Objective: Lumbar-dural combination is the most common anesthesia method, depending on the rate of injection, and thus affecting the patients anesthesia and hemodynamics. Methods: All of the 120 subjects in this surve...Objective: Lumbar-dural combination is the most common anesthesia method, depending on the rate of injection, and thus affecting the patients anesthesia and hemodynamics. Methods: All of the 120 subjects in this survey underwent surgery, using waist-hard-soft anesthesia, during the hospital stay of our hospital.[September 2020, August 2021], grouped by lottery, group A (n40), B (n40) at speeds of 10s, 15s, 20s and C (n40), respectively. The anesthesia effect of the three groups was evaluated, and the main parameters selected were: maximum block plane, T6 block time, anesthesia effect, action block, etc., and the patient was monitored for blood dynamics.(1) Comparison: Group A (maximum block plane between groups) and T6 block (T6 block) (no significant difference between groups) (no significant difference between groups) (maximum block plane 8.28 ± 1.26 min, T6) (no significant difference between groups) were significantly better than Group A (8.28 ± 1.26 min, T6 block 7.47 ± 1.45 min), P 0.05. (2) Anesthesia (Group A 97.50%, Group B 100.00%, Group C) anesthesia block (Group A 2.540.58), Group B (Bromage) score (2.720.39), Group C (Bromage) (2.63 + 0.64), and Group C (Bromage) (2.63 + 0.64).(3) Three groups of patients before anesthesia heart rate, arterial pressure, oxygen saturation hemodynamic index level is similar, there is no significant statistical significance (P> 0.05), the index after anesthesia level changes larger, and there are significant statistical significance (P 0.05), the lowest in heart rate, the highest in arterial pressure and oxygen saturation group C, p 0.05. Conclusion: In clinical practice, hard lumbar puncture anesthesia should maintain the anesthesia rate of 15 seconds or 20 seconds, while the hemodynamic effect is at least within 20 seconds, and the optimal injection rate can be determined according to the patients condition.展开更多
Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in ou...Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in our hospital were divided into experimental group(25 cases,general anesthesia+femoral nerve and sciatic nerve block)and control group(25 cases,general body anesthesia).Compare the MAP,HR,anesthesia effect,and adverse reactions between the two groups at each time period.Results:Before induction,the difference in MAP and HR between the two groups of patients did not form,p>0.05;the MAP and HR of the experimental group were compared with the control group at the time of skin incision,1 hour during the operation,and removal of the laryngeal mask,P<0.05;the time of extubation in the experimental group(14.28±3.18)min,awake time(5.57±1.32)min,orientation recovery time(11.89±2.23)min,propofol dosage(191.36±22.48)mg,remifentanil dosage(0.23±0.04)mg,Compared with the control group,P<0.05;the adverse reaction rate of the experimental group(8%,2/25)was lower than that of the control group(32%,8/25),P<0.05.Conclusion:The use of ultrasound-guided femoral nerve and sciatic nerve block for elderly patients with lower limb fractures can enhance the effect of anesthesia,effectively reduce the use of anesthetics,and have fewer adverse reactions.It is worthy of promotion.展开更多
As a means of pain relief, anesthesia is becoming more and more recognized and used by the medical community. Epidural anesthesia is the injection of a local anesthetic into the epidural cavity to block the spinal ner...As a means of pain relief, anesthesia is becoming more and more recognized and used by the medical community. Epidural anesthesia is the injection of a local anesthetic into the epidural cavity to block the spinal nerve root and temporarily paralyze the innervated area. Combined lumbar anesthetic-epidural block anesthesia is the injection of a local anesthetic into the cerebrospinal fluid. Blocking is produced by acting directly on the anterior and posterior roots of the spinal nerve and spinal cord. Waist anesthesia-epidural combined block anesthesia is effective in maintaining normal cardiopulmonary function and works quickly. In this study, 100 patients treated from April 2018 to June 2021 were randomly divided into observation and control groups, with 50 patients in each group. The control group underwent epidural anesthesia, and the observation group performed both lumbar anesthesia and epidural anesthesia to analyze the anesthesia effect. The results are reported as follows.展开更多
