ABSTRACT
Spinal anesthesia with advantages of easy operation, fast effect and small maternal and neonatal effects has always been the preferred anes?thetic technique for cesarean section in China. However, maternal hypotension induced by spinal anesthesia remain a large challenge for anaesthetist. Perioperative fluid management plays important roles in maintaining maternal and fetal hemodynamics. This review mainly analyzes pathophysiological mechanism of maternal hypotension induced by spinal anesthesia,introduces different fluid?management strategy and functions on prevention of maternal hypotension.
ABSTRACT
Objective To investigate the effect of isoflurane pretreatment on hypoxia/reoxygenation (H/R)-induced syndecan-1 shedding from human umbilical vein endothelial cells (HUVECs) . Methods HUVECs were cultured in EMB-2 medium and randomly divided into 3 groups ( n = 32 each) : control group (group C), H/R group and isoflurane pretreatment group (group I). H/R was produced by 4 h exposure of HUVECs to hypoxia followed by 2 h reoxygenation in H/R and I groups. HUVECs were exposed to the mixture of 5% CO2 and 95% O2 for 30 min and then cultured in normal culture atmosphere (21% O2) in group C. In group I, HUVECs were expased to 1.73% isoflurane and incubated for 30 min before H/R. The syndecan-1 expression, concentrations of shed syndecan-1 in the medium, and cell permeability and viability were measured at the end of reoxygenation. Results Compared with group C, the shed syndecan-1 concentration in the medium and cell permeability were significantly increased, while the syndecan-1 expression and cell viability decreased in H/R and Ⅰ groups ( P ＜ 0.01) . Compared with group H/R, the shed syndecan-1 concentration in the medium and cell permeability were significantly decreased, while the syndecan-1 expression and cell viability increased in group Ⅰ (P ＜ 0.01) . Conclusion Isoflurane pretreatment can protect HUVECs against H/R injury through inhibiting the syndecan-1 shedding.
ABSTRACT
AIM: To observe the effect of continuous epidural analgesia (CEA) of tramadol on postoperative gastrointestinal function and serum motilin level in the patients with cholecystectomy. METHODS: Twenty eight ASAⅠ-Ⅱpatients (8 male, 20 female) aged 24-56 yr, scheduled for elective cholecystectomy under epidural anesthesia, were randomly divided into tramadol group (T, n=14) and control group (C, n=14). The combination of tramadol 800 mg+ bupivacaine 150 mg+ droperidol 5 mg, which diluted with normal saline to 100 ml and pumped 2 ml?h -1, was administered in group T. The combination in group C was bupivacaine 150 mg+ droperidol 5 mg. The VAS values, the first anorectum exhaust timing (FAET), and the time of the first eliminating stool timing (FEST) were recorded, and serum motilin level measured with radioimmunoassay at the different times after surgery. RESULTS: There was a significant difference in the mean VAS values between group T ( 1.2? 1.2) and group C ( 3.3? 1.3) (P