Determination of 50% effective concentration of ropivacaine plus sufentanil in dural puncture epidural analgesia for labor / 中国医师进修杂志

Objective:To determine the 50% effective concentration (EC 50) of ropivacaine plus sufentanil for labor analgesia using the dural puncture epidural technique. Methods:Using the method of prospective study, sixty parturients requiring labor analgesia in Dalian Women and Children′s Medical Group from May 2021 to May 2022 were divided into six groups using a random number table and administered 0.3 mg/L sufentanil and ropivacaine at different concentrations: 0.05% (group D1), 0.06% (group D2), 0.07% (group D3), 0.08% (group D4), 0.09% (group D5), and 0.1% (group D6). A probit model was constructed to compute the EC 50 values and 95% confidence intervals (95% CI) of ropivacaine plus sufentanil in dural puncture epidural analgesia (DPEA) for labor. The pain intensity of uterine contractions before labor analgesia and 30 min after administration was recorded and assessed on a numeric rating scale (NRS), and decreases in blood pressures and heart rates, vomiting and nausea, postpartum headaches, and fetal bradycardia were documented. Results:When using ropivacaine plus sufentanil for labor analgesia via DPE, the EC 50 was 0.061%, and the 95% CI ranged from 0.051 to 0.067; the 90% effective concentration (EC 90) was 0.081%, and the 95% CI was between 0.074 and 0.098. Among the six groups, there was one case of fetal bradycardia in group D3 and one case of decreased heart rates in group D4. No decreased blood pressure, vomiting and nausea, or postpartum headaches were reported. Conclusions:In DPEA for labor, ropivacaine plus sufentanil has an EC 50 of 0.061%, with the 95% CI falling between 0.051 and 0.067, similar to the EC 50 value in epidural analgesia.

Effect of pre-administered flurbiprofen axetil on the EC50 of propofol during anesthesia in unstimulated patients: a randomized clinical trial / Efeito da pré‐ administração de flurbiprofeno axetil na CE50 do propofol durante anestesia em pacientes não estimulados: estudo clínico randomizado

Abstract Background and objectives Preoperative use of flurbiprofen axetil (FA) is extensively adopted to modulate the effects of analgesia. However, the relationship between FA and sedation agents remains unclear. In this study, we aimed to investigate the effects of different doses of FA on the median Effective Concentration (EC50) of propofol. Methods Ninety-six patients (ASA I or II, aged 18-65 years) were randomly assigned into one of four groups in a 1:1:1:1 ratio. Group A (control group) received 10 mL of Intralipid, and groups B, C and D received 0.5 mg.kg−1, 0.75 mg.kg−1 and 1 mg.kg−1 of FA, respectively, 10 minutes before induction. The depth of anesthesia was measured by the Bispectral Index (BIS). The "up-and-down" method was used to calculate the EC50 of propofol. During the equilibration period, if BIS ≤ 50 (or BIS > 50), the next patient would receive a 0.5 µg.mL−1-lower (or -higher) propofol Target-Controlled Infusion (TCI) concentration. The hemodynamic data were recorded at baseline, 10 minutes after FA administration, after induction, after intubation and 15 minutes after intubation. Results The EC50 of propofol was lower in Group C (2.32 µg.mL−1, 95% Confidence Interval [95% CI] 1.85-2.75) and D (2.39 µg.mL−1, 95% CI 1.91-2.67) than in Group A (2.96 µg.mL−1, 95% CI 2.55-3.33) (p = 0.023, p = 0.048, respectively). There were no significant differences in the EC50 between Group B (2.53 µg.mL−1, 95% CI 2.33-2.71) and Group A (p > 0.05). There were no significant differences in Heart Rate (HR) among groups A, B and C. The HR was significantly lower in Group D than in Group A after intubation (66 ± 6 vs. 80 ± 10 bpm, p < 0.01) and 15 minutes after intubation (61 ± 4 vs. 70 ± 8 bpm, p < 0.01). There were no significant differences among the four groups in Mean Arterial Pressure (MAP) at any time point. The MAP of the four groups was significantly lower after induction, after intubation, and 15 minutes after intubation than at baseline (p < 0.05). Conclusion High-dose FA (0.75 mg.kg−1 or 1 mg.kg−1) reduces the EC50 of propofol, and 1 mg.kg−1 FA reduces the HR for adequate anesthesia in unstimulated patients. Although this result should be investigated in cases of surgical stimulation, we suggest that FA pre-administration may reduce the propofol requirement when the depth of anesthesia is measured by BIS.