BACKGROUND Lower extremity fractures are mainly treated by surgical reduction,but this operation is often affected by the patient’s level of agitation and the type of anesthesia used.The main treatment for lower-extr...BACKGROUND Lower extremity fractures are mainly treated by surgical reduction,but this operation is often affected by the patient’s level of agitation and the type of anesthesia used.The main treatment for lower-extremity fractures is operative reduction.However,operations can often be affected by both agitation and the degree of anesthesia.Therefore,it is of great importance to develop an effective anesthesia program to effectively ensure the progress of surgery.AIM To discuss the effect of ultrasound-guided nerve block combined with dexmedetomidine anesthesia in lower extremity fracture surgery.METHODS A total of 120 hospital patients with lower extremity fractures were selected for this retrospective study and divided into an observation group(n=60)and a control group(n=60)according to the anesthesia scheme;the control group received ultrasound-guided nerve block;the observation group was treated with dextromethomidine on the basis of the control group,and the mean arterial pressure,heart rate(HR),and blood oxygen saturation were observed in the two groups.RESULTS The mean arterial pressure of T1,T2 and T3 in the observation group were 94.40±7.10,90.84±7.21 and 91.03±6.84 mmHg,significantly higher than that of the control group(P<0.05).The observation group’s HR at T1 was 76.60±7.52 times/min,significantly lower than that of the control group(P<0.05);The observation group’s HR at T2 and T3 was 75.40±8.03 times/min and 76.64±7.11 times/min,significantly higher than that of the control group(P<0.05).The observation group’s visual analog score at 2 h,6 h and 12 h after operation was 3.55±0.87,2.84±0.65 and 2.05±0.40.the recovery time was 15.51±4.21 min,significantly lower than that of the control group(P<0.05).Six hours post-anesthesia,epinephrine and norepinephrine in the observation group were 81.10±21.19 pg/mL and 510.20±98.27 pg/mL,significantly lower than that of the control group(P<0.05),and the mini-mental state exam score of the observation group was 25.51±1.15,significantly higher than that in the control group(P<0.05).CONCLUSION Ultrasound-guided nerve block combined with dexmedetomidine has a good anesthetic effect in the operation of lower limb fractures and has little effect on the hemodynamics of patients.展开更多
Objective to analyze the value of low-flow sevoflurane in anesthesia maintenance during laparoscopic surgery to maintain the stability of patients signs during operation and ensure the safety of patients after operati...Objective to analyze the value of low-flow sevoflurane in anesthesia maintenance during laparoscopic surgery to maintain the stability of patients signs during operation and ensure the safety of patients after operation. Methods: 60 patients who underwent laparoscopic surgery in our hospital from April 2020 to April 2022 were selected as samples. After they were enrolled into the group, they were divided into standardized groups, and different anesthesia schemes were given to carry out the comparative analysis, namely the control group (Levantin anesthesia maintenance) and the observation group (low flow sevoflurane anesthesia maintenance). Statistic the differences of anesthesia indexes of different groups of samples, and the effects of different anesthesia schemes on the changes of patients signs and safety. Results: the time required for each stage of anesthesia in the two groups was measured. The results showed that the clinical indexes of the patients in the observation group were better, the time of onset of anesthesia, complete block, and the time required for patients to wake up after operation were shorter, and the dosage of anesthetic drugs was lower (P 0.05). Before anesthesia induction, there was no significant difference in baseline data (including heart rate, systolic blood pressure, diastolic blood pressure) among patient groups (P > 0.05). After anesthesia, the patients physical signs were monitored again before and 10 minutes after the establishment of pneumoperitoneum, all of which showed that the changes of the patients physical signs in the observation group were more stable, with