1.Effects of exogenous nitric oxide on hippocampus gaseous transmitters in rats with global cerebral ischemic-reperfusion injury
Wei LI ; Guangyu ZHAO ; Zhonghui WANG
The Journal of Clinical Anesthesiology 2010;26(3):248-250
Objective To investigate the effects of exogenous nitric oxide (NO) on gaseous transmitter molecule of the hippocampus in rats with global cerebral ischemic-reperfusion(I-R) injury.Methods Twenty-four Wistar male rates were randomly divided into 4 groups of sham operation (group S),I-R control(group I-R),I-R plus sodium nitroproside(SNP) 2 mg/kg(LSNP) or plus SNP 4 mg/kg(group HSNP) with 6 rats each.Global cerebral I-R model was established by 4-vessel occlusion.SNP was injected at 30 min before clamping the bilateral carotid arteries in groups of LSNP and HSNP.The carotid arteries were clasped for 20 min.The rats were killed after cerebral reperfusion for 6 h.The concentrations of hydrogen sulfide(H_2S),NO and CO,the activity of cystathionine beta synthase(CBS),HO and inducible nitric oxide synthase(iNOS),as well as the expression levels of CBS mRNA,iNOS mRNA and hemeoxygenase-1 (HO-1) mRNA in the hippocampus were measured.Results Compared to group S,the concentrations of H_2S,NO and CO,the activities of CBS,HO and iNOS and the expressions of CBS mRNA,iNOS mRNA and HO-1 mRNA in group I-R were increased(P<0.05 or P<0.01) ,which were all higher in groups of LSNP and HSNP than those in group I-R(P<0.05 or P<0.01).Conclusion Exogenous NO can induce the expressions of CBS mRNA and HO-1 mRNA,activate CBS and HO in rats with global cerebral I-R injury,indicating that NO has a modulation effect on the CBS/ H_2S and iNOS/NO systemes.
2.Effects of tidal volume on arterial oxygenation and intrapulmonary shunt during one lung ventilation
The Journal of Clinical Anesthesiology 2010;26(3):206-208
Objective To investigate the effects of different tidal volume (V_T) on arterial oxygenation and intrapulmonary shunt(Q_S/Q_T) during one lung ventilation(OLV).Methods Sixty patients scheduled for selective lobectomy under left lateral decubitus position were randomly divided into groups of A,B and C with 20 cases each.After bronchial induction,two lung ventilation(TLV) was performed with V_T 10 ml/kg,frequency(f) 12 breaths per minute(BPM),ratio of inspiration to expiration(I: E) was 1:2 at first.During OLV,I: E was kept steady,V_T 6 ml/kg and f 20 BPM were chosed in group A,V_T8 ml/kg and f 15 BPM in group B,V_T 10ml/kg,f 12 BPM in group C.Blood gas analysis was determined before OLV (T_1) and at 10 min(T_2) ,20 min(T_3) ,and 30 min after OLV (T_4).Q_S/Q_T and lung complience(Cdyn) was calculated.Results OLV Compaired to T_1,PaO_2 and Cdyn were lower (P<0.05) and Q_S,Q_T and peak airway pression were increased (P<0.05).The decrease of PaO_2 was more in groups of A and C than that in group B(P<0.05).Conclusion During OLV,a better PaO_2.may be maintained with the ventilation parameters of V_T8 ml/kg and f 15 BPM with less increase in Q_S/Q_T and higher Cdyn.
3.Effect of midazolam as premedication on stress response in patients undergoing cervical plexus block
The Journal of Clinical Anesthesiology 2010;26(3):200-202
Objective To investigate the effect of midazolam as premedication on stress response in patients undergoing cervical plexus block.Methods Sixty female patients undergoing selective thyroid surgery were equally randomized into groups of A and B.The patients in group A were intramuscularly injected midazolam 0.08 mg/kg before cervical plexus block and those in group B were not as the controls.Cervical plexus block was performed with 20 ml mixeture of 1% lidocaine and 0.25% ropivacaine 20 min later.BP and HR were recorded,rate-systolic pressure product (RPP) was calculated,and serum glucose(Glu),cortisol (Cor) and angiotensin Ⅱ (AT-Ⅱ) were detected before enter(T_0),before cervical plexus block(T_1),at 5 min(T_2),15 min(T_3) and 25 min(T_4) after cervical plexus block injection.Results In group B BP,HR,RPP,Glu,Cor and AT-Ⅱ all higher at T_1-T_4 than those at T_0 BP,HR,RPP,Glu,Cor and AT-Ⅱ were all lower in group A than those in group B at T_1-T_4 (P<0.05).Conclusion Intramuscularly premedication with midazolam is effective in reducing stress response in patients undergoing cervical plexus block.
