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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2014年第8期15卷 743-749页

作者： Yu-hong LI Rui HE Jin-guang RUAN department of anesthesiology Shaoxing People’s Hospital department of anesthesiology the First Affiliated HospitalSchool of Medicine Zhejiang University

Objective： To explore the effect of hepatic function on loss of consciousness （LOC） and bispectral index （BIS） during sedation with midazolam （MDZ）. Methods： Forty-five patients were assigned to three groups according to their liver function. Thirty of these patients with diagnoses of cholelithiasis were scheduled laparoscopic cholecys- tectomy, including 15 patients with normal liver function （normal group）, and 15 patients with moderately abnormal liver function based on the results of ultrasonic diagnosis of a moderately fatty liver and elevated alanine transaminase levels of less than three times normal （moderate group）. The other 15 patients with end-stage liver disease （severe group） underwent liver transplantation. Each patient was administered MDZ by way of target-controlled infusion to increase the concentration gradually. At the time of LOC, the BIS was recorded and a blood sample was withdrawn for measurement of the concentration of MDZ. The concentration of MDZ （EC50） and the BIS value （BIS50） at which 50% of patients lose consciousness were calculated using logistic regression. Results： At the time of LOC, the EC50 of MDZ and the BIS50 were similar in the normal and moderate groups （P〉0.05）. LOC occurred at a lower EC50 of MDZ and at a higher BIS50 in the severe group, compared with the normal and moderate groups （P〈0.01）. Conclusions： Patients with end-stage liver disease were more sensitive to MDZ and this affected the prediction of their time of LOC following MDZ administration. There were no changes in response in patients with moderately abnormal hepatic function.

关键词： Midazolam Hepatic function EC50 Bispectral index (BIS) Loss of consciousness

托烷司琼不同时间给药预防肛肠科手术术中和术后恶心及呕吐

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中国新药与临床杂志 2010年第11期29卷 876-878页

作者：艾春雨马虹中国医科大学附属第一医院麻醉科辽宁沈阳110001

目的评价托烷司琼不同时间给药对腰硬联合麻醉下肛肠科手术术中和术后恶心、呕吐的预防效果。方法择期肛肠科手术患者80例,ASAⅠ～Ⅱ级,随机分为4组,每组20例。对照组(C组)不给予托烷司琼;托烷司琼术前组(Ⅰ组),于腰麻成功后静脉注射(静... 详细信息

目的评价托烷司琼不同时间给药对腰硬联合麻醉下肛肠科手术术中和术后恶心、呕吐的预防效果。方法择期肛肠科手术患者80例,ASAⅠ～Ⅱ级,随机分为4组,每组20例。对照组(C组)不给予托烷司琼;托烷司琼术前组(Ⅰ组),于腰麻成功后静脉注射(静注)托烷司琼5 mg;托烷司琼术前和术后联合用药组(Ⅱ组),于腰麻成功后静注托烷司琼2 mg,术毕静注托烷司琼3 mg;托烷司琼术后组(Ⅲ组),于术毕静注托烷司琼5 mg。观察各组术中和术后24 h恶心、呕吐发生情况,并记录有无过度镇静及锥体外系反应等不良反应的发生。结果与C组比较,Ⅰ、Ⅱ组术中恶心及呕吐发生情况明显改善(P<0.05)。与C组比较,Ⅰ、Ⅱ和Ⅲ组术后恶心及呕吐发生情况改善明显(P<0.05),Ⅱ、Ⅲ组恶心及呕吐发生率低于Ⅰ组,差异具有显著意义(P<0.05)。4组均无过度镇静及锥体外系反应发生。结论托烷司琼术前和术后联合给药能明显减少腰硬联合麻醉下肛肠科手术患者恶心、呕吐的发生。

关键词：托烷司琼恶心呕吐麻醉

Involvement of CYP2B6 in the biotransformation of propofol by human liver microsomes

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沈阳药科大学学报 2008年第S1期25卷 102-102页

作者： TANG Bing1,WANG Jun-ke1,FENG Wan-yu2(1.department of anesthesiology,first affiliated hospital,china medical University,Shenyang 110001,china 2.department of Clinical Pharmacology,the first affiliated hospital,china medical University,Shenyang 110001,china)

