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Enhanced recovery after surgery (ERAS) emphasizes applicating a series of sophisticated measures with the synergy effect of optimized combination to minimize various physical and mental stress reaction.The aim of ERAS is to accelerate postoperative recovery,shorten duration of hospital stay and hospital expenses,improve postoperative life quality of patients.ERAS includes minimally invasive surgery,anesthetic management,reasonable postoperative management,among which anesthetic management is very important.
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<p><b>BACKGROUND</b>The effects of hydroxyethyl starch 130/0.4 (HES130/0.4) on myocardial ischemia/reperfusion (I/R) injury and its mechanism are uncertain. The aim of this study was to investigate the protective effects of HES 130/0.4 on myocardial I/R injury.</p><p><b>METHODS</b>Forty-eight Sprague-Dawley rats were assigned to sham-operation group (S group), ischemia-reperfusion group (I/R group), albumin-I/R group (A-I/R group) and HES130/0.4-I/R group (H-I/R group). The fluids were administered at 25 minutes after ischemia. H-I/R group was given 7.5 ml/kg of HES 130/0.4; I/R group and A-I/R group received the same volume of normal saline and 5% albumin, respectively. The rats in S group were sham operated and received the same fluid as I/R group. After 30 minutes of ischemia and 3 hours of reperfusion, blood samples were taken for cytokines assay, myocardium was excised for detection of NF-κB activity and myocardial infarction areas were taken for immunohistochemical analysis.</p><p><b>RESULTS</b>Hemodynamic parameters of H-I/R group were better than I/R and A-I/R groups at all designated time points. The results of 2,3,5-triphenyl-tetrazolium (TTC) and HE staining were better in the H-I/R group. Myeloperoxidase (MPO), NF-κB activity and concentrations of TNF-α, IL-1β were elevated markedly in I/R groups. HES130/0.4 lessened the release of TNF-α and IL-1β consistent with the reduction of MPO activity, and HES 130/0.4 inhibited the activity of NF-κB in H-I/R group. The number of apoptotic cells in the H-I/R group was also significantly reduced compared with I/R and A-I/R group</p><p><b>CONCLUSION</b>HES130/0.4 has a protective effect on I/R injured myocardium, probably by inhibiting NF-κB activity, reducing the release of pro-inflammatory cytokines and interfering with the apoptosis of cardiomyocytes.</p>
Subject(s)
Animals , Male , Rats , Hemodynamics , Hydroxyethyl Starch Derivatives , Therapeutic Uses , Interleukin-1beta , Metabolism , NF-kappa B , Metabolism , Peroxidase , Metabolism , Rats, Sprague-Dawley , Reperfusion Injury , Metabolism , Pathology , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
BACKGROUND: Bupivacaine is widely used to alleviate post-operation pain and cure acute and chronic pain caused by inflammation or cancer.Its analgesic time cannot meet the request that drug is released slowly to prolong the analgesic time in clinic.OBJECTIVE: To detect the alleviating effect of bupivacaine polylactic acid microspheres taking high molecular polymer-polylactic acid as vector in rabbits with high performance liquid chromatograph (HPLC) and traditional skin test method.DESIGN: A completely randomized controlled animal experimental study.SETTING: School of Pharmacy, Second Military Medical University of Chinese PLAMATERIALS: Sixteen New Zealand rabbits, weighing (2.58±0.17)kg were used in this experiment.INTERVENTIONS: The experiment was carried out at the Department of pharmaceutics, School of Pharmacy, Second Military Medical University of Chinese PLA between September and November 2002. ① Animal models were established according to traditional skin test method. ② Totally 16 New Zealand rabbits were randomly divided into 2 groups: Group A and Group B, with 8 in each one. 5 mg/kg bupivacaine parenteral solution was injected subcutaneously in Group A, 5 mg/kg bupivacaine polylactic acid microspheres were implanted between subcutaneous tissue and sarcolemma in Group B. We took 1.5 mL blood from ear border vein at 5, 10, 20, 30,45 minutes, 1, 2, 3, 4, 6, 8, 12 and 24 hours after administration of bupivacaine parenteral solution respectively in Group A and another 1.5 mL at 0.5, 1, 2, 3, 4, 5, 6, 8, 12, 24, 3 6, 48 and 60 hours after admistration of bupivacaine microsphere powder for index detection. ③ HPLC method was used to detect the concentration and releasing effect of bupivacaine in blood serum.MAIN OUTCOME MEASURES: Concentration change of bupivacaine in blood serum and efficacy diameter of local anesthetic.RESULTS:All the 16 rabbits entered the stage of result analysis. ①Change of bupivacaine concentration: Plasma bupivacaine concentration in Group A reached the peaked quickly after subutaneous injection with the high concentration of 2.466 4 mg/L, then declined quickly. Plasma bupivacaine concentration in Group B was relative stable, reached a peak much slowly after subcutaneous implantation, with peak concentration of 0.778 1 mg/L, and the plasma bupivacaine concentration maintained a relative low level, the mean retention time was obviously prolonged (P ＜ 0.05).② Alleviating effect of bupivacaine: The analgesic time was significantly longer in the bupivacaine microsphere group than in the bupivacaine parenteral solution group (P ＜ 0.05).CONCLUSION:Bupivacaine polylactic acid microspheres have sustained release effects in rabbits.
