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<p><b>OBJECTIVE</b>To evaluate efficacy of dexmedetomidine in preventing shivering after general anesthesia in women undergoing laparoscopic surgery.</p><p><b>METHODS</b>Eighty patients scheduled for laparoscopic gynecological surgery were randomized into dexmedetomidine group (n=40) and control group (n=40) to receive 1.0 µg/kg dexmedetomidine or an equal volume of saline slowly injected (for over 10 min) at 30 min before the anticipated completion of surgery. The postoperative incidences of shivering and the side effects were recorded.</p><p><b>RESULTS</b>The patients in the control group showed a significantly higher postoperative incidence of shivering (37.5%) than those in dexmedetomidine group (P<0.05). Heart rate and mean arterial pressure showed significant variations postoperatively in dexmedetomidine group (P<0.05), which had a significantly greater sedation score (P<0.05), a higher incidence of dry mouth (P=0.000), but a significantly lower incidence of nausea and vomiting than the control group (P<0.05).</p><p><b>CONCLUSION</b>Dexmedetomidine can lower the incidence of shivering after general anesthesia for laparoscopic gynecological surgery.</p>
Subject(s)
Adult , Female , Humans , Anesthesia, General , Dexmedetomidine , Therapeutic Uses , Gynecologic Surgical Procedures , Methods , Laparoscopy , Methods , Prospective Studies , Shivering , Single-Blind MethodABSTRACT
Objective To investigate the association between the C609T polymorphism of NAD (P)H:quinoneoxidoreductase (NQO1) gene and post operative cognitive dysfunction (POCD).Methods 90 ASA Ⅰ-Ⅱ patients of 59 to 78 years old, undergoing elective hip replacement with epidural anesthesia were enrolled.All patients were given a battery of 5 neuropsychological tests before operation and seven days after operation.Patients were divided into POCD group and control group according to test results (45 patients in each group).The single nucleotide polymorphism C609T of NQO1 gene was detected using real-time PCR by Taqman probes and subjected to odd ratio assessment.Results 5 samples in control group couldn' t be used in the real-time PCR analysis due to quality control.The frequency of C/C genotype in POCD control was lower than that of control group ( 30.0% vs 11.1% ) with statistical significance ( OR = 0.292,95 % CI 0.092 ～ 0.92 1, P ＜ 0.05 ).The C/T +T/T genotype frequency was significantly higher in group POCD than in the control group(88.8% vs 70% ).Patients presented with C/T + T/T genotype showed an evidently increased risk of POCD ( OR =3.42,95% CI 1.08 ～ 10.82,P ＜ 0.05 ).The frequency of C allele of NQO1 gene in group control was 56.2%, as compared with 40% in group POCD with significance ( OR = 0.519,95% CI 0.282 ～ 0.955, P ＜ 0.05 ).The frequency of T allele of NQOI gene in control group was 43.7% ,as compared with 60.0% in POCD group( OR = 1.93,95% CI 1.047 ～3.552,P＜O.05).Conclusion The NQO1 gene single nucleotide polymorphism C609T is evidently associated with the increased risk of POCD.
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Objective To determine whether fetal rats exposure to isoflurane will cause postnatal learning and memory deficits,and change Bcl-2/Bax ratio in the hippocampus CA1 and retrosplenial cortex in fetal brain of rats. Methods Twenty-eight Sprague Dawley pregnant rats at gestation day 21 (E21) were randomly divided into isoflurane treatment group(n=14) and sham control group(n=14). Rats in isoflurane treatment group were ex-posed to 1.3% isoflurane in a carrying gas of 30% oxygen, balance nitrogen for 6 h in a warmed, humidified cham-ber. For sham control group,animals were treated at the same condition with only carrying gas. In behavior study,the spatial learning and memory ability at juvenile ages was determined with the Morris Water Maze(MWM). In immunohistochemistry study,changes of Bcl-2 and Bax expression in hippocampus CA1 and retrosplenial cortex in the fetus brain after isoflurane treatment at 2 hours was performed by using immunofluorecence staining.Results In the MWM training, the escape latency to platform in the place trials showed no significant difference between the two groups,but the postnatal rats in 1.3% isoflurane group showed obviously improved retention of memory by spending more percentage of time swimming in the probe quadrant as compared to the control animals ((42.33±2.31) s vs (33.2±2.15) s, t=2.21, P<0.05) in the probe test. Compared to controls, 1.3% isoflu-rane exposure for 6 h to the pregnant rats increased the intensity of Bcl-2, decreased the intensity of Bax, and sig-nificantly increased the Bcl-2/Bax ratio in the fetal hippocampal CA1 region (4.40±0. 86 vs 1.31±0.32, t=3. 378, P<0.01) and the fetal retrosplenial cortex (5.07±1.27 vs 1.47±0.48, t=2.656, P < 0.05) respec-tively. Conclusion 1.3% isoflurane exposure in pregnant rats significantly improves the spatial retention memo-ry of their rat pups at a juvenile age and increases the Bcl-2/Bax ratio in the hippocampal CA1 region and the ret-resplenial cortex in the fetal rat brains.
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Objective To investigate the effect of morphine postconditioning on myocardial ischemiarepedusion(I/R)injury and the role of PI3K/Akt signaling pathway in the effect.Methods Seventy male SD rats weighing 280-330 g aged 16-17 weeks Were randomly divided into 5 groups(n=14 each):group Ⅰ sham operation(S);group Ⅱ I/R;group Ⅲ morphine postconditioning(M);group Ⅳ morphine postconditioning+ wortmannin(W+M);groupV wortmannin(W).Myocardial I/R injury wa.g produced by occlusion of anterior descending branch of left coronary artery for 45 min followed by 120 min reperfusion.In group M and W+M (groupⅢ,Ⅳ)morphine 1.25 mCkg was given iv at 3 min before and 2 min after reperfusion.In group W+M and W(groupⅣ,Ⅴ)wortmannin(a specific PDK inhibitor)15μ/gkg Was given iv at 20 min before ischemia. The animals were sacrificed at the end of 120 min repedusion for assessment of ischemic and infarct area and determination of total and phosphorylated Akt expression in myocardium by Western blot.Results There were no significant differences in the size of ischemic area and total Akt expression among the 5 groups. The infarct area was significantly smaller in group M than in group I/R. The were no significant differenees in the size of infarct area between group 1/R, W + M and W (group Ⅱ , Ⅳ,Ⅴ ). The phosphorylated Akt expression was significantly upregulated in group I/R and M as compared with group S, and was significantly higher in group M than in group I/R.Conclusion The PI3K/Akt signaling pathway activation is involved in the protective effect of morphine posteondifioning on myocardium against I/R injury.