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Effects of Panax Pseudo-ginseng on the Liver in SMAO Shocked Rabbits

The Journal of Clinical Anesthesiology.2000;16(12):613-614.

Objective:To study the effects of panax pseudo-ginseng on the liver in rabbits suffered from SMAO shock.Methods:20 rabbits were divided randomly into control group and treatment group. SMAO (superior mesenteric artery occlusion)shock model was made by occluding the superior mesenteric artery for 1 hour. In treatment group, 200 mg/kg of panax pseudo-ginseng diluted in normal saline was given intravenously. In control group, the same volume of normal saline without drug was given intravenously. Mean blood pressures and 4-hour survival rates were monitored during the study. Biopsies from the left lobe of the liver were taken from all animals at the end of the study for microstructure study using electro-microscope.Results:Compared to control group, animals in the treatment group had a significant prolonged survival time and improved mean blood pressures. Impairment of hepatocytes in treatment group was significantly reduced. Conclusion: Panax pseudo-ginseng has benefit effects on the liver. This plays an important role in prolonging the survival time of the rabbits with SMAO shock.

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A Clinical Observation of the Effects of In-flow Anesthetic Gas Absorber on Recovery Time

Lei CHEN ; Buwei YU

The Journal of Clinical Anesthesiology.2000;16(12):602-603.

Objective:To observe whether the in-flow anesthetic gas absorber can reduce the recovery time after stopping inhalation of enflurane or isoflurane. Methods: In fixed tidal volume, minute volume and fresh gas flow, the recovery time of isoflurane or enflurane anesthesia with or without in-flow anesthetic gas absorber were compared after closing the vaporizer.Results: With in-flow anesthetic gas absorber, the time for anesthetic gas concentration in circle to reduce the MAC to 0.3was 3.3±0.5 min for isoflurane, which was significntly shorter than that without absorber (20±0.3min) ( P＜0.01 ) and the time for enflurane was 3.5±0.5min and 25±0.1min respectively. Conclusion:Anesthetic gas absorber can reduce the recovery time of either enflurane or isoflurane inhalational anesthesia significantly.

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The Effect of Recombinant Human Erythropoietin on Postoperative Anemia in Cardiac Surgery Patients

Xiaoying LIU ; Wenying ZHANG ; Xinmin WU

The Journal of Clinical Anesthesiology.2000;16(12):599-601.

Objective:To observe the change of endogenous erythropoietin(EPO) in patients undergoing elective major surgeries and the impact of recombinant human erythropoietin(rhEPO) on blood viscosity of animalsunder normal physiologic al conditions. In addition, the effect of rhEPO on postoperative anemia in cardiac surgery patients was evaluated. Methods:Ten patients scheduled for elective major procedures were studied. Included criteria were no preoperative anemia, moderate intraoperative blood loss and no postoperative transfusion. Serum EPO levers were measured prior to operation, immediately after the operation, as well as on postoperative days(PODs) 1, 2, 4, 6, 8. The change of Hct was measured too. (EPO group) Six adult rabbits received 300IU/kg of rhEPO weekly for two weeks. Specimens of Hb, Hct, RBC, serum ALT, serum potassium and blood viscosity were obtained before, during and after administration of rhEPO. Six patients with postoperative anemia (Hb＜100g/L) who underwent cardiac surgeries received 300IU/kg of rhEPO weekly for two weeks. The changes of Hb,Hct were compared(rhEpO group). Results: In EPO group serum EPO concentration increased immediately after the operation, reached a peak level during 24-48h postoperatively and remained significantly elevated above the operative value until POD 8. Hct significantly declined after the operation and was still significantly lower than the preoperative value on POD 8.On the 12th day after applying rhEPO, Hb, Hct and RBC of the rabbits were increased significantly, (P＜0.01 ) but serum ALT, potassium and blood viscosity did not changed significantly. In rhEPO group, Hb, Hct increased significantly on the 14 days after applying rhEPO. Conclusion: It is effective and safe to treat postoperative anemia with a high dose of rhEPO in patients undergoing cardiac procedures. The administration of rhEPO corrects postoperative anemia quickly, then precludes many complications related to decrease oxygen delivery capacity.

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Desflurane Anesthesia Used in Patients undergoing Intracranial Operations

Sue FU ; Jianguo XU ; Zhengshan SHI

The Journal of Clinical Anesthesiology.2000;16(12):597-598.