Resumo Justificativa e objetivos A administração pré‐operatória de Flurbiprofeno Axetil (FA) é amplamente usada para a modulação da analgesia. No entanto, a relação entre FA e fármacos sedativos permanece obscura. Neste estudo, nosso objetivo foi investigar os efeitos de diferentes doses de FA na Concentração Efetiva mediana (CE50) do propofol. Métodos Noventa e seis pacientes (ASA I ou II, com idades de 18-65 anos) foram alocados aleatoriamente em quatro grupos na proporção de 1:1:1:1. Dez minutos antes da indução, o Grupo A (grupo controle) recebeu 10 mL de Intralipid, enquanto os grupos B, C e D receberam FA na dose de 0,5 mg.kg‐1; 0,75 mg.kg‐1 e 1 mg.kg‐1, respectivamente. A profundidade da anestesia foi medida pelo Índice Bispectral (BIS). O método up‐and‐down foi usado para calcular a CE50 do propofol. Durante o período de equilíbrio, se o valor do BIS fosse ≤ 50 ou BIS > 50, o próximo paciente tinha a infusão de propofol ajustada para uma concentração alvo‐controlada 0,5 µg.mL‐1 inferior ou superior, respectivamente. Os dados hemodinâmicos foram registrados no início do estudo, 10 minutos após a administração de FA, após a indução, após a intubação e 15 minutos após a intubação. Resultados A CE50 do propofol foi menor no Grupo C (2,32 µg.mL‐1, Intervalo de Confiança de 95% [95% IC] 1,85-2,75) e D (2,39 µg.mL‐1, 95% IC 1,91-2,67) do que no Grupo A (2,96 µg.mL‐1; 95% IC 2,55-3,33) (p = 0,023, p = 0,048, respectivamente). Não houve diferenças significantes na CE50 entre o Grupo B (2,53 µg.mL‐1, 95% IC 2,33-2,71) e o Grupo A (p > 0,05). Não houve diferenças significantes na Frequência Cardíaca (FC) entre os grupos A, B e C. A FC foi significantemente menor no grupo D do que no grupo A após a intubação (66 ± 6 vs. 80 ± 10 bpm, p < 0,01) e 15 minutos após a intubação (61 ± 4 vs. 70 ± 8 bpm, p < 0,01). Não houve diferenças significantes entre os quatro grupos na Pressão Arterial Média (PAM) em qualquer momento. A PAM dos quatro grupos foi significantemente menor após a indução, após a intubação e 15 minutos após a intubação do que na linha de base (p < 0,05). Conclusão FA em altas doses (0,75 mg.kg‐1 ou 1 mg.kg‐1) reduz a CE50 do propofol, e 1 mg.kg‐1 de FA reduz a FC durante níveis adequados de anestesia em pacientes não estimulados. Embora esse resultado deva ser investigado na presença de estimulação cirúrgica, sugerimos que a pré‐administração de FA pode reduzir a necessidade de propofol durante anestesia cuja profundidade seja monitorada pelo BIS.

