ObjectiveTo observe the effect of thiopental on T lymphocyte subsets in mice. MethodsT lymphocyte subsets were measured by flow cytorneter and monoclonal antibodies and immunofluorescence technic. ResaltsThe CD4 T cell and the CD4/CD8 ratio decreased after thiopental anaesthesia in mice. At the same time the whole amount of white blood cells has no statistical significant difference between test group and control group. ConclusionThiopental anaesthesia inhibits immune function.

ObjectiveTo investigate the changes of renin-angiotensin-aldosterone system (RAAS) and glomerular filtration rate (GFR) in epidurally-anesthetized patients undergoing gynecological laparoscopy with 15° head-down position and low insufflation pressure. MethodsTwenty gynecological patients(ASA grade I- Ⅱ )were studied during CO2 insufflation with an intra-abdominal pressure of 1012mmHg and 15° head-down position. Arterial blood samples were obtained for the measurements of serum concentrations of plasma renin activity(PRA), angiotensin Ⅱ (All), aldosterone(ALD) and β2-microglobulin(β2-MG)by radioimmunoassay at the following five time points: before insufflation, at 10min, 30min and 60 min after insufflation respectively and after desufflation. Arterial blood gas analysis was made in 10 of the cases simultaneously. ResultsCompared with preinsufflation, there was no significant decrease in the plasma levels of PRA, All ,ALD and β2-MG during CO2 pneumoperitoneum except for PRA at 10 min after insufflation(P ＜0.05). As the time of insufflation went on, the measurements above showed a tendency of slightly increase. The PaCO2 during peritoneal CO2 insufflation was increeseing ( P ＞ 0.05) and reached its maximum at 30 min after insufflation. The pH values of 30～60 min after insufflation were significantly decreased as compared with that of before insufflation. ConclusionThe epidural anesthesia may inhibit the response of RAAS to (CO2 insufflation pressure of 10-12mmHg and has no effect on GFR during gynecological laParoscopy.

Objective To study the relationship of implicit memory and amnesia effect of oral midazolarn premedication and toobserve its anterograde amnesia, the effect on short-term memory and the onset time and out come of retrograde amnesia. Methods60 patients with ASA I - Ⅱ status undergoing abdomen and limb operations were divided into 3 groups with 20 cases each. Group A:oral midazolam 7.5mg;Group B:oral 15mg;Group C:placebo. The patients received combined spinal-epidural anesthesia after oral midazolam. The parameterns of EEG, SEF 95 %, BISwere collected at the same time and the degree and remark of sedation were dome according to OAA/S. The amnesia and implicit memory were investigated with pictures and muddy identified hearing rate 6 hours after operation. Results (1)Twenty min following drug ad dministration the remarks of sedation of group A and B were significantly loWver than that before and that of group C, Which was not significently different between group A and B. ( 2)The amnesia rates tested six hrs after surgery were significantly higher at 30min in group A, 20min in group B than those before treatment and were kept at 70%-80% levels, which in group C was remained zero. (3)The muddy identified hearing rate was not different significantly, among the three groups. (4) The short-term memory was all 100%during the period of drug action. (5)BIS and SEF 95% Were lower 30min after the treatment and all kept at 80 Hz and 20 Hz, which were not different remarkably between group A and B. ConclnsionOral midazolam 7. 5mg has a good effect on anterograde amnesia 30min after treatment, which may not be improved with increament in dosage. It does not lead to retrograde amnesia. The long-term memory, but not short-term memory, was impaired by midazolam. It only affects the explicit memory. Oral premnedication with midazolam can not prevent the awareness during operation totally.

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.