1.Comparison of the effects of isoflurane and propofol in conjunction with thoracic epidural block on oxygenation and shunt fraction during one-lung anesthesia
Ying SUN ; Yi FENG ; Baxian YANG
Chinese Journal of Anesthesiology 1996;0(07):-
Objective To compare the effects of isoflurane and propofol on arterial oxygenation and intrapulmonary shunt during one-lung ventilation (OLV) when combined with continuous thoracic epidural block. Methods Twenty-four ASA Ⅰ -Ⅱ patients with normal ventilatory function undergoing elective thoracic surgery were enrolled in this study. Patients with abnormal cardiac, liver or kidney function were excluded. The patients were premedicated with scopolamine 0. 3mg I. M. .Epidural block was performed at T7-8 or T8-9 . An epidural catheter was placed and its position confirmed by epidural 1% lidocaine 5 ml. General anesthesia was induced with propofol l.5mg?kg-1, fentanyl 3?g?kg-1 and vecuronium 0.lmg?kg-1 . Double-lumen catheter was inserted and its correct position was confirmed by a combination of unilateral lung ventilation and auscultation in both supine and lateral position. The patients were mechanically ventilated. Tidal volume was set at 8-10 ml?kg-1, FiO2 = 1, I:E=1:1.5, RR=10-12bpm and PETCO2 was maintained between 35-45 mm Hg. The parameters remained unchanged during one-lung ventilation. The patients were assigned to one of two groups : propofol group and isoflurane group. Anesthesia was maintained with propofol infusion in propofol group and isoflurane inhalation in isoflurane group and BIS was maintained at 45-55. A bolus of 0.5 % ropivacaine 7-9ml was given epidurally followed by 0.5% ropivacaine infusion at a rate of 3-5ml?h-1 in both groups during maintenance of anesthesia. Besides ECG, BP and BIS, continuous cardiac output(CCO Baxter) was monitored during operation. Blood samples were taken from radial artery and pulmonary artery simultaneously before anesthesia when patients were lying supine and breathing spontaneously (T0 ), in lateral position when both lungs were ventilated (T1 ), at 5,15, 30, 60 min of one-lung ventilation(T2-5 ) and when both lungs were ventilated again for 30min(T6) for blood gas analysis. Qs/Qt was calculated.Results (1) The two groups were comparable with respect to demographic data. Propofol infusion was maintained at 4-6 mg?kg-1?h-1 in propofol group and end-tidal isoflurane was maintained between 0.3%-0.5% in isoflurane group. (2) Venous admixture increased significantly at T1 and further increased after T2 and reached its peak at T3(31.1% ?4.2%) in propofol group and at T4 (33.5% ? 7.8% ) in isoflurane group. Shunt fraction was significantly lower in propofol at T4-5 than that in isoflurane group. (3) PaO2 decreased significantly during OLV in both groups, but there was no significant difference in PaO2 between the two groups. Conclusions When combined with thoracic epidural block, intravenous propofol infusion exerts less effect on intrapulmonary shunt than isoflurane inhalation during OLV but there was no significant difference in arterial oxygenation between the two groups.
2.Effect of four different anesthetic techniques on oxygenation and intrapulmonary shunt during prolonged one-lung ventilation
Ying SUN ; Yi FENG ; Baxian YANG
Chinese Journal of Anesthesiology 1994;0(05):-
Objective To investigate the changes in oxygenation and intrapulmonary shunt duringprolonged one-lung ventilation (OLV) and compare the effects of four different anesthetic techniques. MethodsForty ASAⅠ -Ⅱ patients (27 male, 13 female) aged 36-74 yr undergoing prolonged OLV during elective thoracicsurgery were randomly allocated to one of four groups: (1) isoflurane (GI, n = 10); (2) isoflurane + epidural(GIE, n =10); (3) propofol (GP, n = 10); (4) propofol + epidural (GPE, n = 10). Radial artery wascannulated and Swan-Ganz catheter was placed via right internal jugular vein before induction of general anesthesia.In group 2 and 4 an epidural catheter was inserted at T_(7-8) or T_(8-9) and advanced 3 .5-4.0 cm in the epidural spacecephalad. Epidural block was produced by a bolus of 0.5 % ropivacaine 7-9 ml followed by continuous infusion of0. 5 % ropivacaine at 3-5 ml?h~(-1). Anesthesia was induced with propofol 1 .0-1. 5 mg?kg~(-1), fentanyl 3?g?kg~(-1) andvecuronium 0. 