Inhibitory effects of baicalein against herpes simplex virus type 1

Herpes simplex virus type 1 (HSV-1) is a ubiquitous and widespread human pathogen, which gives rise to a range of diseases, including cold sores, corneal blindness, and encephalitis. Currently, the use of nucleoside analogs, such as acyclovir and penciclovir, in treating HSV-1 infection often presents limitation due to their side effects and low efficacy for drug-resistance strains. Therefore, new anti-herpetic drugs and strategies should be urgently developed. Here, we reported that baicalein, a naturally derived compound widely used in Asian countries, strongly inhibited HSV-1 replication in several models. Baicalein was effective against the replication of both HSV-1/F and HSV-1/Blue (an acyclovir-resistant strain)

In vivo sensitivity of Phakopsora pachyrhizi to fungicides / Sensibilidade in vivo de Phakopsora pachyrhizi a fungicidas

ABSTRACT: Asian soybean rust is one of the most destructive diseases that can be found in this crop. It can be largely controlled by fungicide application. The objective was to assess the sensitivity of P. pachyrhizi isolates to fungicides. The tests were performed in a completely randomized design, with six replicates. The sensitivity of twelve isolates to site-specific and multisite fungicides at concentrations of 0.1; 1.0; 10.0, and 100.0 mg L-1, plus a control with absence of fungicide (0.0 mg L-1) was assessed. Soybean leaflets were immersed in the appropriate fungicide solutions, disposed in wet chambers in plastic boxes, and inoculated using each uredinia suspension of P. pachyhrizi (5.0 x 104 uredospores mL-1), separately. Boxes were incubated for 20 days at a temperature of 23°C and a 12-hour photoperiod. Next, the number of uredinia per cm2 on the abaxial face of each leaflet was evaluated. The active ingredients prothioconazole, trifloxystrobin, fluxapiroxade, trifloxystrobin + prothioconazole, trifloxystrobin + bixafen + prothioconazole, azoxystrobin + benzovindiflupyr, and azoxystrobin + benzovindiflupyr + diphenoconazole were highly fungitoxic for the majority of the isolates, with EC50 lower than 1.0 mg L-1. Diphenoconazole, azoxystrobin, and fenpropimorph were considered moderately fungitoxic for nine of the twelve isolates, with EC50 between 1 and 10 mg L-1. The multisites mancozeb and copper oxychloride presented EC50 responses classified as low toxic for the twelve isolates and eight for chlorothalonil (EC50 between 10 mg L-1 and 50 mg L-1). Site-specific fungicides showed high-to-moderate fungitoxicity to P. pachyrhizi isolates, even as the multisites presented moderate-to-less toxic activity.

RESUMO: A ferrugem-asiática da soja é uma das doenças mais destrutivas que ocorre na cultura. Seu controle é baseado, principalmente, na aplicação de fungicidas. O objetivo foi avaliar a sensibilidade de isolados de P. pachyrhizi a fungicidas. Os ensaios foram realizados em delineamento inteiramente casualizado, com seis repetições. Por meio de teste de folíolos destacados de soja, foram avaliadas as sensibilidades de doze isolados do fungo a fungicidas sítio-específicos e multissítios, nas concentrações de 0,1; 1,0; 10,0 e 100,0 mg L-1, mais uma testemunha sem fungicida (0,0 mg L-1). Os folíolos de soja foram imersos nas devidas soluções fungicida, dispostos em câmaras úmidas em caixas gerbox e inoculados com as devidas suspensões de esporos de P. pachyhrizi (5,0x104 uredosporos mL-1). As caixas foram incubadas durante 20 dias, em temperatura de 23 oC e fotoperíodo de 12 h. Em seguida, avaliou-se o número de urédias cm-2 da face abaxial de cada folíolo. Os ingredientes ativos protioconazol, trifloxistrobina, fluxapiroxade, trifloxistrobina + protioconazol, trifloxistrobina + bixafem + protioconazol, azoxistrobina + benzovindiflupir e azoxistrobina + benzovindiflupir + difenoconazol foram altamente fungitóxicos para a maioria dos isolados, com CE50 menor do que 1,0 mg L-1. Difenoconazol, azoxistrobina e fenpropimorfe foram considerados medianamente fungitóxicos para nove dos doze isolados, com CE50 entre 1 e 10 mg L-1. Os multissítios mancozebe e oxicloreto de cobre apresentaram respostas de CE50 classificadas como pouco tóxicas para os doze isolados do fungo e o clorotalonil para oito deles (CE50 entre 10 e 50 mg L-1). Os fungicidas sítio-específico apresentaram alta a moderada fungitoxicidade aos isolados de P. pachyrhizi oriundos dos distintos locais, enquanto os multissítios apresentaram atividade moderada a pouco tóxica.

