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The double-lumen endobronchial tubes are usually applied to the anesthesia of wet lung operation for the isolation of both lungs during anesthesia and one-lung ventilation.Many young physicians of the department and on-the-anesthesia training doctors are very interested in the intubatton.According to the past teaching experiences,some opinions are given in such aspects as the tube standard,pre-checking,estimation of the intubation depth and the significance of monitoring the airway resistance.These basic considerations are always easily overlooked by some young anesthetists.
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The experimental results showed that the level of CAMP, the ratio of cAPM to cGMP,IL-2R expression and IL-2 production in vitro in lymphocytes immediate and 2 weeks after cardiopulmonary bypass (CPB) were significantly lower than those before anesthetics in the patients undergoing cardiac surgery with CPB. These findings suggested that CPB could cause serious damage to adrenergic beta receptor-adenylate cyclase system on circulating lymphocytes surfaces,which might be one of the mechanisms resulting in immunosuppression after open heart surgery with CPB.
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The experimental results showed that the level of CAMP, the ratio of cAPM to cGMP,IL-2R expression and IL-2 production in vitro in lymphocytes immediate and 2 weeks after cardiopulmonary bypass (CPB) were significantly lower than those before anesthetics in the patients undergoing cardiac surgery with CPB. These findings suggested that CPB could cause serious damage to adrenergic beta receptor-adenylate cyclase system on circulating lymphocytes surfaces,which might be one of the mechanisms resulting in immunosuppression after open heart surgery with CPB.
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Objective:The stimulative effects of clonidine on release of enkephalin and substance P from periaqueductal gray was studied to analyse the analgesic neurotransmitters related to alpha 2 adrenoceptor activation. Method: Twenty SD rats were allocated in pairs to receiving intraperitoneal clonidine 40?g in clonidine group or normal saline in control group. Immunohistochemical technique was used to measure the contents of enkephalin and substance P in slice of rat midbrain. Result:The immunoreaction of enkephalin from slice of rat midbrain was decreased significantly in clonidine group compared with control group(P
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Ten mongrel dogs,divided randomly into a control group (A) and a cerebroplegia group (B) ,were supported by closed-chest cardiopulmonary bypass,subjected to 2 hours of hypothermic circulatory arrest at 18 C. In group B, oxygenated asanguineous solution 50ml/kg was infused into the carotid artery at the onset of arrest. and 10 ml/kg was supplemented every 30 minutes during 2hours arrest. Nothing was infused in group A. Then all animals were rewarmed to 37 C and killed 6 hours later At five time points cerebral cortex was collected to study adnosine triphosphate (ATP),malondialde hyde (MDA) and ultrastructure. Electroencephalography (EEG) was recorded continuously. In group A, ATP content decreased gradually from the beginning of arrest to the end of the experiment (P
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Objective: To evaluate the safety of controlled hypotension produced by human ?-calcitonin gene-related peptide(?-hCGRP)and sodium nitroprusside. Method: Twenty SD rats were randomly divided into ?-hCGRP(C) and sodium nitroprusside(S) groups. Animals in group C were infused intravenously with 0.001％ ?-hCGRP and those in group S with 0.01％ sodium nitroprusside. The mean blood pressure of rat was reduced to 6.7kPa and maintained for 30 min. Cerebral glucose,lactate,ATP, and phosphocreatine levels were measured at 0 and 30th min of hypotension. Result: Cerebral glucose level increased slightly,lactate level decreased significantly,ATP and phosphocreatine contents did not change in group C at 30th min of hypotension compared with those at 0 min of hypotension,respectively.Cerebral glucose level increased slightly,lactate concentration increased significantly,ATP and phosphocreatine contents decreased significantly in group S at 30th min of hypotension in comparison with those at 0 min of hypotension, respectively. Conclusion: Hypotension induced with alpha-hCGRP can maintain adequate cerebral oxygen supply,but with sodium nitroprusside may cause cerebral hypoxia.
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Objective:The somatosensory evoked cerebral potential (SEP)was used to assess the analgesia effect of clonidine. Method: Twenty-three SD rats was randomly divided into two groups, the control group (n=8) and clonidine group (n=15). The control group rats was injected 1 ml normal saline to peritoneal cavity and the clonidine group rats was injected 10mg(1ml) clonidine peritoneally. The SEP waves were recorded in both groups at preinjection and 20,40,60 min after injection. Pain relief ratio was calculated according to the N15-P25 peak-peak amplitude of SEP wave. Result:SEP amplitude and latency were markedly reduced in clonidine group and remained unchanged in control group. The peak Pain relief ratio was 80. 6％at 20-40 min after clonidine administration. Conclusion:Clonidine does have a effect of pain relief
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To evaluate the influence of human ?-caleitonin gene related peptide (?-hCGRP) used in the controlled hypotension on hepatic blood flow, oxygen supply and oxygen consumption in rats. Method: Alpha-hCGRP and sodium nitroprusside were administered intravenously to reduce the blood pressure of rats to 6.7 kPa maintained for 1 h. Radiomierospheres were employd to measure hepatic arterial blood flow (HABF), portal venous blood flow (PVBF), and total hepatic blood flow (TABF). The arterial0portal,and hepatic venous blood gases were analyzed. The hepatic oxygen supply and oxygen consumption were calculated according to values of blood flow and gases. Result: HABF, TABF, and hepatic oxygen supply increased significantly, and PVBF decreased slightly during ?-hCGRPinduced hypotension. HABF, TABF and hepatic oxygen consumption increased significantly, and hepatic oxygen supply decreased significantly during sodium nitroprusside hypotension. Rebound hypertension occurred after the discontinua tion of sodium nitroprusside rather than ?-hCGRP. Conclusion: Alpha-hCGRP does not cause hepatic hypoxia during controlled hypotension, while sodium nitroprusside may result in hepatic hypoxia. Alpha hCGRP is more adequate to be used to controlled hypotension than sodium nitroprusside. No rebound hypotension is another advantage of ?-hCGRP.
