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.

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.

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

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.

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.