Effect of ketamine and sufentanyl on respiratory depression induced by propofol in pediatric patients / 新乡医学院学报

Objective To compare the effect of ketamine and sufentanyl on respiratory depression induced by propofol in pediatric patients.Methods Sixty children with taplipes equines in the Department of Pediatric Orthopedics,the Third Affiliated Hospital of Zhengzhou University from February 2014 to August 2015 were selected and divided into ketamine group,sufentanil group and control group,with 20 patients in each group.The patients in ketamine group were given ketamine 1.50 mg· kg-1 by intravenous injection and maintained with ketamine 0.75 mg · kg-1 · h-1 by pump infusion;the patients in sufentanil group were given sufentanil 0.2 μg · kg-1 by intravenous injection and maintained with sufentanil 0.1 μg · kg-1 · h-1 by pump infusion;the patients in control group were given the same volume of saline.The initial plasma concentration of propofol in ketamine group,sufentanil group and control group was 1.1 mg · L-1,and the ratio between the two successive concentration gradients was 1.1.It was defined as positive when patients developed respiration depression.The bispectral index (BIS) and the observer's assessment of alertness/sedation (OAA/S) score of patients in the three groups were recorded at the time point of intravenous infusion ketamine or sufentanil (T1),3 min after propofol target controlled infusion (TCI) (T2),5 min after propofol TCI (T3) and after the target effect-site and plasma concentrations were balanced(T4).The target effect-site concentration was recorded when the BIS dropped to 65 or OAA/S score was 3.The median effective concentration(EC50) and its 95％ confidence interval (CI) of propofol inducing respiratory depression were calculated.Results There was no statistic difference in BIS and OAA/S scores of patients at the time point of T1 among the three group(P ＞ 0.05);the BIS and OAA/S scores of patients in ketamine group and sufentanil group were significantly lower than those in the control group at the time point of T2,T3 and T4 (P ＜ 0.05);the BIS and OAA/S scores of patients in ketamine group were significantly lower than those in the sufentanil group at the time point of T2,T3,T4 (P ＜ 0.05).The EC50 and its 95 ％ CI of respiratory depression induced by propofol in ketamine group,sufentanil group and the control group were 1.75 (1.56-2.34),1.86 (1.47-2.23),2.82 (2.56-3.02) mg · L-1 respectively.The EC50 of patients in ketamine group and sufentanil group was significantly lower than that in control group (P ＜ 0.05),but there was no statistic difference in EC50 of patients between the ketamine group and sufentanil group (P ＞ 0.05).Conclusion Both ketamine and sufentanil can increase the EC50 of respiratory depression induced by propofol in pediatric patients,but the effects of both drugs are the same.Ketamine and sufentanil can reduce the BIS and OAA/S scores of patients,enhance the sedation efficacy of propofol,and the effect of ketamine is better than sufentanil.