4.Effects of limb ischemia-reperfusion injury on blood coagulation
The Journal of Clinical Anesthesiology 2010;26(3):224-226
Objective To investigate the effects of limb ischemia-reperfusion injury(I-RI) on blood coagulation.Methods Eighteen patients scheduled for unilateral knee arthroscopy surgery under epidural anesthesia were treated with an inflatable tourniquet to ptoduce ischemia for (42 ± 6) min.Venous blood was taken before tourniquet inflation,at 30 min during ischemia,3 min and 30 min during reperfusion for measuring blood coagulation by thrombelastography(TEG).Results TEG showed the decreases in reaction time(R value) and coagulation time(K value),and the increases in alpha angle(α) and maximal amplitude(MA),which were all within the normal limits and had no significant differences among four time points of testing.Conclusion I-RI of the limbs has no significant effects on blood coagulation.
5.Treatment of lower-limb nenropathic pain with linear polarized light irradiation
The Journal of Clinical Anesthesiology 2010;26(3):217-218
Objective To observe the therapeutic effect of irradiation of the lumbar sympathetic ganglia by linear polarized light for the lower-limb neuropathie pain.Methods The lumbar sympathetic ganglia was irradiated by super liar therapeutic equipment focused on L_2 as the center,once a day,20 min each time for 30 days.Skin temperature on the lower limb,VAS score and pain threshold were evaluated.Results Compared to before,the skin temperature increased (P<0.01),VAS decreased (P<0.01),and pain threshold incresed(P<0.01).Conclusion The super lizer irradiation has a good therapeutic effect on lower extremity neuropathic pain
6.Effects of acute hypervolemic hemodilution with HSH 40 on hemodynamics and fluid balance in patients antler general anesthesia
Xihua LU ; Yi ZHOU ; Jianwei WANG
The Journal of Clinical Anesthesiology 2010;26(3):215-216
Objective To obeserve the effects of acute hypervolemic hemodilution(AHH) with hypertonic .sodium chloride hydroxyethyl starch 40(HSH 40) on hemodynamics and fluid balance in patients under general anesthesia.Methods Fifty patients undergoing radical surgery for gastral cancer under general anesthesia were randomly divided into 2 groups with 25 patients each.Acute hypervolemic bemodilution (AHH) was performed with HSH 40 6 ml/kg in group A or with hydroxyethyl statch(HES) 6 ml/kg in group,which was infused within 30 minuts.HR,MAP,CVP were recorded before(T_0),at 30 min (T_1),60 min (T_2) after infusionand and the end of operation (T_3).The amounts of bleeding,HSH 40 and HES and urine output were recorded as well.Results There were no significant diferences in HR and MAP between two groups at all time points.CVP was sighificantly higher at T_1-T_3 than that at To in two groups.The urine output was more in groups A than that in group B(P<0.05).Conclusion AHH with HSH 40 can effectively expand blood vlume and increase urine output in surgical patients under general anesthesia.
7.Effects of oxytocin on hemodynamics during epidural block
The Journal of Clinical Anesthesiology 2010;26(3):212-214
Objective To investigate the effects of oxytocin on hemodynamies in patients under epidural block.Methods Twenty-six selective myomectomy patients were randomly divided into epidural block group(E) and general anesthesia group(G) with 13 cases each.Epidural anesthesia with 2 % lidocaine was performed with the blocking plane of T_6-T_8.Group G was given general anesthesia with propofol,fentanyl,remifentanyl and vecuroniurn.Oxytocin 5 U was injected in 30 s when hysteromyoma was removed and the hemodynamics was stable.MAP and HR were recorded before and after oxytocin injection.Results Compared to those before,MAP was decreased and HR was increased after oxytocin injection in both groups(P<0.05 or P<0.01).The decrease of MAP was slower but lasted for a longer period in group E than those in group G(P<0.05 or P<0.01).Conclusion Epidural blockade may aggravate the hypotensive effect of oxytocin and inhibit oxytocin-induced HR increasise.