significant difference compared with the control group (P 0.05). The indexes of heart rate, systolic blood pressure and diastolic blood pressure in the immediate observation group were better, P 0.05. The incidence of unsafe events during and after operation in the two groups was evaluated. The evaluation value of the observation group was 6.67%, which was significantly lower than that of the control group by 26.67%, P 0.05. Conclusion: low-flow sevoflurane is adopted in anesthesia maintenance scheme of laparoscopic surgery, which has significant value in maintaining the stability of patients signs during operation and ensuring the safety of patients after operation.展开更多
The brain constitutes a formidably complicated structural network. There are three main types of connectivity used to describe neuronal networks, which reflect three parallel levels of investigation: anatomical connec...The brain constitutes a formidably complicated structural network. There are three main types of connectivity used to describe neuronal networks, which reflect three parallel levels of investigation: anatomical connectivity, functional connectivity and effective connectivity. Effective connectivity indicates the direct influence that a node exerts on another, and in the context of neuronal?circuits, a causal relationship between the activities of two nodes. Since its definition, effective?connectivity analysis has been used to describe causal relationship across multiple spatial scales in?PET imaging, fMRI, electroencephalography (EEG) and magnetoencephalography (MEG), single-unit, and local field potential. There are diverse literatures which probe the anesthetized state?using effective connectivity analysis over the past two decades. The examination of effective connectivity in the anesthetized state is of relevance to both anesthesiologists and neuroscientists, as it has the potential to elucidate still unclear mechanisms of anesthesia while offering insight into intrinsic functional activity in the brain. The present review attempts to examine, elucidate, and integrate the insight that effective connectivity analysis of the anesthetized state has generated thus far.展开更多
To investigate the effects of continuous spinal anesthesia with different concentrations and doses of ropivacaine on the ultrastructure of the spinal cord and nerve roots.Methods Twenty-four male SD rats weighing 220...To investigate the effects of continuous spinal anesthesia with different concentrations and doses of ropivacaine on the ultrastructure of the spinal cord and nerve roots.Methods Twenty-four male SD rats weighing 220～280 g were anesthetized with intraperitoneal 10% chloral hydrate 300～350 mg/kg.A polyurethane microcatheter was inserted into the lumbar subarachnoid space according to the technique described by Yaksh.An 8 cm catheter segment was left in the subarachnoid space.The animals were randomized to receive normal saline,0.5%,0.75% or 1.0% ropivacaine 40 μl intrathecally 3 times at 1.5 h interval.Six hours after the first intrathecal administration the animals were decaptiated and L 1,2 segment of the spinal cord and nerve roots were immediately removed for electron microscopic examination.Results Electron microscopic examination revealed that in animals which received intrathecal (i.t.) normal saline,0.5% or 0.75% ropivacaine the neurolemma of the nerve roots and the mitochondria and endoplasmic reticulum of the neurons in the spinal cord were intact,while in animals which received i.t. 10.% ropivacaine the neurolemma was stratified and partly disrupted and there were swelling of endoplasmic reticulum and vacuole degeneration.Conclusion Six hours continuous spinal anesthesia with 10.% ropivacaine may be injurious to the spinal cord and nerve roots.12 refs,8 figs,1 tab.展开更多
Objective:To study and analyze the clinical effect of electroacupuncture at Baihui and Neiguan Points on cognitive function recovery of elderly patients after general anesthesia.Methods:The subjects were 80 elderly pa...Objective:To study and analyze the clinical effect of electroacupuncture at Baihui and Neiguan Points on cognitive function recovery of elderly patients after general anesthesia.Methods:The subjects were 80 elderly patients who received general anesthesia from January 2019 to February 2021.According to different anesthesia methods,they were divided into research group(electroacupuncture at Baihui and Neiguan combined with conventional drug anesthesia)and control group(simple drug anesthesia).The postoperative cognitive function recovery of the two groups was observed and compared.Results:Compared with the control group,the MMSE score and POCD incidence of research group were significantly better.There was significant difference between the two groups(P<0.05).Conclusion:Conclusion electroacupuncture at Baihui and Neiguan combined with conventional drug anesthesia can promote the recovery of cognitive function and prevent cognitive dysfunction in elderly patients under general anesthesia.展开更多
