Maximum dose of continuous infusion of mivacurium for thyroid surgery under total intravenous anesthesia: a sequential trial of monitoring neurological function in 30 patients / 南方医科大学学报

OBJECTIVE@#To investigate the maximum dose of continuous mivacurium infusion for intraoperative neuromonitoring (IONM) and observe the adverse reactions during thyroid surgery under total intravenous anesthesia (TIVA).@*METHODS@#Thirty patients undergoing IONM during thyroid surgery received continuous infusion of mivacurium at the initial rate of 14.97 μg · kg@*RESULTS@#The EC@*CONCLUSIONS@#In patients undergoing thyroid surgery under TIVA, the EC

Effect of operative trauma and multiple propofol anesthesia on neurodevelopment and cognitive function in developmental rats / 浙江大学学报·医学版

To investigate the effect of multiple propofol anesthesia and operative trauma on neuroinflammation and cognitive function in development rats and its mechanism. A total of 104 13-day-old neonatal Sprague-Dawley rats were randomly divided into 4 groups with 26 rats in each group: control group was treated with saline q.d for propofol group was treated with propofol q.d for surgery group received abdominal surgery under local anesthesia and then treated with saline q.d for surgery with propofol group received propofol anesthesia plus abdominal surgery under local anesthesia with ropivacaine at d1, then treated with propofol q.d for At d2 of experiment, 13 rats from each group were sacrificed and brain tissue samples were taken, the concentration of TNF-α in hippocampus was detected with ELISA, the expression of caspase-3 and c-fos in hippocampal tissue was determined with immunohistochemical method, the number of apoptotic neurons in hippocampus was examined with TUNEL assay. Morris water maze test was used to examine the cognitive function of the rest rats at the age of 60 d, and the TNF-α concentration, caspase-3, c-fos expressions and the number of apoptotic neurons in hippocampus were also detected. Compared with control group, TNF-α concentration, caspase-3, c-fos expression and the neuroapoptosis in hippocampus increased significantly in other three groups (all 0.05). Morris water maze test showed that there were no significant differences in swimming speed, escape latency, target quadrant residence time and crossing times among groups (all >0.05). TNF-α level, expressions of caspase-3 and c-fos and apoptotic cell numbers in hippocampus had no significant differences among the 4 adult rats groups (all >0.05). Abdominal surgery and multiple propofol treatment can induce neuroinflammation and neuroapoptosis in hippocampus of neonatal rats, however, which may not cause adverse effects on neurodevelopment and cognitive function when they grown up.

Sequential method for determining the maximum dose of mivacurium continuously infused for intraoperative neuromonitoring in thyroid surgery / 南方医科大学学报

OBJECTIVE@#To determine the maximum dose of continuously infused mivacurium for intraoperative neuromonitoring and observe its adverse effects in thyroid surgery.@*METHODS@#Twenty-eight patients undergoing thyroid surgery with intraoperative neuromonitoring received continuous infusion of mivacurium at the initial rate of 5.43 μg?kg?min, and the infusion rate for the next patient was adjusted based on the response of the previous patient according to the results of neurological monitoring. The depth of anesthesia was maintained with sevoflurane and remifentanil during the surgery. The LD50 and 95% of mivacurium were calculated using Brownlee's up-and-down sequential method.@*RESULTS@#The LD50 of continuously infused mivacurium was 8.94 μg?kg?min (95% : 8.89- 8.99 μg?kg?min) during thyroid surgery, which did not affect neurological function monitoring. Transient chest skin redness occurred after induction in 9 patients (32.1%). None of the patients experienced intubation difficulties or showed intraoperative body motions during the surgery.@*CONCLUSIONS@#In patients undergoing thyroid surgery under anesthesia maintained by inhalation and intravenous infusion, the LD50 of mivacurium was 8.94 μg?kg?min (95% : 8.89-8.99 μg?kg?min) for continuous infusion, which does not cause serious adverse effects during the operation.

