ObjectiveTo compare the neuromuscular blockade induced by different target effect-site concentrations (Ces) of rocuronium in female patients.MethodsOne hundred and twenty ASA Ⅰ or Ⅱ female patients,aged 40-55 yr,with body mass index 18-22 kg/m2,scheduled for elective thyroid or breast surgery under general anesthesia,were included in the study.Anesthesia was induced with midazolam 0.1 mg/kg and fentanyl 5 μg/kg.Target-controlled infusion of rocuronium was started to facilitate tracheal intubation as soon as the patients lost consciousness.The patients were randomly divided into 4 groups ( n =30 each):A,B,C and D groups.In groups A,B,and C,the target Ce of rocuronium was set at 3.5 μg/ml during induction of anesthesia and at 1.0,1.2 and 1.4 μg/ml respectively during maintenance of anesthesia.In group D,the target Ce of rocuronium was set at 3.8 μg/ml during induction of anesthesia and at 1.2 μg/ml during maintenance of anesthesia.The onset time (time from the beginning of target-controlled infusion of rocuronium to T1 =5％ of the control twitch),recovery time (when T1 retumed to 25 ％ of the control twitch),recovery index (the time for Tt to return from 25 ％ to 75 ％of the control twitch),and the total amount of rocuronium consumed during operation were recorded.The intubation conditions and degree of muscle relaxation during operation were assessed.ResultsNeuromuscular block during operation was significantly better and the rate of satisfactory neuromuscular block was significantly higher in groups B,C and D than in group A ( P ＜ 0.05).Onset time was significantly shorter in group D than in groups A,B and C ( P ＜ 0.05).Compared with group C,the total amount of rocuronium consumed during operation,recovery time and recovery index were significantly decreased in groups A,B and D ( P ＜ 0.05).There was no significant difference in the total amount of rocuronium consumed during operation,recovery time and recovery index between groups B and D (P ＞0.05).ConclusionRocuronium with the target Ce set at 3.8 and 1.2 μg/ml during induction of anesthesia and mainterance of anesthesia respectively can provide satisfactory neuromuscular block,is helpful to the recovery of neuromuscular block and is more suitable for female patients.

Objective To compare HC video-laryngoscope with Macintosh laryngoscope for tracheal intubation.Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with body mass index 19-27 kg/m2,Mallampati grade Ⅰ-Ⅱ,undergoing elective surgery,were randomly divided into 2 groups (n =30 each):HC video-laryngoscope group (group H) and Macintosh laryngoscope (group M).After induction of anesthesia,the patients underwent orotracheal intubation assisted by HC video-laryngoscope in group H,and by Macintosh laryngoscope in group M.The glottic exposure time,intubation time,Cormack-Lehane grade,the number of pressing the cricoid and intubation-related complications were recorded.Results The rate of satisfactory glottic exposure was significantly higher and the number of pressing the cricoid was smaller in group H than in group M (P ＜ 0.05).There was no significant difference in the glottic exposure time,intubation time and incidence of intubation-related complications between the two groups (P ＞ 0.05).Conclusion The efficacy of tracheal intubation guided by HC video-laryngoscope is better than that guided by Macintosh laryngoscope.

Objective:To investigate the effect of combined use of midazolam and remifentanil without muscle relaxant on tracheal intubation in female patients undergoing breast surgery.Methods:A retrospective analysis was performed on 40 female patients with breast disease who underwent tracheal intubation and general anesthesia at The First Affiliated Hospital of Zhengzhou University between January 2023 and June 2023. These patients were divided into a control group ( n = 20) and an observation group ( n = 20) based on whether muscle relaxants were applied at the time of intubation. The control group received intravenous rocuronium bromide, whereas the observation group did not use muscle relaxants. Both groups were intravenously administered midazolam (0.1 mg/kg) and remifentanil (4 μg/kg) prior to tracheal intubation. The intubation conditions were evaluated based on factors such as the ease of inserting the laryngoscope and the patient's response to intubation, including coughing. Results:There were no statistically significant differences in age, height, and body mass between the two groups (all P > 0.05). The excellent rate of intubation conditions was significantly lower in the observation group compared with the control group [45% (9/20) vs. 85% (17/20), χ2 = 7.03, P = 0.008). The good rate of intubation conditions was significantly higher in the observation group compared with the control group [40% (8/20) vs. 5% (1/20), χ2 = 7.03, P < 0.05]. There was no statistically significant difference in the excellent and good rates of intubation conditions between the observation and control groups [85% (17/20) vs. 90% (18/20), χ2 = 0.23, P > 0.05]. No significant difference in intraoperative awareness score was observed between the observation and control groups [(2.59 ± 0.44) points vs. (2.61 ± 0.31) points, P > 0.05]. None of the patients in either group exhibited any episodes of arrhythmias. Furthermore, no adverse reactions such as muscle stiffness, nausea, vomiting, or skin itching were observed in either group following the surgical procedure. Conclusion:Without the use of muscle relaxants, intravenous administration of midazolam at 0.1 mg/kg and remifentanil at 4 μg/kg for tracheal intubation in female patients undergoing breast surgery can offer excellent intubation conditions, ensuring that the patient remains unconscious throughout the surgical procedure.

Background: The mechanism of peripheral axon transport in neuropathic pain is still unclear. Chemokine ligand 13 (CXCL13) and its receptor (C-X-C chemokine receptor type 5, CXCR5) as well as GABA transporter 1 (GAT-1) play an important role in the development of pain. The aim of this study was to explore the axonal transport of CXCL13/CXCR5 and GAT-1 with the aid of the analgesic effect of botulinum toxin type A (BTX-A) in rats. Methods: Chronic constriction injury (CCI) rat models were established. BTX-A was administered to rats through subcutaneous injection in the hind paw. The pain behaviors in CCI rats were measured by paw withdrawal threshold and paw withdrawal latencies. The levels of CXCL13/CXCR5 and GAT-1 were measured by western blots. Results: The subcutaneous injection of BTX-A relieved the mechanical allodynia and heat hyperalgesia induced by CCI surgery and reversed the overexpression of CXCL13/CXCR5 and GAT-1 in the spinal cord, dorsal root ganglia (DRG), sciatic nerve, and plantar skin in CCI rats. After 10 mmol/L colchicine blocked the axon transport of sciatic nerve, the inhibitory effect of BTX-A disappeared, and the levels of CXCL13/CXCR5 and GAT-1 in the spinal cord and DRG were reduced in CCI rats. Conclusions BTX-A regulated the levels of CXCL13/CXCR5 and GAT-1 in the spine and DRG through axonal transport. Chemokines (such as CXCL13) may be transported from the injury site to the spine or DRG through axonal transport. Axon molecular transport may be a target to enhance pain management in neuropathic pain.