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Objective To observe analgesia effect of morphine hydrochloride and hydromorphone hydrochloride in patients after transurethral resection of prostate. Methods Patients after transurethral resection of the prostate (TURP) were randomly divided into 2 groups, morphine hydrochloride group (n=45) and hydromorphone hydrochloride group (n=47). Analgesia, sedation efficacy and adverse reactions were evaluated at 6 and 24 h after they received epidural postoperative analgesia by using VAS score and Ramsay score. Results In 6 h, hydromorphone hydrochloride group had a better pain tolerance and feeling than morphine hydrochloride group (P0.05).There were no differences in adverse reactions between the two groups ( P>0. 05 ) . Conclusion Hydromorphone has a better effect than morphine in epidural analgesia in 6 h.
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Objective To evaluate the effect of 8% emulsified isoflurane preconditioning on renal ischemia-reperfusion (I/R) injury in rats.Methods Thirty-two male Sprague-Dawley rats,aged 10-13 weeks,weighing 220-300 g,were randomly divided into 4 groups (n =8 each):sham operation group (group S); I/R group;emulsified isoflurane preconditioning group (group E) ; intralipid preconditioning group (group I).Renal ischemia was induced by occlusion of the left renal pedicle for 45 min with atraumatic microclips followed by 3 h reperfusion.8 % emulsified isoflurane and 30 % intralipid 4 ml· kg-1· h-1 were infused intravenously for 30 min followed by 15 min washout before renal UR in groups E and I,respectively.Arterial blood samples were taken at 3 h of reperfusion to determine the concentrations of serum creatinine (Cr),cystatin C (Cys C),TNF-α,IL-6 and IL-10.The animals were then sacrificed and left kidneys were removed and stained with hematoxylin-eosin for microscopic examination and assessment of necrosis of renal proximal convoluted tubules (0 =normal,4 =necrosis of whole segment of proximal convoluted tubules).Results Compared with group S,the serum Cr,Cys C,TNF-α,IL-6 and IL-10 concentrations and severity of necrosis of renal proximal convoluted tubules were significantly increased in groups I/R,E and I (P ＜ 0.05).The serum Cr,Cys C,TNF-α and IL-6 concentrations and severity of necrosis of renal proximal convoluted tubules were significantly lower,while the serum IL-10 concentration was higher in group E than in groups I/R and I (P ＜0.05).There was no significant difference in the indexes mentioned above between groups L and I/R (P ＞ 0.05).The damage to renal tissues was less serious in group E than in groups I/R and L.Conclusion Preconditioning with 8 % emulsified isoflurane can attenuate renal I/R injury by inhibiting inflammatory responses in rats.
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bjective To clarify the heart rate variability (HRV) changes in patients subjected to deliberate hypotension with alprostadil.Methods Eighty-six elderly patients scheduled for nasal endoscopic surgery in general anesthesia were divided into alprostadil group (group A) and nitroglycerin group (group N) with 43 cases each by random digits table.Hypotension was induced with alprostadil and nitroglycerin through continuous infusion respectively,and the mean arterial pressure (MAP) was reduced to about 25％-30％ of baseline MAP.The MAP,heart rate (HR),total power ( TP ),low frequency (LF),high frequency (HF),and LF/HF were continuously monitored and blood was taken for analysis of lactate (LAC) before deliberate hypotension (T0),at the time of dropping to target blood pressure (T1),at 5 and 30 min after deliberate hypotension (T2 and T3),stopping deliberate hypotersion (T4) and 30 min after recovery from hypotension (T5).Results HR at T1-T4 was faster than that at T0in group N(P ＜ 0.05),and faster than that in group A( P ＜ 0.05 ),HR at T5 was faster than that at T0 in group N( P ＜ 0.05 ),but HR was stable at T1-T5 in group A (P ＞ 0.05 ).There was no significant difference in LAC of group A and group N whether in interior group or between two groups (P＞ 0.05).TP,LF and HF at T1-T4 were lower than those at T0 in two groups ( P ＜ 0.05 ),HF at T1-T4 was higher in group A than that in group N(P ＜ 0.05 ) ; LF/HF was no change at T1-T4 compared with that at T0 in group A (P ＞ 0.05),but increased in group N (P ＜ 0.05 ) which was higher than that in group A at the same time ( P ＜ 0.05 ) ;TP,LF and HF was recovered at Ts in two groups,and HF at T5 in group A was higher than that in group N( P ＜ 0.05 ) ; LF/HF at T5 in group A maintained the level at T0,but decreased in group N and lower than that at T5 in group N(P ＜ 0.05).Conclusion Alprostadil for deliberate hypotension is more likely to maintain cardiac autonomic nerve balance that is helpful for perioperative security of elderly patients.
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The disease incidence of aortic dissecting aneurysm showed an increasing tendency.Recently,the clinical application of endovascular stent-graft implantation received good results in treating aortic dissecting aneurysm,which is characterized by minimally invasive,safe,with high success rates.However,the chosen of anesthesia is still in dispute.Local anesthesia,intraspinal anesthesia and general anesthesia can be used in this operation.The investigation demonstrated that intubation general anesthesia is more security in this operation with less complication,which is conductive to controlling blood pressure and braking conditions.
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OBJECTIVE: To investigate the analeptic action of Xingnaojing injection(XNJI) in patients undergoing total intravenous anesthesia and the possible mechanism.METHODS: 60 patients undergoing selective abdominal operation with tracheal intubation(scored grade Ⅰ or grade Ⅱ using ASA score) were transferred to post-anesthctic ICU(PACU) after surgery and randomly divided into two groups of 30 each: X group(XNJI 0.5 mL?kg-1) and C group(control group).The X group received XNJI(0.5 mL?kg-1) by drip infusion within 10 minutes,while C group received same amount of normal saline.The vocal reaction recovery time,autonomous breath recovery time,extubation time and duration of PACU stay were recorded.The mean arterial pressure(MAP),heart rate(HR),the concentrations of Epinephrine(E),and Norepinephrine(NE) and ?-endorphin(?-EP) in arterial blood were detected at 0,5,15,30 and 45 minutes before and after medication.RESULTS: No significant differences were noted for X group in hemodynamics parameters after medication as compared with before medication,but significant differences were noted for C group at 30 min and 45 min when compared with before medication or compared with X group at the same different time points.The vocal reaction recovery time,autonomous breath recovery time,extubation time and the duration of PACU stay were all significantly shorter in X group than in C group(P