1.Effect of aerosolized iloprost inhalation on pulmonary arterial pressure and hypoxic pulmonary vasocon-striction during one-lung ventilation
Jing ZHOU ; Hong GAO ; Tongchun WANG
The Journal of Clinical Anesthesiology 2017;33(2):172-175
Objective To investigate the effect of aerosol inhalation of iloprost on pulmonary arterial pressure and hypoxic pulmonary vasoconstriction (HPV)during one-lung ventilation (OLV) in rats.Methods Thirty male rats were randomly divided into three groups,10 in each group. Models of lung perfusion were established,100% FiO 2 was ensured under the condition of OLV and the atomizers were opened.Atomization inhalation with normal saline was performed in group A,ilo-prost at a concentration of 0.05 μg·kg-1 ·min-1 in group B and iloprost at a concentration of 0.1μg·kg-1 ·min-1 in group C.Mean pulmonary artery pressure (MPAP)and PaO 2 of drainage-fluid from left atrium were recorded at time points of perfusion for 10 min (T1 ),aerosol inhalation for 10 min (T2 )and OLV for 1 h (T3 ).Oxygenation index (OI)was calculated with PaO 2 at each time point.Both lungs were harvested for electronic microscope detection.Results MPAPs at T2 and T3 were higher in contrast with that at T1 (P <0.05).A decrease of MPAP at T2 and T3 showed in group B and C when compared with those in group A (P <0.05).Group C had lower MPAP in comparison with group B at each time point.Considering the time span,we found that OIs at T2 and T3 were lower than that at T1 .In addition,OIs at T2 and T3 in group C were higher than those in group B,respectively.Under elec-tronic microscope,nuclear membranes typeⅡ alveolar epithelial cells of both lungs in group A and of non-ventilated lungs in group B and C bulged out or invaginated and lamellar bodies were evacuated,especially when compared to those in ventilated lungs in groups B and C.Conclusion In rat models of lung perfusion, atomization inhalation with iloprost can decreased MPAP,reduce intrapulmonary shunt and increase oxygen-ation.
2.The effect of intrathecal low doses of meperidine on shivering during cesarean delivery
Tongchun WANG ; Ronghua HUANG ; Yong LUO ; Dahong YAN ; Xinfan PENG
Chinese Journal of Postgraduates of Medicine 2013;36(36):1-3
Objective To investigate the effect of different intrathecal doses of meperidine on shivering during cesarean delivery under spinal-epidural anesthesia.Methods Sixty parturient women,ASA grade Ⅰ-Ⅱ grade,scheduled for cesarean delivery were enrolled in four groups by random digits table with 15 cases each group.All patients underwent combined spinal-epidural anesthesia.Spinal anesthesia consisted of isobaric bupivacaine 0.5% (10 mg) in the standard group (group A),isobaric bupivacaine 0.5% (10 mg) plus 5 mg meperidine in group B,isobaric bupivacaine 0.5% (10 mg) plus 10 mg meperidine in group C,isobaric bupivacaine 0.5%(10 mg) plus 15 mg meperidine in group D.The signs and symptoms were recorded 10,20,30,60 min after anesthesia respectively.Results All patients were successfully operated,not unexpected.Four groups at each time point of vital signs,nausea and vomiting,and the number of cases of neonatal 1,5 min Apgar scores was no significant difference (P > 0.05).Group A of shivering and the third grade shivering were significantly more than the number of group B,C,D(11 cases vs.2,1,1 cases;4 cases vs.0,0,0 cases,P< 0.01).Conclusion Epidural anesthesia,intrathecal meperidine 5-15 mg can effectively prevent shivering in cesarean section.