Objective To determine whether the cytochrome P4502B6(CYP2B6)is involved in the oxidation of propofol by human liver *** The change of propofol concentration in an incubation mixture with human liver microsomes was monitored by the high performance liquid chromatography(HPLC),in order to calculate the rate constants of metabolism of *** correlation between the rate constants and the rate of metabolism of CYP2B6 selective substrate bupropion,and the effect of two different CYP2B6 specific inhibitors on the propofol metabolism were *** The mean rate constant of propofol metabolism by liver microsomes obtained from twelve individuals was 3.9(95% confidence intervals 3.3,4.5)nmol·min-1·mg-1 *** rate constants of propofol metabolism by liver microsomes were significantly correlated with bupropion hydroxylation(r=0.888,P<0.001).Both selective chemical inhibitors of CYP2B6,orphenadrine and N,N',N″-triethylenethiophosphoramide(thioTEPA),reduced the rate constants of propofol metabolism by 37.5%(P<0.001)and 42.7%(P<0.001)in liver microsomes,*** CYP2B6 is predominantly involved in the oxidation of propofol by human liver microsomes.

关键词： propofol CYP2B6 liver microsomes HPLC

Anesthesia Management of Living RelatedLiver Transplantation(A case report)

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Journal of Nanjing medical University 2000年第1期14卷 27-29页

作者： Fu Chengzhang(傅诚章) Gao Qiaolan(高巧兰) Liu Cunming(刘存明) Zhang Guolou (张国楼) Zhuang Chanfen (庄蟾芬) department of anesthesiology, the first affiliated hospital, Nangjing medical University,Nanjing 210029, P.R.china department of anesthesiology the First Affiliated HospitalNangjing Medical UniversityNanjing 210029P. R. China

Objective To investigate the effects of anesthesia management on living related liver transplantation. Methods The donor was given procaine fentanyl balanced anesthesia; the recipient was given thiopentol fentanyl atracurium intravenous balanced anesthesia. ECG, P ET CO 2,SpO 2, blood gas, glucose and potassium were monitored. Results Cardiovascular system and respiratory system of the recipient during operation were stable. Conclusion Fentanyl intravenous balanced anesthesia may be used to manage living related liver transplantion. But, the following problems shoud be paid to attention. ①Citrate and lactic acid might accumulate causing metabolic acidosis. ②Hyperkalemia might be developed as the donated liver was reperfused. ③As the liver was an important place for glycogenesis, glycogenolysis, blood glucose was carefully observed and insulin was given to the liver transplantation patient.④As the living related liver was translated, reperfusion syndrome could develop.⑤ The patient was monitored carefully postoperation. Analgesic was given if needed.

关键词： living related liver transplantation anesthesia

APPLICATION OF ACUPUNCTURE COMBINING WITH DRUGS DURING HYPOPHYSOMA RESECTION

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针刺研究 1989年第Z1期 207-207页

作者： Wang Mengmin Ma Junzhi Song Jinxeng department of anesthesiology, the first affiliated hospital, Henan medical University

Clinical DataOperations were performed on 69 patients under acupuncture anesthesiacombining with drugs from 1980 to 1985, among them, males 39, females *** oldest patient was 62 years old, the youngest 19, most cases were *** "U" shape incision on righ frontal part, or coronary shape incision onfrontal part was used. Duration of operations: The longest was 240 minutes,the shortest 73 minutes.

关键词： APPLICATION OF ACUPUNCTURE COMBINING WITH DRUGS DURING HYPOPHYSOMA RESECTION

帕瑞昔布防止瑞芬太尼全身麻醉苏醒期躁动及对术后镇痛的影响

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中国新药与临床杂志 2010年第6期29卷 441-444页

作者：魏珂闵苏童珊珊重庆医科大学附属第一医院麻醉科重庆400016

目的了解帕瑞昔布对防止瑞芬太尼全身麻醉(全麻)手术患者苏醒期躁动的效果,评价其对术后静脉自控镇痛的影响。方法拟于全麻下行妇科及骨科手术的50例患者随机分为2组,每组25例。所有患者均采用静吸复合麻醉,术中持续静脉泵注瑞芬太尼。... 详细信息