Previous studies have shown that visual cortical neurons in old mammals exhibit higher spontaneous activity,higher responsiveness to visual stimuli,and lower selectivity for stimulus orientations and motion directions...Previous studies have shown that visual cortical neurons in old mammals exhibit higher spontaneous activity,higher responsiveness to visual stimuli,and lower selectivity for stimulus orientations and motion directions than did neurons in young adult counterparts.However,whether the responsive difference in cortical neurons between young and old animals resulted from different effects induced by anesthetics has remained unclear.To clarify this issue,we recorded the response properties of individual neurons in the primary visual cortex of old and young adult cats while systematically varying the anesthesia level of urethane,a widely used anesthetic in physiology experiments.Our results showed that cumulatively administrating 50 mg and 100 mg of urethane upon the minimal level of urethane required to anesthetize an old or young adult cat did not significantly alter the degree of neuronal response selectivity for stimulus orientations and motion directions nor significantly change the visually-driven response and spontaneous activity of neurons in old and young adult cats.Cumulatively administrating 150 mg of urethane decreased neuronal responsiveness similarly in both age groups.Therefore,urethane appears to exert similar effects on neuronal response properties of old and young adult animals.展开更多
BACKGROUND Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy.However,due to the physiological charac-teristics of elderly patients,the safety of periop...BACKGROUND Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy.However,due to the physiological charac-teristics of elderly patients,the safety of perioperative anesthesia needs special attention.As anα2-adrenergic receptor agonist,dexmedetomidine(Dex)has attracted much attention from anesthesiologists due to its stabilizing effect on heart rate and blood pressure,inhibitory effect on inflammation,and sedative and analgesic effects.Its application in general anesthesia may have a positive impact on the quality of anesthesia and postoperative recovery in elderly patients undergoing radical resection of colon cancer.METHODS A total of 165 colon cancer patients who underwent radical surgery for colon cancer under general anesthesia at Qingdao University Affiliated Haici Hospital,Qingdao,China were recruited and divided into two groups:A and B.In group A,Dex was administered 30 min before surgery,while group B received an equivalent amount of normal saline.The hemodynamic changes,pulmonary compliance,airway pressure,inflammatory factors,confusion assessment method scores,Ramsay Sedation-Agitation Scale scores,and cellular immune function indicators were compared between the two groups.RESULTS Group A showed less intraoperative hemodynamic fluctuations,better pulmonary compliance,and lower airway resistance compared with group B.Twelve hours after the surgery,the serum levels of TLR-2,TLR-4,IL-6,and TNF-αin group A were significantly lower than those of group B(P<0.05).After extubation,the Ramsay Sedation-Agitation Scale score of group A patients was significantly higher than that of group B patients,indicating a higher level of sedation.The incidence of delirium was significantly lower in group A than in group B(P<0.05).CONCLUSION The use of Dex as an adjunct to general anesthesia for radical surgery in elderly patients with colon cancer results in better effectiveness of anesthesia.展开更多
