Objective To investigate the effects of nicardipine,urapidil,and esmolol on baroreflex sensitivity(BRS) in patients with essential hypertension(EH) during induction of general anesthesia.Methods EH patients were divided into four groups,who were given nicardipine 0.5μg/kg(group N,15 cases),urapidil 0.5 mg/kg(group U,16 cases),esmolol 0.25 mg/kg(group E,16 cases)or normal saline (group C,15 cases)at 2 min before induction.The induction of general anesthesia was performed with the same drugs.Sodium nitroprusside 50-100 μg was administered tomake systolic pressure(SBP)decreased by 15-25 mm Hg at different time points of before induction,before incubation,at 5,10,15,20 and 30 rain after intubation.The RR intervel on ECG was recor(ded and BRS was calculated during hypotensive period.Results BRS was reduced in groups of N,U and C after intubation compared with that before(P<0.05 or P<0.01),which was lower in grouP N than that in group C,but was higher in group E than that in group C at all time points(P<0.05).Conclusion The induction of general anesthesia may reduce BRS in EH patients.which is aggravatedby preinjection of nicardipine.Urapidil has no effect on BRS,but esmolol may increase BRS during induction of general anesthesia.

Objective To investigate the effect of combined general anesthesia with localanesthetic infiltration on heart rate variability and hemodynamics in laparoscopic cholecystectomy.Methods By simple randomization 70 patients undergoing laparoscopic cholecystectomy were assignedto two groups,68 patients completed the study(34 in each group).Group GA was given generalanesthesia.Group GL was given general anesthesia combined with local anesthetic.Iow-frectuency(LF),high-frequency(HF),LF/HF,Lfnu(LF/TP×100%),Hfnu(HF/TP×100%)and totalpower(TP),were recorded at the time points of baseline(T_0),skin incision(T_1),skin closure(T_2)and 1 h(T_3),3 h(T_4)after surgery.MAP and HR were recorded at the points of baseline,skinincision,skin closure and 1,3 h after surgery.Results Compared with the baseline,there was anincrease in MAP and HR at T_1,T_3,T_4(P<0.05)in group GA. Heart rate variability changesshowed that in group GA Lfnu,LF/HF increased significantly at T_1-T_4(P<0.05)and in group GLLF/HF increased significantly at T_1,T_2(P<0.05),and TP in group GA and group GL decreasedsignificantly at T_1,T_2(P<0.05).Conclusion Our results support that combined general anesthesiawith local anesthetic infiltration has lass influence on hemodynamics and automomic nerve,and can bean useful analgesic adjuvanct for patients undergoing laparoscopic cholecystectomy.

Objective To determine the median effective dose of remifentanil for maintaining the tolerance to ProSeal laryngeal mask airway in awake and spontaneously breathing patients.Methods Sixty ASA Ⅰ orⅡpatients aged 20-55 years old were recruited.Sixty patients was randomized into six groups with 10 case each Remifentanil was infused in a dose of 0.061,0.048,0.039,0.03,0.025 or 0.02μg·kg~(-1) 5 minutes after inserting PLMA.Single dose of remifentanil 0.25/μg/kg was given before continuous intravenous infusion.Respiratory response subscore of comfort scale(CSRR)and Ramsay sedation scale(RSS)were recorded after 25 minutes.ED50 was calculated.Results The ED50 of remifentanil for ProSeal laryngeal mask airway tolerance was 0.027μg·kg~(-1)(95%CI:0.023-0.030μg·kg~(-1)·min~(-1)in awake and spontaneously breathing patients.Conclusion The patients tolerate stimulus of laryngeal mask with a low dose continuous intravenous infusion of remifentanil in awake.and can maintain the hemodynamics stable.

