Effect of N(2)-L-alanyl-L-glutamine on perioperafive insulin resistance in patients undergoing colon cancerresection / 中华麻醉学杂志

ObjectiveTo evaluate the effect of N(2)-L-alanyl-L-glutamine (Ala-Glu) on perioperative insulin resistance in patients undergoing radical colon cancer operation.MethodsSixty ASA Ⅰ or Ⅱ patients of both sexes aged 35-75 yr with BMI of 18.5-25.0 kg/m2 undergoing redical colon cancer operation under general anesthesia were randomly divided into 3 groups ( n =20 each):control group(group C) ; vehicle group (group Ⅴ) and group Ala-Glu.Ala-Glu 22.5 ml/kg was administered iv at 24 h before and 1 h after operation in group AlaGlu,while in groups C and V equal volume of normal saline and vehicle were given iv instead of Ala-Glu.Venous blood samples were taken at 24 h before operation (T1),30 main before ( T2 ) and 3 h after induction of anesthesia (T3) and 1 and 24 h after operation (T4,T5 ) for determination of blood concentrations of glucose (BG),insulin ( INS)-,TNF-α and free fatty acid (FFA).Insulin resistance ( HOMA-IR =BG × INS ÷ 22.5) and insulin sensitivity index (ISI =1 ÷ (lgBG + lgINS) ) were calculated.The time when the patients passed flatus,the days of hospitali-zation after operation,and the incidence of insulin resistance were recorded.ResuitsAla-Glu significantly decreased blood concentrations of BG,INS,TNF-α,FFA and HOMA-IR and increased ISI in group Ala-Glu as compared with groups C and V.The patients passed flatus earlier after operation and postoperative hospital stay was shorter and the incidence of insulin resistance was lower in group Ala-Glu than in groups C and V.There was no significant difference in all the indexes between group C and group V.ConclusionN (2)-L-alanyl-L-glutamine can attenuate perioperative insulin resistance in patients undergoing colon cancer resection and is helpful to patient' s recovery,and the decrease in the concentrations of TNF-α and FFA may be involved in the mechanism.

Effect of dexamethasone on Iumbar plexus combined sciatic nerve block with 0.5% ropivacaine / 临床麻醉学杂志

Objective To evaluate the effect of dexamethasone on lumbar plexus combined sciatic nerve block (CLPSNB). Methods Sixty patients were randomly allocated into three groups with 20 cases each. Guided by a nerve stimulator,CLPSNB was performed with 0. 5% ropivacaine 45 ml plus dexametbasone 10 mg in group A,0. 5% ropivacaine 45 ml plus normal saline(NS) 2 ml and dexametbasone 10 rng Ⅳ. in group B,or 0. 5% ropivacaine 45 ml plus NS 2 ml in group C. ResultsThe durations of sensory and motor blockade in group A were [(15. 2 ± 3. 3)h and (12. 6 ± 2. 8)h], respectively, which were significantly longer than [(10. 1 ± 2. 1)h and (7. 9 ± 1.6)h]in group B and [(10. 4±2. 5)h and (7. 6±2. 3)hi in group C(P<0. 05). Conclusion Dexarnetbasone added to 0. 5% ropivacaine significantly prolonges CLPSNB.