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Adsorption of fentanyl in different materials of analgesia pump reservoir

The Journal of Clinical Anesthesiology.2010;(12):1064-1065.

Objective To observe the adsorption of fentanyl by different materials of the analgesic pump reservoir. Methods The concentrations of fentanyl in pump reservoirs,which were made by different materials （glass,silica gel,polyvinyl chloride,non polyvinyl chloride） were detected with the time by high-performance liquid chromatography. The measurement was repeated three times.Results Fentanyl concentration in these reservoirs decreased with time,which decreased 6.3% in silica gel reservoir （P0.05）,2.7% in non polyvinyl chloride（P0.05）,1.5% in PVC and 1.2% in glass bottles.Conclusion Fentanyl citrate will be adsorbed by different materials of analgesia pump reservoir within 72 h,and the adsorption sequence was silica capsule,non polyvinyl chloride,polyvinyl chloride,and glass bottles.

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The influence of dexmedetomidine on sedation and requirment of propofol during anesthesia induction

Yanna SI ; Tao SHI ; Hongguang BAO

The Journal of Clinical Anesthesiology.2010;(12):1053-1055.

Objective To evaluate the influence of dexmedetomidine（Dex） on sedation and requirement of propofol during anesthesia induction. Methods Thirty patients（ASA Ⅰ or Ⅱ） undergoing selective operation were randomly divided into 2 groups：Dexmedetomidine group （group D,n=15） or control group （group C,n=15）. Patients in the group D received 1 μg/kg dex diluted to 10ml over 10 min by pumped infusion and patients in the group C was simply recieved normol saline at the same way.Twenty minutes after administrating the drug,patients in both groups were pumped propofol at the speed of 0.4 mg·kg-1·min-1. When holding up jaw without movement,patients received 1 μg/kg fentanyl and 0.6 mg/kg rocuronium,and endotracheal intubated 1.5 minutes later. RE,SE,Ramsay sedation scale of the patients were recorded before（T0） and after 5,10,20 minutes（T1-T3） of drug adminstration.The minimum dose and total dose of propofol during induction were recorded.Results Compared with group C and T0,RE and SE in group D decreased obviously at T1-T3 （P0.01）,while Ramsay sedation scale rised significantly （P0.01）. Compared with group C,the minimum dose and the total dose of propofol decreased obviously in group D during induction （P0.01）.Conclusion Dexmedetomidine causes sadetive without respiratory depression,and has the propofol sparing effect during anesthesia induction.

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Preemptive analgesia effect of parecoxib sodium in patients with cervical carcinoma undergoing radical resection under laparoscopy

La WEI ; Fufen MENG ; Feng YANG

The Journal of Clinical Anesthesiology.2010;(12):1037-1039.

Objective To observe the preemptive analgesia effect of parecoxib sodium in patients undergoing laparoscopic cervical carcinoma radical resection.Methods Seventy patients undergoing laparoscopic cervical carcinoma radical resection were randomly divided into 2 groups with 35 cases each. Parecoxib sodium 40 mg was injected intravenously 10 min before operation and repeatedly given every 12 h. Equal volume physiological saline was given at same time in the control group. Two groups received postoperative PCIA with morphine. The numerical rating scale （NRS） was used to rate pain intensity at following time points：immediately after extubation,2,6,12,18,and 24 h after operation. Twenty-four hour morphine consumption and side effects were recorded.Results The NRS rating of pain at each time point in the parecoxib group was significantly lower than that of the control group （P0.05）,and the total morphine consumption （10.4±7.6）mg was less than the control （17.7±8.9）mg （P0.05）; correspondingly,the incidences of nausea,vomiting and drowsiness were less,and the number of patients left bed for activity was increased in the parecoxib group than those in the control one （P0.05）. Conclusion Preoperative parecoxib sodium 40 mg can improve the analgesic effect of PCIA with morphine,and reduce morphine consumption and the incidences of side effects.

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Relationship between Bispectral index,Narcotrend index and the predicted effect-site concentration at different clinical end-point during target-controlled infusion of propofol

Hongwei YANG ; Haobo YANG ; Qulian GUO

The Journal of Clinical Anesthesiology.2010;(12):1026-1028.

