ABSTRACT
Objective To observe the efficacy and safety of Dexmedetomidine mixed with Ropivacaine for adductor canal block combined with general anesthesia in patients undergoing arthroscopic knee surgery. Methods Ninety patients underwent elective unilateral arthroscopic knee surgery were randomly divided into three groups (n = 30 each): general anesthesia group (Group G), general anesthesia + Ropivacaine for adductor canal block group (Group G+R) and general anesthesia + Dexmedetomidine mixed with Ropivacaine for adductor canal block group (Group G+DR). After the end of anesthesia induction, ultrasound-guided adductor canal block was performed in G+R and G+DR groups. In G+R and G+DR groups, 20 ml of 0.375% Ropivacaine and 20 ml of 0.375% Ropivacaine mixed with 0.6 μg/kg Dexmedetomidine were injected, respectively. After the induction of general anesthesia, the i-gel laryngeal mask airway was inserted, and the patients were mechanically ventilated in the two groups. Anesthesia was maintained with Remifentanil 0.15 μg/(kg?min) and Propofol adjusted to maintain BIS between 45 and 55. The time for recovery of spontaneous breathing, emergence time, and time for removal of LMA were recorded. The VAS scores at rest, during active functional exercise (AFE) and continuous passive movement (CPM) were recorded at the following points: 1 h, 4 h, 8 h, 12 h and 24 h after surgery. And quadriceps strength was evaluated at the following points: preoperative evaluation, 1 h, 4 h, 8 h, 12 h and 24 h after surgery. The total consumption of rescue analgesics, complications associated with adductor canal block, and occurrence of adverse cardiovascular events, over-sedation and postoperative nausea and vomiting were also recorded. Results Compared with Group G and Group G+R, the time for recovery of spontaneous breathing, emergence time, and time for removal of LMA were significantly shorter (P < 0.01). Compared with Group G, the VAS scores at rest, during AFE and CPM at 1 h and 4 h after surgery and the total consumption of Flurbiprofen axetil in Group G+R, and the VAS scores at rest, during AFE and CPM at 1 h, 4 h, 8 h and 12 h after surgery and the total consumption of Flurbiprofen axetil in Group G+DR were lower (all P < 0.05). Compared with Group G+R, the VAS scores at rest, during AFE and CPM at 8 h and 12 h after surgery and the total consumption of Flurbiprofen axetil in Group G+DR were lower (P < 0.01). No significant differences were seen among three groups in the terms of quadriceps strength, Dezocine consumption and adverse reactions (P > 0.05). Conclusion 0.6 μg/kg Dexmedetomidine mixed with 0.375% Ropivacaine 20 ml can provide faster recovery from anesthesia and effectively improve postoperative analgesia without inducing obvious adverse reactions when used for adductor canal block combined with general anesthesia in patients undergoing arthroscopic knee surgery.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the expression of 17 beta-hydroxysteroid dehydrogenase type 1 (17β-HSD1) in the kidney of rats and explore the capacity of the kidney for synthesizing sex hormones.</p><p><b>METHODS</b>The expressions of 17-HSD1 and sex hormones were detected by Western blotting and radioimmunoassay in rat renal cells in primary cultured for 24 and 48 h in the presence or absence of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).</p><p><b>RESULTS</b>After cell culture for 24 h, the primary rat renal cells expressed a low level of 17β-HSD1 (0.1843±0.076), which increased to 1.6651±0.044 (P<0.01) in response to co-stimulation by FSH and LH. Low levels of estradiol, progesterone and testosterone were also detected in rat renal cells (3.30±3.78, 62.60±12.33, and 22.12±3.36, respectively), and co-stimulation of FSH and LH significantly increased their levels to 8.50±2.64, 117.80±9.79, and 45.04±4.39, respectively (P<0.05). The levels of these hormones showed no significant differences between cells cultured for 24 h and 48 h (P>0.05).</p><p><b>CONCLUSION</b>The rat renal cells express 17β-HSD1 and are capable of stably secreting sex hormones in response to co-stimulation with FSH and LH, suggesting the capacity of the rat kidneys for synthesizing sex hormones. These findings enrich the understanding of the endocrine function of the kidney.</p>