1 mg?kg~(-1). A left-sided double-lumen tube was inserted and correct position was confirmed. Thepatients were mechenically ventilated. The ventilation collditions were FiO_2 = 100 %, V_T = 8-10 ml?kg~(-1), I: E =1: 5 and respiratory rate was adjusted to maintained P_(ET) CO_2 at 35-45 mm Hg during both two-lung ventilation(TLV) and OLV. Anesthesia was maintained with isoflurane inhalation in group 1 and 2 or continuous infusion ofpropofol in group 3 and 4 supplemented with intermittent i. v. boluses of fentanyl. MAP, HR, ECG, MPAP,CVP, continuous cardiac output (CCO), BIS and TOF were continuously monitored during anesthesia. BIS was maintained at 45-55. Arterial and pulmonary blood gases were analyzed before induction of anesthesia (T_1), 30min after TLV was started (T_2 ), and 5, 15, 30, 60, 120 and 180 min after OLV was started (T_(3-8)) and 30 minafter TLV was resumed (T_9 ). The Qs/Qt (shunt fraction) was calculated at T_(1-9) Results Qs/Qt was significantlyincreased after induction of general anesthesia and mechanical ventilation and increased further during OLVcompared with the baseline value (T_1) in all four groups. The calculated Qs/Qt values were highest at 15 min (T_4)or 30 min (T_5) of OLV and remained high for 30-60 min and then gradually decreasing. During OLV QS/Qt washigher in group 1 than in the other three groups (P0.05). Cardiac output was significantly higher in group 1 and 2 than thatin group 3 and 4 during OLV. Conclusion During prolonged OLV intrapulmonary shunt tends to decrease withincreasing oxygenation with time, regardless of anesthetic techniques employed. Isoflurane inhalation is associatedwith a signifficant increase in shunt fraction. Combined general and epidural anesthesia may induce greaterhemodynamic changes.
3.The effect of epidural ropivacaine on arterial oxygenation and intrapulmonary shunt during one-lung ventilation
Yi FENG ; Ying SUN ; Baxian YANG
Chinese Journal of Anesthesiology 1994;0(03):-
Objective To determine the effect of of thoracic epidural block on arterial oxygenation and intrapulmonary shunt during one-lung ventilation(OLV).Methods Twenty-four ASA class I - Ⅱ patients undergoing prolonged periods of OLV during elective general thoracic surgery were divided into two groups: general anesthesia group(GA)(n=12) and general anesthesia + epidural block group(GE, n = 12). The patients were premedicated with only scopolamine 0.3mg. Radial artery was cannulated and Swan-Ganz catheter placed via right internal jugular vein under local anesthesia. Epidural block was performed at T7-8or T8-9 and a catheter was inserted and advanced in the epidural space cranially for 3.5-4 cm. General anesthesia was induced with propofol l.5mg?kg-1, fentanyl 3?g?kg-1 and vecuronium 0.1 mg?kg-1. Right or left-sided double-lumen endobronchial tube was placed blindly and the correct position was determined by a combination of unilateral clamping and unclamping and auscultation of the lungs. In GA group anesthesia was maintained with continuous infusion of propofol (150-200 ?g?kg-1?min-1 ) and intermittent IV boluses of fentanyl and vecuronium. BIS was maintained at 45-50. In GE group anesthesia was maintained with infusion of propofol(80 - 120 ?g?kg-1?min-1 ) and epidural block (a loading dose of 0.5% ropivacaine 7-9ml followed by epidural infusion of 0.5% ropivacaine 3-5 ml?h-1) .The patients were mechanically ventilated. VT = 8-10 ml?kg-1, FiO2 = 1, I: R = 1:1.5 and respiratory rate was adjusted to maintain PET CO2 at 35-45 mm Hg. During OLV the above parameters were maintained. ECG, HR, MAP, MPAP, CVP, continuous cardiac output, BIS and TOP were continuously monitored during operation. Blood samples were taken from radial artery and S-G catheter for blood gas analysis at following intervals: (1) during spontaneous breathing when the patients was a wake (baseline); (2) when the patient was placed in lateral position and the two lungs were being ventilated for 30 min(TLV 30 I) ; (3) 5,15, 30 and 60 minduring the course of OLV; (4) the two lungs were ventilated again for 30 min (TLV 30II) andQs/Qt was calculated. Results Venous admixture increased significantly after induction of anesthesia and during mechanical ventilation and increased further during OLV as compared with the baseline(P
4.Effects of thoracic epidural anesthesia on systemic oxygen supply-demand relationship during one-lung ventilation
Yi FENG ; Ying SUN ; Baxian YANG
Chinese Journal of Anesthesiology 1995;0(10):-