Effects of target-controlled infusion of dexmedetomidine on the median effective concentration of effect-site of propofol at loss of consciousness / 临床麻醉学杂志

Objective To investigate the effects of target-controlled infusion (TCI)of dexme-detomidine on the median effective concentration of effect-site (Ce50 )of propofol at loss of conscious-ness (LOC)in patients.Methods Sixty-four patients,28 males and 36 females,aged 20-60 years, ASA physical status Ⅰ or Ⅱ,scheduled for elective surgery,were randomly allocated to receive dexmedetomidine of 0 ng/ml (group P),dexmedetomidine of 0.4 ng/ml (group D1),dexmedetomi-dine of 0.6 ng/ml (group D2)and dexmedetomidine of 0.8 ng/ml (group D3)for 1 5 min before TCI of propofol,n =1 6 in each group.The propofol infusion was started to provide an effect-site concen-tration of 1.0 μg/ml,and increased by 0.2 μg/ml when propofol effect-site concentration and target concentration were equilibrium until LOC.Results The Ce50 (95%CI )at loss of consciousness in groups P,D1,D2 and D3 were 2.30 (2.24-2.36)μg/ml,1.92 (1.87-1.96 )μg/ml,1.60 (1.55-1.65)μg/ml and 1.41 (1.35-1.45 )μg/ml,respectively.There was a negative correlation between the effect-site concentration of propofol-induced LOC and target concentration of dexmedetomidine (r=-0.84,P <0.01).Compared with groups P,D1 and D2,the incidence of bradycardia was higher in group D3 (P <0.05).Conclusion The Ce50 of propofol-induced LOC gradually decreases with in-creasing target concentration of dexmedetomidine.Combining propofol with dexmedetomidine of 0.4 or 0.6 ng/ml that can reduce the Ce50 of propofol-induced LOC,which is suitable for induction of an-esthesia with a lower incidence of bradycardia.

Determination of EC50 of Dexmedetomidine Hydrochloride Causing Disappearance of Explicit Memory by Process Dissociation Procedure / 医药导报

Objective To determine the EC50 of dexmedetomidine hydrochloride ( DEX) which causes disappearance of explicit memory by process dissociation procedure (PDP). Methods Forty patients those who had senior middle school or higher educational background undergoing lower extremity surgery with grade ASA Ⅰ or Ⅱ, without hearing impairment, dysphasia,nervous system disorders,and having no drugs in the treatment of the central nervous system were included.PDP was applied to establish study table and record, and calculate performance of explicit memory and implicit memory. Memory performance was statistically compared with 0, 0 memory was considered to be statistically significant and disappearance, respectively.Sequential method was used for determination.According to explicit memory disappearance or not,target concentration of the next patient was adjusted (increase or decrease).DEX target concentration of the first patient was set to 4 ng?mL-1,and the ratio of target concentration between the adjacent patients was 1.2.If the explicit memory of the former patient disappeared,the target concentration of the next patient was decreased by 1 concentration gradient;if the explicit memory of the former patient did not disappear,the target concentration of the next patient was increased by 1 concentration gradient, and so forth. All the 40 patients were determined.The median effective dose (D1) and 95% confidence interval (CI) of DEX were calculated. Results The ED50 of DEX causing explicit memory disappearance was 5.23 ng?mL-1,and the 95% CI was 4.07-6.39 ng?mL-1. Conclusion In clinical,target concentration of dexmedetomidine hydrochloride 5.23 ng?mL-1 levels for sedation,can cause half of patients’ explicit memory disappear,so as to avoid intraoperative awareness.

Photopic laryngoscope can reduce half effective concentration of Propofol for inhibiting intubation response / 中国内镜杂志

Objective To compare the EC50 of Propofol for inhibiting intubation response. Methods 80 cases un-derwent tracheal intubation general anesthesia, all patients were randomly divided into two groups. The general situ-ation between the two groups showed no significant difference. Except for Propofol, other anesthesia drugs infusion method and dosage were the same. Sequential determination the EC50 of Propofol which for inhibiting intubation re-sponse of each groups by up-and-down. Propofol target concentration of the first patient was set to 4 μg/ml, and ad-justed according to intubation stress response disappeared or not, concentration of two adjacent patients with ratio of 1.2. Results A group inhibited the cardiovascular responses of Propofol EC50 and 95%CI was 5.19 μg/ml (95%CI:4.88 ~ 5.50 μg/ml). B group inhibited the cardiovascular responses of Propofol EC50 and 95 %CI was 4.15μg/ml (95%CI:3.80~4.40μg/ml). The EC50 and 95% confidence interval of the B group were significantly lower than those of the A group ( P 0.05).Conclusion The EC50 and 95% confidence interval of Propofol for inhibiting intubation response under photopic laryngoscopes was significant lower than those of under direct laryngoscopes, the circulation during period of induc-tion and intubation was more stable.

