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

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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The effect of patient-control transcutaneous electroacupoint stimulation on PONV of gynecological laparoscopy patients

Yu ZHOU ; Wei WANG ; Honghui HUANG ; Ning ZHANG ; Hui WANG ; Ruidong QIAO

The Journal of Clinical Anesthesiology.2014;(6):592-593.

Objective To evaluate the effect of the electronic anti-nausea instrument on the postoperative nausea and vomiting of patients with gynecological laparoscopic surgery.Methods One hundred and eighty patients for gynecological laparoscopic surgery were enrolled and randomized into 2 groups with 90 patients in each.Patients in group T accepted patient-control transcutaneous elec-troacupoint stimulation at P6 (Neiguan)point from the time before the induction of anesthesia to 24 h after surgery.Patients in group C accepted the same device of electronic anti-nausea instrument with-out transcutaneous acupoint stimulation.Data were recorded of the nausea and vomiting in postopera-tive 2,6,12 and 24 h respectively.Results The incidence and severity of nausea at 6,12 and 24 h and vomiting at 6,24 h after operation in group T were both lower than those in group C(P < 0.05 ). Conclusion With patient-control transcutaneous acupoint stimulation at P6 point,the incidence of both early PONV and late PONV are reduced in patients with gynecological laparoscopic surgery.

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Application of mivacurium in moden non-convulsively electuoconvulsive therapy

Yingping LAN ; Tianbei LIANG ; Yiwei WANG

The Journal of Clinical Anesthesiology.2014;(6):584-585.

Objective To observe the effect of mivacurium,succinylcholine and atracurium in modified electric convulsive therapy (MECT).Methods Sixty ASA Ⅰ or Ⅱ patients with schizo-phrenia aged from 18 to 60 years old were randomly divided into 3 groups :mivacurium group (group A,n=20),succinylcholine group (group B,n=20),atracurium group (group C,n=20).The on-set time of muscle relaxation,the recovery time of spontaneous breathing after MECT,the awake time,as well as the changes of 5 min MAP,HR and SpO2 before and after MECT were observed re-spectively.Results The onset time of muscle relaxation and the recovery time of spontaneous breath-ing in group B were shorter than those in groups A and C (P <0.05).The onset time of muscle re-laxation and the recovery time of spontaneous breathing in group A were shorter than those in group C (P <0.05).Conclusion Mivacurium is a better alternative medicine in MECT in the situation of no succinylcholine or succnylcholine contraindication.

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Effects of ED50 of ropivacaine combined with sufentanil for spinal anesthesia in elderly patients

Qiang LU ; Lu DING ; Zhengfei HAN ; Zhike YANG

The Journal of Clinical Anesthesiology.2014;(6):581-583.

Objective To investigate the effects of median effective dose (ED50 )of ropivacaine combined with sufentanil for spinal anesthesia in elderly patients.Methods Forty-eight elderly patients (ASAⅠ-Ⅲ)scheduled for elective lower limb or perineum operation under spinal anesthesia were enrolled in this study.All patients were randomly divided into two groups:control group (group C)and sufentanil group (group S).L3-4 intervertebral puncture was selected for all patients.Anesthetic solution in group C was 0.5% ropivacaine,in group S was 0.5% ropivacaine and sufentanil,which was fixed at 5.0 μg,based on the experimental results and sequential principle.The ropivacaine dose of first patient in the control group was 9.0 mg,and in sufentanil group was 8.0 mg,followed by reducing the dose of ropivacaine,each time 1.0 mg.If the patient appeared invalid standards response,the previous one was selected as the first case. ED50 was determined by Dixon??s sequential method.Results The ED50 of sufentanil combined with ropiva-caine for spinal anesthesia in elderly patients with lower extremity or perineal surgery was 6.40 mg (95%CI:5.98-6.80 mg),ED50 of only ropivacaine was 8.42 mg (95% CI:7.79-9.03 mg).Compared with pre-dose,MAP at 3,6,15 min after treated in group C were decreased,and lower than those in group S (P <0.01).Conclusion Combined with 5.0 μg sufentanil in spinal anesthesia for lower limb or perineal surgery elderly,median effective dose of ropivacaine is reduced.

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The influence and correlation analysis between PaCO2 and PET CO2 in prone position surgery

Faxian GONG ; Fang WU ; Yonghai ZHANG ; Ling MA ; Hanxiang MA

The Journal of Clinical Anesthesiology.2014;(6):574-576.

