ABSTRACT
Objective:To evaluate the effect of stellate ganglion block on nighttime sleep quality in the patients with primary sleep disorders.Methods:Sixty patients of both sexes with primary sleep disorders, of American Society of Anesthesiology physical status Ⅰ or Ⅱ, aged 18-64 yr, weighing 40-75 kg, were randomized to 2 groups ( n=30 each): control group (group C) and stellate ganglion block group (group S). In group S, 0.2% ropivacaine 5 ml was injected into the surface of the right longus colli muscle where the the stellate ganglion was located under ultrasound guidance once a day for 7 consecutive days starting from 1 h before bedtime.While the equal volume of normal saline was given instead in group C. Patients′ Subjective Sleep Quality was assessed using the Pittsburgh Sleep Quality Index Questionnaire before treatment (T 0) and 1-7 days after treatment.The objective sleep quality was evaluated with polysomnography.A bispectral index(BIS)monitor and a cerebral and regional blood oxygen monitoring system were used to monitor the BIS value and regional cerebral oxygen saturation (rSO 2) during sleep, which were recorded once every 30 min, and the 7-day average was calculated.The patients′ daytime advanced cognitive function was assessed for 3 consecutive days after the end of treatment (T 8-10), including the Continuous Attention Test and the Behavioral Test for Performing Defect Syndrome, and the 3-day average value was calculated.Venous blood samples were collected at T 0 and T 8 to measure the plasma noradrenaline, cortisol, and serotonin concentrations by high-performance liquid chromatography. Results:Compared with group C, the individual and total scores of Pittsburgh Sleep Quality Index were significantly decreased, the sleep latency, awakening time and fast wave sleep latency were shortened, the number of awakening was increased, the total sleep time was prolonged, the sleep efficiency and proportion of fast wave sleep were increased, S 1-S 2 ratio in slow-wave sleep was decreased, S 3-S 4 ratio was increased, BIS value was decreased, rSO 2 was increased, each parameter of Continuous Attention Test was decreased and each parameter of Behavioral Test for Performing Defect Syndrome was increased after treatment, and plasma noradrenaline level was decreased at T 8 in group S ( P<0.05). Conclusion:Stellate ganglion block can improve nighttime sleep quality in patients with primary sleep disorders.
ABSTRACT
Objective To evaluate the efficacy of aminophylline for prevention of the negative chronotropic effect of remifentanil.Methods Forty patients undergoing general anesthesia,aged 20-55 yr,with body mass index of 18-25 kg/m2,of ASA physical status Ⅰ or 1Ⅱ,were randomly divided into control group (group C) and aminophylline group (group AP),with 20 patients in each group.At 30 min before induction of anesthesia,normal saline 20 ml was infused intravenously in group C,and aminophylline 3 mg/kg was infused intravenously in group AP.Midazolam 0.1 mg/kg was then injected intravenously.Remifentanil 2 μg/kg was injected intravenously after the patients fell asleep and then artificial ventilation was performed.Vecuronium 0.1 mg/kg,fentanyl 3 μg/kg,and etomidate 0.3 mg/kg were injected intravenously 7 min later.The patients were then endotracheally intubated and mechanically ventilated.HR and MAP were recorded before induction of anesthesia (T0),after falling asleep (T1),and at 0,1,3,5 and 7 min (T2-6) after the end of remifentanil injection.Low frequency (LF) and high frequency (HF) were recorded at T0,T1 and T2,and the ratio of LF/HF was calculated.Results Compared with the baseline value at T0,MAP and HR were significantly decreased at T2-6 in the two groups,and LF and HF were decreased at T1,and LF/HF ratio was increased at T1 in group AP.HR and LF/HF ratio were significantly higher,and LF and HF were lower at T1 in group AP than in group C.Conclusion The efficacy of aminophylline for prevention of the negative chronotropic effect of remifentanil on the hearts of patients is good.
ABSTRACT
BACKGROUND: Studies show that riluzole can greatly inhibit protein kinase C-?Ⅱ in mediating vascular endothelial cell growth factor effects on endothelial cells, so we presume it can be used in inhibiting retinal neovascularization. OBJECTIVE: To explore the inhibitory effects of riluzole on the proliferation of human umbilical vein endothelial cells and retinal neovascularization, and investigate potential mechanism of its effects. DESIGN, TIME AND SETTING: Single-sample observation and randomized controlled animal trial were performed at the Animal Laboratory and Basic Study Laboratory of Chongqing University of Medical Sciences from August to December 2007. MATERIALS: Thirty 3-day-old healthy C57BL/6 mice (60 eyes), irrespective of gender, were selected to model proliferative retinopathy induced by hyperoxia. Raw material of riluzole was product of Venturepharm Laboratories Limited, Beijing (No. 060630, content ≥98.5%). METHODS: Human umbilical vein endothelial cells were cultured, and randomly divided into 3 groups. The mice in hyperoxia model group and riluzole group were modeled, and riluzole group was additionally intraperitoneally injected 10 mg/kg per day riluzole; control group was intraperitoneally injected normal saline. MAIN OUTCOME MEASURES: Effect of riluzole on proliferation of endothelial cell proliferation induced by vascular endothelial growth factor was observed using MTT assay; The inhibitory effects of riluzole on retinal neovascularization were evaluated by counting the endotheliocyte nuclei of new vessels beyond the inner limiting membrane in sections with HE staining. The expression of retinal protein kinase C-?Ⅱand vascular endothelial growth factor were detected with SABC immunohistochemistry. RESULTS: The riluzole of 0.1-10 ?mol/L inhibited proliferation of human umbilical vein endothelial cells in a dose-effect dependent manner. The number of the endotheliocyte nuclei of new vessels beyond the inner limiting membrane was obviously less in eyes of normal control and riluzole groups than in the hyperoxia group (P