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Objective To compare the effects of dexmedetomidine (DEX) and remifentainil (REM) combined with sevoflurane (SEV) for general anesthesia on recovery quality in patients undergoing laparoscopic cholecystectomy (LC).Methods Sixty patients (ASA grade Ⅰ-Ⅱ) who underwent LC were divided into DEX combined with SEV for general anesthesia group (DEX group) and REM combined with SEV for general anesthesia group (REM group) by table of random digit,with 30 cases each.Time of first inspiration,eye opening,extubation,orientation recovery and passage of gas by anus were recorded.Vital sign,numeric rating score (NRS),Ramsay score and untoward reaction were recorded.Degree of satisfaction of patients,post-anesthesia care unit (PACU) nurse and surgeon were evaluated.Results The time of extubation and passage of gas by anus in DEX group were significantly shorter than those in REM group [(12.0 ±3.9) min vs.(15.9 ±5.6) min,t =-3.130,P =0.003; (18.5 ±3.4) h vs.(23.6 ±5.8) h,t =-5.455,P =0.000].However,the time of eye opening and orientation recovery in DEX group were significantly longer than those in REM group [(15.5 ± 4.2) min vs.(11.7 ± 2.9) min,t =4.078,P =0.000;(19.5 ± 4.5) min vs.(14.8 ± 3.6) min,t =4.315,P =0.000].During the first 2 h after operation,Ramsay score in DEX group was significantly higher than that in REM group (P ＜ 0.05),but NRS in DEX group was significanty lower than that in REM group (P ＜ 0.05),the patients with additional analgesics was minor than REM group (2 cases vs.9 cases,P ＜ 0.05).The percentages of patients suffering shivering and postoperative nausea and vomiting in DEX group were significantly lower than those in REM group [3.3％(1/30) vs.33.3％(10/30),6.7％(2/30) vs.30.0％ (9/30),P ＜0.05].Degree of satisfaction of patients and PACU nurse in DEX group were higher than those in REM group [89.0(72.0-100.0) scores vs.80.0(70.0-95.0) scores,Z =-4.066,P =0.000; 92.0 (80.0-99.0) scores vs.90.0 (80.0-95.0) scores,Z =-2.906,P =0.004],but degree of satisfaction of surgeon in REM group was higher than that in DEX group [(91.8 ± 5.8) scores vs.(81.7 ±6.1) scores,t =-6.568,P =0.004].Conclusion Compared with REM combined with SEV for general anesthesia,DEX combined with SEV for general anesthesia has a faster recovery for respiration and passing of gas by anus,lower NRS and incidence rates of shivering,nausea and vomiting,improves the quality of recovery for patients undergoing LC.
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Objective To investigate the effect of edaravone pretreatment on myocardial injury induced by carbon dioxide pneumoperitoneum in patients undergoing laparoscopic gynecologic surgery.Methods Thirty patients undergoing laparoscopic gynecologic surgery,ASA Ⅰ or Ⅱ grade,were divided into two groups by random digits table with 15 cases each:control group and edaravone group.Edaravone group following tracheal intubation received vein infusion of edaravone 0.5 mg/kg,control group received equal volume of 0.9％ sodium chloride.The carbon dioxide pneumoperitoneum pressure was maintained at 10-15 mm Hg (1 mm Hg =0.133 kPa).Venous blood samples were collected before anesthesia induction and after operation 8 h for the measurement of the serum creatine kinase (CK),creatine kinase-MB (CK-MB),aspartate aminotransferase (AST) and lactate dehydrogenase (LDH).Results The serum levels of CK and AST were significantly higher after operation 8 h in control group than those of before anesthesia induction in control group and after operation 8 h in edaravone group [(205 ± 27) U/L vs.(123 ± 25) and (123 ± 29)U/L,(48±5) U/L vs.(34 ±3) and (36 ±5) U/L,P＜0.05].There was no significant difference in the serum levels of CK-MB and LDH between two groups and the group (P ＞ 0.05).Conclusion Pretreatment with edaravone 0.5 mg/kg can protect myocardium in patients undergoing laparoscopic gynecologic surgery.
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Objective To investigate the change in GABA receptor-activated current in dorsal root ganglion (DRG) neurons in rats with neuropathic pain. Methods Twenty adult SD rats of both sexes weighing 100-150 g were randomly divided into 2 gorups: sham operation group (group S, n = 5) and neuropathic pain group (group NP, n= 15). Neuropathic pain was induced by ligation of right L5 spinal nerve. The animals were sacrificed at 5 days after operation. The L5 DRG( neurons in group NP and L3-5 DRG neurons in group S were immediately isolated. Whole-cellpatch- clamp technique was used. The extracellular solution contained GABA 100μmol/L.The frequency and amplitude of the GABA-activated current in DRG neurons and the changes in action potential (threshold potential, rheobase and overshoot) and resting potential before and after GABA administration were recorded. Results GABA 100μmol/L induced rapid inactivation of inward current in most neurons. Compared with the baseline before application of GABA, in group S GABA induced depolarization,increased resting potential and decreased amplitude and rheobase of action potential in large and medium DRG neurons, while in group NP GABA increased resting potential but induced no significant change in threshold potential and rheobase and overshoot of action potential. The frequency and amplitude of GABA-activated current and the degree of change in resting potential and rheobase and overshoot of action potential were significantly lower in group NP than in group S.Spontaneous discharge occurred in small DRG neurons in both groups. No GABA-activated current was observed in all DRG neurons with spontaneous discharge. Conclusions Neuropathic pain is induced by decreasing GABA-mediated inhibition signals in large and medium DRG neurons leading to increased excitability of neurons.
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Objective To evaluate the role of GABAA receptors in uninjured dorsal root ganglion(L4DRG)in a rat model of neuropathic pain.Methods Thirty adult female SD rats weighing 200-250 g were randomly divided into 3 groups(n = 10 each): control group(group C),muscimol group(group M)and bicuculline group(group B).Neuropathic pain was produced by L5 spinal nerve ligation.Normal saline 50 μl,GABAA receptor agonist-muscimol 50 μl or GABAA receptor antagonist- bicucullin 50 μl was injected into the L4 DRG.The thermal pain threshold and mechanical pain threshold were measured and recorded from 1 day before operation to 10 days after operation.Results Compared with group C,the mechanical pain threshold was significantly increased(P ＜ 0.05),while no significant difference was found in thermal pain threshold in group M(P ＞ 0.05),and the thermal pain threshold and mechanical pain threshold were significantly decreased in group B(P ＜ 0.05).Conclusion Activation of GABAA receptors in uninjured DRG is involved in mechanical hyperalgesia in a rat model of neuropathic pain,but it dose not play a leading role.