ABSTRACT
Objective To study the clinical significance of dexamethasone (DT) in the combined spinal and epidural anesthesia for delivery of elderly parturient women. Methods 134 elderly parturient women were selected as the research object, and randomly divided into two groups. 69 cases in DT group received intramuscular injection of dexamethasone and combined anesthesia, while 65 cases in INN group received intramuscular injection of tramadol (INN) and combined spinal and epidural anesthesia. The anesthetic effect of the two groups were observed. Results After treatment, the interleukin (IL-6), myeloperoxidase (MPO), tumor necrosis factor-α (TNF-α) and methane dicarboxylic aldehyde (MDA) in DT group were significantly higher than INN group (P<0.05). The five kinds of immunoglobulins levels (IgA, IgD, IgE, IgG and IgM) in DT group were higher than those in INN group (P<0.05). The heart rate (HR) in DT group was lower and mean arterial pressure (MAP) was higher than that in INN group(P<0.05). There was 1 cases of macrosomia, 2 cases of premature delivery in DT group, the adverse pregnancy outcomes was 4.35%(3/69). there was 1 cases of macrosomia, 1 cases of congenital deformity, 1 cases of premature delivery and 1 case of postterm delivery in DT group, the adverse pregnancy outcomes was 5.80%(4/69), with no significant difference between two groups. Conclusion Dexamethasone combined with anesthesia is very effective for delivery of elderly parturient women which shows very good anti-inflammatory and immunoregulation.
ABSTRACT
Objective To investigate the effect of breviscapine on lung injury in children undergoing open heart surgery with cardiopulmonary bypass(CPB).Methods Forty-five ASA Ⅱ or Ⅲ children aged 3-65 months weighing 5-21 kg undergoing open heart surgery with CPB were randomly assigned to 3 groups ( n =15 each):control group (group C),low dose breviscapine group (group B1 ) and high dose breviscapine group (group B2).Normal saline 15 ml(group C),breviscapine 0.5 mg/kg (group B1 )or 1.0 mg/kg(group B2 ) were injected iv over 30min after anesthesia induction.Blood samples were taken before operation ( T0 ),at 30 min and 1 h of aortic unclamping (T1,T2 ),at 3 h and 6 h after operation (T3,T4 ) for determination of plasma procalcitonin (PCT)and neutrophil elastase(NE) concentrations.PaO2 and PaCO2 were recorded at T0,T3,T4 for caculation of oxygenation index (OI) and alveolo-arterial oxygen partial pressure difference (PA-a O2 ).Results There were no significant differences in OI and PA-a O2 among the 3 groups( P ＞ 0.05).Plasma concentration of PCT was higher at T1～4in 3 groups,and plasma concentration of NE was higher at T1 in group C than that at T0 ( P ＜ 0.01 ).Plasma concentrations of PCT and NE were lower in groups B1 and B2 than in group C ( P ＜ 0.01).There were no significant differences in plasma concentrations of PCT and NE between groups B1 and B2 ( P ＞ 0.05).Conclusion Breviscapine(0.5,1 mg/kg) can inhibite systemic inflammatory response and attenuate lung injury in children undergoing open heart surgery with CPB.