Effects of propofol and etomidate on inflammation and oxidative stress in septic mice / 临床麻醉学杂志

Objective To observe the effects of propofol and etomidate on inflammation and ox-idative stress in septic mice.Methods Sixty-four male adult BALB/c mice were randomly divided into four groups:normal control group (N),sepsis group (S),propofol treatment group (P)and etomid-ate treatment group (E).The septic mice model was established by lipopolysaccharide (LPS,20 mg/kg)intraperitoneal injection,and propofol (60 mg/kg)or etomidate (10 mg/kg)was injected in the abdominal cavity at 0.5 h after LPS injection.Serum interleukin-6 (IL-6)concentrations and in-terleukin-10 (IL-10)concentrations were measured at 2 h and 6 h after LPS injection;malondialde-hyde (MDA)content of lung,liver and kidney tissue was measured at 6 h after LPS injection. Results Compared with group N,serum IL-6 concentrations increased significantly (P <0.05),and IL-10 concentrations decreased significantly (P <0.05)at 2 h and 6 h after LPS injection in group S;MDA content of lung,liver,kidney increased significantly (P <0.05 )at 6 h after LPS injection in group S;Compared with group S,serum IL-6 concentrations decreased significantly (P <0.05),and IL-10 concentrations increased significantly (P < 0.05 )at 2 h and 6 h after LPS injection in both group P and E;MDA content of lung,liver,kidney decreased significantly (P <0.05 )at 6 h after LPS injection in group E,but only MDA content of lung decreased significantly (P <0.05)at 6 h af-ter LPS injection in group P;Compared with group P,serum IL-6 concentrations was significantly lower (P <0.05),and IL-10 concentrations was significantly higher (P <0.05)at 2 h and 6 h after LPS injection in group E;MDA content of lung,liver,kidney was significantly lower (P <0.05)at 6 h after LPS injection in group E.Conclusion Both propofol and etomidate injected in the abdominal cavity can reduce injury of inflammatory and oxidative stress in septic mice induced by LPS,and the effect of etomidate is more significant.

Dexmedetomidine protects against LPS-induced ALI in septic mice / 军事医学

Objective To observe the effect of dexmedetomidine on inflammation, oxidative stress and lung injury in lipopolysaccharide( LPS)-induced septic mice.Methods Forty eight male adult BALB/c mice were randomly divided into three groups (n=16): normal control group (Ctrl), sepsis group (Sep), and Dex group.Ae septic mice model was established by LPS 20 mg/kg,and Dex 30μg/kg injected intraperitoneally at 0.5 h after LPS injection.The concentrations of serum IL-6 and IL-10 were detected at 2 h and 6 h after LPS injection while myeloperoxidase ( MPO ) activity and malondialdehyde( MDA) content of lungs were detected and weight dry ratio ( W/D) of lungs was calculated at 6 h after LPS injection.Pathological changes were observed in left lung HE stained with optical microscopy at 6 h after LPS injection. Results Compared with Sep group, the concentrations of serum IL-6 decreased significantly(P <0.05), while the concentrations of IL-10 increased significantly(P<0.05) at 2 h and 6 h after LPS injection in Dex group.MPO activity, MDA content and W/D of lungs decreased significantly(P<0.05) at 6 h after LPS injection in Dex group.The injury to the lung was lightened significantly under optical microscopy in Dex group.Conclusion Dex protects against LPS-induced ALI in septic mice by inhibiting systemic inflammatory response, reducing lung tissue inflammatory infiltration and oxidative stress.

Anesthetic effects of repeated dosing with propofol and vitamin C in mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the anesthetic effects of repeated administration of propofol combined with vitamin C in mice.</p><p><b>METHODS</b>Forty mice were subjected to daily intraperitoneal injections of 80 mg/kg propofol (P80 group), 70 mg/kg propofol and 50 mg/kg vitamin C (P70+Vc50 group), 55 mg/kg propofol and 100 mg/kg vitamin C (P55+Vc100 group), or 50 mg/kg propofol and 200 mg/kg vitamin C (P50+Vc200 group) for 6 consecutive days, and the anesthesia induction time and anesthesia duration were recorded.</p><p><b>RESULTS</b>Compared with the P80 group, the mice in P55 + Vc100 group and P50 + Vc200 group showed significantly shorter anesthesia duration on the first 3 days (P<0.05). In all the groups, anesthesia duration was significantly shortened in the following days compared with that on day 1 (P<0.01); anesthesia duration was shorter on day 3 than on day 2 in P50 + Vc200 group (P<0.01), and was shorter on days 4, 5, and 6 than on day 2 in all the groups (P<0.01). In all the groups, the rate of loss of righting reflex (LORR) decreased gradually with time in a similar pattern.</p><p><b>CONCLUSION</b>Vitamin C can reduce the dose of propofol without obviously affecting the anesthetic effect to reduce the incidence of drug tolerance and potential dose-related side effects of propofol.</p>