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To study effects of clonidine on release of substance P from rat spinal cord for analysing the spinal sites of its pain relief, Method: Twenty rats were randomly divided into two groups: clonidine group and control group, clonidine 40?g or normal saline was injected intraperitoneally. Immunohistochemica] PAP technique was used to measure substance P in slices of rat spinal cord. Result: The optical density(OD) of immunoreaction of substance P in medial-lateral part of spinal dorsal horn and spinal Lissauer's tract was increased significantly in clonidine group com pared with that of control group (P
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Objective: Effects of human ?-calcitonin gene-related peptide (?-hCGRP) on renal function and renin-angiotensin system were studied during controlled hypotension. Method:Twenty SD rats were divided into ?-hCGRP (C) and sodium nitroprusside (S) groups. The mean blood pressure of rats was reduced to and maintained at 6.7kPa for 1h. The glomerular filtration rate (GFR),effective renal plasma flow (ERPF),plasma renal activity (PRA),angiotensin Ⅱ(AⅡ), urine volume, heart rate (HR)and the excretory rates of sodium,chloride and potassium of rats were measured beforeand 1h following hypotension. Result:GFR and ERPF increased significantly at the end of 1h hypotension when compared to pre-hypotension in the group C. GFR and ERPF decreased mark during hypotension period in group S. In both groups during hypotension,PRA and A Ⅱ increased by eight-folds or so,the excretory rates of sodium and chloride decreased significantly and the excretory rate of potassium increased slightly, urine volume de creased and HR increased markly. Conclusion:The ?-hCGRP,a potent vasodilator,has a protective effect on renal function as a controlled hypotensive agent. Sodium nitroprusside may harm renal function. The increased excitation of renin-angiotensin system may be responsible for the changes of urine volume,heart rate and the excretory rates of sodium ,chloride and potassium during hypotension.
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A certain amount of potassium chloride is required to correct the hypokalemia occuring commonly during perioperation,but the overdosage may be harmful. To investigate the proper dose of KCl,40 adult rabbits were randomly and evenly assigned to be intravenously infused with normal saline(group Ⅰ),or saline containing 4,25 or 50 mmol/L KCI (group Ⅱ,Ⅲ,Ⅳ),at rate of 10 ml?kg~(-1)?h~(-1) during operation respectively. As compared with those before operation,the serum level of potassium decreased significantly in group Ⅰ and Ⅱ, changed unsignificantly in group Ⅲ,and increased in group Ⅳ during and after operation;the potassium amounts in liver and skeletal muscles increased markedly after operation. S-T segment was depressed in group Ⅰ and Ⅱ,T wave became peaked in group Ⅳ, and ECG remained normal in group Ⅲ. it is indicated that intravenous KCl infusion at concentration 25 mmol/L and rate of 10ml?kg~(-1)?h~(-1) may properly correct the hypokalemia during perioperation,and the occurance of perioperatine hypokelemia may be related to the uptake of liver and skeletal muscles
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In order to evaluate the post-traumatic changes of serum levels of interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF_?) and their relationship to the occurance of multiple system organ failure (MSOF), 80 adult patients with severe multiple trauma(SMT), injury severity score(ISS) 32?14. served as the tested subjects. of which 50 cases received operations and the other did not. Thirty adult patient, scheduled for elective abdominal surgery, were randomly chosen as trauma control, and 20 healthy blood donors acted as normal control. The venous blood samples were taken on that day of injury, 3, 10 and 20 days post-traumatically, and immediately before dis charge. to measure serum concentrations of IL-6 by immunocytochemistry method and TNF_? by enzymo-immunoassay, respectively. The diagnosis of post-traumatic MSOF was made according to Baue's criteria. As compared with normal control levels, the concentrations of IL-6 and TFN_?, increased significantly in patients with SMT(P0.05). In comparison correspondingly with those of trauma control, the levels of IL-6 and TFN_? were elevated markedly (P
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Haemorheological changes, including blood viscosity (?b) and plasma viscosity (?p) measured on a cone-plate viscometer, erythrocyte aggregation calculated, erytkrocyte deformability (DI) determined by the nuclear pore microfiltration technique and red blood cell shape using scanning electromicroscopy, were observed in patients during anesthesia There acs a significant reduction in ?b (at shear rates range 7. 68- 307. 20 s-l ), ?p and haemotocrit after induction (preintubation ) and 30 min after enflurane in the presence of iv fentanyl, compared with pre-aneathesia, accompanying remarkable increased DI. No changes of erythrocyte shape, however, was found add, nor was the difference of the index between induction period and maintenance of anesthesia. These findings suggest that general anesthesia leads to haemorheological alterations which may improve the microcirculation of the patients.