[Objectives]This study aimed to investigate the effects of ropivacaine-sufentanil epidural analgesia on labor and maternal and neonatal outcomes.[Methods]A total of 180 primiparas in full-term pregnancy were selected....[Objectives]This study aimed to investigate the effects of ropivacaine-sufentanil epidural analgesia on labor and maternal and neonatal outcomes.[Methods]A total of 180 primiparas in full-term pregnancy were selected.They were randomly divided into treatment group(n=90)and control group(n=90).The primiparas in the treatment group were injected epidurally with ropivacaine and sufentanil for analgesia,and the primiparas in the control group were subjected to vaginal delivery.The VAS scores at 5,10,30 and 60 min of analgesia were observed.The vaginal bleeding amount,total labor duration,neonatal Apgar score and vaginal delivery rate of the two groups were compared.[Results]Compared with the control group,the VAS score in the treatment group differed insignificantly after 5 min of analgesia(P>0.05),and decreased significantly after 10,30 and 60 min of analgesia(P<0.05).The vaginal bleeding amount of the treatment group was significantly smaller than that of the control group(P<0.05).There was no significant difference in the neonatal Apgar score between the two groups(P>0.05).In the treatment group,the vaginal delivery rate increased(P<0.05),the second stage of labor was prolonged(P<0.05),and the first and third stages of labor did not change significantly(P>0.05).[Conclusions]Epidural analgesia with ropivacaine and sufentanil has a good analgesic effect and good safety,and is worthy of clinical promotion.展开更多
文摘Objective: Lumbar-dural combination is the most common anesthesia method, depending on the rate of injection, and thus affecting the patients anesthesia and hemodynamics. Methods: All of the 120 subjects in this survey underwent surgery, using waist-hard-soft anesthesia, during the hospital stay of our hospital.[September 2020, August 2021], grouped by lottery, group A (n40), B (n40) at speeds of 10s, 15s, 20s and C (n40), respectively. The anesthesia effect of the three groups was evaluated, and the main parameters selected were: maximum block plane, T6 block time, anesthesia effect, action block, etc., and the patient was monitored for blood dynamics.(1) Comparison: Group A (maximum block plane between groups) and T6 block (T6 block) (no significant difference between groups) (no significant difference between groups) (maximum block plane 8.28 ± 1.26 min, T6) (no significant difference between groups) were significantly better than Group A (8.28 ± 1.26 min, T6 block 7.47 ± 1.45 min), P 0.05. (2) Anesthesia (Group A 97.50%, Group B 100.00%, Group C) anesthesia block (Group A 2.540.58), Group B (Bromage) score (2.720.39), Group C (Bromage) (2.63 + 0.64), and Group C (Bromage) (2.63 + 0.64).(3) Three groups of patients before anesthesia heart rate, arterial pressure, oxygen saturation hemodynamic index level is similar, there is no significant statistical significance (P> 0.05), the index after anesthesia level changes larger, and there are significant statistical significance (P 0.05), the lowest in heart rate, the highest in arterial pressure and oxygen saturation group C, p 0.05. Conclusion: In clinical practice, hard lumbar puncture anesthesia should maintain the anesthesia rate of 15 seconds or 20 seconds, while the hemodynamic effect is at least within 20 seconds, and the optimal injection rate can be determined according to the patients condition.
文摘Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in our hospital were divided into experimental group(25 cases,general anesthesia+femoral nerve and sciatic nerve block)and control group(25 cases,general body anesthesia).Compare the MAP,HR,anesthesia effect,and adverse reactions between the two groups at each time period.Results:Before induction,the difference in MAP and HR between the two groups of patients did not form,p>0.05;the MAP and HR of the experimental group were compared with the control group at the time of skin incision,1 hour during the operation,and removal of the laryngeal mask,P<0.05;the time of extubation in the experimental group(14.28±3.18)min,awake time(5.57±1.32)min,orientation recovery time(11.89±2.23)min,propofol dosage(191.36±22.48)mg,remifentanil dosage(0.23±0.04)mg,Compared with the control group,P<0.05;the adverse reaction rate of the experimental group(8%,2/25)was lower than that of the control group(32%,8/25),P<0.05.Conclusion:The use of ultrasound-guided femoral nerve and sciatic nerve block for elderly patients with lower limb fractures can enhance the effect of anesthesia,effectively reduce the use of anesthetics,and have fewer adverse reactions.It is worthy of promotion.
