ABSTRACT
Objective To evaluate the effects of different depths of sedation on postoperative cognitive function in elderly patients with mild cognitive impairment.Methods A total of 100 patients with mild cognitive impairment before surgery,aged 65-75 yr,weighing 55-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective gynecological surgery under general anesthesia,were divided into Ⅰ and Ⅱ groups (n =50 each) using a random number table method.Propofol was given by closed-loop target-controlled infusion,and the target plasma concentration was automatically regulated.The bispectral index value was maintained at 40-50 in group Ⅰ and at＞50-60 in group Ⅱ.Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate the cognitive function at 1 day before operation (T0) and 7 days after operation (T1),and the development of postoperative cognitive dysfunction (POCD) was recorded.Venous blood samples were collected at T0 and T1 for determination of the concentrations of serum interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-α) by enzyme-linked immunosorbent assay.Results Compared with the baseline value at T0,MoCA and MMSE scores were significantly decreased at T1,and the serum concentrations of IL-10 and TNF-α were increased in both groups (P＜0.05).Compared with group Ⅰ,MoCA and MMSE scores were significantly decreased at T1,and the incidence of POCD was increased,the serum concentration of TNF-α was increased,and the serum concentration of IL-t0 was decreased in group Ⅱ (P ＜ 0.05).Conclusion Maintaining BIS value at 40-50 during operation can decrease the development of POCD in elderly patients with mild cognitive impairment,which may be related to reduced systemic inflammatory responses.
ABSTRACT
Objective To evaluate the effect of age factor on the sedative efficacy of propofol given by closed-loop infusion in patients undergoing gynecological laparoscopic surgery.Methods A total of 100 patients,weighing 55-75 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective gynecological laparoscopic surgery under general anesthesia,were divided into 2 groups (n =50 each) according to age:middle-aged group (45-64 yr) and elderly group (65-75 yr).Propofol was given by closed-loop infusion,and the target plasma concentration was automatically regulated to maintain bispectral index (BIS) value within the target range of 45-55.Remifentanil was given by target-controlled infusion at a target plasma concentration of 2-6 ng/ml to maintain anesthesia,and cisatracurium was injected intermittently to maintain muscle relaxation.The total consumption of propofol and remifentanil,regulating frequency of propofol,time ratio of BIS40-60,global score reflecting performance of closed-loop infusion system,emergence time and extubation time were recorded.Results Compared with middle-aged group,the time ratio of BIS40-60 was significantly increased,global score was decreased,the total consumption of propofol and remifentanil was significantly decreased,the regulating frequency of propofol was increased (P＜0.05),and no significant change was found in emergence time or extubation time in elderly group (P＞0.05).Conclusion The sedative efficacy of propofol given by closed-loop infusion is influenced by age factors when used for gynecologic laparoscopic surgery,and the stability in elderly patients is superior to that in middle-aged patients.
ABSTRACT
Objective To determine telmisartan and amlodipine assay in the compound tablet .Methods First derivative UV spectrophotometry was used at wavelength 236 nm for telmisartan and 390 nm for amlodipine .Results Telmisartan con-tent has a good linear relationship in the concentration range of (4~20) × 10-3 mg/ml .The standard curve equation is Y =0 .0043 X-0 .0005 and correlation coefficient R2 =0 .9993 .Amlodipine content has a good linear relationship in the concen-tration range of (10~90) × 10-3 mg/ml .The standard curve equation is Y =0 .0003 X+0 .0002 and correlation coefficient R2 =0 .9995 .Conclusion The assay results from this method are consistent with the results from HPLC .This procedure pro-vides a specific ,accurate and precise method to assay the amlodipine and telmisartan in compound tablet .