1.Evaluation of the accuracy of administration of propofol by a TCI system in children
Qingquan LIAN ; Huacheng LIU ; Wangning SHANGGUAN
Chinese Journal of Anesthesiology 1995;0(02):-
Objective To develop a target-controlled infusion (TCI) system incorporating population pharmacokinetics of propofol for children and evaluate its accuracy. Methods The TCI system was composed of a Samsung Q20 laptop computer, Graseby 3500 infusion pump, Stanpump software (Version 1.0 designed by Shafer et al. Stanford) and pharmacokinetic parameter set for propofol in children reported by Lian et al. Twenty-four ASA Ⅰ children undergoing elective orthopedic or urological surgery under general anesthesia were divided into 2 age groups: group A 3-5 yrs ( n = 12) and group B 5-10 yrs (n = 12). Radial artery and internal jugular vein were cannulated. The pediatric patients were sedated with ketamine 4 mg?kg-1 IM (uncooperative patients) or 2 mg? kg-1 Ⅳ( cooperative patients) . Anesthesia was induced with fentanyl 3 ?g?kg-1, propofol by TCI and vecuronium 0.1 mg?kg-1. Target plasma concentration of propofol was set at 3 ?g?ml-1. TCI of propofol was maintained for 60 min. Arterial blood samples were taken at 1, 3, 5, 10, 20, 30, 40, 50 and 60 min after TCI was started and at 2.5, 5, 10, 20 and 30 min after termination of TCI for determination of blood propofol concentration by HPLC. The median performance error ( MDPE) , MDPE without first five minutes ( MDPE1) , median absolute performance error ( MDAPE), wobble and divergence were calculated. Results During the first 40 minutes of TCI there was a remarkable difference between the measured plasma propofol concentration ( Cm) and the target plasma concentration (Cp). The difference was narrowing gradually until the 50 min of TCI. After the termination of TCI the Cm was significantly lower than Cp. The MDPE was 27% in group A and 26% in group B; MDPE1 was 7% (A) and 12% (B) and MDAPE 27% (A) and 26% (B) during TCI. The wobble was 23 % (A) and 24% (B) and the divergence - 0.75%?h-1 (A) and -0.80%?h-1 respectively. Conclusion The bias and divergence of our TCI system for propofol are small and the accuracy is high and a stable plasma concentration of propofol can be maintained in children.
2.Effect of propofol on gastric intramucosal pH after myocardial ischemia-reperf usion in rabbits
Wangning SHANGGUAN ; Bing ZHANG ; Qingquan LIAN
Chinese Journal of Anesthesiology 1997;0(11):-
Objective To investigate the changes in gastric intramucosal pH (pHi) and the effect of propofol on microcirculatory perfusion after myocardial ischemia-reperfusion injury in rabbits. Methods Twenty healthy adult rabbits of both sexes, weighing 2.0-2.7kg were randomly divided into two groups: A control group (n=10) and B propofol group (n = 10) . The animals were anesthetized with 2% sodium pentothal iv. Anesthesia was maintained with intermittent iv boluses of fentanyl and vecuronium. The animals were tracheotomized and mechanically ventilated during fluid and propofol infusion. PaCO2 was maintained at 35-40 mm Hg. Right internal jugular vein was cannulated for fluid and propofol infusion. Left carotid artery was cannulated for BP and HR monitoring and blood sampling. TRIP tonometry catheter (14F) was placed in the stomach. Lactated Ringer's solution was infused at 6-8 ml-kg-1 h-1 during experiment. In group B propofol was infused at 5mg-kg-1-h-1 when BP and HR were stabilized for 10 min, chest was opened and heart exposed. Left anterior descending artery (LAD) was tied for 60 min and then released for reperfusion. Hemodynamics and pHi were measured before myocardial ischemia (T0) , 60 min after myocardial ischemia (T1), 60 min (T2), 90min (T3) and 180min (T4) after reperfusion was started. Results There was no significant difference in BP and HR from T0 to T4 between the two groups. pHi decreased significantly after myocardial ischemia-reperfusion injury in both groups. pHi was significantly lower at T3 in propofol group than that in control group (P
3.Pharmacokinetics of propofol in different age children after a single dose
Qingquan LIAN ; Wangning SHANGGUAN ; Zengshou WANG
Chinese Journal of Anesthesiology 1994;0(06):-
Objective To investigate the pharmacokinetics of propofol in children of different ages after a single dose. Methods Thirty-five ASA Ⅰ or Ⅱ children were divided into 3 age groups: group A
4.Effect of breviscapine on lung injury in children undergoing open heart surgery with cardiopulmonary bypass
Jun CHEN ; Yinghua ZHAO ; Xiulan LIU ; Xiaoling CHEN ; Boxi XIA ; Jun LI ; Qingquan LIAN ; Wangning SHANGGUAN
Chinese Journal of Anesthesiology 2011;31(9):1106-1109
