RESUMEN
Objective:To evaluate the effects of different doses of dexmedetomidine infused at nighttime on early postoperative cognitive dysfunction (POCD) in elderly patients undergoing radical resection of malignant gastrointestinal tumors.Methods:Eighty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of either sex, aged 65-75 yr, with body mass index of 18-24 kg/m 2, scheduled for elective radical resection of malignant gastrointestinal tumors, were divided into 4 groups ( n=20 each) using a random number table method: control group (group C) and different doses of dexmedetomidine groups (D 1-3 groups). Dexmedetomidine 0.1, 0.2 and 0.3 μg·kg -1·h -1 (infusion rate 4 ml/h) were intravenously infused from 21: 00 on the day of surgery and the first day after surgery until 6: 00 in the next morning.Normal saline was given instead of dexmedetomidine in group C. The period of sleep and the number of awakening at night were recorded before surgery and at 2 and 7 days after surgery.Cognitive function was assessed at 1 day before surgery and 7 days after surgery.The concentrations of plasma cortisol were measured at 16: 00 before surgery and 2 and 7 days after surgery and at 8: 00 in the corresponding morning of the next day.The difference in the plasma cortisol concentration measured at 8: 00 every day and at 16: 00 of the previous day were calculated. Results:The incidence of POCD was significantly lower in D 2, 3 groups than in group C ( P<0.05). The number of awakening at night was significantly decreased at 2 days after surgery in group D 3 as compared with the other three groups ( P<0.05). The difference in the plasma cortisol concentration was significantly decreased at 2 and 7 days after surgery in D 2, 3 groups when compared with group C and group D 1 ( P<0.05). Compared with group D 2, no significant change was found in the difference in the plasma cortisol concentration at each time point in group D 3 ( P>0.05). There were no significant differences in the incidence of hypotension, hypertension, bradycardia, and tachycardia among the four groups ( P>0.05). Conclusion:Infusing dexmedetomidine 0.2 or 0.3 μg·kg -1·h -1 at the nighttime can reduce the development of POCD in the elderly patients undergoing radical resection of malignant gastrointestinal tumors.
RESUMEN
Objective:To evaluate the improved efficacy of nalbuphine combined with propofol in artificial abortion.Methods:One hundred American Society of Anesthesiologists physical status Ⅰor Ⅱ patients, aged 20-43 yr, weighing 50-80 kg, undergoing elective artificial abortion, were divided into 2 groups ( n=50 each) using a random number table method: propofol group (group P) and nalbuphine combined with propofol group (group NP). Phloroglucinol 40 mg was intramuscularly injected at 15 min before surgery.Propofol 2.0 mg/kg was intravenously injected in group P. In group NP, nalbuphine 0.1 mg/kg was intravenously injected, and 2 min later propofol 2.0 mg/kg was intravenously injected.The operation was started after the eyelash reflex disappeared.When operation was affected due to the body movement occurred during operation, an increment of propofol 0.5 mg/kg was given.Visual analogue scale (VAS) score was used to assess the degree of uterine contraction pain during the awake period and the highest degree of uterine contraction pain during the recovery period.The consumption of propofol, development of adverse effects and surgeon′s satisfaction with the anesthetic effect were recorded. Results:Compared with group P, the consumption of propofol was significantly reduced, VAS scores during the awake period and the highest VAS score during the recovery period were decreased, the incidence of body movement that affected operation was decreased (16%/2%), and the surgeon′s satisfaction with the anesthetic effect was increased in group NP ( P<0.05). No adverse cardiovascular events and respiratory depression during operation and postoperative nausea and vomiting was found in the two groups. Conclusion:Intravenous injection of nalbuphine 0.1 mg/kg combined with propofol 2.0 mg/kg can be safely and effectively used for the comfort medical treatment of artificial abortion, and the combination has a significant optimized effect than propofol alone.
RESUMEN
Objective To evaluate the effect of sleep dysfunction on sedation induced by propofol in the patients undergoing radical mastectomy.Methods One hundred breast cancer patients,aged 25-60 yr,with body mass index of 19-23 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective modified radical mastectomy,were randomly divided into 2 groups according to sleep quality.The patients with global Pittsburgh Sleep Quality Index (PSQI) score ≤7 served as regular sleep quality group (Ⅰ group,n =59).The patients with global PSQI score ＞ 7 served as sleep dysfunction group (group Ⅱ,n =41).Anesthesia was induced with propofol given by target-controlled infusion (target plasma concentration of 3.5 μg/ml),and then with remifentanil 4 μg/kg and rocuronium 0.6 mg/kg after loss of consciousness.The consumption of propofol at loss of consciousness was recorded.Results Compared with group Ⅰ,the consumption of propofol at loss of consciousness was significantly decreased in group Ⅱ.Conclusion Sleep dysfunction can enhance propofol-induced sedation in the patients undergoing radical mastectomy.