目的了解帕瑞昔布对防止瑞芬太尼全身麻醉(全麻)手术患者苏醒期躁动的效果,评价其对术后静脉自控镇痛的影响。方法拟于全麻下行妇科及骨科手术的50例患者随机分为2组,每组25例。所有患者均采用静吸复合麻醉,术中持续静脉泵注瑞芬太尼。开始缝合皮肤时帕瑞昔布组静脉注射帕瑞昔布40 mg并复合吸入七氟烷直至皮肤缝合结束。对照组静脉泵注瑞芬太尼并复合吸入七氟烷直至皮肤缝合结束。术毕开始自控静脉镇痛。观察给药后不同时点的平均动脉压(MAP)和心率(HR)。记录手术时间、拔管时间、恢复期躁动情况,术后48 h内不同时点疼痛评分、自控镇痛效果的总体评价,并观察药物不良反应。结果帕瑞昔布组术毕10 min至拔管前MAP和HR均低于对照组(P<0.05)。对照组苏醒期躁动发生率(24%)高于帕瑞昔布组(4%,P<0.05)。帕瑞昔布组患者出恢复室至回病房后4 h内VAS静态评分均低于对照组(P<0.05),动态评分回病房后1～4 h低于对照组(P<0.05)。2组均未见严重不良反应发生。结论帕瑞昔布能减少瑞芬太尼全麻苏醒期躁动,有益于完善术后早期自控镇痛效果。

关键词：麻醉,全身镇痛瑞芬太尼帕瑞昔布

Effects of Intraoperative Autologous Blood Donation and Tepid Temperature Cardiopulmonary Bypass on Blood System

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Journal of Huazhong University of Science and Technology(medical Sciences) 2000年第2期20卷 151-153页

作者：张诗海姚尚龙 department of anesthesiology Xiehe Hospital Tangji Medical University Wuhan

The effects of the intraoperative autologous bind donation and tepid temperature cardiopulmonary bypass (CPB) on blood system were investigated. Twenty-four patients with rheumatic heart valve diseases scheduled for open heart surgery were selected and divided randomly into group A (intraoperative autologous blood donation and tepid temperature, nasopharyngeal temperature was at 32-34 ℃ during CPB) and group B (control, nasopharyngeal temperature was at 25-28 ℃ during CPB). The plasmatic concentrations of GMP-140 and D-Dimer and the plasmatic activities of 6- ketoPGF1α and AT- Ⅲ were measured by using ELISA or substrate luminescence techniques before operation, at the end of CPB, after discontinuation of CPB and postoperatively. Red blood cell count, platelet count, hematocrit, the amount of blood drainage and the amount of blood transfusion needed were measured or recorded postoperatively. The results showed the plasmatic concentrations of GMP140 and D-Dimer in group A were significantly less (P<0. 05) than those in group B during and after operation. The activity of 6-keto--PGF1α in group A was higher (P<0. 05) than that in group B during and after operation. The AT- Ⅲ activity in group A was less (P<0. 05) during CPB but higher 30 min after discontinuation of CPB than that in group B. The amount of postoperative blood loss (283± 166 versus 722± 194 ml, P

关键词： cardiopulmonary bypass blood system autologous blood donation tepid temperature

Combined general/epidural anesthesia(ropivacaine)versus general anesthesia for abdominal surgery

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Combined general/epidural anesthesia(ropivacaine)versus gene...

Effect of heme oxygenase-endogenous carbon monoxide on mortality during septic shock in rats

2006年浙江省麻醉学学术年会

作者： Yuhong Li MD, PhD, Shengmei Zhu MD, PhD, Meijuan Yan MS department of anesthesiology, first affiliated hospital, School of Medicine, Zhejiang University, china.

The present study used the bispectral index score (BIS) to examine the additional epidural anesthesia with ropivacaine 0.375% on perioperative characteristic in patients, receiving general ***-six ASA status Ⅰ-Ⅱ patients scheduled for elective upper abdominal surgery were randomly assigned to one of two groups: epidural (saline) /general anesthesia (Groups C) and epidural (0.375% ropivacaine) /general (Group R) *** of anesthesia was performed with TCI sufentanil and propofol titrated to achieve BIS between 40-50. Endotracheal intubation was facilitated by the TCI administration of

关键词： anesthesia, combined epidural-general ropivacaine propofol, stress hormone

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Effect of heme oxygenase-endogenous carbon monoxide on morta...