Objective To investigate the effect of breviscapine on lung injury in children undergoing open heart surgery with cardiopulmonary bypass(CPB).Methods Forty-five ASA Ⅱ or Ⅲ children aged 3-65 months weighing 5-21 kg undergoing open heart surgery with CPB were randomly assigned to 3 groups ( n =15 each):control group (group C),low dose breviscapine group (group B1 ) and high dose breviscapine group (group B2).Normal saline 15 ml(group C),breviscapine 0.5 mg/kg (group B1 )or 1.0 mg/kg(group B2 ) were injected iv over 30min after anesthesia induction.Blood samples were taken before operation ( T0 ),at 30 min and 1 h of aortic unclamping (T1,T2 ),at 3 h and 6 h after operation (T3,T4 ) for determination of plasma procalcitonin (PCT)and neutrophil elastase(NE) concentrations.PaO2 and PaCO2 were recorded at T0,T3,T4 for caculation of oxygenation index (OI) and alveolo-arterial oxygen partial pressure difference (PA-a O2 ).Results There were no significant differences in OI and PA-a O2 among the 3 groups( P > 0.05).Plasma concentration of PCT was higher at T1~4in 3 groups,and plasma concentration of NE was higher at T1 in group C than that at T0 ( P < 0.01 ).Plasma concentrations of PCT and NE were lower in groups B1 and B2 than in group C ( P < 0.01).There were no significant differences in plasma concentrations of PCT and NE between groups B1 and B2 ( P > 0.05).Conclusion Breviscapine(0.5,1 mg/kg) can inhibite systemic inflammatory response and attenuate lung injury in children undergoing open heart surgery with CPB.
5.Effects of propofol on apoptosis and invasiveness of human lung cancer cell line A549 cells
Jing ZHANG ; Yanjie SHEN ; Hongxia MEI ; Han LIN ; Jun LI ; Qingquan LIAN ; Wangning SHANGGUAN
Chinese Journal of Anesthesiology 2014;34(9):1079-1081
Objective To evaluate the effects of propofol on apoptosis and invasiveness of human lung cancer cell line A549 cells.Methods Human lung cancer cell line A549 were seeded onto 96-well plates (100 μl/well) and 6-well plates (2 000 μl/well) at a density of 2× 105 cells/ml,and cultured for24 h at 37 ℃ in 5% CO2.The cells were randomly divided into 2 groups (n =60 each) using a random number table:dimethyl sulfoxide (DMSO) group and propofol group (group P).In group P,propofol with the final concentration of 100 μmoYL was added.In group DMSO,0.5% DMSO with the final concentration of 0.5% was added.At 24 h of incubation with drugs,caspase-3 expression was detected by high content screening (HCS); the expression of matrix metalloproteinase (MMP-2) was detected by Western blot analysis.At 0.5,1 and 5 h of incubation,ERK1/2 expression was also measured using Western blot analysis.Results Compared with group DMSO,the expression of caspase-3 was up-regulated,the expression of MMP-2 was down-regulated,ERK1/2 expression was up-regulated at 0.5 of incubation and down-regulated at 1 h of incubation,and no significant change was found in ERK1/2 expression at 5 h of incubation in group P.Conclusion Propofol can promote apoptosis in A549 cells and inhibit invasiveness of human lung cancer cell line A549 cells.
7.Anatomical factor and risk assessment of right internal jugular vein puncture-related damage to vertebral artery at different neck planes in pediatric patients
Kaiming YUAN ; Qinsai WANG ; Enci LIU ; Wangning SHANGGUAN ; Qingquan LIAN ; Jun LI
Chinese Journal of Anesthesiology 2018;38(4):395-398
Objective To evaluate the anatomical factor and risk assessment of right internal jugular vein (IJV) puncture-related damage to the vertebral artery (VA) at different neck planes in pediatric patients.Methods Two hundred and ten pediatric patients of both sexes,aged 6 months-10 yr,with body mass index less than 28 kg/m2,undergoing elective surgery,were enrolled in this study.At the cricoid cartilage plane,supraclavicular area plane and intermediate plane,the right IJVs and VAs were examined using ultrasound.The VA position relative to the IJV,diameters of IJVs and VAs (the diameter ratio of VAs to IJVs was calculated),extent of overlap between IJVs and VAs,and horizontal and vertical distance from VAs to IJVs were recorded,and the risk coefficient of accidental VA puncture was calculated.Results Ninety-seven percent of VAs lay deep and lateral to right IJVs.There was no significant difference in each parameter of VA position relative to IJVs between the three planes (P>0.05).The diameter ratio of VAs to IJVs was decreased with the decreasing neck plane,the horizontal and vertical distance from VAs to IJVs was significantly shortened,the overlapping rate between VAs and IJVs was increased,and the risk coefficient of accidental VA puncture was increased (P<0.05 or 0.01).The vertical distance from VAs to IJVs was not correlated with age,body weight or height (P>0.05).The risk coefficient of VA damage was not correlated with age,body weight or height at the cricoid cartilage plane and intermediate plane (P > 0.05).The risk coefficient of VA damage was positively correlated with the weight of pediatric patients at the supraclavicular area plane (P<0.05,r=0.215).Conclusion Right VAs come nearer IJVs with the decreasing neck plane;the risk of VA damage increases gradually with the lowering of neck planes in pediatric patients.
