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Objective To evaluate the efficacy of ultrasound guided transversus abdominis plane block for elderly herpetic neuralgia located in anterior abdominal wall.Methods A total of 112 elderly patients aged 65-75 years with less than 30 days of herpes zoster neuralgia located in anterior abdominal wall were enrolled for receiving a treatment of transversus abdominis plane block.Patients were randomly allocated into two groups:the control group (n =56) taking gabapentin and celebrex,and the observation group (n =56)receiving transversus abdominis plane block (three times per week for two weeks) as add on therapy to gabapentin and celebrex.Morphine 10 mg was ready for oral application in breakthrough pain.Pain was evaluated by McGill scores assessed by short-form of Mcgill pain questionnaire(SF-M PQ)and visual analogue scale(VAS)before(T0)and after 1 (T1)and 2 weeks(T2)of transversus abdominis plane block,and 1 (T3)and 8(T4)weeks after end of the treatment.Pain relief(PAR)was calculated by the formula:PAR=(VAS score before block-VAS score after block)/ VAS score before block × 100％.The morphine consumption and sleep quality were observed during the treatment and 1 week after treatment.Analgesic efficacy was graded 8 weeks after end of treatment.The effective rate and good response rate were calculated.Incidences of complications were recorded.Results There was no significant difference in the VAS score between the two groups before treatment(t =0.419,P ＞0.05),while VAS scores after treatment were lower in the observation group than in the control group(t =17.925,19.662,12.580 and 13.987,respectively,P＜0.05).Before treatment,there was no significant difference in the total score of McGill between the two groups(t =0.544,P＞0.05).After treatment,the total scores of McGill were lower in the observation group than in the control group(t =18.612,20.135,13.213 and 12.356,respectively,P ＜0.05).The pre-therapy scores of sleep quality after treatment were decreased in the observation group as compared with the control group(t =7.798,9.545,10.335 and 16.318,respectively,P ＜0.05).Before treatment and at different time points of T1,T2,T3,T4,the morphine consumptions were not significant different between two groups(t =1.939,P＞0.05).While after treatment,the morphine consumptions were decreased in the observation group versus in the control group(t =22.341,16.758,17.827,15.541 respectively,P ＜0.05).No punctures of abdominal cavity,chest cavity,internal organs or blood vessels by mistake occurred.Conclusions Ultrasound-guided transversus abdominis plane block is effective and has less adverse reactions in treating herpetic neuralgia located in anterior abdominal wall.
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Objective To evaluate the role of mitochondrion-dependent apoptosis in reduction of bupivacaine-induced cardiotoxicity by lipid emulsion in rats.Methods Forty-five healthy adult male Sprague-Dawley rats,weighing 300-350 g,were divided into 3 groups by a random number table method:sham operation group (Sham group,n =5),bupivacaine group (B group,n =20),and lipid emulsion group (L group,n =20).Cardiac arrest was induced by intravenously injecting 0.4％ bupivacaine 30mg/kg over 20 s to establish the cardiotoxicity model.Twenty percent lipid emulsion was intravenously injected in a dose of 5 ml/kg during resuscitation in group L,and normal saline was intravenously injected in a loading dose of 5 ml/kg during resuscitation in group B,followed by a 3-min infusion of 1 ml · kg-1 · min-1 in two groups.The successful resuscitation and survival rate at 120 min of return of spontaneous circulation (ROSC) were recorded.Systolic blood pressure,heart rate,mean arterial pressure,rate-pressure product (RPP) and ratio of RPP at each time point after recovery of spontaneous heart beat to baseline value (RPPh) were recorded every 10 min after ROSC.The time from administration to cardiac arrest (T0),time from beginning of cardiopulmonary resuscitation to appearance of the first spontaneous heart beat (Ts) and time from beginning of cardiopulmonary resuscitation to appearance of ROSC (Tr) were recorded.Rats were sacrificed at 120 min of ROSC,and left ventricular tissues were obtained for determination of the expression of Bax,Bcl-2,cleaved caspase-9,cleaved caspase-3,cytochrome C (Cyt c) in cytoplasm and mitochondria (by Western blot) and expression of Bax and Bcl-2 mRNA (by real-time polymerase chain reaction) and for examination of myocardial ultrastructure.Results Compared with Sham group,the expression of Bcl-2 protein and mRNA and mitochondrial Cyt c was significantly down-regulated,and the expression of Bax protein and mRNA,cleaved caspase-9,cleaved caspase-3 and cytoplasmic Cyt c was up-regulated in B group (P＜0.05).Compared with B group,the rate of successful resuscitation and survival rate were signif-icantly increased,Tr was shortened,systolic blood pressure,heart rate,RPP and RPPh were increased after ROSC,the expression of Bcl-2 protein and mRNA and mitochondrial Cyt c was up-regulated,the expression of Bax protein and mRNA,cleaved caspase-9,cleaved caspase-3 and cytoplasmic Cyt c was downregulated (P＜0.05),no significant change was found in To or Ts (P＞0.05),and the pathological changes of myocardium were significantly attenuated in L group.Conclusion The mechanism by which lipid emulsion reduces bupivacaine-induced cardiotoxicity may be related to inhibiting mitochondrion-dependent apoptosis in rats.