Objective: To investigate the appropriateness of desflurane anesthesia used in patients undergoing intracranial operations. Methods: Sixteen patients were scheduled for removal of supratentorial mass. A radial artery catheter and a subarachanoid catheter were placed respectively prior to induetion of anesthesia. MAP, cerebrospinal pressure (CSFP), PETCO2 and HR were monitored. Anesthesia was induced with intravenous midazolan, fentanyl, propofol and vecuronium. After endotracheal intubation, anesthesia was maintained by desfurane inhalation in a concentration of 6 % (1MAC) throughout the operation. MAP, CSFP and PETCO2 were recorded before and during induction, at 20min, 30min, 40min and 50min during desflurane inhalation. Results: Compared with the baseline data recorded before anesthesia, CSFP and MAP were decreased significantly during induction. The CSFP tended to increase at 20 min after inhalation of 6 % desflurane, but remained below the baseline till 50min. MAP was decreased following inhalation of 6 % desflurane and kept relatively stable thereafter. No significnt change in HR was noted. Conclusion:Under the condition of PETCO2 28-30mmHg, 1MAC desflurane anesthesia can be used safely without any increase in ICP in patients undergoing intracranial operations.

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Preventive Effect of Ephedrine on the Hypotension Spinal Anesthesia

Jianping YANG ; Jian CAI

The Journal of Clinical Anesthesiology.2000;16(12):592-594.

Objective: To evaluate the preventive effect of ephedrine on hypotension under spinal anesthesia in patients with different age. Methods: Sixty patients scheduled for spinal anesthesia were randomly allocated to four groups with 15 each. Group Ⅰ and Ⅱ were adult patients aged from 25 to 55 years old and group Ⅲ and Ⅳ were geratic aged patients of 6575 years old. Every patient received a fluid loading of 7ml/kg before spinal anesthesia. The ephedrine was administrated to group Ⅱ and IV patients in a dose of 10mg i v and 30 mg i m and same amount of normal saline was administrated to group Ⅰ and Ⅲ as soon as spinal anesthesia was performed. Results:Thirty patients in the placebo groups developed a maximal decrease in MAP exceeding 20%. Ten of these (2 in group Ⅰ and 8 in group Ⅲ ) developed a decrease in MAP exceeding 35% and required treatment. In aged groups, all patients in group Ⅲ had a decrease in MAP exceeding 20 %, 53 % of whom, the decrease exceeded 35 %. Conclusion:Prophylactic use of ephedrine is effective in the prevention of hypotension during spinal anesthesia, especially in aged patients.

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Endotoxin Inhibits Orphan Opioid Receptor Gene Expression in Peripheral Blood Lymphocyte

Xiangming FANG

The Journal of Clinical Anesthesiology.2000;16(12):589-591.

Objective: To investigate the effects of endotoxin stimulation on the expression of orphan opioid receptor (ORL-1) gene in peripheral blood lymphocyte in vivo. Methods: Total RNA was extracted from peripheral blood lymphocytes, which have been incubated with variable lipopolysaccharide concentrations(0, 0.1, 10,100ng/ml) for different periods of time(0, 3, 6, 12, 24h). The level of mRNA was measured with the method of semi-quantitative reverse transcription polymerase chain reaction(RT-PCR) using GAPDH as an internal standard. The specificity of the amplified DNA fragments was verified by Southern blot. Results: The level of ORL- 1 mRNA in peripheral blood lymphocyte was 1.060±0. 390 under the basal condition. An endotoxin dose-and time-dependent inhibition of ex vivo ORL-1 gene expression in lymphocyte was observed. A significant descrease of the ORL-1 mRNA was detected in lymphocyte at 3 hrs with the stimulation of 100ng/ml of endotoxin, at 6 hrs with the stimulation of 10ng/ml of endotoxin, at 12 hrs with the stimulation of 0.1ng/ml of endotoxin.No significant change of ORL-1 mRNA level was found without the stimulation of endotoxin. Conclusions: Endotoxin inhibits the expression of ORL-1 gene in normal human peripheral blood lymphocyte. The level of ORL-1 mRNA is related to the functional state of lymphocyte. Nociceptin(OFQ) may have an important immunological function.

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Protective Effect of Shen-Mai Injection on Perfusion and Oxygenation of Intestinal Mucosal during Hemorrhagic Shock-reperfusion in Rabbits

Zhongyuan XIA ; Limin ZHENG ; Haibuo HUANG

The Journal of Clinical Anesthesiology.2000;16(9):452-454.