8. Propofol relieves the subcutaneous chloroquine-induced pruritus in rats via TRPV1 and CB1 receptors of spinal cord
Bingbing HENG ; Danfeng YANG ; Shuyang DAI ; Wangning SHANGGUAN ; Danfeng YANG ; Shuyang DAI
Chinese Journal of Clinical Pharmacology and Therapeutics 2023;28(10):1101-1108
AIM: To explore the possible mechanism of propofol in alleviating pruritus induced by subcutaneous injection of chloroquine in rats. METHODS: The pruritus model of chloroquine in SD rats was established and the administration time was determined. 18 rats with successful pruritus model induced by subcutaneous injection of chloroquine were randomly divided into NS group, I group and P group. Normal saline 80 μL/kg, fat emulsion 80 μL/kg and propofol 0.8 mg/kg were injected through internal jugular vein catheter 5 minutes after subcutaneous injection of chloroquine. Another 6 rats were randomly selected as group C, and the same volume of normal saline as the other 3 groups was injected subcutaneously in the back of the neck and through the internal jugular vein catheter. The rats were killed 16 minutes after the corresponding drugs were injected into the internal jugular vein. The expressions of TRPV1 and CB1 receptors in the spinal cord were detected by Western blot. RESULTS: Compared with NS group and I group, the expression level of TRPV1 receptor in the spinal cord of P group rats was significantly increased (P<0.01), while there was no statistically significant difference between C group, NS group, and I group; The expression level of CB1 receptor was significantly higher than that of group C, NS, and I (P<0.05), while there was no statistically significant difference between group C, NS, and I. CONCLUSION: Propofol can significantly alleviate pruritus caused by subcutaneous injection of chloroquine in rats, which may exert an antipruritic effect by increasing the expression of TRPV1 and CB1 receptors in the spinal cord of rats.
9. Effects of alfentanil on tracheal intubation during tonsillectomy in children: A randomized double-blind study
Jiajia LI ; Mengmeng CHEN ; Ruixian WANG ; Mengmeng HUANG ; Jun LI ; Wangning SHANGGUAN
Chinese Journal of Clinical Pharmacology and Therapeutics 2022;27(2):184-189
AIM: To compare the effects of different doses of alfentanil on tracheal intubation conditions, hemodynamic parameters and recovery quality in children undergoing tonsillectomy. METHODS: Ninety children undergoing tonsillectomy were randomly divided into 3 groups, and received alfentanil 20 μg/kg (A20 group), 40 μg/kg (A40 group) and 60 μg/kg (A60 group) for anesthesiainduction respectively, 30 cases in each group. The remaining anesthesia induction and maintenance protocols were the same. The Helbo-Hansen scores of the three groups were evaluated, and the MAP and HR before anesthesia induction (T0), before tracheal intubation (T1), immediately after tracheal intubation (T2), and 1 min after intubation (T3) as well as the recovery time of spontaneous breathing, eye opening time, extubated time, agitation score in PACU, and adverse drug reactions were recorded. RESULTS: Compared with A20 group, the total values of Helbo-Hansen score and cough scores in group A40 and A60 were lower (P<0.05). Compared with T0, the MAP at T1-T3 were decreased in group A40 and A60, and HR increased at T2 and T3 in group A20 while HR slowed down at T1 in group A40, and at T1-T3 in group A60 (P<0.05). Compared with A20 group, children in group A40 had lower MAP and slower HR at T1-T3, while those in group A60 had lower MAP and slower HR at T1-T3 (P<0.05). The recovery time of spontaneous breathe and extubated time were prolonged in group A60 (P<0.05). CONCLUSION: During the anesthesia induction period of tonsillectomy in children, both afentanil 40 μg/kg or 60 μg/kg combined with propofol 3 mg/kg and rocuronium 0.3 mg/kg can provide satisfactory intubation condition, while the vital signs are more stable during anesthesia induction in afentanil 40 μg/kg group and rapid extubation after operation can be achieved.