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Objective@#To evaluate the role of mitochondrion-dependent apoptosis in reduction of bupivacaine-induced cardiotoxicity by lipid emulsion in rats.@*Methods@#Forty-five healthy adult male Sprague-Dawley rats, weighing 300-350 g, were divided into 3 groups by a random number table method: sham operation group (Sham group, n=5), bupivacaine group (B group, n=20), and lipid emulsion group (L group, n=20). Cardiac arrest was induced by intravenously injecting 0.4% bupivacaine 30 mg/kg over 20 s to establish the cardiotoxicity model.Twenty percent lipid emulsion was intravenously injected in a dose of 5 ml/kg during resuscitation in group L, and normal saline was intravenously injected in a loading dose of 5 ml/kg during resuscitation in group B, followed by a 3-min infusion of 1 ml·kg-1·min-1in two groups.The successful resuscitation and survival rate at 120 min of return of spontaneous circulation (ROSC) were recorded.Systolic blood pressure, heart rate, mean arterial pressure, rate-pressure product (RPP) and ratio of RPP at each time point after recovery of spontaneous heart beat to baseline value (RPPh) were recorded every 10 min after ROSC.The time from administration to cardiac arrest (T0), time from beginning of cardiopulmonary resuscitation to appearance of the first spontaneous heart beat (Ts) and time from beginning of cardiopulmonary resuscitation to appearance of ROSC (Tr) were recorded.Rats were sacrificed at 120 min of ROSC, and left ventricular tissues were obtained for determination of the expression of Bax, Bcl-2, cleaved caspase-9, cleaved caspase-3, cytochrome C (Cyt c) in cytoplasm and mitochondria (by Western blot) and expression of Bax and Bcl-2 mRNA (by real-time polymerase chain reaction) and for examination of myocardial ultrastructure.@*Results@#Compared with Sham group, the expression of Bcl-2 protein and mRNA and mitochondrial Cyt c was significantly down-regulated, and the expression of Bax protein and mRNA, cleaved caspase-9, cleaved caspase-3 and cytoplasmic Cyt c was up-regulated in B group (P<0.05). Compared with B group, the rate of successful resuscitation and survival rate were significantly increased, Tr was shortened, systolic blood pressure, heart rate, RPP and RPPh were increased after ROSC, the expression of Bcl-2 protein and mRNA and mitochondrial Cyt c was up-regulated, the expression of Bax protein and mRNA, cleaved caspase-9, cleaved caspase-3 and cytoplasmic Cyt c was down-regulated (P<0.05), no significant change was found in To or Ts (P>0.05), and the pathological changes of myocardium were significantly attenuated in L group.@*Conclusion@#The mechanism by which lipid emulsion reduces bupivacaine-induced cardiotoxicity may be related to inhibiting mitochondrion-dependent apoptosis in rats.
