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Objective To explore whether dexmedetomidine(Dex)could mitigate acute lung in-jury induced by hind limb ischemia reperfusion(I/R).Methods One hundred and twenty SD rat weigh-ting 250-300 g were allocated to receive hind limb I/R,I/R plus Dex (25 μg/kg Dex was intraperitoneal in-jection 30 min before ischemia)and norm control group,and each group was further divided into five sub-groups:before operation and 4 h ischemia followed by 0,1,3 and 6 h reperfusion.After euthanization,lung W/D weight ratio,PaO2 ,SOD,MDA and TNF-α were determined.Results Compared with group C, hind limb I/R injury significantly increased serum TNF-α concentration and W/D ratio,with significantly decreasing PaO2 level at any time of reperfusion in the group I/R,the concentration of MDA increased and the SOD activity decresed at 1,3,6 h of reperfusion.Conversely,W/D ratio as well as the concentration of TNF-αin the serum of the I/R plus group Dex were significantly lower than those of the I/R at 6 h of reperfusion,PaO2 level increased respectively;the concentration of MDA decresed at 1,3,6 h of reperfusion and the SOD activity increased at 3,6 h of reperfusion in I/R plus group Dex.Conclusion Dex mitigates a-cute lung injury induced by unilateral hind limb I/R in rats.The mechanisms may involve attenuating oxida-tive stress and inhibiting inflammatory response.
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Objective To investigate the effect of different excipients of propofol on blood lipids and liver function during orthotopic liver transplantation. Methods Forty ASA Ⅲ- Ⅳ patients aged 40-64 yr weighing 50-75 kg undergoing orthotopic liver transplantation were randomly divided into 2 groups ( n = 20 each): propofol medium-chain triglycerides/long-chain triglycerides (MCT/LCT) group (group M) and propofol LCT group (group L). Anesthesia was induced with penehyclidine 1 mg, midazolam 0.04-0.06 mg/kg, sufentanil 0.6-0.8 μg/kg and propofol 1.5-2.0 mg/kg. Tracheal intubation was facilitated with vecuronium 0.10-0.15 mg/kg. The patients were mechanically ventilated. Anesthesia was maintained with 1%-2% isoflurane, continuous infusion of propofol blood samples were collected after admission into the operation room (T1), before skin incision (T2), at the end of pre-anhepatic phase (T3), at the end of anhepatic phase (T4) and 30 and 240 min of neohepatic phase (T5, T6 )for determination of plasma concentrations of triglyceride (TG), total cholesterol (CH), high-density-lipoproteincholesterol (HDL-C), low density-lipoprotein-cholesterol (LDL-C), and activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The changes in parameters from baseline values were calculated. Results Compared with group L, △TG was significant1y decreased at T4-6 in group M ( P ＜ 0.05 ) . There was no significant difference in △CH, △HDL-C, △LDL-C, △AST and △ALT,plasma concentrations of TG,CH, HDL-C and LDL-C,and activities of AST and ALT between the two groups ( P ＞ 0.05). Conclusion The effect of the two formulations of propofol on liver function is comparable. Propofol MCT/LCT exerts less effect on blood lipids during liver transplantation and is more suitable for this type of surgery.
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@#ObjectiveTo investigate the remote renal injury after liver ischemia-reperfusion(I/R) and the renal protection afforded by propofol.Methods 72 male SD rats were randomly divided into three groups:normol control group, I/R group and propofol group .The animals were killed after 60 minutes ischemia of liver followed by reperfusion for 4 h,2 h. Blood urea nitrogen (BUN) and creatinine (Cr) were detected,and renal histopathologic lesion were observed.ResultsIn I/R group,the serum level of BUN and Cr increased significantly compared with the baseline before liver I/R,while propofol could decrease the serum level of BUN and Cr significantly.ConclusionPropofol can reduce the renal injury during liver I/R.
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@#ObjectiveTo observe the effect of patient controlled analgesia (PCA) of with tramadol intravenous and epidural injection after prostate operation.Methods90 patients undergoing prostatectomy were randomly divided into intravenous PCA group (PCIA), epidural PCA group (PCEA) and control group (not using easy pain drug), with 30 cases in each group. The loading dose of tramadol was 1 mg/kg. The severity of pain, incidence of nausea and vomiting, total dosage of tramadol used in 24 h ,and patient's satisfaction were assessed.ResultsThe postoperative pain scores of PCIA group were significantly lower than that of PCEA group. Between two groups, there were no significant differences in the overall satisfaction of pain relief, sedation and vomiting.ConclusionPCA with tromadol is safe and effect after prostate operation, and the effect of intravenous PCA is better than that of epidural PCA.
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Objective To observe the changes in acid-base balance and the contents of electrolytes in patients during liver transplantation to explore the relationship between such changes and ASA grading, and to look for an optimal anesthetic intervention. Methods Arterial pH, PaO_2, PaCO_2, HCO~-_3, BE, K~+, Ca~ 2+ , Na~+, and glucose were monitored in 89 patients undergoing liver transplantation at four specific periods: before anesthesia (T_0), after skin incision (T1), 10 minutes before reperfusion (T_2), and 10 minutes after reperfusion (T_3). Changes in blood acid-base and electrolyte parameters of the patients with different ASA status were compared. Result The pH and BE in ASA V patients was significantly lower at T_0, T_1, T_2 and T_3, and HCO~-_3 was lower in ASA V at T_3. The PaCO_2 in ASA V patients was significantly higher at T_0, T_1 and T_2. The Na~+ content in ASA V patients was significant higher at T_2 and T_3. At T_0 and T_1, the glucose level in ASA Ⅳ and Ⅴ were significant higher than in ASAⅢ. Significant differences in pH, PaCO_2, HCO~-_3, BE and glucose level were observed at different stages of the surgical procedure. The pH, BE and HCO~-_3 were significantly lowered at T_2 and T_3. Mean glucose and HR levels were gradually increased from T_1 to T_3. Conclusion Patients with advanced ASA grades are more prone to acid-base and electrolyte disturbances during reperfusion of the liver transplant. High ASA grades contitute an increased risk for cardiovascular collapse after reperfusion, calling for proper treatment.