Perioperative anesthetic management for patients who received percutaneous nephroscopic peripancreatic necrectomy for acute necrotizing pancreatitis / 中华肝胆外科杂志

Objective To review our experiences on perioperative anesthetic management for patients who received percutaneous nephroscopic peripancreatic necrectomy for acute necrotizing pancreatitis.Method The clinical data on 18 patients with acute necrotizing pancreatitis who received percutaneous nephroscopic peripancreatic necrectomy in our hospital from August 2008 to January 2011 were retrospectively analyzed.Results There was a marked fluctuation in hemodynamic status of the patients which required the use of vasoactive drugs during perioperative period.PETCO2 significantly increased after pneumoperitoneum.Tracheal extubation was possible in 11 patients immediately after surgery in the operation room,while 7 patients required tracheal intuhation to be transported back to the surgical intensive care unit (SICU).Conclusion Most patients who underwent percutaneous nephroscopic peripancreatic necrectomy had a varying degree of shock and multi-organ injury before operation.Proper anesthetic induction and maintenance,correct use of vasoactive drugs and lung protective ventilation strategy,and active fluid resuscitation are the keys to good perioperative anesthetic management and to improve treatment results.

Comparison of blocking effect of ropivacaine and bupivacaine on sodium channels of rat dosal root ganglia / 中国临床药理学与治疗学

AIM: To compare the blocking effect of ropivacaine and bupivacaine on sodium channels of rat dosal root ganglia(DRG) using whole cell recording technique. METHODS: Rat DRG neurons were enzymatically isolated , tetrodotoxin-sensitive(TTX-s) and tetrodotoxin-resistant (TTX-r) sodium currents of DRG were recorded by whole cell recording.Drugs were given in bath solution.The concentrations of ropivacaine were 10,30,100, 1 000 ?mol?L~ -1 and bupivacaine were 10,30,100,300 ?mol?L~ -1 . The recording number in each dose group was six. RESULTS: CsCl in extracellular fluid and TEA in intracellular fluid were used to block the potassium channels. Sodium currents were recorded when the holding potential was - 70 mV and a serials of pulse with step 10 mV and duration 70 ms was given.TTX-s sodium channel was recorded in 80.1 % large DRG cells and TTX-r sodium channel was recorded in 92.4 % medium and small DRG cells,of which 56.3 % cells had no response to 1 ?mol?L~ -1 TTX. The half-maximal blocking concentrations of ropivacaine on TTX-r sodium channel was 65.7 ? 6.1 ?mol?L~ -1 , which was much lower than that on TTX-s sodium channel 246.8 ? 11.2 ?mol?L~ -1 (P 0.05 ). CONCLUSION: Ropivacaine preferentially blocks TTX-r sodium channel.Selective blocking of TTX-r and TTX-s sodium channel was one of the reasons of seperation of sensation and motion when it is used in epidural anesthesia.

Effect of intrathecal injection of ?-conopeptide SO3 on inducible nitric oxide synthase expression in spinal cord and chronically constricted sciatic nerve in rat / 解放军医学杂志

Objective To evaluate the effect of intrathecal administration of ?-conopeptide SO3 on inducible nitric oxide synthase(iNOS)expression of spinal cord and the ligated sciatic nerve in a rat model with chronic constriction injury(CCI).Methods 40 male SD rats were randomly divided into 4 groups of 10 animals each.Rats in the N group served as controls;in group C 4 loose ligatures were placed around the right sciatic nerve for 14 days;in group CN,normal saline 1?l/h was injected intrathecally slowly for 7 days seven days after the ligation;in group CS,?-conopeptide SO3 30ng/h was administered intrathecally slowly for 7 days seven days after the ligature.Local expression of iNOS was assayed in samples taken from injured nerves(between and distal to the CCI site)and the spinal cord using Western blotting analysis,with GAPDH as an internal reference.Results A 130 kDa band,corresponding to iNOS protein was detected in the middle and distal sections of the injured nerves and the spinal cord.The iNOS immunoreactivity was inhibited by continuous intrathecal injection of ?-conopeptide SO3.There was no difference in the expression of iNOS between group CN and group C.Conclusion The expression of iNOS in the spinal cord and injured nerves of CCI rats was enhanced.Intrathecal injection of ?-conopeptide SO3 can inhibit the expression of iNOS.The data suggested that N-type calcium channel blocker took part in the expression of iNOS.