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Objective To explore the protective effects of duloxetine on ventricular arrhythmia in rats with ischemia reperfusion injury.Methods Thirty Sprague Dawley (SD) rats were randomly divided into 3 groups:Sham group,ischemia reperfusion group (IR group),duloxetine-treated group (Dulo group).The rats in IR group were subjected to 30min-ischemia of left anterior descending artery ligation followed by 120min of reperfusion,while intraperitoneal injection of duloxetine 40mg/kg were give prior ischemia in Dulo group,and the remaining experiment protocols were same as IR group.The left anterior descending artery of rats in sham group was exposed without being clamped.Two biopotential leads ECG monitor was used to record the arrhythmia in each group,and ECG parameters were analyzed by LabChart 8 software.Triphenyltetrazolium chloride (TTC) was used for determination of infarct area.The protein expressions of Akt,extracellular regulated protein kinases (Erk),caspase-3,superoxide dismutase (SOD) 1,SOD2 and Connexin 43 (Cx 43) were measured by western blot analysis.Results As compared to IR group,the incidences of both ventricular extrasystoles and tachycardia were decreased during ischemic period (P ＜0.05),and the incidence of ventricular tachycardia was decreased with no significant changes in ventricular extrasystoles during reperfusion period in Dulo group (P ＜ 0.05).Duloxetine decreased the prolonged QTc and infraeted area during IR injury (P ＜ 0.05).Duloxetine inhibited the phosphorylation of Akt and Erk,and downregulated the protein expressions of cleaved caspase-3,cytochrome C,while upregulated SOD1,SOD2 and Cx 43 protein expression during I/R injury (P ＜ 0.05).Conclusion Duloxetine decreases the phosphorylation of Akt and Erk,inhibits oxidative stress and apoptosis,exerts anti-arrhythmogenic effects and decreases the occurrence of ventricular arrhythmia and infracted area induced by myocardial IR.
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Objective To learn the application effects of selective appointment by items of medical care at the endoscope center. Methods Data of the patients receiving gastroscopy examination scheduled by appointment with designated doctors in October through December of 2016 (the control group), and that in January through March scheduled by selective appointment by medical care items ( the improvement group) were selected for comparison.The appointment time, waiting time, workload, secondary waiting time, and patient/doctor satisfaction of the two appointment methods were documented, and compared using independent sample t test, and non-parameter Mann-Whitney U sum of ranks test. Results Compared with the control group, the appointment waiting time of the improvement group [(15.4 ± 2.0)days vs.(24.4 ± 2.2) days], waiting time[(40.0 ± 12.6) min vs.(54.8 ± 15.3) min] were shortened significantly( P<0.05), with much less secondary waiting patients in the improvement groups as well (24.5 ± 7.1 vs. 37.8 ± 9.0, P <0.05 ). Conclusions Design and application of this selective appointment IT system has shortened both appointment and waiting time of patients, securing better medical environment, higher patient satisfaction by means of IT-based and AI-based endoscope appointments.
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Objective To evaluate the efficacy of the anterior approach to quadratus lumborum block in each abdominal and back region.Methods Twelve healthy volunteers of both sexes,aged 18-45 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with body mass index of 18-30 kg/m2,were enrolled in the study.Quadratus lumborum block was performed via the anterior approach under the guidance of ultrasound with 0.375％ ropivacaine 20 ml.The block was assessed by cold stimulation (ice cake) in each abdominal and back region (the right side of the body was divided into 15 regions using the anatomical landmarks on the body surface).The positive condition in each region was recorded at 30 min after administration.Results The region in which the positive rate ≤ 5％ was 0.The regions in which the positive rate ＞5％-20％ were 1 and 13 regions.The regions in which the positive rate ＞20％-50％ were 2,3 and 4 regions.The regions in which the positive rate ＞50％-70％ were 6,7 and 10 regions.The regions in which the positive rate ＞70％-＜95％ were 5,14 and 15 regions.The regions in which the positive rate ≥95％ were 8,9,11 and 12 regions.Conclusion The anterior approach to quadratus lumborum block is effective in the middle-lower region of the anterior abdominal wall on the blocked side.