Bioefficacy of pectolinaringenin from Clerodendrum phlomidis Linn. F. against Anopheles stephensi and bhendi fruit borer, Earias vittella fab.

Larvicidal activity of pectolinaringenin from Clerodendrum phlomidis was evaluated against Anopheles stephensi and antifeedant, larvicidal and growth inhibitory activities were evaluated against Earias vittella. Pectolinaringenin exhibited larvicidal activity of 100 and 98.24% against 2nd and 4th instar larvae of Anopheles stephensi at 5ppm concentration. It exhibited LC50 values of 0.35 and 0.55 ppm for 2nd and 4th instar larvae, respectively. At 100 ppm concentration, pectolinaringenin exhibited maximum antifeedant activity of 74.00% and larvicidal activity of 89.98%. The LC50 values were 36.2 and 10.23 ppm for antifeedant and larvicidal, respectively. The compound completely prevented the adult emergence at 50 and 100 ppm concentrations. This is the first report of pectolinaringenin from C. phlomidis evaluated against An. stephensi and E. vittella. The results suggested that the pectolinaringenin from C. philomidis could be used to develop a new botanical formulation to manage vector mosquitoes and agricultural pests.

Minimum effective concentration of bupivacaine for axillary brachial plexus block guided by ultrasound / Concentração mínima efetiva de bupivacaína para o bloqueio do plexo braquial via axilar guiado por ultrassom / Concentración mínima efectiva de bupivacaína para el bloqueo del plexo braquial vía axilar guiado por ecografía

INTRODUCTION: The use of ultrasound in regional anesthesia allows reducing the dose of local anesthetic used for peripheral nerve block. The present study was performed to determine the minimum effective concentration (MEC90) of bupivacaine for axillary brachial plexus block. METHODS: Patients undergoing hand surgery were recruited. To estimate the MEC90, a sequential up-down biased coin method of allocation was used. The bupivacaine dose was 5 mL for each nerve (radial, ulnar, median, and musculocutaneous). The initial concentration was 0.35%. This concentration was changed by 0.05% depending on the previous block; a blockade failure resulted in increased concentration for the next patient; in case of success, the next patient could receive or reduction (0.1 probability) or the same concentration (0.9 probability). Surgical anesthesia was defined as driving force ≤2 according to the modified Bromage scale, lack of thermal sensitivity and response to pinprick. Postoperative analgesia was assessed in the recovery room with numeric pain scale and the amount of drugs used within 4 h after the blockade. RESULTS: MEC90 was 0.241% [R 2: 0.978, confidence interval: 0.20-0.34%]. No patient, with successful block, reported pain after 4 h. CONCLUSION: This study demonstrated that ultrasound guided axillary brachial plexus block can be performed with the use of low concentration of local anesthetics, increasing the safety of the procedure. Further studies should be conducted to assess blockade duration at low concentrations. .