文摘As a means of pain relief, anesthesia is becoming more and more recognized and used by the medical community. Epidural anesthesia is the injection of a local anesthetic into the epidural cavity to block the spinal nerve root and temporarily paralyze the innervated area. Combined lumbar anesthetic-epidural block anesthesia is the injection of a local anesthetic into the cerebrospinal fluid. Blocking is produced by acting directly on the anterior and posterior roots of the spinal nerve and spinal cord. Waist anesthesia-epidural combined block anesthesia is effective in maintaining normal cardiopulmonary function and works quickly. In this study, 100 patients treated from April 2018 to June 2021 were randomly divided into observation and control groups, with 50 patients in each group. The control group underwent epidural anesthesia, and the observation group performed both lumbar anesthesia and epidural anesthesia to analyze the anesthesia effect. The results are reported as follows.
文摘BACKGROUND Lower extremity fractures are mainly treated by surgical reduction,but this operation is often affected by the patient’s level of agitation and the type of anesthesia used.The main treatment for lower-extremity fractures is operative reduction.However,operations can often be affected by both agitation and the degree of anesthesia.Therefore,it is of great importance to develop an effective anesthesia program to effectively ensure the progress of surgery.AIM To discuss the effect of ultrasound-guided nerve block combined with dexmedetomidine anesthesia in lower extremity fracture surgery.METHODS A total of 120 hospital patients with lower extremity fractures were selected for this retrospective study and divided into an observation group(n=60)and a control group(n=60)according to the anesthesia scheme;the control group received ultrasound-guided nerve block;the observation group was treated with dextromethomidine on the basis of the control group,and the mean arterial pressure,heart rate(HR),and blood oxygen saturation were observed in the two groups.RESULTS The mean arterial pressure of T1,T2 and T3 in the observation group were 94.40±7.10,90.84±7.21 and 91.03±6.84 mmHg,significantly higher than that of the control group(P<0.05).The observation group’s HR at T1 was 76.60±7.52 times/min,significantly lower than that of the control group(P<0.05);The observation group’s HR at T2 and T3 was 75.40±8.03 times/min and 76.64±7.11 times/min,significantly higher than that of the control group(P<0.05).The observation group’s visual analog score at 2 h,6 h and 12 h after operation was 3.55±0.87,2.84±0.65 and 2.05±0.40.the recovery time was 15.51±4.21 min,significantly lower than that of the control group(P<0.05).Six hours post-anesthesia,epinephrine and norepinephrine in the observation group were 81.10±21.19 pg/mL and 510.20±98.27 pg/mL,significantly lower than that of the control group(P<0.05),and the mini-mental state exam score of the observation group was 25.51±1.15,significantly higher than that in the control group(P<0.05).CONCLUSION Ultrasound-guided nerve block combined with dexmedetomidine has a good anesthetic effect in the operation of lower limb fractures and has little effect on the hemodynamics of patients.
文摘Objective to analyze the value of low-flow sevoflurane in anesthesia maintenance during laparoscopic surgery to maintain the stability of patients signs during operation and ensure the safety of patients after operation. Methods: 60 patients who underwent laparoscopic surgery in our hospital from April 2020 to April 2022 were selected as samples. After they were enrolled into the group, they were divided into standardized groups, and different anesthesia schemes were given to carry out the comparative analysis, namely the control group (Levantin anesthesia maintenance) and the observation group (low flow sevoflurane anesthesia maintenance). Statistic the differences of anesthesia indexes of different groups of samples, and the effects of different anesthesia schemes on the changes of patients signs and safety. Results: the time required for each stage of anesthesia in the two groups was measured. The results showed that the clinical indexes of the patients in the observation group were better, the time of onset of anesthesia, complete block, and the time required for patients to wake up after operation were shorter, and the dosage of anesthetic drugs was lower (P 0.05). Before anesthesia induction, there was no significant difference in baseline data (including heart rate, systolic blood pressure, diastolic blood pressure) among patient groups (P > 0.05). After anesthesia, the patients physical signs were monitored again before and 10 minutes after the establishment of pneumoperitoneum, all of which showed that the changes of the patients physical signs in the observation group were more stable, with significant difference compared with the control group (P 0.05). The indexes of heart rate, systolic blood pressure and diastolic blood pressure in the immediate observation group were better, P 0.05. The incidence of unsafe events during and after operation in the two groups was evaluated. The evaluation value of the observation group was 6.67%, which was significantly lower than that of the control group by 26.67%, P 0.05. Conclusion: low-flow sevoflurane is adopted in anesthesia maintenance scheme of laparoscopic surgery, which has significant value in maintaining the stability of patients signs during operation and ensuring the safety of patients after operation.
