RESUMEN
Objective To investigate the sedative effect of propofol combined with different doses of midazolam in patients undergoing long-time microsurgeries.Methods Forty ASA(American Society of Anesthesiologists)Ⅰ～Ⅱ patients were randomly divided into 4 groups.Normal saline(NS) 2 mL was administered in groupⅠ,while midazolam 0.01,0.02 and 0.04 mg/kg was administered in groupⅡ,Ⅲ,Ⅳ respectively.one min later,propofol was infused at a rate of 5～10 mg/kg?h combined with midazolam based on the abovementioned dosage per hour for groupⅡ,Ⅲ,Ⅳ respectively.Taking auditory evoked potential index(AAI) as a parameter,after it decreased to 40,the infusion rate of propofol was adjusted to keep AAI at the level of 30～45,and maintained the level by infusing propofol and midazolam for 5 hours.The dosage of propofol required for induction and maintenance was recorded.The emergence time and whether patients had awareness during the operation were recorded after the infusion stopped.Results At the target sedative level of AAI 30～45,the Observer's Assessment of alertness/sedation(OAA/S) score of all patients in the four groups reached 0～1.The induction period was obviously shortened and the propofol dosage was dramatically reduced in group Ⅱ～Ⅳ as compared with groupⅠ.At the stage of maintenance of sedation,the dosages of propofol in both groupⅠandⅡ were larger than those in group Ⅲ and Ⅳ.The emergence time in group Ⅳ was dramatically longer than the other groups(P
RESUMEN
Objective To evaluate the myocardial protective effects of thoracic epidural anesthesia (TEA) with 0 5% ropivacaine during acute myocardial ischemia reperfusion Methods Eighteen healthy hybrid dogs were randomly divided into three groups: ropivacaine group (group Ⅰ), bupivacaine group (group Ⅱa) and normal saline group (group Ⅱb) Anesthesia was induced and maintained with intravenous anesthesia and ventilation was mechanically controlled Epidural catheter was placed at T 6 7 and 0 5% ropivacaine, 0 5% bupivacaine or normal saline 12ml was administered epidurally 15min after epidural administration of local anesthetics or normal saline, the anterior descending branch of left coronary artery was temporarilly occluded for 45min Blood samples were taken from right atrium and assayed for cardiac troponin T (cTnT) before epidural administration and 6h after reperfusion Myocardial tissues of left ventricular infarction area were examined by electron microscopy Results Plasma cTnT levels were comparable (P
RESUMEN
Objective To study the effects of three anesthetic techniques on the neuroendocrine and immune responses to surgical stress Methods Thirty patients undergoing elective upper abdominal surgery, were allocated randomly to epidural anesthesia group(groupⅠ), general anesthesia group (groupⅡ)and combination of epidural and general anesthesia group(group Ⅲ ) The serum concentrations of IL 6 and cortisol, and T cell subsections were measured respectively before induction, before incision, 1 h following the operation, at the operative end , on the first and fifth postoperative day Results Serum IL 6 concentrations increased significantly in groupⅠand Ⅱ(P0 05) during and after the operation, and serum IL 6 concentrations of all patients at the operative end were correlated positively to the operative duration (r=0 61, P