INTRODUÇÃO: O uso do ultrassom na anestesia regional permite a redução da dose de anestésico local utilizada para o bloqueio de nervos periféricos. O presente estudo foi conduzido com o objetivo de determinar a concentração mínima efetiva (CME90) de bupivacaína para o bloqueio do plexo braquial via axilar (BPVA). MÉTODOS: Pacientes submetidos a cirurgias da mão foram recrutados. Foi usado um método de alocação "biased coin" seqüencial "up-down" para estimar a CME90. A dose de bupivacaína foi de 5 mL para cada nervo (radial, ulnar, mediano e musculocutâneo). A concentração inicial de era 0,35%. Essa concentração era alterada em 0,05% dependendo do bloqueio anterior: a falha do bloqueio resultava em aumento da concentração para o próximo paciente; no caso de sucesso, o próximo paciente poderia receber ou redução (probabilidade de 0,1) ou mesma concentração (probabilidade 0,9). A anestesia cirúrgica foi definida como força motora ≤ 2 segundo a escala de Bromage modificada, ausência de sensibilidade térmica e de resposta ao pinprick. A analgesia pós-operatória foi verificada na sala de recuperação anestésica com escala numérica de dor e a quantidade de analgésicos utilizados até 4 horas após o bloqueio. RESULTADOS: A CME90 foi de 0,241% [R2: 0,978, Intervalo de Confiança: 0,20%-0,34%]. Além disso, nenhum paciente com sucesso do bloqueio apresentou dor após 4 horas. CONCLUSÃO: Este estudo demonstrou que pode-se realizar o BPVA guiado por ultrassom utilizando-se baixas concentrações de anestésico local, aumentando a segurança do procedimento. Novos estudos devem ser realizados para avaliar a duração de bloqueios com baixas concentrações. .

INTRODUCCIÓN: El uso de la ecografía en la anestesia regional permite la reducción de la dosis de anestésico local utilizada para el bloqueo de nervios periféricos. El presente estudio fue llevado a cabo con el objetivo de determinar la concentración mínima efectiva (CME90) de bupivacaína para el bloqueo del plexo braquial vía axilar. MÉTODOS: Fueron reclutados pacientes sometidos a cirugías de la mano. Se usó un método de ubicación "biased coin" secuencial "up-down" para estimar la CME90. La dosis de bupivacaína fue de 5 mL para cada nervio (radial, cubital, mediano y musculocutáneo). La concentración inicial era de un 0,35%. Esa concentración era alterada en un 0,05% dependiendo del bloqueo anterior: El fallo del bloqueo revertía en un aumento de la concentración al próximo paciente; en caso de éxito, el próximo paciente podría recibir o una reducción (probabilidad de 0,1) o la misma concentración (probabilidad 0,9). La anestesia quirúrgica fue definida como fuerza motora ≤ 2 según la escala de Bromage modificada, ausencia de sensibilidad térmica y de respuesta al pinprick (test del pinchazo de la aguja). La analgesia postoperatoria fue verificada en la sala de recuperación anestésica con la escala numérica de dolor y la cantidad de analgésicos utilizados hasta 4 h después del bloqueo. RESULTADOS: La CME90 fue del 0,241% [R2: 0,978, intervalo de confianza: 0,20-0,34%]. Además, ningún paciente con éxito en el bloqueo tuvo dolor después de 4 h. CONCLUSIÓN: Este estudio demostró que se puede realizar el bloqueo del plexo braquial vía axilar guiado por ecografía utilizando bajas concentraciones de anestésico local, aumentando la seguridad del procedimiento. Nuevos estudios deben ser realizados para calcular la duración de bloqueos con bajas concentraciones. .

Effects of ED50 of ropivacaine combined with sufentanil for spinal anesthesia in elderly patients / 临床麻醉学杂志

Objective To investigate the effects of median effective dose (ED50 )of ropivacaine combined with sufentanil for spinal anesthesia in elderly patients.Methods Forty-eight elderly patients (ASAⅠ-Ⅲ)scheduled for elective lower limb or perineum operation under spinal anesthesia were enrolled in this study.All patients were randomly divided into two groups:control group (group C)and sufentanil group (group S).L3-4 intervertebral puncture was selected for all patients.Anesthetic solution in group C was 0.5% ropivacaine,in group S was 0.5% ropivacaine and sufentanil,which was fixed at 5.0 μg,based on the experimental results and sequential principle.The ropivacaine dose of first patient in the control group was 9.0 mg,and in sufentanil group was 8.0 mg,followed by reducing the dose of ropivacaine,each time 1.0 mg.If the patient appeared invalid standards response,the previous one was selected as the first case. ED50 was determined by Dixon??s sequential method.Results The ED50 of sufentanil combined with ropiva-caine for spinal anesthesia in elderly patients with lower extremity or perineal surgery was 6.40 mg (95%CI:5.98-6.80 mg),ED50 of only ropivacaine was 8.42 mg (95% CI:7.79-9.03 mg).Compared with pre-dose,MAP at 3,6,15 min after treated in group C were decreased,and lower than those in group S (P <0.01).Conclusion Combined with 5.0 μg sufentanil in spinal anesthesia for lower limb or perineal surgery elderly,median effective dose of ropivacaine is reduced.

