ABSTRACT
Objective To evaluate the effect of continuous intravenous lidocaine administration during surgery for short-term pain control in patients undergoing laparoscopic colorectal surgery, the postoperative use of opioid, and gastrointestinal function recovery. Methods Forty patients who underwent laparoscopic colorectal surgery were randomly assigned to lidocaine and control groups. Each group consisted of 20 patients. The lidocaine group received an intravenous injection of 2％ lidocaine 2 mg/kg during induction of anesthesia, followed by continuous pumping of lidocaine 1.5 mg/ (kg·h) till the end of surgery. In the control group, saline was used in place of lidocaine. The visual analogue scale (VAS), time of first defecation, amount of opioids used intraoperatively and postoperatively, postoperative nausea and vomiting, and lidocaine toxicity symptoms were recorded at 3 h, 12 h, 72 h, 5 d, 7 d, and 30 d after surgery, respectively. Results At3 h, 12 h, 72 h, 5 d, and 7 d (at rest), the VAS scores in the lidocaine group were significantly lower than those in the control group (P ＜0.05). At 72 h (on walking) and 30 d after surgery, no significant differences in VAS scores were found between the two groups. In comparison with the control group, the dosage of opioids in the lidocaine group was significantly reduced (P ＜ 0.05), the recovery of gastrointestinal function was significantly faster (P ＜ 0.05), and the symptom of nausea and vomiting were significantly reduced in the lidocaine group (P ＜ 0.05). No symptoms of lidocaine toxicity were observed in either group. Conclusion Continuous intravenous lidocaine administration during surgery is beneficial for postoperative pain control after laparoscopic colorectal surgery. It can also reduce the use of opioids and accelerate the recovery of gastrointestinal function.
ABSTRACT
Objective To investigate the effect of splenectomy on tau expression in rat hippocampus.Methods One hundred and five male SD rats aged 6 months weighing 350-400 g were randomly divided into 3 groups: group A control (n = 15); group B anesthesia (n =45) and group C surgery (n =45). The animals were anesthetized, intubated and mechanically ventilated. In group B and C the animals were anesthetized with 1.5% isoflurane for 2 h. In group C splenectomy was performed. The animals were killed on the 1st, 3rd and 7th day after anesthesia and surgery. The hippocampi were immediately removed for determination of IL-1 and TNF-α mRNA and protein expression, expression of total tau, phosphorylated tau at Thr-205 and Ser-396 and activity of glycogen synthase kinase-3 beta (GSK-3β). Results There was no significant difference in the expression of phosphorylated tau at Thr-205 and Ser-396 between control and anesthesia groups. Surgery significantly increased the expression of IL-1β and TNF-α and induced rapid and massive hyperphosphorylation of tau at Thr-205 and Ser-396 epitope in the hippocampus and activation of GSK-3β. Conclusion Surgical trauma induces inflammatory response in hippocampus, activates GSK-3β and increases phosphorylation of tau.