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Objective To compare the volume kinetics of lactated Ringer' s solution during induction of general and epidural anesthesia in elderly patients.Methods Forty ASA Ⅰ or Ⅱ patients,aged 66-86 yr,weighing 45-86 kg,undergoing elective surgery,were studied.In epidural anesthesia group (n =20),lactated Ringer' s solution was infused intravenously starting from 10 min before epidural anesthesia was performed with local anesthetics.In general anesthesia group (n =20),lactated Ringer' s solution 1000 ml was infused intravenously over 60 min starting from 20 min before induction of anesthesia.Arterial blood samples were obtained every 5 min for measurement of hemoglobin concentrations.The plasma dilution,volume increase,and volume expansion efficacy were calculated.Results The plasma dilution,volume increase and volume expansion were significantly higher at 30-60 min of lactated Ringer' s solution infusion in general anesthesia group than in epidural anesthesia group (P ＜ 0.05 or 0.01).Conclusion The volume expansion of lactated Ringer' s solution is greater in elderly patients during induction of general anesthesia than that during induction of epidural anesthesia.
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Objective To observe the effects of different posture on hemodynamics and plasma atrial natriuretic polypeptide(ANP) during laparoscopic surgery. Methods Forty patients who scheduled for elective laparoscopic surgery under general anesthesia were allocated into two groups according to their posture during laparoscopic surgery,20 cases for each group. In group A, the patients were arranged in a head-down tilt position, in group B, the patients were arranged in a head-up tilt position systolic blood pressure (SBP),diastolic blood pressure (DBP),central venous pressure (CVP) and electro cardio gram (ECC) were monitored continuously. Blood samples were taken from central venous at four time points of prepneumoperitoneum(T1), 10 minutes after that(T2) and 20 mintues(T3) when the patients were arranged at the different operation-needed position with a stable pneumoperitoneum pressure of 14 mm Hg (1 mm Hg = 0.133 kPa),and at 5 minutes (T4) after deflation of pneumoperitoneum when the patients returned to supine position. The plasma ANP was assessed by radioimmunoassay. Results In group A,the CVP at T2 and T3 [(14.45 ±2.72),(14.20 ±2.46) mm Hg] was significantly higher than that at T1 [(6.05 ±1.76) mm Hg] (P<0.01), in group B,the CVP at T2 and T3 [(8.90±1.27),(9.02 ±0.47) mm Hg] was significantly higher than that at T1[(6.30 ±1.34) mm Hg](P< 0.01) ,with a higher level in group A than those in group B at the same time point during pneumoperitoneum(P< 0.01). The ANP level in group A was higher at T2 than that at T1, and there was significantly higher at T3 than that at T1 (P < 0.05). But the ANP level was significantly higher in group A than that in group B at the same time points of T2 and T3 (P < 0.05). Conclusion The posture may have obvious effect on CVP and plasma ANP level during laparoscopic surgery.
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Objective: To investigate the effects of different anaesthesia on serum catechlomine and IL-6 in surgical breast cancer patients,and evaluate the influence of anaesthesia on surgical stress.Methods: Forty breast cancer patients submitted to elective masteetomy were randomly divided into 2 groups:GEA group (general plus epidural anaesthesia,n=20),GA group (genernal anaesthesia,n=20). Blood samples were taken before operation, 30min, 120min following the incision and at the 1st and 3nd postoperative days. The concentrations of serum catechlomine and IL-6 were detected.Results: The concentrations of serum norepinephrine(NE),epinephrine(E),dopamine(DA) and catechlomine(CA) were similar in 2 groups before operation,and remarkably increased at 30min after incision and reached the peak values at 120min after incision. They were at the high level at the 1st day after operation(P