文摘The brain constitutes a formidably complicated structural network. There are three main types of connectivity used to describe neuronal networks, which reflect three parallel levels of investigation: anatomical connectivity, functional connectivity and effective connectivity. Effective connectivity indicates the direct influence that a node exerts on another, and in the context of neuronal?circuits, a causal relationship between the activities of two nodes. Since its definition, effective?connectivity analysis has been used to describe causal relationship across multiple spatial scales in?PET imaging, fMRI, electroencephalography (EEG) and magnetoencephalography (MEG), single-unit, and local field potential. There are diverse literatures which probe the anesthetized state?using effective connectivity analysis over the past two decades. The examination of effective connectivity in the anesthetized state is of relevance to both anesthesiologists and neuroscientists, as it has the potential to elucidate still unclear mechanisms of anesthesia while offering insight into intrinsic functional activity in the brain. The present review attempts to examine, elucidate, and integrate the insight that effective connectivity analysis of the anesthetized state has generated thus far.
文摘To investigate the effects of continuous spinal anesthesia with different concentrations and doses of ropivacaine on the ultrastructure of the spinal cord and nerve roots.Methods Twenty-four male SD rats weighing 220～280 g were anesthetized with intraperitoneal 10% chloral hydrate 300～350 mg/kg.A polyurethane microcatheter was inserted into the lumbar subarachnoid space according to the technique described by Yaksh.An 8 cm catheter segment was left in the subarachnoid space.The animals were randomized to receive normal saline,0.5%,0.75% or 1.0% ropivacaine 40 μl intrathecally 3 times at 1.5 h interval.Six hours after the first intrathecal administration the animals were decaptiated and L 1,2 segment of the spinal cord and nerve roots were immediately removed for electron microscopic examination.Results Electron microscopic examination revealed that in animals which received intrathecal (i.t.) normal saline,0.5% or 0.75% ropivacaine the neurolemma of the nerve roots and the mitochondria and endoplasmic reticulum of the neurons in the spinal cord were intact,while in animals which received i.t. 10.% ropivacaine the neurolemma was stratified and partly disrupted and there were swelling of endoplasmic reticulum and vacuole degeneration.Conclusion Six hours continuous spinal anesthesia with 10.% ropivacaine may be injurious to the spinal cord and nerve roots.12 refs,8 figs,1 tab.
基金Natural Science Basic Research Program of Shaanxi Province(No.:2020JQ-950).
文摘Objective:To study and analyze the clinical effect of electroacupuncture at Baihui and Neiguan Points on cognitive function recovery of elderly patients after general anesthesia.Methods:The subjects were 80 elderly patients who received general anesthesia from January 2019 to February 2021.According to different anesthesia methods,they were divided into research group(electroacupuncture at Baihui and Neiguan combined with conventional drug anesthesia)and control group(simple drug anesthesia).The postoperative cognitive function recovery of the two groups was observed and compared.Results:Compared with the control group,the MMSE score and POCD incidence of research group were significantly better.There was significant difference between the two groups(P<0.05).Conclusion:Conclusion electroacupuncture at Baihui and Neiguan combined with conventional drug anesthesia can promote the recovery of cognitive function and prevent cognitive dysfunction in elderly patients under general anesthesia.