8.Effect of nicardipine on perioperative insulin sensitivity in patients with essential hypertension
Yujun MING ; Hui LI ; Junmei XU
The Journal of Clinical Anesthesiology 2010;26(2):97-99
Objective To investigate the effect of nicardipine on perioperative insulin sensitivity in patients with essential hypertension(EH). Methods Thirty-eight patients undergoing lobectomy continuously after induction of anesthesia in group N, while normal saline was infused in group C instead of nicardipine. Blood samples were taken immediately before induction of anesthesia(T_0), 2 h after skin incision(T_1) ,4 h after surgery(T_2) and 24 h after surgery(T_3). Blood glucose(BG) and plasma insulin (Ins) were measured. The Insulin sensitivity index (ISI) was calculated. Results Values of BG at T_2and T_3 in group C were higher than those at T_0 (P<0. 05). Value of Ins at T_2 in group C was higher than that at T_0 (P<0. 05),which at T_3 in group C was significantly higher than that at T_0 (P<0. 01). ISI at T_2 in group C was lower than that at T_0 (P<0. 05) ,which at T_3 in group C was lower significantly than that at T_0 (P<0. 01). Values of BG and Ins at T_3 in group N were higher than those at T_0 (P<0. 05), ISI at T_3 in group N was lower than that at T_0 (P<0. 05). Value of BG at T_2 was significantly lower in group N than that in group C(P<0. 05). Value of Ins at T_3 was significantly lower in group N than that in group C(P<0. 01). ISI at T_2 and T_3 in group N was min~(-1) infused continuously during and after lobectomy can increase significantly insulin sensitivity and improve postopertive insulin resistance state in EH patients.
9.Expression of EAAC1 in dorsal root ganglion in rats with inflammatory pain-morphine tolerance
Yi CHEN ; Yonghao YU ; Guolin WANG
The Journal of Clinical Anesthesiology 2010;26(1):54-56
Objective To explore the role of excitatory amino acid carrier 1 (EAAC1)in dorsal root ganglion (DRG) in the mechanism of developing morphine tolerance. Methods Thirty male SD rats were implanted intrathecal catheters and randomized into 6 groups with 5 rats each. The rats of 4 groups were made into the model of adjuvant-induced arthritis in the left hind limb and were administered intrathecally, morphine 10 μg(group M_(10)), morphine 20μg(group M_(20)), morphine 20 μg plus naloxone 10 μg(group MN) ,or saline(group C) respectively. The other 2 groups without were administered intrathecally saline (group C_0) or morphine 20 μg (group M0). The drugs were administered twice daily for 7 days. Mechanical withdrawl threshold(MWT) of the left hind limb was examined to evaluate the behavior. Immunohistochemistry was used to detect the expression of EAAC1 in the left L_(3-4) and L_(4-5) DRG. Results Morphine tolerance was formmed stably in the arthritis rats of group M_(10) and group M_(20) after administering morphine for 7 days. The expression of EAAC1 in DRG was downregulated. Conclusion DRG EAAC1 may be involved in the mechanism of developing morphine tolerance in rats with inflammatory pain.
10.Effect of anesthesia methods on perioperative body temperature in patients undergoing operation for esophagus cancer
Xiaojun HUA ; Faping WU ; Huaying WU
The Journal of Clinical Anesthesiology 2010;26(1):11-13
Objective To investigate the effect of different anesthesia methods on perioperative body temperature. Methods Eighty patients undergoing esophagus cancer resection were randomized into two groups of combined general and epidural anesthesia(GEA, group A,42 cases) and general anesthesia(GA, group B, 38 cases). Epipharynx and peripheral temperatures were recorded at the same time every 30 minutes for 3 hours after induction. Epipharynx temperature was recorded than after when circulating water mattresses and fluid warming were used to rewarming. The incidence of postoperative shivering was recorded. Results The peripheral temperature was gradually decreased after induction in both groups. The core temperature was decreased quickly within the first 1 hour in both groups, which was reduced slowly within the next two hours with a greater magnitude of temperature reduction in group A than that in group B(P<0.05). The incidence of shivering was higher in group A than that in group B during warming up. Conclusion The patients undergoing long procedures such as esophagus cancer recection under GEA is at more risk for hypothermia than those under GA.