Objective To investigate the risks and anesthetic management of scar uterus undergoing cesarean section.MethodsOne hundred pregnant women(aged 24-43 years old)with scar uterus underwent cesarean section.Epidural anesthesia was used in 90 cases(group A)and general anesthesia in 10 cases(group B).The monitorings included ECG,BP,HR and SpO_2.CVP was measured in the high risk cases.The time from skin incision tO neonatal delivery(I-D).the time from uterine incision to delivery(U-D),and Apgar scores of neonates were recorded.Results Incomplete blockade was seen in 20 cases(22％).The I-D time was shorter in group B than that in group A[(7.5±2.0)min vs.(12.3±2.6)min](P<0.01).Intraoperative hypotension occurred in 32 cases (32％).Neonatal asphyxia happened in 21 cases(21%).Apgar scores of 11 neonatals werc less than 3,of whom 5 neonates died.Apgar scores were 4 to 7 in 10 cases,8 to 10 in 79 cases.Subtotal uterectomy was performed in 2 cases.Repair of injuried bladder had to be done in one case.Intraoperative huge bleeding took place in 15 cases.Conclusion The scar uterus undergoing cesarean section has a high risk for mothers and neonates.The incidence of incomplete epidural blockade is higher.Effectively preventing and managing the risk factors are the keys for reducing maternal and neonatal complications and mortality.

Objective To observe the effect of preemptive analgesia with lornoxicam on balance of Th1/Th2 during radical gastrectomy. Methods Thirty patients undergoing selective radical gastrectomy were randomly divided into 2 groups with 15 cases each. Lornoxicam 8 mg was used.before surgery,and PCA with lornoxieam and morphine was used for postoperative analgesia in group Ⅰ.PCA with morphine was used for postoperative analgesia in group Ⅱ. Plasma cortisol, interferon-γ(IFN-γ) and interleukin-4 (IL-4) were measured before induction of anesthesia(T_0 ), at the end ofoperation(T_1 ),at 24 h(T_1 ) and 72 h(T_3 ) after operation. Results Compared to that at T_0 ,Cor washigher at T_1 and T_2 in group Ⅱ and at T_2in group I(P<0. 05). (Cor levels at T_1 and T_2were lower ingroup Ⅰ than those in group Ⅱ(P<0. 05). IL-4 of group Ⅰ was lower at T_2 than that at T_0 (P<0.05). IL_4 at T_3 was lower in group Ⅰ than that in group Ⅱ (P < 0.05). IFN-γ of group Ⅰ washigher at T_1 than that at T_0 (P<0. 05), which was higher at T_2 than that of group Ⅱ(P＜0. 05). Theratio of IFN-γ/IL-4 in both groups was significantly higher at T_1-T_3 than those at T_0, which at T_2 washigher in group Ⅰ than that in group Ⅱ (P<0. 05). Conclusion Preemptive analgesia with lornoxicamcan alleviate the excurtion degree of Th1/Th2 and improve inmmnological suppression after radicalgastrectomy.

Objective To observe the outcomes of satellite ganglion block(SGB)via posterior edge of stcmoclcidomastoid approach.Methods SGB was performed in 2 400 patients,who wererandomly divided into two groups with l 200 cases each.The puncture of SGB in group SPA was via posterior edge of sternocleidomastoid approach and that in group TPA via traditional paratracheal approac}L The same local anesthetics was used in two groups.The success rate(Horner'S syndrome appearance)and complications were compared.Results The success rate was higher in group SPA than that in group TPA(97% VS.92%)(P<0.05).Repeated puncture was needed in 16 cases ingroup SPA,which were less than 98 cases in group TPA(P<0.05).Laryngeal nerve block wasoccurred in 24 cases in group SPA.which were less than 37 cases in group TPA(P<0.05).Conclusion Compared to the traditional paratracheal approach,SGB via posterior edge ofsternocleidomastoid approach has the advantages of clear positioning,easy puncture,higher success rate and less complications.

