ABSTRACT
Objective To investigate the effects of ropivacaine infiltration combined with dezo-cine intravenous on stress response during recovery from general anesthesia in patients undergoing e-sophageal cancer surgery.Methods One hundred and forty-four patients of esophageal cancer under-going elective surgery were randomly divided into dezocine group (group D,n = 48 ),ropivacaine group (group R,n =47)and ropivacaine combined with dezocine group (group RD,n =49 ).Before slicing 10 min,patients in group D were taken 20 ml saline infiltration anesthesia (1∶200 000 epi-nephrine),while in group R and group RD were taken 20 ml 0.5% ropivacaine infiltration anesthesia. Patients in the group R were injected intravenously 2 ml saline,while in group D and group RD were injected intravenously 10 mg dezocine 30 min before the end of surgery.Peri-operative bleeding,oper-ation time,recovery time of anesthesia,extubation time and the dosage of propofol and sufentanil of three groups were recorded respectively.At the time points of before induction of anesthesia (T0 ), the end of the surgery (T1 ),removal trachea immediate (T2 ),10 min (T3 )and 30 min (T4 ),the blood pressures and heart rates were recorded,and the serum levels of malondialdehyde (MDA),epi-nephrine (E)and norepinephrine (NE)were detected.Results Recovery time of anesthesia and extu-bation time in group R and group RD were shorter than that in group D significantly (P <0.05).The dosage of propofol and sufentanil in group R and group RD were less than that in group D significantly (P <0.05).Compared with T0 ,SBP in three groups were elevated significantly at T1-T4 (P <0.05), DBP and HR in group D and group R increased significantly at T3 (P <0.05).DBP and HR in group RD at T3 were lower than that in group D and group R significantly (P <0.05).Compared with T0 , the levels of blood sugar,Cor,MDA,E and NE in three groups were elevated significantly at T1-T4 (P <0.05).The levels of blood sugar,Cor,MDA,E and NE in group RD at T1-T4 were lower than that in group D and group R significantly(P < 0.05 ).The incidences of agitation and elevation of blood pressure in group RD were lower than that in group D and group R significantly (P <0.05 ). Conclusion Ropivacaine infiltration combined with dezocine intravenous applied in the esophageal cancer surgery could effectively reduce the stress response during recovery from anesthesia,and de-crease the incidence of agitation.
ABSTRACT
Objective To observe the changes of PPARγ expression in ventilator-induced lung injury rats and explore the role of PPARγ in the pathogenesis of ventilator-induced lung injury. Methods Sixty male Sprague-Dawley rats were randomly divided into 3 groups ( n=21 each ):group N received large tidal volume with mechanical ventilation ( Vt=12 mL/kg);group C received lower tidal volume with mechanical ventilation ( Vt=6 mL/kg);group R received room air without mechanical ventilation. Rats in every group were randomly divided into 3 subgroups respectively by 1,4 and 8 h. The samples of lung were collected at 1,4 and 8 h after ventilation. Lung pathological examina-tion, total protein and white blood cells in bronchoalveolar fluid and wet-to-dry weight were detected. The exoressions of PPARγmRNA were detected by RTPCR;PPARγ protein in lung tissues was detected by western bolt. Result After 4 and 8 h ventilation in group N,total pro-tein and WBC in bronchoalvelor fluid,W/D were markedly higher than those of group C and R (P 0. 05). Conclusion PPARγmRNA and protein expressions in the rats lung tissue of ventilator-induced lung injury were decreased and as-sociated with inflammation and damage of lung tissue.
ABSTRACT
Objective To compare the efficacy of tramadol for patient-controlled intravenous versus provicial epidural analgesia (PCIA vs PCEA) and their effects on the T-lymphocyte subsets and natural killer (NK) cells during postoperative period in patients undergoing gynecological operation for tumor. Methods Thirty-nine ASA Ⅰ-Ⅱ patients aged 18-83 yr undergoing elective surgery for ovarian cancer or uterine cancer or myoma were randomly divided into two groups : PCIA group (n = 21) and PCEA group ( n = 18). Premedication consisted of intramuscular atropine 0.5 mg and phenobarbital 0.1 g. Operation was performed under epidural anesthesia. Epidural catheter was inserted at T12 -L1 approximately 3-4 cm into epidural space cephalad. The patients received a test dose of 2% lidocaine 5 ml. The first dose was 2% lidocaine 10-12 ml followed by 0.5% bupivacaine 5 ml every 45-60 min. Tramadol 100 mg was given iv in PCIA group or epidurally in PCEA group 15 min before the end of surgery. 100 ml of PCIA solution contained tramadol 800 mg (16 ml), haloperidol 5 mg (1 ml) and normal saline 83 ml and 100 ml of PCEA solution contained tramadol 400 mg (8 ml), haloperidol 5 mg (1 ml) and NS 91 ml. The PCA pump was set to deliver a background infusion at 2 ml?h-1 and a bolus dose 0.5 ml with lock-out interval of 15 min. Analgesia was assessed using VAS. Venous blood samples were taken for determination of T-lymphocyte subset (CD3+ , CD4+ , CD8+) and NK cell counts by flow cytometry the day before surgery and on 1st and 2nd postoperative day. Results The postoperative analgesia was satisfactory in both groups, and there was no significant difference in VAS scores between the two groups. No vomiting and respiratory depression were observed in both groups. The NK cell counts decreased significantly on the 1 st and 2nd postoperative day as compared with the preoperative value (P