Objective To investigate the correlation between arterial carbon dioxide partial pressure (PaCO2 )and end-tidal carbon dioxide partial pressure (PET CO2 )in prone position operation and calculate the value of PaCO2 according to the PET CO2 .Methods Forty patients with ASA Ⅰ orⅡ undergoing spinal surgery were selected,and the values of PaCO2 and PET CO2 as basic value (T0 ) after induction of general anesthesia in supine position monitor and record the value of PET CO2 and PaCO2 in prone position after 30 min (T1 ),60 min (T2 )and 90 min (T3 ).The correlation between PaCO2 and PET CO2 in each time point were analyzed,and the equation of PaCO2 (y)and PET CO2 (x) with curve fitting and difference of PaCO2 and PET CO2 were calculated.Results There was significant correlation between PaCO2 and PET CO2 in the supine and prone position,their correlation coefficients were r 0 =0.84,r 1 =0.88,r 2 =0.84,r 3 =0.82 (P <0.01).The Pa-ET CO2 was (5.3±2.1)(T0 )in supine position and (6.6± 2.1 )mm Hg (T1 ),(5.8 ± 2.2 )mm Hg (T2 ),(5.9 ± 2.1 )mm Hg (T3 )in prone position.The equation in each time point PaCO2 (y)and PET CO2 (x)were y0 =1.1 x0 +2.5,y1 =1.1 x1 +2.3,y2 =1.1 x2 +2.4,y3 =1.1 x3 +4.6,and the Pa-ET CO2 was 3.7-8.7 mm Hg. There was no significant difference between PaCO2 and PET CO2 at T1-T3 .Conclusion Whenever in prone position or supine position,PET CO2 and PaCO2 have significant correlation in prone position and supine position.The overall range of Pa-ET CO2 is 3.7-8.7 mm Hg,and the PET CO2 can be as indica-tor to estimate PaCO2 in prone position.

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The application of acute normovolemic hemodilution in cesarean section for pregnant women with total placenta praevia and accrete

Yan NI ; Qinhai ZHOU ; Xiuhong JIANG ; Zhengnian DING

The Journal of Clinical Anesthesiology.2014;(6):571-573.

Objective To investigate the efficacy and safety of acute normovolemic hemodilu-tion for pregnant women with total placenta pravia and accreta.Methods Fifty-two pregnant women with placenta praevia and accreta were randomly divided into three groups.Groups A and B received ANH or AHH before the operation while group C received the normal treatment.The total blood loss,transfusion of allogeneic blood and preoperative and postoperative routine blood test were recor-ded;the infants’umblical artery blood samples were taken immediately after birth,and 1 min,5 min Apgar scores and the blood gas was analyzied.Results There were no significant difference in the general condition,operation duration,blood loss among the three groups;the transfusion of allogeneic blood in groups B and C were much more than group A (P <0.05);the postoperative hemoglobin and hematocrit and the count of plateletsin in group A were better than groups B and C (P <0.05),while there were no statistically difference between groups B and C;there were not only seldom difference in the Apgar scores of 1 min and 5 min,but also barely change in the blood gas analysis of umbilical ar-tery in new borns from the three groups.Conclusion ANH could play an important role in the pre-vention of postpartum hemorrhage without doing any harm to the mother and infant.

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The effects of different concentrations of sevoflurane combined with propofol on recovery quality in pa-tients undergoing partial hepatic resection

Lingxi ZHOU ; Qing LIU ; Jinsong PENG ; Juanbao PENG ; Yuxia NI

The Journal of Clinical Anesthesiology.2014;(6):550-553.

Objective To observe effects of different concentrations of sevoflurane combined with propofol on recovery quality in patients undergoing partial hepatic resection.Methods Seventy-eight patients,aged 20-70 years old,selected for partial hepatic resection were randomly divided into three groups,26 patients in each group:total intravenous propofol anesthesia group (group T), propofol combined with 0.5 MAC sevoflurane anesthesia group (group S1),propofol combined with 1.0 MAC sevoflurane anesthesia group (group S2).Spontaneous respiration recovery time,recovery time,extubation time and modified Aldrete score of 9 time were recorded after operation.Modified OAA/S scores as well as modified Aldrete score at extubation immediate time (T1 )and 5 min (T2 ), 1 5 min(T3 ),30 min(T4 )after extubation were also recorded.Results Total amount of propofol in groups S1,S2 significantly less than group T and total amount of propofol in group S2 significantly less than group S1(P <0.05).The recovery time,extubation time,modified Aldrete score of 9 time in groups S1 and S2 were significantly shorter than group T (P <0.05).Modified OAA/S scores at T1 ,T2 and the modified Aldrete scores at T1 in both groups S1 and S2 were significantly higher than group T,while group S2 was significantly higher than group S1 (P <0.05).Conclusion Compared with total intravenous propofol anesthesia,both propofol combined with 0.5 MAC sevoflurane and propofol combined with 1.0 MAC sevoflurane anesthesia improves the recovery quality in patients un-dergoing partial hepatic resection,and the recovery time was decreased in propofol combined with 1.0 MAC sevoflurane anesthesia.