Objective To assess the influence of upper thoracic epidural anesthesia (TEA) on systemic oxygen supply-demand relationship during one-lung ventilation (OLV). Methods Twenty ASA Ⅰ-Ⅲ patients undergoing elective esophageal surgery were randomly divided into 2 groups : group Ⅰ general anesthesia (GI n = 10) and group Ⅱ combined general-epidural anesthesia (GIE n = 10). In both groups anesthesia was induced with propofol 1.5-2.0 mg?kg-1, fentanyl 3 ?g?kg-1 and vecuronium 0.1 mg?kg-1. The patients were intubated with double-lumen catheter. Correct positioning was verified by auscultation and fiberoptic bronchoscopy. Anesthesia was maintained with isoflurane (1.5-2.0% ) and intermittent i. v. boluses of fentanyl. BIS was maintained at 45-55 during operation. In GIE group epidural puncture was performed at T7-8 or T8-9. The catheter was advanced 3.5-4.0 ml in the epidural space cephalad. 0.5% ropivacaine was infused at 3-5 ml?h-1 during operation. Anesthetic block levels ranged from T2-4 to T10-12 . Radial artery was cannulated for BP monitoring and blood sampling and Swan-Ganz catheter was positioned in the pulmonary artery via right internal jugular vein. ECG, MAP, HR, CVP, continuous cardiac output index (CCI) and BIS were continuously monitored during anesthesia. Arterial and mixed venous blood samples were obtained before induction of anesthesia (T0 ), 30 min after intubation while two lungs were being ventilated (T1) at 15, 30, 60 and 120 min of OLV (T2-3) and 30 min after TLV was resumed (T6 ) . MAP, CVP, cardiac output index (CI) and arterial and mixed venous blood oxygen content were measured and oxygen supply (DO2) and consumption (VO2) were calculated at each time point. Results In GIE group MAP was significantly lower than that in GI group ( P 0.05). At 15, 30 and 60 min of OLV (T2-4) mixed venous oxygen saturation (SVO2 ) was significantly lower while VO2 significantly higher in group GIE than in group GI. Consequently DO2/ VO2 in group GIE was significantly lower than that in group GI. Conclusion Thoracic epidural anesthesia combined with general anesthesia increases oxygen consumption (VO2) and consequently decreases DO2/ VO2 during OLV.
5.The Role of CNQX in the Different Types of Synaptic Release in Mice
Yi YU ; Ying MEI ; Yi RONG ; Xianguang LIN ; Xiaofei YANG
Progress in Modern Biomedicine 2017;17(27):5219-5222
Objective:To explore the role of 6-CYANO-2,3-DIHYDROXY-7-NITROQUIN OXALINE (CNQX) in different types of synapse secretion.Methods:The spontaneous mEPSCs and eEPSCs at different extracellular concentrations of CNQX in cultured cortical or hippocampal neurons were recorded respectively.Results:The half inhibitory concentration (IC50) of CNQX in evoked neurotransmitter release was significantly higher than that of spontaneous release,indicating that the spontaneous neurotransmitter release was more sensitive to CNQX.No apparent difference was observed between cortical and hippocampal cells,suggesting that the blocking effect of CNQX was similar in different brain regions.Conclusion:CNQX might have differential regulating mechanisms between excitatory spontaneous and evoked neurotransmitter release,but without brain regions specificity.
6.Study on effect of ultramicro-shatter technology on penetrating skin absorption of Pollen Typhae in Zhongtongxiao Cataplasm
Yuehui LI ; Ying YANG ; Yonghua YANG ; Guangxian CAI ; Yankui YI
China Journal of Traditional Chinese Medicine and Pharmacy 2006;0(09):-
Objective:To study the effect of ultramicro-shatter technology on penetrating skin absorption of isorhamnetin-3-O-neohesperidin in Zhongtongxiao Cataplasm.Methods:To apply reformed Frans penetrating skin absorption cell marching extraorgan penetrating skin experiment.HPLC method was used to determine the content of isorhamnetin-3-Oneohesperidin in ultramicro-shatter Zhongtongxiao Cataplasm and in common Zhongtongxiao Cataplasm.Results:The Q-t equation of ultramicro-shatter Zhongtongxiao Cataplasm:Q=3.0382t+47.082,penetrating skin velocity:3.0382(?g.cm2/h);the Q-t equation of common Zhongtongxiao Cataplasm:Q=2.7967t+39.752,penetrating skin velocity:2.7967(?g.cm2/h);Extraction rate of dynamic extracting micro-powder,the ephedrina hydrochloridum,glycyrrhizic acid and glycyrrhizae glycoside were higher than the trdtional cut crude drug decocting.Conclusion:The accumulating osmolality and penetrating skin velocity of isorhamnetin-3-O-neohesperidin in ultramicro-shatter Zhongtongxiao Cataplasm were all better than those in common Zhongtongxiao Cataplasm,it explained that ultramicro-shatter technology accelerate the dissolution of medicine compsitions.
