Objective: To evaluate the feasibility and safety of postoperative patient-controlled epidural analgesia (PCEA)in children. Methods: Forty postoperative pediatric patients(5-11 years old)were divided into two groups. A and B. Both wereinstituted with postoperative PCEA with LCP model (loading dose 2.05 + 0.13ml), continuos infusion rate 0.82 + 0.15mi/h, PCA dose 0.81 + 0.16ml)by Graseby-9300 PCA pump. The PCEA solution of group A was 0.075% bupivacaine plus0.0012 % buprenorphine, that of group B was same while 0. 005% droperidol was added as an adjuvant. Results:The volumeof PCEA sdution consumption in group B was significantly less than that in group A on the first and second postoperative day (P< 0.01-0.05). Good analgesic efficiency with little side effects was obtained, as evaluated by the VASF emasay or D/D score and complications in two groups, but the analgesic effect of group B was better than that of group A. Conclusion: Thepediatric PCEA with low concentration of bupivaeaine plus buprenorphine is feasible and safe. Droperidol may enhance theanalgesic effects of PCEA.

2 h) and the amount of remifentanil, propofol and midazolam administered. The onset time, duration of peak effect (T1 from 0-5 % ), the time for T, from 5 % -25 % and recovery index (T1 from 25 % -75 % ) were significantly longer in group Ⅰ than in group Ⅱ ( P

Objective To compare the safety and efficacy of different doses of intrathecal sufentanil for labor analgesia in parturients. Methods One-hundred ASA I or II nulliparous parturients at 39-40 weeks of gestation who requested labor analgesia were included in this randomized double-blinded study. They were all in active labor with a 2-3 cm cervical dilatation. The subarachnoid block was performed at L2, 3 . The patients were randomized to received intrathecal sufentanil 1,3,5,7,or 10 ?g. An epidural cather was then placed for patient-controlled epidural analgesia (PCEA) . The PCEA solution contained 0.1% ropivacaine and sufentanil 0.4 ?g ? kg-1 .The PCEA settings were as follows: background infusion 5 ml?h-1 , demand bolus 3 ml and lock-time interval 10min. Pain relief was assessed by VAS scores, oxytocin dose, maternal satisfaction, hemodynamics and side effects. Apgar scores of the new-borns were recorded. Results Demographic data including age, sex, body weight and baseline VAS were similar among the five dose groups. There were significant differences in the onset , duration and efficacy of analgesia among the five dose groups. Significantly more patients who received 10 ?g sufentanil reported nausea and vomiting and pruritus than those who received 1 or 3 fig sufentanil. There was no significant difference in Apgar scores among the 5 dose groups. Conclusion Intrathecal sufentanil combined with PECA is safe and effective for labor analgesia. Intrathecal sufentanil 3-5 ?g is the dose of choice for labor pain relief.

0 05)respeetively before induction, which shoued no statistic difference between two groups.AEP index and BIS of two groups after induction were decreased to below 30 a nd 55 respeetively(T 1 vs. T 0 ,P0 01) ) . The changing tendency of the elderly group and the young group were identical a t all time points. Conclusions AEP index can be used for the anesthesia depth monitoring for the elderly without obvious auditory dysfunction during tracheal intubation.

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

Objective To measure the EC50 of propofol administered by target-controll infusion(TCI) and BIS50 and AAI50 for different levels of sedation during combined spinal-epidural anesthesia (CSEA). EC50 , BIS50 and AAI50 were defined as the effective target effect-site concentration of propofol and BIS and AAI values at which different levels of sedation were achieved in 50% of patients.Methods Forty-five ASA Ⅰ patients (37 males, 8 females) aged 16-60 yr weighing 35-86 kg undergoing lower abdominal or lower limb surgery under CSEA were studied. CSEA was performed at L2-3 or L3-4 interspace. 0.75% bupivacaine 2 ml (15 mg) was injected into CSF. Intermittent boluses of 2% lidocaine were given through the epidural catheter during operation when needed. The average level of spinal block was T8 (T6-10 ) . The patients were sedated with propofol given by TCI. The level of sedation was assessed using observer assessment of the alertness/sedation scale (OAA/S) . BIS, AAI, MAP, ECG, HR, RR and SpO2 were monitored during anesthesia. Binary logistic regression was used to estimate the population values for EC50 BIS50 and AAI50 at different OAA/S scores. Results The EC50 of propofol from the score of 4-1 on the OAA/S scale were 0.6, 1.0, 1.3 and 1.6 ?g?mi-1 ; the BIS50 values 85, 75, 67 and 61 and AAI50 values 72, 59, 39 and 30 respectively. Conclusion EC50 of propofol given by TCI, BIS50 and AAI50 for different levels of sedation were measured during operation under CSEA and are useful for maintaining conscious sedation during CSEA.