RESUMEN
Objective To evaluate the effect of chemotherapy on sedation with propofol in breast cancer patients.Methods One hundred female patients,of ASA physical status Ⅰ or Ⅱ,aged 20-60 yr,scheduled for elective modified radical mastectomy,were divided into 2 groups (n =50 each) according to whether receiving neoadjuvant chemotherapy before operation:non-chemotherapy group (group Ⅰ) and neoadjuvant chemotherapy group (group Ⅱ).The breast cancer patients received operation directly in group Ⅰ.The breast cancer patients received neoadjuvant chemotherapy in group Ⅱ.Epirubicin 75-100 mg/m2 was injected intravenously on 1st and 2nd days,docetaxel 75 mg/m2 was injected intravenously on 3rd day,and 3 weeks were considered as 1 course of treatment.The patients received operation at 3 weeks after the end of 4 courses of treatment in group 1.Anesthesia was induced with propofol given by target-controlled infusion and the target plasma concentration of propofol was 3.5 μg/ml.The time for loss of consciousness and consumption of propofol at loss of consciousness were recorded.Results Compared with group Ⅰ,the time for loss of consciousness was significantly shortened,and the consumption of propofol at loss of consciousness and BIS value were decreased in group Ⅱ.Conclusion Chemotherapy can enhance propofol-induced sedation and promote the onset of propofol in breast cancer patients.
RESUMEN
Objective To investigate the effects of fentanyl and remifentanil on the viability of human adenocarcinoma cell line A549.Methods Human adenocarcinoma A549 cells cultured in logarithmic growth phase were seeded in 75 ml culture bottles or 96-well plates.After being cultured for 24 h,the cells were randomly divided into 9 groups (n =30 each):4 fentanyl groups (groups F1-4 ),4 remifentanil groups (groups RF1-4 ) and control group (group C).Groups F1-4 were exposed to fentanyl with the final concentrations of 0.5,5.0,50.0 and 500.0 ng/ml respectively.Groups RF1-4 were exposed to remifentanil with the final concentrations of 0.5,5.0,50.0 and 500.0 ng/ml respectively.The viability of the cells was determined by methyl thiazolyl tetrazolium assay after being incubated for 24,48 and 72 h.The cell cycle progression and apoptosis were determined by flow cytometry after being incubated for 24 h.Results Compared with group C,the viability of A549 cells were gradually decreased at 72 h of incubation,the proportion of the cells in S phase was gradually decreased at 24 h of incubation,and the proportion of the cells in G2/M phase and apoptotic rate were gradually increased in groups F2-4 and in groups RF2-4 ( P ＜ 0.05).Conclusion Fentanyl and remifentanil with the final concentration ≥5 ng/ml can inhibit the viability of human adenocarcinoma cell line A549 in a dose-independent manner by inducing cell apoptosis and cell cycle arrest in G2/M phase.
RESUMEN
Objective To investigated the analgesic effect of processed Aconiti tuber(PAT) in rats with a sciatic nerve chronic constriction injury(CCI) .Methods The study was conducted in two parts. CCI model was developed with four ligatures placed around the right sciatic nerve and tied without obstructing the blood supply of the nerve. In part Ⅰ, forty rats were randomly divided into five groups(n = 8) . In group Ⅰ normal saline 1 ml , In group Ⅱ-Ⅴ PAT 0.5 ,1, 2 ,or 4 g/kg was administered orally 14 days after CCI respectively. In part Ⅱ , thirty-two rats were randomly divided into four groups (n = 8) . In group Ⅰ oral normal saline 1 ml, in group Ⅱ oral PAT 2 g/kg, in group Ⅲ oral PAT 2 g/kg + intraperitoneal nor-binaltorphimine (nor-BNI) 2 mg/kg, in group Ⅳ oral PAT 2 g/kg + intrathecal nor-BNI 100 ?g was administered 14 days after CCI. As indicators of mechanical and heat hyperalgesia, the paw withdrawal pressure threshold (PWPT) in response to a graded pressure stimulus with a filament and the paw withdrawal latency (PWL) in response to radiant heat were measured in both hind paws before and after drugs administration.Results In part Ⅰ, in group Ⅲ-Ⅴ PWL was prolonged significantly and in group Ⅳ - Ⅴ PWPT were significantly increased compared with those in group I . There was no significant difference in PWL and PWPT between group Ⅰ and group Ⅱ . In part Ⅱ , in group Ⅲ, Ⅳ PWPT and PWL were significantly lower than those in group Ⅱ . There was no significantly difference in PWL and PWPT between group Ⅰ and group Ⅲ, Ⅳ . Conclusion In rat with neuropathic pain processed Aconiti tuber exerts analgesic effect via the spinal ?-opioid receptor activation.