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Objective To evaluate the effect of epidural labor analgesia with different concentra-tions of ropivacaine combined with sufentanil on fever. Methods A total of 104 healthy parturients, of A-merican Society of Anesthesiologists physical status Ⅰ or Ⅱ, with New York Heart Association gradeⅠ orⅡ, with body height 150-175 cm, weighing 50-90 kg, at 37-45 weeks of gestation, scheduled for elec-tive labor analgesia, were divided into 0. 075％ ropivacaine group ( group R1, n=51) and 0. 125％ ropiva-caine group ( group R2, n=53) by a random number table method. Epidural labor analgesia was performed with 0. 075％ ropivacaine plus 0. 25μg∕ml sufentanil and with 0. 125％ ropivacaine plus 0. 25μg∕ml sufen-tanil in group R1 and group R2, respectively, to maintain visual analog scale score<3. Body temperature was measured before analgesia ( T0 ) , at 30 min, 1, 3 and 5 h of analgesia ( T1-4 ) , immediately after de-livery and at 2 h after delivery ( T5,6 ) . Venous blood samples were collected at T0,3,5 to detect the concen-tration of interleukin-6 ( IL-6) in serum. The incidence of fever, plane of anesthesia, fluid infusion rate, consumption of sufentanil and ropivacaine, the number of increment of drugs and length of labor were recor-ded. Results Compared with group R1, the degree of increase in body temperature was significantly in-creased at T1-6 , the consumption of ropivacaine and concentration of IL-6 at T3 were increased in group R2 (P<0. 05). There was no significant difference in the rate of fever, plane of anesthesia, fluid infusion rate, consumption of sufentanil and ropivacaine, the number of increment of drugs or length of labor be-tween two groups ( P>0. 05) . Conclusion Epidural labor analgesia with different concentrations of ropiva-caine combined with sufentanil exerts no effect on fever, 0. 075％ ropivacaine induces less changes in body temperature of parturients than 0. 125％ ropivacaine, which is related to the lower concentration of IL-6.
RESUMO
Objective To study intermediate and long term efficacy of uterine arterial embolization (UAE)with sodium alginate microspheres(KMG)at diameters 500-700μm in treatment of diffuse adenomyosis.Methods Totally 40 patients with standard difluse adenomyosis were enrolled and treated with UAE.KMG at diameters 500-700 μm for vascular embolization were used to embolize the arteries.The degree of dysmenorrhea,amount of menorrhea and uterine volume,as well as the level of serum CA125,follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)were investigated before andafter UAE.Results The follow up rates were 100%(40/40),100%(40/40),80%(32/40),68%(27/40),58%(23/40)after uterine arterial UAE 12,24,36,48 and 60 months respectively.The early,intermediate and long-term effective rates were 90%(36/40),88%(28/32),83%(19/23).The degree of dysmenorrhea,the amount of menorrhea and the uterine volume,as well as serum CA125 all decreased significantly 3 mouths after UAE at varying degrees(P＜0.05).Compared with other follow-up time,thedegree of dysmenorrhea and the amount of menorrhea declined to their lowest point at 6 month after UAE (P＜0.01).Paralleled with the decrease of volume of uterine,serum CA125 also decreased significantly and reached the lowest level 12 months later compared with other follow-up times(P＜0.01).Even at the 12th month after UAE serum CA125was not normal and FSH,LH and E2 did not change all the times after UAE(P>0.05).No recurrence was found during the 60 months after UAE.Condusion KMG used in UAE at diameters 500-700 μm has good intermediate and long term effectiveness in treatment of diffuse adenomyosis with no side effects.