Comparison of the effects of propofol total intravenous anesthesia vs higher dosages of fentanyl anesthesia on myocardial function in CABG operation / 解放军医学杂志

Objective To evaluate the effects of different anesthetic methods on myocardial function after the CABG operation and compare the hemodynamic variables under the propofol total intravenous anesthesia with high dosages fentanyl anesthesia. Methods 12 patients (ASA Ⅲ) undergoing selective CABG operation under CPB were randomly divided into two groups (with 6 in each): Group Ⅰ (large dosages of fentanyle anesthesia), and Group Ⅱ (propofol total intravenous anesthesia). The hemodynamic parameters were recorded after induction of anesthesia, after sternotomy, after CPB, and after closure of thoracostomy. Results There were no significant differences of MBP, HR, SVRI, CI, LVEF, and A/E, Tei index between the two groups. Conclusion The method of propofol total intravenous anesthesia (TIVA) was safe, effective and praticable for the CABG operations under CPB.

The comparison of cerebral oximetry and somatosensory evoked potential for monitoring carotid endarterectomy / 解放军医学杂志

Objective To compare cerebral oximetry(rSO 2 %)and somatosensory evoked potential (N 35 ) in their accuracy in monitoring cerebral perfusion during carotid endarterectomy procedure under general anesthesia. Methods Ten patients (6 males, 4 females), scheduled for selective carotid endarterectomy, were enrolled in the study. Their rSO 2 %and N 35 were also continuously monitored and recorded during perioperative periods. The patients' cognitive function was evaluated at the same time. The MAP, HR, SpO 2 were continuously monitored during operation. Results There was a significant difference in rSO 2 % between that at the period of elamping and that at the period of declamping of the carotid artery. No patients suffered from cognition dysfunction during perioperative period. Conclusion With comparison to the amplitude of N 35 it was rSO 2 % which was earlier to show alteration in cerebral perfusion in case of cerebral oxygen deficit. In monitoring cerebral perfusion, rSO 2 % was better than N 35

7-Nitro indazole as a selective inhibitor of neuronal NO synthase decreases sevoflurane MAC and cerebellar cMGP content / 中华麻醉学杂志

Objective:To examine the effects of acute or chronic administration of 7-nitro indazole (7-NI) on the MAC of sevoflurane and cerebellar cGMP levels in mice. Method:In acute experiment,sevoflurane MAC was determined in mice after 7-NI 120mg/kg, 180mg/kg or 120mg/kg plus L-arginine 600mg/kg was given intraperitoneally. During chronic experiment, MAC was measured on 1st, 4th and 7th day during week-long gavage feeding of 7-NI. The levels of cerebellar cGMP also were measured after acute and chronic administration of 7-NI. Result:Acute administration of 7-NI 120mg/kg decreased sevoflurane MAC by about 20% and cerebellar cGMP level by 96%. 7-NI 180mg/kg did decrease MAC not more than 7-NI 120mg/kg. No significant reduction of MAC was observed in mice treated by intraperitoneal 7-NI 120mg/kg+L-arginine 600mg/kg. In chronic experiment,sevoflurane MAC and cerebellar cGMP were decreased significantly on 1st 4th and 7th day to the similar extend, with 15%-20% reduction in MAC and 46%-60% in cGMP levels. Conclusion:Acute and chronic selective inhibition of nNOS decreases sevoflurane MAC and cerebellar cGMP levels in mice. The maximal reduction (only about 20%) of MAC can be obtained when cGMP levesl are decreased about 50% and further inhibition of generation of cGMP does not produce more enhancement to the potency of sevoflurane anesthesia. No compensatory mechanism for the inhibition of L-Arg-NO-cGMP pathway appears during week-long treatment with 7-NI.