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Objective To evaluate the effect of ultrasound-guided mid-humeral block on the motor function of upper extremities of the patients undergoing day-case surgery in a department of hand surgery. Methods Thirty patients,weighing 50-75kg,aged 18-64 yr,of American Society of Anesthesiologists physical statusⅠ-Ⅲ,scheduled for elective hand,wrist or forearm surgery,were divided into group Ⅰ(n=15)and group Ⅱ(n=15)using a random number table. Ultrasound-guided mid-humeral block was performed in group Ⅰ,and ultrasound-guided supraclavicular brachial plexus block was performed in group Ⅱ,both with 0.375% ropivacaine 25ml. The onset time of sensory block,recovery time of sensory function,recovery time of motor function of shoulder and elbow joints,allowable hospital discharge time and patient′s satisfaction were recorded. Results Compared with group Ⅱ,the onset time of sensory block,recovery time of motor function of shoulder and elbow joints and allowable hospital discharge time were significantly shortened,and the degree of patient′s satisfaction was increased in group Ⅰ(P<0.01).There were no significant differences in the recovery time of sensory function between the two groups(P＞0.01).Conclusion Ultrasound-guided mid-humeral block has shorter onset time and less influence on the motor function of upper extremities than ultrasound-guided supraclavicular brachial plexus block in the patients undergoing day-case surgery in a department of hand surgery.
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Objective To compare the clinical effects of HC video laryngoscope and fiberoptic bronchoscope (FOB)in guidance of endotracheal intubation for patients undergoing cervical surgery.Meth-ods A total of 50 patients (ASA I or II)with cervical vertebra injury,nerve root cervical spondylopathy or cervical spondylotic myelopathy in the first affiliated hospital of Wenzhou medical university were selected, all of whom were undergone selective cervical operations between March 2014 and June 2015.The patients were randomly divided into two groups (n =25):HC video laryngoscope group (group H)and FOB group (group F).After induction of anesthesia,HC video laryngoscope and FOB were used for tracheal intuba-tion.⑴ Intubation time and success rates of intubation were recorded,and visual analogue scale (VAS) was used to evaluate the difficulty of intubation;⑵ Mean arterial pressure (MAP),heart rate (HR),and rate-pressure product (RPP)before incubation (Tb),immediate after intubation (T0),and 1min after in-cubation (T1)were recorded;(3)Intubation-related complications were recorded.Results ⑴ The dura-tion of intubation (19.7 ±7.1 )s in the group H was significantly shorter than that of group F (51.9 ± 19.2)s (P 0.05).⑶ The incidence of complications (sore throat)was lower in group H (P <0.05).Conclusions Compared to FOB,HC vid-eo laryngoscope-guided selective cervical operation has the characteristics of higher success rate of intubat-ion,shorter operation time,and easier operation,more stable hemodynamics and lower incidence of intuba-tion complications.Therefore,HC video laryngoscope is a safe and effective method in the intubation for pa-tients undergoing cervical surgery.
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Objective To evaluate the effects of age factors on the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block in patients.Methods Twenty patients of both sexes,aged ≥ 18 yr,weighing 50-75 kg,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,scheduled for elective lower extremity surgery,were divided into 2 groups (n=10 each) according to age:young and middle-aged group (18-59 yr) and elderly group (≥ 60 yr).Combined lumbar plexus-sciatic never block was performed using an ultrasonic instrument and a nerve stimulator.Lumbar plexus block was performed with 0.5％ ropivacaine 30 ml.Sciatic never block was performed with 2％ lidocaine 10 ml plus 0.75％ ropivacaine 10 ml.Before administration and at 5,10,15,20,30,45,60,120,180 and 360 min after administration,blood samples were collected from the radial artery for determination of the blood concentration of ropivacaine by high-performance liquid chromatography.The area under the concentrationtime curve,maximum concentration (Cmax),time to C terminal elimination half-life and clearance were calculated.Results Compared with young and middle-aged group,the blood concentration of ropivacaine was significantly decreased at 5-45 min after administration,the Cmax was significantly decreased,terminal elimination half-life was significantly prolonged (P＜0.05),and no significant change was found in area under the concentration-time curve,the time to C and clearance in elderly group (P＞ 0.05).Conclusion Age factors can affect the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block,and both absorption and metabolism of ropivacaine are slower in elderly patients than in young and middle-aged patients.
