Objective To compare the influences of sulfentanyl or fentanyl combined with midazolam on respiratory function in slow induction of anesthesia.Methods Forty ASA Ⅰ-Ⅱ patients were divided into two groups.Anesthesia was induced with midazolam 0.03mg/kg in both groups,and fentanyl 2?g/kg(i.v.)was given in fentanyl group or sulfentanyl 0.2?g/kg(i.v.)in sulfentanyl group.Five minutes later,2ml of 1% decicaine was administered by cricothyroid membrane puncture to facilitate the intubation.Respiratory indexes(respiratory frequency,VT,MVV,PETCO2,SPO2),circulatory indexes(MAP,HR)and sedation level were measured before and 1,2,3,4,5 minute(s)after injection of drugs,at cricothyroid membrane puncture,and pre-and post-intubation.Results Patients showed respiratory depression(respiratory frequency was reduced)in both groups 2 minutes after injection of drugs.However,respiratory frequency was decreased more markedly in fentanyl group than that in sulfentanyl group.Ten out of 20 patients were obliged to receive breathing intervention in fentanyl group,but two in sulfentanyl group.Conclusion In combination with midazolam,sedative effect of sulfentanyl is stronger than that of fentanyl in equivalent analgesic dose,but with less respiratory depression.Sulfentanyl may be more suitable for slow induction of anesthesia.

Thirty patients, randomly assigned into three groups, received bolus injection of ketamine 0. 5mg/ kg,midazolam 40ug/kg and one of the three narcotics: fentanyl 3ug/kg (group F ) or sufentanil 0. 4ug/kg (group S)or dihydroetorphine 0. 3ug/kg(group D)just before incision, and then a constant infusion of ketamine 0. 8mg/kg, midazolam 40ug/kg and fentanyl 3ug/kg (or sufentanil 0. 4ug/kg, or dihydroetorphine 0. 3ug/kg)mixture in 100ml normal saline at a rate of 3ml/min for 30 min in beginning, and 1 - 1. 5ml/min thereafter for maintenance. The infusion of narcotics and midazolam was terminated about 45min, and he tamine 15min prior to the end of surgery. Blood pressure and heart rate were all stable,with recovery time shortest in group S (6. 5min ) and longest in group D (12. 5min). Anesthesia were satisfactory in all the patients,except one in group D. It is concluded that this combination of tv anesthetics may be simple and effective and can be considered as an alternative anesthesia technique in the management of mass casualties.

Objective: To observe changes of EEG parameters,including bispectral index (BIS),spectral edge frequency(SEF)and median frequency(MF),and the association between the changes of EEG variables and hemodynamic responses to intubation during induction by propofol with or without fentanyl. Method: Twenty-four ASA grade Ⅰ-Ⅱ patients were randomly assigned to double-blindly receiving intravenous propofol/normal saline (group P, n=12)or propofol/fentanyl 2?g/kg(group PF,n=12), respectively. Intubation was performed following 5-min maintenance of BIS within 45?5. EEG and hemodynamic variables were recorded at endpoints of pre-induction, pre-intubation and post-intubation. Result:In group P,blood pressure and heart rate at post-intubation were significantly increased compared with pre-induction value(P

Objective To investigate the analgesic effect and safety of intravenous flurbiprofen axetil combind with fentanyl and propofol on coloscopy.Methods Ninety patients undergone coloscopy were randomly assigned into three groups according to different analgesics received(30 in each,groupⅠ: fentanyl 1?g/kg;groupⅡ flurbiprofen axetil combined with fentany 0.5?g/kg;group Ⅲ: fentany 0.5?g/kg).Patients in group Ⅱ received intravenous flurbiprofen axetil 1mg/kg 10min before examination.All patients were given intravenous midazolam 0.02mg/kg 2mins before examination,however patients in group Ⅰ received intravenous fentanyl 1?g/kg followed by intravenous propofol 0.5-1mg/kg,whereas patients in group Ⅱ and Ⅲ received intravenous fentanyl 0.5?g/kg followed by equal dosage of propofol.Propofol was administrated according to patients' reaction during examination.After the examination all patients were transferred to recovery room.BP,HR and SpO2 were measured before and after drug administration,when the coloscope reached the splenic flexure of the colon and after the examination.Dosage of propofol and fentanyl,duration of coloscopy,side effects and patients' memory of pain during examination were recorded.Results Propofol dosages of the three groups were 82.0?23.8mg,73.0?25.0mg and 108.2?36.5mg,respectively.Propofol dosage of group Ⅲ was much larger than that of groups Ⅰand Ⅱ(P0.05).Dizziness and nausea occurred in 17 patients in group Ⅰ when they left the recovery room,whereas the same side effects only appeared in one patient in group Ⅱ and 3 patients in group Ⅲ,respectively.It was shown by follow-up that all patients of the three groups had no memory of pain.Conclusion Intravenous flurbiprofen axetil may strengthen intraoperative analgesia during coloscopy,reduce the dosage of fentanyl and propofol,and decrease the side effects of anesthesia.

