Accuracy of anesthesia index for monitoring depth of sedation induced by propofol: a comparison with bispectral index / 中华麻醉学杂志

Objective To evaluate the accuracy of anesthesia index (AI) for monitoring depth of sedation induced by propofol.Methods Thirty patients of both sexes,aged 41-64 yr,with body mass index of 20-30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were enrolled in the study.Propofol was given by target-controlled infusion (TCI) with the initial target effect-site concentration (Ce) of 1.2 μg/ml using Marsh pharmacokinetic model,and then the Ce of propofol was increased in 0.3 μg/ml increment,and Observer's Assessment of Alertness/Sedation (OAA/S) score was evaluated.OAA/S score was 5 before TCI of propofol.When OAA/S score reached 4,3,2 and 1 in turn during TCI of propofol,the bispectral index (BIS),AI and corresponding Ce were recorded.Results The correlation coefficients of BIS,AI and Ce levels with the OAA/S scores were rBIS-OAA/S =0.962,rAI-OAA/S =0.960 and rce-OAA/S =-0.795,respectively (P＜0.05).The correlation coefficients of BIS and AI with the Ce of propofol were rBIs-ce =-0.736 and rAI-Ce =-0.737,respectively (P＜0.05).There was no significant difference between rBIS-OAA/s and rAI-oAA/S,and between rBIS-Ce and rAI-Ce (P＞ 0.05).Conclusion AI can accurately monitor the depth of sedation induced by propofol in adult patients without noxious stimuli and there is no significant change in the accuracy in comparison with BIS.

Effects of normovolemic hemodilution with hetastarch starch 130/0.4 and electrolyte solution on blood coagulation during resection for liver cancer in elderly patients / 中华麻醉学杂志

Objective To evaluate the effects of normovolemic hemodilution (NH) with hetastarch starch 130/0.4 and electrolyte solution on blood coagulation during resection for liver cancer in the elderly patients.Methods Forty patients,of ASA physical status Ⅱ,aged 65-74 yr,scheduled for elective resection for liver cancer under general anesthesia,were randomly divided into NH group (n =20) and control group (group C,n =20).NH group underwent NH with 6％ hematocrit starch 130/0.4 and electrolyte solution after induction of anesthesia,while group C underwent routine fluid management.Before induction of anesthesia (T1),at 30 min after NH (T2),at 1 h during operation (T3),and at the end of operation (T4),venous blood samples were collected for measurement of the routine parameters of blood coagulation,and levels of soluble fibrin monomer complex (SFMC),and platelet membrane glycoprotein (PAC-1,platelet activation marker).Results Compared with group C,no significant changes were found in intraoperative blood loss,PT,APTT,and levels of SFMC and PAC-1,the volume of allogeneic blood transfused was reduced,and Fib was decreased at T2-4 in NH group.Compared with the baseline value at T1,Fib was decreased significantly at T2-4 in NH group,and PT and APTT were prolonged but still within the normal range,and no significant changes were found in the other parameters in both groups.Conclusion NH with hetastarch starch 130/0.4 and electrolyte solution exerts no effect on blood coagulation during resection for liver cancer and provides blood-saving effect to some extent in the elderly patients.

The level and clinical significance of laminin and hyaluronic acid in the cerebrospinal fluid of patients with neuropsychiatric lupus / 中华风湿病学杂志

Objective To investigate the level and clinical significance of laminin (LN) and hyalu-ronic acid (HA) in cerebrospinal fluid (CSF) of patients with neuropsychiatric lupus (NPLE). Methods The level of LN and HA in CSF in 31 cases of NPLE, 36 cases of no-NPLE SLE, 23 cases of no-SLE cerebrovascular disease and 39 normal controls were messured by radioimmunoassay method. Results The level of LN and HA in CSF of NPLE patients was higher than that of the no-NPLE, no-SLE cerebrovascular disease and normal controls (P