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Objective To compare the degree of pain in patients after radical gastrectomy under different anesthetic regimens.Methods One hundred and two ASA Ⅰ or Ⅱ patients of both sexes,aged 50-75 yr,weighing 45-70 kg,undergoing elective radical gastrectomy,were randomly divided into 3 groups ( n =34 each):general anesthesia (GA) group,combined general-subcostal transversus abdominis plane block (CGTA) group and combined general-epidural anesthesia (CGEA) group.The patients were sent to the postanesthesia care unit (PACU) after tracheal extubation,and the VAS score on arrival in the PACU was recorded.The degree of pain was evaluated by VAS score,and when VAS scores ＞ 3,the patients received intravenous morphine titration.When VAS scores ≤ 3,morphine titration was stopped and all the patients were connected to patient-controlled intravenous analgesia and/or epidural analgesia pump.The total amount of morphine consumed was recorded at the end of titration,and the occurrence of adverse reactions was also observed.Results Compared with groups GA and CGTA,the incidence of moderate to severe postoperative pain was significantly decreased in group CGEA (P ＜0.01).The incidence of severe postoperative pain,the VAS score on arrival in the PACU and the total amount of morphine consumed were decreased gradually in groups GA,CGTA and CGEA ( P ＜ 0.01 ).The incidence of sedation was significantly lower in group CGEA than in group GA (P ＜ 0.01 ).There were no significant differences in the other adverse reactions among the three groups ( P ＞ 0.05 ).Conclusion The degree of pain is reduced gradually in patients after radical gastrectomy under GA,CGTA and CGEA.
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Objective To evaluate the efficacy of continuous lumbar plexus block (CLPB) combined with a bolus dose added at night for postoperative analgesia in patients undergoing hip arthroplasty.Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes,aged 51-75 yr,weighing 47-77 kg,with body height 150-180 cm,scheduled for hip arthroplasty,were randomized to receive either CLPB (group CLPB) or patient-controlled intravenous analgesia (PCIA) (PCIA group) for postoperative analgesia (n =30 each).Spinal anesthesia was performed at L3,4 interspace.Postoperative analgesia was performed at 30 min before the end of surgery.PCIA solution contained morphine 100 mg in 100 ml of normal saline.The PCA pump was set up with a 2 mg bolus dose and a 5 min lockout interval.CLPB solution contained 0.125 ％ ropivacaine hydrochloride 200 ml.CLPB pump was set up to deliver a 4 ml bolus dose with a 30-min lockout interval and background infusion at 8 ml/h after a loading dose of 0.125％ ropivacaine 30 ml.In addition the patients received 0.25％ ropivacaine 30 ml at 8 o' clock every night after surgery in group CLPB.VAS scores at rest and during activity were recorded at 6,12,18,24,30,36,42 and 48h after operation.The side effect such as nausea and vomiting,pruritus and urinary retention were recorded within 48 h after operation.The patient' s satisfaction was assessed.The maximal hip flexion and abduction ranges of motion were recorded at 12,24,36 and 48 h after operation.The times of sleep interruption resulted from pain during nighttime were also recorded.Results Compared with group PCIA,the VAS scores during activity,severity of nausea and vomiting,pruritus and urinary retention,and times of sleep interruption resulted from pain during nighttime were significantly decreased,and the overall satisfaction score and maximal hip flexion and abduction ranges of motion were increased in group CLPB (P ＜ 0.05).Conclusion CLPB combined with a bolus dose added at night can provide better efficacy for postoperative analgesia in patients undergoing hip arthroplasty than PCIA,with fewer complications.
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Objective To evaluate ultrasound-guided posterior approach to intercostal block for herpetic neuralgia. Methods Forty-eight patients with herpetic neuralgia after appearance of rashes on the back of chest (the coursc ＜ 30 days) aged 56-84 yr received intercostal block performed via posterior approach under the guidance of ultrasound with a mixture of 0.75% ropivacaine, glucocorticoid and methylene blue. Pain was assessed with visual analogue scale (VAS) before block and at 1, 2, 4 and 8 weeks after block. Pain relief (PAR) was cal-culated (PAR= (VAS score before block- VAS score after block) ÷ VAS score before block × 100%). Results No patient developed dyspnea and pneumothorax. VAS scores were reduced significantly, quality of life was improved and PAR increased at 1, 2, 4 ancl 8 weeks after block ( P ＜ 0.05 or 0.01). Concluslon Ultracound-guided posterior approach to intercostal block is safe and effective for the treatment of herpetic neuralgia.