7.Functional and morphological outcome after pyeloplasty for children with unilateral hydronephrosis
Maoxian LI ; Yi YANG ; Ying HOU ; Hui CHEN ; Zhibin NIU
Chinese Journal of Urology 2016;37(6):431-435
Objective To analyze the factors associated with the outcome of pyeloplasty in term of renal function and morphology improvement in children with unilateral ureteropelvic junction obstruction,in order to provide clinical evidence for the treatment of hydronephrosis in children.Methods Clinical data of 174 children who underwent unilateral dismembered pyeloplasty from January 2009 to June 2014 were retrospectively studied.Differential changes in renal function and renal morphology after pyeloplasty were assessed by serial renal scan and ultrasound.On the basis of preoperative split DRF,these patients were divided into three groups:group Ⅰ with DRF ≥40% (n =99),group Ⅱ with DRF 30%-40% (n =29) and group Ⅲwith DRF < 30% (n =46).According to their age at surgery,the children were divided into four groups,including group A aged 1-3 months (n =52),group B aged 3 months-3 years (n =44),groupCaged3-6years (n =37),and group D aged more than 6 years (n =41).Results Inall 174 children,postoperative complication occurred in 7 cases,including urinary tract infection in 6 cases and renal atrophy in 1 case.A significant improvement of both function and morphology was confirmed in most patients (P < 0.01).Patients in group Ⅰ showed stable renal function after operation(DRF 48.46% ±4.80% vs.50.78% ± 5.45%,P < 0.01),of them who underwent pyeloplasty at 1-3 months of age showed the best obvious recovery of renal morphology.Renal function of patients in group Ⅱ recovered obviously and most of them reached to the initial values (DRF 35.18% ± 2.95% vs.43.91% ± 6.89%,P < 0.01).While renal function of patients in group Ⅲ recovered significantly after surgery,most of them failed to restore the initial values(DRF 20.70% ± 6.90% vs.33.78% ± 12.49%,P < 0.01),and among them,the aged 1-3 months group possessed the best recovery.Moreover,the morphological improvement was similar to the functional improvement.The time for hydronephrosis recovered to less than Grade 2 of Society for Fetal Urology(SFU)was 6,24 and over 24 months respectively in group Ⅰ,Ⅱ and Ⅲll,and the renal morphology gradually improved with the increasing duration of follow-up.Conclusions The renal function and morphology of most patients improved significantly after pyeloplasty.Recovery of renal function and morphology after surgery was significantly correlated with the preoperative DRF.Early surgical intervention may improve the function and morphology recovery of the involved renal unit.
8.Compound Gentamicin-Fluorometholone vs Tobramycin-Dexamethasone Eyedrops after Cataract Phacoemulsification:A Clinical Comparative Study
Yi YAO ; Maonian ZHANG ; Yufeng LIU ; Ying WANG ; Bingjian YANG
Chinese Journal of Nosocomiology 1994;0(01):-
OBJECTIVE To investigate influence of compound gentamicin-fluorometholone(GentaFluoro) and tobramycin dexamethasone(TobraDex) eyedrops for treating ocular inflammation after cataract phacoemulsification.METHODS Sixty eyes in 60 patients after cataract phacoemulsification were equally randomized into two groups,such as GentaFluoro group and TobraDex group according to order of operation.Two groups were used respectively the two sort of eyedrops: GentaFluoro and TobraDex were used 6 times per day during first three days after the operation,later four days were four times per day.RESULTS GentaFluoro group and TobraDex group had identical results in controlling inflammation of anterior chamber. CONCLUSIONS The effects of GentaFluoro and TobraDex eyedrops for treating ocular inflammation after phacoemulsification are reliable.
9.Influencing factors on microencapsulation of volatile oil microcapsules
Yi FENG ; Ying ZHANG ; Yin YANG ; Desheng XU
Chinese Traditional Patent Medicine 1992;0(02):-
AIM: To find optimium conditions which would be beneficial to the microencapsulation of the citrus oils microcapsules. METHODS: The influenceing factors,such as the kind and concentration of coating material、plasticizer and antiadherent,ratio of volatile oil to coating material were investigated using appearance,encapsulation efficiency and volatile oil loading as evaluation parameters. RESULTS: The microcapsules prepared by optimium conditions were smooth and possessed encapsulation efficiency of 84.50%,volatile oil loading of 28.32%. CONCLUSION: The optimum conditions are chosen reasonably to help increase the stability of volatile oils microcapsules.
10.Quality evaluation method of mandarin oil microcapsules
Yi FENG ; Ying ZHANG ; Yin YANG ; Desheng XU
Chinese Traditional Patent Medicine 1992;0(09):-
AIM: To establish a method of evaluating totally the quality of mandarin oils microcapsules. METHODS: The quality evaluation method of the mandarin oils microcapsules was investigated according to the appearance shape,in-vitro release,compressibility index and microcapsule dissociative film's physical characters research. RESULTS: The method to investigate compressibility index,hydroscopicity and the capability of penetrating oxygen and resisting tension was established. CONCLUSION: These methods can evaluate the quality of essential oils microcapsules rather exactly.