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Postoperative analgesic effect of sub anesthetic dose of ketamine combined with sufentanil after esophagus cancer resection

Liqin WAN ; Zhichun WANG ; Qiaolin ZHOU ; Di CHI ; Xiaoyun CHEN ; Yu CHEN

The Journal of Clinical Anesthesiology.2014;(6):557-560.

Objective To evaluate the effects of sub anesthetic dose of ketamine combined with sufentanil on postoperative patient-controlled intravenous analgesia (PCIA)in patients undergoing radical resection of esophageal cancer.Methods Ninety patients,ASAⅠorⅡ,aged 55-75 years old,se-lected for radical resection of esophageal cancer were randomly divided into three groups:group S1,group S2,group SK,30 patients in each group were treated with PCIA.Group S1,2 μg/kg sufentanyl;group S2,2.5 μg/kg sufentanyl;group SK 2 μg/kg sufentanyl+90 μg·kg-1·h-1 ketamine.6 mg of granisetron was added to each group,and then diluted into 100 ml of normal saline.All patients were administered load-ing doses of 5 ml analgesics 30 min before the end of the operation.The VAS score,Ramsay sedation score, SBP,DBP,HR,SpO2 and adverse effects were recorded respectively at 4,8,24 and 48 hours after opera-tion.The total times of pressing PCIA were also recorded in 48 h after operation.Results There was no statistically significant difference in Ramsay sedation score,SBP,DBP,HR and SpO2 at 4,8,24,48 hours after operation in the three groups.Compared with group S1,the VAS score and total number of pressing PCIA times in groups SK and S2 were significantly lower in 48 h after operation (P <0.05).Compared with group S2,VAS score and the total number of pressing PCIA times in group SK were significantly de-creased in 48 h after operation (P <0.05).Two patients from group SK occurred respiratory depression 48 h after operation.There was no statistically significant difference in incidence of adverse effects in the three groups.Conclusion Sub anesthetic dose of ketamine combined with sufentanil on PCIA can reduce postoper-ative sufentanil consumption and significantly relieve the postoperative pain in patients undergoing radical re-section of esophageal cancer.The analgesic effect is better than using sufentanil alone.

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Effects of dexmedetomidine on short-latency somatosensory evoked potentials

Meng WEI ; Cunming LIU ; Shiyang DONG ; Yuan XU

The Journal of Clinical Anesthesiology.2014;(6):554-556.

Objective To investigate the effects of two different dosages of dexmedetomidine on short-latency somatosensory evoked potentials (SLSEP)in intracranial surgery.Methods Forty pa-tients,ASA Ⅰor Ⅱ,aged 20-65 years old,selected for intracranial surgery were randomly divided in-to two groups,20 patients in each group.Bolus dose of 0.5 μg/kg dexmedetomidine was infused within first 10 min and followed by continuous infusion of 0.5 μg·kg-1·h-1 for 10 min in group A;Bolus dose of 1.0 μg/kg dexmedetomidine was infused within first 10 mins and followed by continu-ous infusion of 1.0 μg·kg-1·h-1 for 10 min in group B.SLSEP indications include N20-P25 amplitute and N20 latent period were observed.MAP,HR,N20-P25 amplitute and N20 latent period were re-corded respectively before dexmedetomidine adminstraition (T0 )and 20 mins after dexmedetomidine adminstraition (T1 ).Results Compared with T0 ,MAP and HR at T1 significantly decreased in both groups(P <0.05).N20-P25 amplitude had no statistically significant difference in both groups,while N20 latent period significantly prolonged (P <0.05).Conclusion Both doses of 0.5 μg/kg and 1.0μg/kg dexmedetomidine can significantly prolong the latent period of N20.

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