Objective To explore the relationship between Bispectral index （BIS） values,Narcotrend index （NTI） values and the predicted effect-site concentration （EC）during target-controlled infusion of propofol. Methods In 30 patients during target-controlled infusion of propofol,the propofol infusion was set at an initial EC of 0.5 mg/L and increased by 0.5 mg/L steps every 5 min until 5 min after the modified observer＇s assessment of alertness/sedation scale（OAA/S） values reached zero. The predicted EC of propofol,the values of NTI,NTS and BIS were recorded,and the sedation level were examined by the modified OAA/S every 20 s. The predicted EC of propofol and the values of BIS and NTI at LVC and LOC in 5%,50% and 95% of patients were calculated. Results There were good linear correlations between BIS,NTI and the predicted EC of propofol （r2=0.787,0.792）.The predicted EC of propofol at LVC in 5%,50% and 95% of patients were 1.2,1.8 and 2.5 mg/L,respectively. The values of BIS and NTI at LVC in 5%,50% and 95% of patients were 78.2,68.2 and 58.2; 73.9,64.9 and 55.8,respectively.The predicted EC of propofol at LOC in 5%,50% and 95% of patients were 1.6,2.6 and 3.5 mg/L,The values of BIS and NTI at LOC in 5%,50% and 95% of patients were 74.6,58.2 and 41.5,66.2,55.8 and 45.3,respectively. Conclusion During target-controlled infusion of propofol,LVC and LOC occurred within a definite range of predicted effect-site concentrations.There were the good linear correlations between BIS,NTI and the predicted EC of propofol.NTI may be more useful than BIS in predicting LVC and LOC because of the smaller range of values for the two clinical end-points.

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The influence of sulfentanil with various doses on the Bispectral index and Narcotrend index under the steady-state anestheaia of sevoflurane

Rongning WANG ; Canlin SUN ; Qulian GUO

The Journal of Clinical Anesthesiology.2010;(12):1017-1019.

Objective To observe the effects of sulfentanil with various doses on the Bispectral index and Narcotrend index without nociceptive stimulus under the sevoflurane anesthesia.Methods Forty-eight ASA Ⅰ or Ⅱ patients undergoing gynecological operations were randomly divided into four groups（n=12）.All patients were induced with sevoflurane,the end-tidal concentrations of sevoflurane in all groups were adjusted to 1.0 MAC after tracheal intubation. Fifteen minutes later,sufentanil was injected in groups of B,C,D with the doses of 0.25,0.5,1.0 μg/kg respectively. The observations were finished when the values of Bispectral index and the Narcotrend index reached the minimum over 5 min. The values of Bispectral index and the Narcotrend index were recorded every minutes after the sufentanil injection. Results Among all groups,the BIS,Narcotrend values and tmax produced no statistical difference. Compared with the time when conscious lost,BIS and Narcotrend values were significantly lower when sevoflurane anesthesia reached steady state in all groups. The values of BIS and Narcotrend were significant lower after the injection of sufentanil in the groups of B,C and D（P0.05）. Conclusion Under the sevoflurane anesthesia with the steady end-tidal concentration of 1.0MAC,sufentanil could reduce the values of BIS and Narcotrend index without nociceptive stimulus without distinction among different doses.

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Comparison of general anesthesia with spinal anesthesia for the mortality in rats with fat embolism

Qingxia MA ; Aizhong WANG ; Wei JIANG

The Journal of Clinical Anesthesiology.2010;(12):1085-1086.

Objective To compare the influence of general anesthesia and spinal anesthesia on the mortality in rats with fat embolism.Methods Three hundred and seventy five rats were randomly assigned to receive general anesthesia （group GF,n=125）,spinal anesthesia （group SF,n=125）,or no anesthesia （group F,n=125）.Rats were injected with a half lethal dose of fat from caudal vein 20 min after anesthesia induction. The mortality was recorded at 2,8,12,and 24 h after fat injection,respectively.Results The mortality was lower in group GF than those in groups SF and F （P0.05）,while there was no statistical difference between group SF and group F.Conclusion The mortality in rats with fat embolism under general anesthesia was lower than that under spinal anesthesia.

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Positioning of double lumen endobronchial tube by three combined ethods with fibroptic bronchoscope

Qingliang WANG ; Yanli ZHAO ; Xiaoming LIU

The Journal of Clinical Anesthesiology.2010;(12):1059-1060.

Objective To observe the correctly positioning rate of left-sided double lumen endobronchial tube by combined adjustment of auscultation,PETCO2 and airway pressure changes.Methods Sixty adult patients undergoing thoracic surgery were intubated with Robertshaw DLTs. DLT position is checked and adjusted by fiberoptic bronchoscope（FOB）. Results In the supine position,successful intubation is 57 cases by three combined methods,one of cases is shallower,two of cases are deeper,satisfactory rate is 95 percents;In the lateral decubitus position,successful intobution is 56 cases by three combined methods,two of cases is shallower,two of cases are deeper,satisfactory rate is 93.4 percents.Conclusion Three combined methods that are simple,reliable can be used repeatedly during postural changes without increasing the opportunities for injury,it is clinically a very good approach,but the absolute scope of safety is very small,FOB is necessary for positioning.

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The effects of TIVA combined epidural anesthesia and postoperative epidural analgesia on cellular immune function and erythrocytes glycometabolism in the patients undergoing thoracic surgery

Xiongxiong PAN ; Xiaokun ZHANG ; Yanning QIAN

The Journal of Clinical Anesthesiology.2010;(12):1029-1031.