Objective To study the effects of acute hypervolemi c hemodilution (AHH) on the coagulation and cardiac function in elderly surgical p atients. Method Sixty surgical patients, aged 60 to70, ASA Ⅰ~ Ⅱ, were randomly divided into three groups (n=20 for each group). 6% HES 50 0~1000ml was infused in a rate of 20ml/min during vasodilation with isoflurane i nhalation (group 1), nitroglycerin (group 2), or nicardipine (group3) with the a id of an intravenous injection pump. The blood coagulation and cardiac functions were observed during hemodilution. Results No significant diff erence was found among the three groups on cardiac function and coagulation func tion during 500ml 6% HES infusion. When the volume of infusion was over 1000ml, the parameters of cardiac function increased and those of coagulation decrease d significantly (P

Objective To study the effects of total intravenous anesthesia and combined inhalation and intravenous anesthesia on arousing time and recovery quality in rectifying surgery of scoliosis. Methods Forty patients (ASAⅠ-Ⅱ) were divided randomly into total-intravenous anesthesia group and combined inhalation and intravenous anesthesia group (n=20 each). Target controlled infusion (TCI) with propofol (2-4?g/ml) was used for maintenance in total intravenous anesthesia group, while isoflurane (0.8%-1.5%) and nitrous oxide (50%) were used in combined inhalation and intravenous anesthesia group. TCI remifentanyl (2-6ng/ml) was used for maintenance in both groups. Results Arousing time were 19.7?5.1min in total intravenous anesthesia group, but 11.9?3.3 min in combined inhalation and intravenous anesthesia group (P

Objective To determine the threshold of stroke volume variation (SVV) in determining the volume expansion responsiveness during fluid therapy in patients ventilated with different tidal volumes. Methods Fifty ASA Ⅰ or Ⅱ patients aged 20-75 yr undergoing elective gastrointestinal surgery under general anesthesia were randomly divided into 2 tidal volume groups (n = 25 each):group Ⅰ VT 8 ml/kg (group V1) and group ⅡVT 10 ml/kg (group V2). Radial artery was cannulated and connected to Vigelo monitor for continuous monitoring of cardiac index (CI), stroke volume index (SVI), systemic vascular resistance index (SVRI) and SVV. Internal jugular vein was cannulated for CVP monitoring. Anesthesia was induced with milazolam, propofol, fentanyl and rocuronium and maintained with intravenous propofol and remifentanil infusion. BIS was maintained at 40-50 during anesthesia. The patients were intubatel and mechanically ventilated (VT 8/10 ml/kg, RR 8-12 bpm, oxygen flow 2 L/min). 6％ HES 130/0.4 7 ml/kg was infused iv at a rate of 0.4 ml·kg-1 ·min-1 after induction of anesthesia. MAP, HR, CVP, CI, SVV, SVI and SVRI were recorded before and at 3 min after fluid therapy. The changing rate of SVV (△SVV) and CI (△CI) were calculated. The criterion for effective volume expansion was △CI 15%. The ROC curve for SVV in determring the volume expansion responsiveness was plotted and the diagnostic threshold was determined. Results ROC curve showed that the diagnostic threshold of SVV was 10.5 % in group V1 and 13.5% in group V2. The sensitivity and specificity in determining effective volume expansion were 93.3 % and 75.0 % in group V1 and 87.5 % and 85.7 % in group V2 respectively. The area under the curve for SVV and 95% confidence interval (CI) were 0.946 (0.860-1.031) in group V1 and 0.951 (0.868-1.034) in group V2. △SVV was negatively correlated with △CI in group V1 (=0.553) and V2 (= 0.602). Conclusion The threshold of SVV in determining the volume expansion responsiveness during fluid therapy is 10.5% and 13.5% in mechanically ventilated patients with tidal volume of 8 and 10 ml/kg respectively.