基金Supported by Natural Science Foundation of Anhui Province (070413138)the Key Research Foundation of Anhui Province Education Department (KJ2009A167)
文摘Previous studies have shown that visual cortical neurons in old mammals exhibit higher spontaneous activity,higher responsiveness to visual stimuli,and lower selectivity for stimulus orientations and motion directions than did neurons in young adult counterparts.However,whether the responsive difference in cortical neurons between young and old animals resulted from different effects induced by anesthetics has remained unclear.To clarify this issue,we recorded the response properties of individual neurons in the primary visual cortex of old and young adult cats while systematically varying the anesthesia level of urethane,a widely used anesthetic in physiology experiments.Our results showed that cumulatively administrating 50 mg and 100 mg of urethane upon the minimal level of urethane required to anesthetize an old or young adult cat did not significantly alter the degree of neuronal response selectivity for stimulus orientations and motion directions nor significantly change the visually-driven response and spontaneous activity of neurons in old and young adult cats.Cumulatively administrating 150 mg of urethane decreased neuronal responsiveness similarly in both age groups.Therefore,urethane appears to exert similar effects on neuronal response properties of old and young adult animals.
文摘BACKGROUND Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy.However,due to the physiological charac-teristics of elderly patients,the safety of perioperative anesthesia needs special attention.As anα2-adrenergic receptor agonist,dexmedetomidine(Dex)has attracted much attention from anesthesiologists due to its stabilizing effect on heart rate and blood pressure,inhibitory effect on inflammation,and sedative and analgesic effects.Its application in general anesthesia may have a positive impact on the quality of anesthesia and postoperative recovery in elderly patients undergoing radical resection of colon cancer.METHODS A total of 165 colon cancer patients who underwent radical surgery for colon cancer under general anesthesia at Qingdao University Affiliated Haici Hospital,Qingdao,China were recruited and divided into two groups:A and B.In group A,Dex was administered 30 min before surgery,while group B received an equivalent amount of normal saline.The hemodynamic changes,pulmonary compliance,airway pressure,inflammatory factors,confusion assessment method scores,Ramsay Sedation-Agitation Scale scores,and cellular immune function indicators were compared between the two groups.RESULTS Group A showed less intraoperative hemodynamic fluctuations,better pulmonary compliance,and lower airway resistance compared with group B.Twelve hours after the surgery,the serum levels of TLR-2,TLR-4,IL-6,and TNF-αin group A were significantly lower than those of group B(P<0.05).After extubation,the Ramsay Sedation-Agitation Scale score of group A patients was significantly higher than that of group B patients,indicating a higher level of sedation.The incidence of delirium was significantly lower in group A than in group B(P<0.05).CONCLUSION The use of Dex as an adjunct to general anesthesia for radical surgery in elderly patients with colon cancer results in better effectiveness of anesthesia.
文摘[Objectives]This study aimed to investigate the effects of ropivacaine-sufentanil epidural analgesia on labor and maternal and neonatal outcomes.[Methods]A total of 180 primiparas in full-term pregnancy were selected.They were randomly divided into treatment group(n=90)and control group(n=90).The primiparas in the treatment group were injected epidurally with ropivacaine and sufentanil for analgesia,and the primiparas in the control group were subjected to vaginal delivery.The VAS scores at 5,10,30 and 60 min of analgesia were observed.The vaginal bleeding amount,total labor duration,neonatal Apgar score and vaginal delivery rate of the two groups were compared.[Results]Compared with the control group,the VAS score in the treatment group differed insignificantly after 5 min of analgesia(P>0.05),and decreased significantly after 10,30 and 60 min of analgesia(P<0.05).The vaginal bleeding amount of the treatment group was significantly smaller than that of the control group(P<0.05).There was no significant difference in the neonatal Apgar score between the two groups(P>0.05).In the treatment group,the vaginal delivery rate increased(P<0.05),the second stage of labor was prolonged(P<0.05),and the first and third stages of labor did not change significantly(P>0.05).[Conclusions]Epidural analgesia with ropivacaine and sufentanil has a good analgesic effect and good safety,and is worthy of clinical promotion.