Comparison of susceptibility testing by EUCAST and CLSI broth microdilution methods against Aspergillus isolates / 中国感染与化疗杂志

Objective To compare the results of susceptibility testing by European Committee on Antimicrobial Susceptibility Testing (EUCAST)and Clinical and Laboratory Standards Institute (CLSI)broth microdilution methods against Aspergillus isolates.Methods The susceptibilities of 116 Aspergillus isolates were determined for amphotericin B, voriconazole, itraconazole,caspofungin and micafungin according to EUCAST (E.DEF 9.1 )and CLSI (M38-A2)methods.The essential agreement (EA),categorical agreement (CA),very major errors (VME)and major errors (ME)of the two methods were compared.Results The EA was 96.3%-100% between the two methods.The CA ,ME,and VME were 98.8%,0-1.2% and 0 respectively for the susceptibility of Aspergillus fumigatus to voriconazole.The CA,ME and VME was 1 00%,0 and 0 respectively for the susceptibility of Aspergillus fumigatus and Aspergillus niger to amphotericin B,or the susceptibility of Aspergillus fumigatus and Aspergillus flavus to itraconazole.Conclusions The results of susceptibility testing by EUCAST and CLSI broth microdilution methods are well consistent against Aspergillus isolates.

Target Effect-site Controlled Infusion of Propofol by Schnider Model: Comparison of Gender and Age / 대한마취과학회지

BACKGROUND: We investigated effect-site median effective concentration (EC50) of propofol for loss of consciousness and effect-site concentration at each anesthetic stage and awakening time to compare the differences by gender or age of patients using Schnider model. METHODS: Total 91 patients were allocated into 4 groups: male patients aged 18-34 year (Group 1), male patients aged 35-55 years (Group 2), female patients aged 18-34 years (Group 3) and female patients aged 35-55 years (Group 4). The effect-site EC50 for loss of consciousness was calculated and the effect-site concentration of propofol at each anesthetic stage and the awakening time of each group were recorded. RESULTS: The effect-site EC50 of propofol for loss of consciousness was 4.53 +/- 0.30microgram/ml, 4.60 +/- 0.25microgram/ml, 4.13 +/- 0.39microgram/ ml and 4.47 +/- 0.65microgram/ml in group 1, 2, 3, and 4, respectively. The effect-site concentrations in male patients aged 18-34 years were significantly higher than those in female patients. The awakening time of female patients aged 35-55 years was shorter than that of male patients. CONCLUSIONS: There were no significant differences of effect-site EC50 for the loss of consciousness of propofol with target effect-site controlled infusion by Schnider model among the groups. However the effect-site concentrations and the awakening time of propofol by Schnider model showed differences in patients' gender and age.

Discussion on EC50 of Ropivacaine Caudal Motor Block / 中国药房

OBJECTIVE:To discuss the median effective concentration(EC50)of ropivacaine caudal motor block. METHODS: The EC50 of ropivacaine caudal epidural block was determined with sequential experimental method. RESULTS:The EC50 of ropivacaine caudal block was 0.22%(95%CI ranged from 0.216% to 0.235%). CONCLUSION:Canales sacralis injected with 0.20%～ 0.22% ropivacaine is suitable for bladder endoscopic examination in out-patient.