Objective To investigate the effects of different doses of propofol on cognitive function after chronic cerebral ischemia-induced injury in aged rats. Methods Eighty male SD rats, aged 18 months, weighing 400-500 g, were randomly divided into 4 groups ( n = 20 each): shame operation group (group S), chronic cerebral ischemia group (group I), two propofol groups (groups P1 and P2 ). The chronic cerebral ischemia was induced by permanent occlusion of bilateral common carotid arteries. On 1 day after operation, intraperitoneal normal saline 2.5 ml was injected twice a day for7 consecutive days in groups S and I, and intraperitoneal propofol 10 and 50 mg/kg in 2.5 ml of normal saline were injected twice a day for 7 consecutive days in groups P1 and P2 respectively. On 3rd and 33rd days after the last injection (T1.2), 10 rats in each group underwent Morris water maze test to assess the cognitive function. After the test was completed, the rats were sacrificed and the hippocampi were removed and sliced (450-500 μm thick). Schaffer lateral branch in CA1 region was stimulated to induce long-term potentiation (LTP). Results Compared with group S, the escape latency was significantly prolonged, the number of animals' swimming across the platform, the ratio of the swimming time spent in the forth quadrant to the total swimming time, and the success rate of LTP induction were significantly decreased at T1 and T2 in groups I, P1 and P2 (P ＜ 0.05). Compared with group I, the escape latency was significantly prolonged, the number of animals' swimming across the platform, the ratio of the swimming time spent in the forth quadrant to the total swimming time, and the success rate of LTP induction were significantly decreased at T1 in groups P1 and P2, and at T2 in group P2 ( P ＜ 0.05). Conclusion Propofol aggravates the damage to cognitive function while it attenuates the chronic cerebral ischemia-induced injury in aged rats, especially the high dose.

Objective To investigate the effect of the mascarinic acetylcholine receptor (mAChR) agonist Oxo-tremorine-M (Oxo-M) on glycinergic spontaneous inhibitory postsynaptic currents (sIPSCs) and micro-inhibitory postaynaptic currents (mIPSCs) in lamina Ⅱ neurons in the spinal cord of rats. Methods Glycinergic IPSCs (sIPSCs and mIPSCs) in lamina Ⅱ neurons of spinal slices were recorded using the whole-cell voltage-clamp method. The non-selective mAchR ngonist Oxo-M was applied through bath perfusian. The effects of Oxo-M 1, 3, 5 and 10 μmol/L on sIPSCs and mIPSCs were examined. Results Oxo-M at the concentrations of 3-10 μmol/L significantly increased the frequency of sIPSCs without changing the amplitude in 16 lamina Ⅱ neurons tested. Interestingly, when the concentration of Oxo-M was increased to 10 μmol/L, the potentiating effect of Oxo-M on the frequency of slPSCs was decreased as compared with 3 μmol/L Oxo-M in the above 16 neurons. The slPSCs were completely abolished by 2 μmol/L strychnine. Atropine, the specific mAChR antagonist, completely blocked the effect of Oxo-M on the frequency of sIPSCs. In 9 additional lamina Ⅱ neurons, 1-10 μmol/L oxo-M failed to alter significantly the frequency and amplitude of glycinergic mIPSCs. Conclusion Activation of mAChRs in the somatodendritic site of glycinergic interneurous increases the synaptic glycine input to spinal dorsal horn neurons, but not in a dose-dependent manner.

Objective To explore the effect of thoracic paravertebral block (TPVB)versus general anaesthesia (GA)on breast surgery.Methods Public databases were searched including Med-line and Springer,in order to collect randomized controlled trial (RCT)of the effects of TPVB and GA on breast surgery.The data of the meta-analysis was analyzed by Stata 11.0 and RevMan 5.1. Results There were five RCTs consisting of 295 patients with breast surgery,group TPVB (n=148) and group GA (n=147).The overall results of meta-analysis showed that pain scores of group TPVB were higher than those of group GA for breast surgery patients (SMD 2.59,95%CI 1.10-4.08),but the postoperative analgesic consumption and postoperative nausea or vomiting of group TPVB were lower than those of group G (RR 0.23,95%CI 0.15-0.37 and RR 0.27,95%CI 0.12-0.61,respec-tively).Conclusion Compared with GA,TPVB has higher pain scores,lower postoperative anal-gesic consumption and postoperative nausea or vomiting.