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Objective To investigate the feasibility of ultrasound-guided interscalenus brachial plexus block used for the emergency surgery.Method From August to December 2007 80 patients from the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou,ASA Ⅰ to Ⅲ,age 18 to 68 years old,weight 45 to 75 kg,without deformity on the shoulder or neck,without limb paresthesia,without contraindications of interscalenus brachial plexus block,were scheduled for emergency surgery of upper limb.They were randomly divided into two groups:interscalenus block guided by ultrasound group(group U,re =40)and nerve stimulator group(group N,re = 40).Patients of both groups received 20 mL mixture of 0.75%ropivacaine and 2%lidocaine.The onset time,and the analgesic efficacy of axillary nerve,lateral antebrachial cutaneous nerve,radial nerve,median nerve,median cutaneous nerve of arm,median antebrachial cutaneous nerve and ulnar nerve,and duration of anesthesia were observed.Statistical analysis was performed by t test,rank sum test and X2 test.Results The onset time of analgesia after nerve block was shorter in group U than that in group N(P＜0.01).The rate of perfect analgesia after nerve block in group U was higher than that in group N(100%vs.87.5%,X2 = 5.267,P = 0.027).The duration of anesthesia lasted in group U was(378 ± 151)minutes and that in group N was(365 ± 163)minutes(t= 0.363,P = 0.718).ConclusionsCompared with the method of nerve block guided by nerve stimulator,the ultrasound-guided interscalenus block offers faster onset and better analgesic efficacy.It is an ideal technique of brachial plexus block for the emergency surgery.
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Objective To assess the anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing video-assisted thoracoscopic surgery(VATS).Methods Forty ASA Ⅰ-Ⅱpatients. undergoing VATS were randomly divided into remifentanil-propofol group(group P,n=20)and remifentanil-desflurance group (group D,n=20).MAP and HR were monitered during the entire procedures. Conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score were recorded and compared between two groups. Results During the operation, MAP was decreased significantly in group D (P＜0.05).There was no significant difference in conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score between two groups. Conclusions The anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing VATS were both with quick recovery, but the fronter has more stable hemodynamics.
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Objective To compare the effectiveness of supraclavicular brachial plexus block guided by ultrasound with that guided by nerve stimulator or anatomical landmarks. Methods One hundred and twenty ASA Ⅰ-Ⅲ patients (81 male, 39 female) aged 16-62 yrs weighing 40-75 kg scheduled for upper extremity operation under brachial plexus block via supraclavicular approach were randomized into 3 groups ( n = 40 each) : In group U block was guided by ultrasound; in group N nerve stimulator was used to locate the brachial plexus and in group T block was performed in the traditional way based on anatomical landmarks. A mixture of equal volumes of 0.75% ropivacaine and 2% lidocaine (0.4 ml?kg-1) was injected in the 3 groups. The onset and intensity of sensory block of musculocutaneous, median, radial and ulnar nerves were measured and analgesia was rated as excellent, effective and failure.Results The rate of satisfactory block of ulnar nerve was significantly lower than that of musculocutaneous and radial nerves in group N and T ( P
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20% . In both groups CH was induced with infusion of 0.01% sodium nitroprusside (NTP) to maintain MAP at 55-65 mm Hg. MAP, HR, CVP cardiac output were continuously monitored. Arterial blood samples were taken before (T0 ) and after AHH (T1 ) , 30 min after CH was induced (T2 ) and 30 min after tennination of CH (T3 ) for blood gas analysis and determination of plasma levels of electrolytes and ?2-microglobulin.Results The two groups were comparable with respect to the demographic data including age, body weight and height. In group Ⅰ pH was significantly decreased after AHH and CH (T1-3) compared to the baseline (T0 ) and was significantly lower than that in group Ⅱ . There was no significant difference in plasma K+ , Na+ , Ca2+ , Cl- and BE between the two groups. Plasma?2- MG decreased significantly after AHH (at T1 ) compared to the baseline value before AHH (T0) in group Ⅰ and was significantly lower than that ingroup Ⅱ at T1-3 . Conclusion Glomerular filtration rate decreases during controlled hypotension as shown by increased plasma?2-MG. AHH combined with CH can improve glomerular filtration rate while exerts no significant effects on blood gases and electrolytes.