RESUMO
Objective To evaluate the efficacy of different concentrations and small dose of lidocaine of combined spinal epi-dural anesthesia(CSEA) in elderly patients with non-procedure for prolapse and haemorrhoids(PPH) anorectal surgery .Methods One hundred and twenty elderly patients undergoing non-PPH anorectal surgery were selected and randomly dividedin to 4 groups , the group A(1 .5% lidocaine) ,B(1 .0% lidocaine) ,C(0 .8% lidocaine) and D ,30cases in each group .The group A ,B and C adopted CSEA ,and the group D adopted the sacral anesthesia .The changes of mean arterial pressure(MAP) and heart rate(HR) at different time points ,stress reactions before and after operation ,anesthetic operating time ,effect onset time ,postoperative reactivating time , anesthetic grade ,success rate ,postoperative patient satisfaction ,postoperative surgeon satisfaction and urine retention were recor-ded .Results MAP and HR at different time points had no statistical difference among 4 groups(P>0 .05) .The anesthetic onset time and postoperative activity recovery time in the group A ,B and C were significantly less than those in the group D(P<0 .01) . The postoperative activity recovery time in the group A was longer than that in the group B and C .The urine retention time in the group A ,B and C was significantly less than that in the group D (P<0 .05) .The postoperative patient satisfaction and surgeon sat-isfaction in the group A and B were 100% .Conclusion 1% lidocaine CSEA is more suitable for the elderly patients with non-PPH anorectal operation .
RESUMO
BACKGROUND:Sufentanil exerts protective effects on tissues, but its roles in the repair of nervous system injury and the underlying mechanism are stil unknown. OBJECTIVE:To explore the protective effect of sufentanil preconditioning in the repair of spinal cord injuries and the underlying mechanism. METHODS:Mouse models of spinal cord injuries were prepared through clipping spinal cord fol owed by intraperitoneal injection of 3 and 6μg/kg sufentanil, respectively. RESULTS AND CONCLUISON:(1) Western blotting, ELISA and TUNEL assays showed that 6μg/kg sufentanil significantly down-regulated the protein expression levels of TLR4, nuclear factor-κBp65, cleaved-caspase 3, tumor necrosis factor-αand interlenkin-1βin the spinal cord of mice (P<0.05);at the same time, the number of apoptotic neurons was significantly decreased (P<0.05). (2) Furthermore, high-dose sufentanil preconditioning significantly ameliorated the recovery of limb function at 14 days after injury (P<0.05). (3) These results administrate that the neuroprotection provided by 6μg/kg sufentanil preconditioning for spinal cord injuries in mice maybe related to the TLR4/nuclear factor-κB signaling pathway inactivation.