ABSTRACT
Objective To investigate the effect of perioperative anesthesia management on postoperative complications of laparoscopic operation for elderly patients,and to provide reference for the clinical anesthesia man-agement.Methods 90 elderly patients who received laparoscopic surgery were randomly divided into observation group and control group,45 cases in each group.The control group was treated with the routine intervention of the perioperative anesthesia management,and the observation group was given to strengthen the perioperative anesthesia management.The intubation,skin incision,withdrawal of blood pressure,heart rate changes before surgery,and abnor-mal blood pressure,chills,hypoxemia,ischemic heart disease,incidence of complications after surgery were compared between the two groups.Results Before surgery,the withdrawal of the systolic blood pressure,diastolic blood pres-sure,heart rate between the two groups had no statistically significant differences (P >0.05 ).In the observation group,during tracheal intubation for systolic blood pressure (136.92 ±19.57 )mmHg,diastolic blood pressure (84.57 ±12.39)mmHg,after skin incision systolic blood pressure (126.93 ±16.68)mmHg,diastolic blood pressure (78.43 ±11.76)mmHg,which were significantly higher than those in the control group (P <0.05).In the observa-tion group,during tracheal intubation the heart rate was (74.46 ±11.28)/min,which was significantly lower than the control group (P <0.05),abnormal blood pressure of the patients in the observation group was 8 cases,2 cases of shivering,hypoxemia in 1 case,the incidence rate of postoperative complications was 24.44%,abnormal blood pres-sure after surgery in the control group had 15 cases,4 cases of shivering,hypoxemia in 5 cases,ischemic heart disease 2 cases,the incidence rate of postoperative complications was 57.78%.The incidence of postoperative complications in the observation group was significantly lower than that of the control group (χ2 =14.58,P <0.05).Conclusion To strengthen the perioperative anesthesia management helps to reduce the blood pressure and heart rate fluctuations during perioperative period,and can reduce the incidence of postoperative complications and improve the safety of anesthesia.
ABSTRACT
Objective To evaluate the role of chemokine CXC ligand 13 (CXCL13) in spinal cord in neuropathic pain (NP) in rats.Methods One hundred and eight male Sprague-Dawley rats,weighing 150-200 g,were randomly divided into 4 groups (n =27 each):sham operation group (group S),group NP,small interference RNA (siRNA) negative control group (group NS) and CXCL13-siRNA group (group CS).The animals were anesthetized with intraperitoneal ketamine 50 mg/kg.NP was induced by ligation of L5 spinal nerve (SNL) in groups NP,NS and CS.L5 spinal nerve was only exposed but not occluded in group S.CXCL13-siRNA lentivirus and siRNA negative control lentivirus were injected intrathecally in groups CS and NS,respectively.Mechanical pain threshold was measured at 3,7 and 14 days after SNL.Then the rats were sacrificed and L4-6 segments of the spinal cord were obtained for determination of coexpression of CXCL13 and Neun (by immunofluorescence),activation of astrocytes,and expression of CXCL13 and glial fibrillary acidic protein (GFAP) protein (by Western blot) and mRNA (by RT-PCR) in spinal cord tissues.Results Compared with group S,mechanical pain threshold was significantly decreased and the expression of CXCL13 and GFAP protein and mRNA was up-regulated at each time point after operation in groups NP,NS and CS (P ＜ 0.05).Compared with group NP,mechanical pain threshold was significantly increased and the expression of CXCL13 and GFAP protein and mRNA was down-regulated at each time point after operation in group CS (P ＜ 0.05).There was no significant difference in the indexes mentioned above at each time point after operation between groups NP and NS (P ＞ 0.05).Conclusion CXCL13 is involved in the development and maintenance of NP in rats via activation of astrocytes.