11-12 and (7.7?2.5) mg and (7.8?2.4) mg in group B2 and B2 with catheter placed at L2-3.The consumption of lomoxicam or morphine was significantly less with epidural catheter placed at T11-12 than that with epidural catheter at L2-3 (P

Objective To investigate the analgesic efficacy and safety of continuous epidural infusion of 0.2% levobupivacaine in patients after lower abdominal surgery.Methods Sixty ASA Ⅰ - Ⅱ patients undergoing lower abdominal gynecologic operation under epidural anesthesia were randomly divided into two groups : group L levobupivacaine (n = 30) and group R ropivacaine ( n = 30) . An epidural catheter was placed at L2-3 . After operation the catheter was connected through a 3-way Stopcock to a Graseby 9 500 infusion pump for continuous infusion of 0.2% levobupivacaine or 0.2% ropivacaine at a rate of 4 ml?h-1 and a Graseby 3300 infusion pump for PCEA with 0.01% morphine (bolus dose = 2ml, lockout interval = 10 min, total dose limit = 16 ml?4 h-1) (1) VAS score (0 = no pain, 100 = severe pain). (2) the ratio of the number of attempts calculated (D1) to the number of successfully delivered doses (D2) (D1/D2), (3) modified Bromage Motor scale score, (4) Bruggmann comfort scale (BCS), (5) Ramsay sedation score and (6) the severity of side effects were recorded 0, 2,4, 8, 12, 20 and 24h after operation.Results The demographic data (age, body weight, height) and duration of operation were comparable between the two groups. The analgesia was satisfactory in both groups. VAS scores were significantly lower in levobupivacaine group than that in ropivacaine group at 8 and 24 h after operation ( P