Objective: To investigate the effects of Shen-Mai injection(SM) on perfusion and oxygenation of intestinaltract during repeffusion in shocked rabbits. Methods:Twenty-one rabbits were divided into control group (Ⅰ,n = 6), shock-repeffusion group ( Ⅱ, n = 9) and SM group ( Ⅲ, n = 6). Intestinal intramucosal pH (pHi) of the sigrnoid colon and portalvein blood gas was observed before shock, at 1 hour after shock, 1 hour and 2 hours of reperfusion. Results: pHi and portal vein pH in group Ⅱ were significantly lower than those in group Ⅰ (P < 0.01), but portal vein increased obviously during reperfusion. There was a good linear positive correlation between pHi and portal vein pH. Portal vein in group Ⅱ was greater than that in group Ⅰ and had anegative correlation with pHi. pHi and portal vein pH of group Ⅲ increased signifi- cantly compared with those of goup Ⅱ ( P < 0.05), while of group Ⅲ returned to the level of group Ⅰ . MAP and CO of group m were higher than those of group Ⅱ after 1 hour or 2 hours reperfusion (P<0.05).CO of group m remained at a high level during reperfusion. But SVR of group Ⅲ was lower than that of group Ⅱ during reperfusion. Conclusion: SM im-proves perfusion and oxygenation of intestinal tract during reperfusion.

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Clinical Effects of Patient-controlled Epidural Analgesia in Children

Jiyun LIU ; Shouzhang SHE ; Xiaoqing XIE

The Journal of Clinical Anesthesiology.2000;16(9):447-449.

Objective: To evaluate the feasibility and safety of postoperative patient-controlled epidural analgesia (PCEA)in children. Methods: Forty postoperative pediatric patients(5-11 years old)were divided into two groups. A and B. Both wereinstituted with postoperative PCEA with LCP model (loading dose 2.05 + 0.13ml), continuos infusion rate 0.82 + 0.15mi/h, PCA dose 0.81 + 0.16ml)by Graseby-9300 PCA pump. The PCEA solution of group A was 0.075% bupivacaine plus0.0012 % buprenorphine, that of group B was same while 0. 005% droperidol was added as an adjuvant. Results:The volumeof PCEA sdution consumption in group B was significantly less than that in group A on the first and second postoperative day (P< 0.01-0.05). Good analgesic efficiency with little side effects was obtained, as evaluated by the VASF emasay or D/D score and complications in two groups, but the analgesic effect of group B was better than that of group A. Conclusion: Thepediatric PCEA with low concentration of bupivaeaine plus buprenorphine is feasible and safe. Droperidol may enhance theanalgesic effects of PCEA.

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Controlled Hypotension Decreases the Cerebral Luxury Perfusion after Arteriovenous Malformation Removal

Shoujing ZHOU ; Jiawei CIEN

The Journal of Clinical Anesthesiology.2000;16(9):430-432.

Objective: To study the effect of controlled hypotention on the prevention and treatment of cerebral swellingafter removal of giant arteriovenous malformation(AVM). Methods:8 cases with AVM( > 6cm) were selected. When Laser-Dopple flowmetry showed an increase of cerebral blood flow after excision arteriovenous malformation (AVM), intraoperativ-ely, 2.5 % thiopental 5-10mg/kg was injected. Results: The basic mean blood pressure of all cases was 77.63 + 4.27mmHgand basic cerebral blood flow value was 35-134PU. After AVM resection, cerebral blood flow was increased obviously. Thechange value 1 was 125-434PU and the increasing amplitude was 223.48% + 0.62% (P < 0. 001). With thiopental injec-tion, mean artery blood pressure was reduced by 23.00 % + 0.02 %. The cerebral blood flow value was reduced too. Thechange value 2 was 89-236PU and the decreasing amplitude was 35 % + 7.35% (P < 0.01) eampared with that beforethiopental injection. Conclusion:Controlled hypotension can decrease the increasing amplitude of cerebral blood flow and thecerebral perfusion after the giant AVM removal.

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Correlation between Mixed Venous Oxygen Saturation and Cardiac Index in Coronary Arterty Bypass Grafting Patients

Xiaoping ZHANG ; Jianpu WANG

The Journal of Clinical Anesthesiology.2000;16(9):437-439.

Objective:Cardiac index(CI) and mixed venous oxygen saturation SvO2 were studied in 85 patients undergoing coronary artery bypass grafting(CABG). Methods: Measurement of CI and SvO2 was carried out with a fiberoptic ballon-tip thermodilation pulmonary artery catheter. Fentanyl-based anesthesia was applied in all patients. Hemodynamic parame-ters were obtained prior to anesthesia induction as the baseline, after endotracheal intubation, after stemotomy, after weaning of cardiopulmonary bypass, at 6 and 24h after operation. Results: CI and SvO2 increased or was not changed at all time intervals, compared with the baselines. The changes of SvO2 correlated well with those of CI. Conclusion: The results suggest that continuous monitoring of SvO2 may be useful to predicting alteration in CI in patients undergoing CABG.

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