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Objective To observe the action of narcotrend monitoring for perioperative anesthesia management in donor and acceptor with living donor renal transplantation. Methods 80 pairs of receptor and donor haing electie living donor renal transplantation surgery, 28 ~ 56 years. The ASA of receptor Ⅲ ~ Ⅳ, and the donerⅠ ~ Ⅱ. The receptor and donor were randomly divided into four groups , the narcotrend monitoring receptor group (R-N), the clinical experience receptor group (R-C), the narcotrend monitoring donor group (D-N), and the clinical experience donor group (D-C). Record the vital signs, the last time of anesthesia induction, operation , extract the endotracheal catheter , and the observation time in post anesthesia care unit , the dosage of propofol and dopamine, the adverse reaction, and postoperative visual analogue scale. Results The dosage of propofol in R-N group is less then the R-C group (P < 0.05). The time of extract the endotracheal catheter,and the observation time in post anesthesia care unit in R-N group was shorter then the R-C group (P < 0.05). No statistical differences between the D-N group and D-C group. Conclusions Narcotrend monitoring can significantly reduce the dosage of propofol , the observation time in post anesthesia care unit , and the postoperative adverse reactions. But there is little effect to the donor.
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BACKGROUND:Bone marrow mesenchymal stem cel s have been shown to be differentiated into periodontal ligament fibroblasts when co-cultured with periodontal ligament cel s. Existing studies have shown that estrogen has the ability to influence bone marrow regeneration. OBJECTIVE:To investigate the effects of estrogen on osteogenesis and fibroblast-related factors alkaline phosphatase, type I and III col agen in bone marrow mesenchymal stem cel s. METHODS:Bone marrow mesenchymal stem cel s isolated from Beagle dogs were treated with estrogen. Osteogenesis and fibroblast-related mRNA and protein expression of bone marrow mesenchymal stem cel s was determined by RT-PCR and western blot assay, respectively. RESULTS AND CONCLUSION:mRNA and protein expression of type I and III col agen in bone marrow mesenchymal stem cel s was upregulated fol owing estrogen treatment;especial y, in contrast with type III col agen, the changes of type I col agen were more obvious. Estrogen did not influence mRNA and protein expression of alkaline phosphatase. These findings suggest that estrogen promotes the differentiation of bone marrow mesenchymal stem cel s into fibroblasts, whereas does not impact the genes involved in parodontium mineralization.
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Objective To investigate the effects of different dose of tranexamic acid in fibrinolysis during liver transplantation. Methods Sixty ASA Ⅱ~ Ⅳ liver transplant recipients, were randomly, double-blind assigned to one of 3 groups (n = 20): group control (group C), group tranexamic acid 1 (group T1) and group tranexamic acid 2 (group T2). The patients in group C received a loading dose of normal saline 10 mL, then continued infuse normal saline at 20 mL/h until neohepatic phase 120 min, while in other two groups, patients received a loading dose of tranexamic acid 1 g, totally 10 mL, followed by continuous infusion at 10 mg/(kg·h) in group T1 or 20 mg/(kg·h) in group T2 until neohepatic phase 120 min. Prothrombin time, fibrinogen, fibrin degradation product and D-dimers were measured before operation (T0), 120 min after the skin incision (T1), nonhepatic phase 30 min (T2), neohepatic phase 120 min (T3). Blood loss, fresh frozen plasma dosage, fibrinogen dosage and thromboembolic events were recorded. Results The plasma concentration of fibrin degradation product and plasma concentration of D-dimers were different in the 3 groups, group T2 0.05). Conclusions Continuous infusion of tranexamic acid can inhibit fibrinolysis during liver transplantation. No adverse event of thrombosis was detected. Larger dose of tranexamic acid can reduce blood loss and fresh frozen plasma transfusion.
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Objective To evaluate the efficacy of anesthesia with different doses of dexmedetomidine combined with propofol and remifentanil in patients undergoing abdominal surgery.Methods Ninety ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 45-80 kg,undergoing abdominal surgery,were randomly assigned into 3 groups ( n =30 each):control group (group C ),dexmedetomidine 0.25 μg· kg-1 · h-1 group ( group D1 ) and dexmedetomidine 0.50 μg· kg-1·h-1 group (group D2 ).Dexmedetomidine was infused at a rate of 0.25 μg·kg-1 ·h-1 and 0.50 μg·kg-1 ·h-1 in groups D1 and D2 respectively until extubation after a loading dose of 0.5 μg/kg over 15 min.In group C,normal saline was infused intravenously at a rate of 10 ml/h.Anesthesia was induced with TCI of propofol with the target plasma concentration (Cp) of 1.0 μg/ml,iv injection of cisatracurium 0.2 mg/kg and TCI of remifentanil with Cp of 3 ng/ml.The patients were tracheal intubated and mechanically ventilated.PETCO2 was maintained 35-40 mm Hg and SpO2 was maintained ≥95％.Anesthesia was maintained with TCI of remifentanil with the target Cp of 5 ng/ml,iv infusion of cisatracurium 0.1 mg· kg-1 · h-1 and TCI of propofol.The target Cp of propofol was increased to maintain Narcotrend index of 37-46.The amount of remifentanil,cisatracurium and propofol consumed,extubation time and eye-opening time,complications during operation and during recovery from anesthesia were recorded.Results There was no significant difference in the amount of remifentanil and cisatracurium consumed and extubation time among the three groups ( P ＞ 0.05).Compared with group C,the eye-opening time was significantly prolonged,the incidence of hypertension and tachycardia during operation,and restlessness,vomitting,hypertension,and tachycardia during recovery from anesthesia was significantly decreased in groups D1 and D2,and the amount of propofol consumed was significantly decreased in group D2 (P ＜ 0.05).Compared with group D1,the eye-opening time was significantly prolonged,the incidence of hypertension during operation,and restlessness,hypertension,and tachycardia during recovery from anesthesia was significantly decreased in group D2 ( P ＜ 0.05).Conclusion When combined with propofol and remifentanil,dexmedetomidine infused at a rate of 0.50 μg·kg-1 · h-1 can provide satisfactory efficacy for abdominal surgery.