ABSTRACT
Objective To evaluate the optimum compatibility of nabufine mixed with flurbiprofen for patient-controlled intravenous analgesia (PCIA) after gynecological laparoscopic surgery.Methods A total of 210 patients,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologist physical status Ⅰ or Ⅱ,scheduled for gynecological laparoscopic surgery under general anesthesia,were divided into 4 groups using a random number table method:sufentanil 2.0 μg/kg+flurbiprofen axetil 2.0 mg/kg group (SF group,n =55),nalbuphine 1.5 mg/kg+flurbiprofen axetil 2.0 mg/kg group (N1 F group,n=49),nalbuphine 2.0 mg/kg+flurbiprofen axetil 2.0 mg/kg group (N2F group,n =55) and nalbuphine 3.0 mg/kg +flurbiprofen axetil 2.0 mg/kg group (N3F group,n=51).PCIA solution was prepared correspondingly after surgery in each group.The PCA pump was set up to deliver a 1 ml bolus dose with a 15-min lockout interval and background infusion at 2.0 ml/h.Nalbuphine 5 mg or sufentanil 5 μg was intravenously injected as a rescue analgesic to maintain visual analogue scale score at rest ＜4 at 48 h after surgery in SF and N1 F-N3F groups.Ramsay sedation scores were recorded on admission to post-anesthesia care unit (T1),at the time of post-anesthesia care unit discharge (T2) and at 6,24 and 48 h after surgery (T3-5).The total pressing times of PCIA in 0-6 h,6-24 h and 24-48 h periods after surgery and requirement for rescue analgesics were recorded.The incidence of adverse reactions such as nausea and vomiting,drowsiness and shivering within 48 h after surgery was also recorded.Results Compared with group SF,the incidence of nausea and vomiting was significantly decreased in N1 F and N2F groups,the requirement for rescue analgesics was significantly decreased,and the total pressing times of PCIA was reduced in N2F and N3 F groups,and Ramsay sedation scores at T3,4 were significantly increased in group N3F (P＜0.05).Compared with group N1 F,the requirement for rescue analgesics was significantly decreased,and the total pressing times of PCIA was reduced in N2F and N3F groups,and the incidence of nausea and vomiting and Ramsay sedation scores at T3,4 were significantly increased in group N3F (P＜0.05).Compared with group N2F,the incidence of nausea and vomiting was significantly increased (P＜ 0.05),and no significant change was found in the requirement for rescue analgesics,total pressing times of PCIA or Ramsay sedation scores in group N3F (P＞0.05).Conclusion Nabufine 2.0 mg/kg mixed with flurbiprofen 2.0 mg/kg is the optimum compatibility when used for PCIA after gynecological laparoscopic surgery.
ABSTRACT
Objective To evaluate the effect of astragaloside Ⅳ on postoperative cognitive function in aged rats.Methods Sixty healthy male Sprague-Dawley rats,aged 22 months,weighing 360-480 g,were divided into 4 groups(n=15 each)using a random number table:control group(group C),surgery group(group S),low-dose astragaloside Ⅳ group(group L-AGS)and high-dose astragaloside IV group(group H-AGS).At 3 days prior to surgery,astragaloside Ⅳ 20 and 40 mg/kg were injected intraperitoneally once a day in L-AGS and H-AGS groups,respectively.The equal volume of normal saline was given instead in C and S groups.The animals underwent splenectomy under anesthesia with 1.8% isoflurane in S,L-AGS and H-AGS groups.Five rats in each group were randomly sacrificed at 1 day after operation,the hippocampi were removed for determination of interleukin-1beta(IL-1β),tumor necrosis factor-alpha(TNF-α)and IL-6 contents(by enzyme-linked immunosorbent assay)and expression of activated caspase-3,Bax and Bcl-2(by Western blot).The left animals underwent Morris water maze test at 15 days after operation.Results Compared with group C,the escape latency was significantly prolonged,the frequency of crossing the original platform was reduced,the space exploration time was shortened,the expression of activated caspase-3 and Bax was up-regulated,the expression of Bcl-2 was down-regulated,and the IL-1β,TNF-α and IL-6 contents were increased after operation in group S(P<0.05).Compared with group S,the escape latency was significantly shortened,the frequency of crossing the original platform was increased,the space exploration time was prolonged,the expression of activated caspase-3 and Bax was down-regulated,the expression of Bcl-2 was up-regulated,and the IL-1β,TNF-α and IL-6 contents were decreased after operation in L-AGS and H-AGS groups(P<0.05).Compared with L-AGS,the escape latency was significantly shortened,the frequency of crossing the original platform was increased,the space exploration time was prolonged,and the TNF-α contents were decreased after operation in group H-AGS(P<0.05).Conclusion Astragaloside Ⅳ can improve the postoperative cognitive function in a dose-dependent manner in aged rats.