Objective To access the analgesia effect and side effect of flurbiprofen axetilcombined with sufentanil.Methods Thirty-eight patients underwent cardiac surgery were randomlydivided into two groups with nineteen cases each.Group S was given sufentanil 250μg diluted to 125ml via PCIA after surgery.Group F was given sufentanil 125 gg plus flurbiprofen axetil 150 mgdiluted to 125 ml via PCIA after surgery.The PCIA pump was set at a rate of 0.2 ml/h,bellus dosewas 0.8 ml.lockout time interval was 10 min. Analgesia grade was accessed,vital sign and sideeffects were recorded.Results 'Fhere was no significant difference in analgesia grade between tWOgroups.The side effects were lower in group F than those in group S.Conclusion Flurbiprofen axetilcombined with sufentanil can obtain similar analgesia effects to sufentanil alone,but can reduce sideeffects and fever temperature.

Objective To observe the effect of sevoflurane inhalation anesthesia and propofolsevoflurane combined anesthesia on glucose concentrations.Methods Thirty patients undergoinggeneral anesthesia were randomly divided into two groups with 15 cases each.The patients in group Awere anesthetized with sevoflurane inhalation and those in group B with sevoflurane combined withprovofol.Blood concentration of glucose was measured before operation and at 2 h during surgery.Results The blood glucose concentrations in groups of A and B were significantly increased at 2 h during surgery than those before[(6.23±1.45)mmol/L vs.(4.86±0.85)mmol/L and(6.66±blood glucose between the two groups.Conclusion Both sevoflurane inhalation anesthesia and combined propofol and sevoflurane anesthesia can not inhibit the increase of blood glucose duringoperation.

Objective To investigate the relationship between hepatic potential capacity and the pharmcodynarnics of rocuroniurn.Methods The indocyanine green (ICG) excretion test waspertormed one day before operation in 71 patients with decompensated hepatic cirrhosis scheduled to receive devascularization combined with splenectomy.On the basis of ICG retention at 15 min(ICGR_(15)),the patients were divided into groups of I_1(22 cases,ICGR_(15)≤10),I_2(35 cases,1020).Another 20 healthy people(group C)were taken as thecontrols.Rocuronium 0.6 mg/kg was intravenously infused and 0.3 mg/kg rocuronium、was addedwhen T_1 value recovered to 25%control value.The twitch high of adductor pollicis muscle wasrecorded.The time of onset,T1 maximum depression,the clinical duration of initial dose,and thespontanous recovery index were recorded.The clinical duration of repeated maintenance doses and themean dosage of each group were recorded as well.Results The onset time,25% TOF responsePeriod and the recovery index after operation were significantly prolonged in groups of I_2 and I_3compared with those in groups of C and I_1(P<0.05 or P<0.01).No response period of grouP I_3was longer than that of other three groups(P<0.0 1).When the maintenance dose of rocuronium wasadded for more than four times,the clinical action time also showed to be prolonged in an older of I_3>I_2＞I_1 and mean dose reduced in an order of I_3

Objective To study target-distribution of flurbiprofen axetil in operative incision tissue in incision-induced rats. Methods Thirty-two-250 g-weight rats were randomly divided into 4 groups. The incision pain model was established by being operated according to Brennan's method. Two hours after vena caudalis injection, all the rats were anesthetized deeply by pentobarbital sodium-perito injection 100 mg/kg,muscles of both hind paws were dissected, homogenated, centrifuged and supernatant fluids were dissociate. The concentration of flurbiprofen were detected by reversed phase high peformance liquid chromatography(RP-HPLC). Results In these groups of different dosage, the concentration of flurbiprofen in operative incision notably increased compared to that in the non-operative incision, especially in group K16. The concentration of flurbiprofen in operative incision of different dosage increased in dose-dependent manner. The difference of concentration of flurbiprofen in non-operative incisions of K2, K4, K8 was statistically insignificant, but the concentration of flurbiprofen in non-operative incision of K6 increased compared to that of K2, K4 and K8. Conclusion The distribution of flurbiprofen axeti in operative incision was targeted. When rats were injected flurbiprofen axetil at 16 mg/kg by vena caudalis, The concentration of flurbiprofen in the non-operative incision increased notably.