Objective To investigate the effects of thoracic epidural anesthesia and analgesia on cellular immune function and erythrocytes glycometabolism in the patients undergoing thoracic surgery.Methods Forty esophageal carcinoma patients,classified as ASA Ⅰ or Ⅱ,scheduled for elective thoracic surgery were randomly divided into two groups with 20 cases each：group A underwent general anesthesia plus thoracic epidural anesthesia （TEA） during thoracic surgery and received patient-controlled epidural analgesia （PCEA） with fentanyl and ropivacaine postoperatively;group B received general anesthesia during thoracic surgery and patient-controlled intravenous analgesia （PCIA） postoperatively. Venous blood samples were collected for the measurement of Th1,Th2 and the activities of PFK,G-6PD and AR before the induction（T0）,2 h after the initiation of the incision（T1）,and 4 h（T2）,24 h（T3）and 48 h（T4）after surgery. Results The Th1/Th2 ratio in both groups were decreased significantly after completion of surgery compared with baseline levels （P0.05）. At T2,T3 and T4 the Th1/Th2 ratio in group A were higher than group B. Compared with these before operation,the activity of PFK was decreased significantly and the activities of G-6PD and AR in erythrocytes were increased markedly at T3 in group B（P0.05）.But erythrocytes PFK,G-6PD and AR activity slightly changed in group A.Conclusion These findings show that thoracic epidural anesthesia and PCEA may inhibit Th0 cells to differentiate into Th2 cells,protect cellular immune function and moderate erythrocyte glucose metabolism changes.

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Effects of dexmedetomidine on acute lung injury induced by hind limb ischemia-reperfusion in rats

Nannan HAO ; Zhili LEI ; Hui CHEN

The Journal of Clinical Anesthesiology.2014;(6):602-605.

Objective To explore whether dexmedetomidine(Dex)could mitigate acute lung in-jury induced by hind limb ischemia reperfusion(I/R).Methods One hundred and twenty SD rat weigh-ting 250-300 g were allocated to receive hind limb I/R,I/R plus Dex (25 μg/kg Dex was intraperitoneal in-jection 30 min before ischemia)and norm control group,and each group was further divided into five sub-groups:before operation and 4 h ischemia followed by 0,1,3 and 6 h reperfusion.After euthanization,lung W/D weight ratio,PaO2 ,SOD,MDA and TNF-α were determined.Results Compared with group C, hind limb I/R injury significantly increased serum TNF-α concentration and W/D ratio,with significantly decreasing PaO2 level at any time of reperfusion in the group I/R,the concentration of MDA increased and the SOD activity decresed at 1,3,6 h of reperfusion.Conversely,W/D ratio as well as the concentration of TNF-αin the serum of the I/R plus group Dex were significantly lower than those of the I/R at 6 h of reperfusion,PaO2 level increased respectively;the concentration of MDA decresed at 1,3,6 h of reperfusion and the SOD activity increased at 3,6 h of reperfusion in I/R plus group Dex.Conclusion Dex mitigates a-cute lung injury induced by unilateral hind limb I/R in rats.The mechanisms may involve attenuating oxida-tive stress and inhibiting inflammatory response.

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Effect of μ-opioid receptor agonist on acute lung injury induced by trauma-LPS two hits in rat model

Gong CHEN ; Xugui CHEN

The Journal of Clinical Anesthesiology.2014;(6):594-597.

Objective To explore the effect of μ-opioid receptor agonist on acute lung injury in-duced by trauma-LPS two hits in rat model.Methods Thirty-two aduld SD rats,were randomized in four groups(n=8):normal control group(group N),blank control group(group B),DAMGO group (group D)and DAMGO+CTOP group(group DC).A rat model was made by intraperitoneal injection of LPS at 6 hours after fracturing bilateral thighbone.Group N didn’t receive trauma and LPS,only anesthesia.The rats in group D received 200 μg/kg of DAMGO,group DC received 600 μg/kg of CTOP and 200 μg/kg of DAMGO,group B obtained the same amount of saline.6 hours after treat-ment,the arterial blood was collected for blood gas analysis,the lungs was harvested to observe lung tissue pathology change and dry-weight/wet-weight ratio,and the levels of MDA,TNF-α,IL-6,SOD activities in lung tissue were determined.Results The results of pathological observation showed that there was obvious inflammatory reaction in lung tissues after two-hits.Compared with group D, PaO2 ,pH and dry-weight/wet-weight ratio were significantly lower in group B and group DC(P <0.05),The score of Smith were significantly increased(P <0.05).The levels of MDA,TNF-α,IL-6 in lung tissue were significantly reduced in group D than those in group B and group DC(P <0.05), SOD activities in group D were significantly higher than those in group B and group DC(P <0.05 ). Conclusion μ-Opioid receptor DAMGO agonist has protective effect on acute lung injury induced by trauma-LPS two hits in rat model.

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