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[Objective]To investigate the relationship between neurogenic pulmonary edema(NPE)and the changes of substance P in serum and bronchoatveolar lavage fluid(BALF)in acute spinal cord injured rats during isoflurane inhalation.[Method]Thirty male SD rats with body weight of 300-330g were randomly divided into 3 groups:1.5% isoflurane group,chloral hydrate group and sham operation group,ten in each group.Epidural balloon compression of the T8 spinal cord was performed.Alt animals were sacrificed 10 min after being compressed.The content of substance P and protein concentration in serum and BALF were measured.Then the lung permeability index(LPI)was calculated.[Result]The content of substance P in serum and BALF in 1.5% isofiurane group was higher than that in chloral hydrate group(P0.05).[Conclusion]1.5% isofturane can stimulate the release of substance P to take part in the development of neurogenic pulmonary edema in rats.
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[Objective]To investigate the changes of the hemodynamics and pulmonary histopathology in acute spinal cord injured rats during isoflurane inhalation.[Method]Sixty male SD rats with body weights of 300～330 g were divided into 3 groups:chloral hydrate group,1.5% isoflurane group and 3% isoflurane group.Epidural balloon compression of the T8 spinal cord was performed.Blood pressure and heart rate were monitored during surgery.All animals were sacrificed 10 min after being compressed.The author harvested the lung and recorded lung wet/dry weight ratios(W/D)to assess lung injury severity,and observed the changes of the pulmonary pathology.[Result]Blood pressure in all animals was higher than that of the baseline during the spinal cord injury,but the heart rate was lower than that of the baseline(P0.05).Rats from the 1.5% isoflurane group exhibited severe neurogenic pulmonary edema.The W/D in 1.5% group was significantly higher than those in the other two groups(P
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Objective To explore the protective effect of uridine 5'-triphosphate (UTP) on cerebral ischemia reperfusion injury in rats.Methods One hundred adult male SD rats were randomly divided into five groups (20 each):sham operation group,saline control group,G_ 10 group,G_ 30 group and G_ 90 group.Ischemia was induced by intraluminal suture embolism of mesocephalic artery (MAO) of the rats in all the groups except sham operation group.UTP solution was delivered through an indwelling tail venous catheter via microinfusion pump 30min after the occlusion of mesocephalic artery at a rate of 5ml/(kg?min),and rats in G_ 10,G_ 30 and G_ 90 group received 10,30 and 90?g/kg UTP,respectively.Rats in sham group and saline control group received normal saline.The total fluid volume was the same,1ml/kg,in all groups.Neurological deficit score (NDS) was determined 24h after reperfusion.Eight SD rats were then randomly selected from each group,and water content of cerebral hemispheres was measured.Two rats from each of sham operation group,saline control group and G_ 90 group were selected for studying the ultrastructure of brain tissue by electron microscopy.Infarct volume was determined by 2,3,5-triphenyl-tetrazolium chloride (TTC) staining with another 10 rats in each group.Results The protective effect of UTP was determined on cerebral ischemia-reperfusion injury in rats,and in G_ 90 group showed the most significant protective effect.For the rats in saline group and G_ 90 group,NDS score was 0.7 and 1.8 (P
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Objective To observe the reactivity of spinal cord transection (SCT) rat abdominal aorta to ?-AR agonists and the infuence of propofol on vascular reactivity, so as to explore the mechanism of autunomic dysreflxia. Methods The rats were divided into sham-operated group and SCT group. 4 weeks after transection of the fourth thoracic spinal cord, the rats were killed, then abdominal aorta rings were adopted to assay their sensitivity to noradrenaline, phenylephrine, clonidine and propofol in isolated organ perfusion system. Results Compared with the rats in sham-operated group, the abdominal aorta reactivity of SCT rats to noradrenaline and clonidine was significantly higher (P