ABSTRACT
Objective To study the relationship ofiliac vein, portal vein(PV) and superior mesenteric vein (SMV), explore the feasibility on application of iliac vein in extended pancreatoduodenoctomy, and observe the clinical results. Methods Portal system and iliac venous system were dissected in 20 adult corpses. The caliber, thickness and branches of iliac vein, PV and SMV were observed and compared. The application of iliac vein in extended pancreateduodenoctomy were studied in 2 patients. Results There were no branch in 30 mm near lilac vein, 1 branch in 30--50 nun and 2-3 branches in 51-70 ram. The thickness and caliber of iliac vein matched with PV's and SMV's, there was no significant difference. Only proper pro-longed operative incisions were needed and the operation time was 5-7 hours. Postoperative vascular throm-bosis, necrosis of intestine, liver failure and so on were not occurred. No evidence of vascular embolism and recurrence happened within 6-16 months' follow-up. Conclusion Uiac vein, as a choice, can be used for vasotransplantation in the pancreatoduodenectomy.
ABSTRACT
Objective To evaluate the effect of clonidine as an adjuvant of PCEA with morphine and ropivacaine in patients with essential hypertension and it' s effects on hemodynamics and plasma concentrations of endothelin-1 ( ET-1) and calcium gene-related peptide ( CGRP) . Methods Sixty ASAⅠ - Ⅱ patients of both sexes (24 males, 36 females) with a history of essential hypertension for 1-2 years were included in this study. The patients ranged in age from 45-72 yrs and in body weight 55-70 kg and were scheduled for elective pelvic surgery under combined general-epidural anesthesia. An epidural catheter was placed at T12-L1 or L1-2 interspace before induction of general anesthesia. Anesthesia was induced with fentanyl 4 ?g ? kg-1 , propofol 2 mg?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with isoflurane and epidural analgesia. The patients received PCEA after operation. The PCEA regimen included a loading dose of 5 ml followed by background infusion at 2 ml?h-1 with an 1 ml bolus dose and a 15 min lockout interval. The PCEA solution contained morphine 2 mg + ropivacaine 75 mg in group A (n = 20); clonidine 150 ?g + morphine 2 mg + ropivacaine 75 mg in group B ( n = 20) ; clonidine 300 ?g + morphine 2 mg + ropivacaine 75 mg in group C ( n = 20) in 60 ml of normal saline. BP, HR, VAS pain score (0 = no pain, 10 worst pain) and Ramsay sedation score (1 = wide awake, 5-6 over sedated) were recorded one day before operation (T0), before induction of anesthesia (T1 ), 0, 5, 15, 30, 60 min, 2, 4, 8, 20, 24 h (T2-11 ) after PCEA was commenced. Blood samples were taken before induction of anesthesia (baseline) and 6 and 24 h after operation for determination of plasma concentrations of ET-1 and CGRP. The total number of button pressing (D1) and the number of actual delivery of bolus dose (D2) and the consumption of PCEA solution were also recorded. Results VAS pain score was significantly higher in group A than that in group B and C ( P
ABSTRACT
Objective To investigate the influence of propofol on the induction of inducible nitric oxide synthase (iNOS) expression in spinal cord after spinal cord injury (SCI) in rats. Methods SCI model was reproduced according to Allen′s method with modification. Seventy-four SD rats were randomly divided into three groups: normal group (n=4), SCI with propofol treatment group (n=35), and SCI with saline treatment group (n=35). Immunohistochemistry and Western blot were employed to detect iNOS expression in spinal cord at different time (1h, 3h, 8h, 1d, 3d, 7d, 14d). Results The results showed that iNOS expression in spinal cord of propofol treatment group was significantly decreased compared with that of saline treatment group (P