This study established an aged rat model of cognitive dysfunction using anesthesia with 2%iso-lfurane and 80%oxygen for 2 hours. Twenty-four hours later, Y-maze test results showed that isoflurane significantly impaired cognitive function in aged rats. Gas chromatography-mass spectrometry results showed that isolfurane also signiifcantly increased the levels of N,N-diethy-lacetamide, n-ethylacetamide, aspartic acid, malic acid and arabinonic acid in the hippocampus of isolfurane-treated rats. Moreover, aspartic acid, N,N-diethylacetamide, n-ethylacetamide and malic acid concentration was positively correlated with the degree of cognitive dysfunction in the isolfurane-treated rats. It is evident that hippocampal metabolite changes are involved in the formation of cognitive dysfunction after isoflurane anesthesia. To further verify these results, this study cultured hippocampal neurons in vitro, which were then treated with aspartic acid (100 μmol/L). Results suggested that aspartic acid concentration in the hippocampus may be a biomarker for predicting the occurrence and disease progress of cognitive dysfunction.

Objective.To assess patients' knowledge,attitudes,and concerns regarding anesthetic management.Method.A survey of 55 items was developed and administered preoperatively to 500 patients including 190 men and 310 women in our hospital.Patients were interviewed on their knowledge of the role of anesthesiologists,their preferences regarding anesthetic management,and also their concern about potential anesthetic complications.Results.Patients' perceptions of anesthesiologists' training and role have reached a certain level.Most significant preoperative concerns regarding the anesthesiologists focused on experience,qualifications,and presence or absence during the anesthesia.Patients' concerns also included the possibility of not being waken up following anesthesia,experiencing postoperative pain,and becoming paralyzed.The variations of concerns depended partially on patients' sex,type of anesthesia,and proposed surgical procedure,partially on their education and living environments.Conclusion.It is suggested that anesthesiologists address significant patient concerns during the preoperative visit to enhance their effectiveness in patient care.Efforts to educate the public on the anesthesiologists' role in preoperative care would improve patients' confidence.

不同全麻下腹腔镜结肠癌切除术病人围术期细胞免疫功能的比较

Objective To compare the effects of different general anesthesia protocols on perioperative cellular immune function in patients undergoing laparoscopic surgery for colorectal cancer.Methods Ninety ASA Ⅰ or Ⅱ colorectal cancer patients,aged 40-64 yr,weighing 50-85 kg,undergoing laparoscopic surgery were randomly divided into 3 groups (n =30 each):group total intravenous anesthesia (group Ⅰ) ; group inhalational anesthesia(group Ⅱ) and group combined intravenous-inhalational anesthesia (group Ⅲ).Anesthesia was induced with iv midazolam,sufentanil,TCI of propofol and remifentanil and vecuronium in groups Ⅰ and Ⅲ.In group Ⅰ anesthesia was maintained with TCI of propofol and remifentanil and intermittent iv boluses of vecuronium,while in group Ⅲ with inhalation of sevoflurane and intermittent iv boluses of vecuronium.In group Ⅱ anesthesia was induced and maintained with inhalation of sevoflurane and intermittent iv boluses of vecuronium.Narcotrend index was used to monitor depth of anesthesia and maintained at 37-64 during operation.Venous blood samples were taken for determination of the levels of T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8 +) and natural killer cells at 30 min before induction of anesthesia (T0),2 h after skin incision (T1),at the end of operation (T2) and 24 h after operation (T3).Results The levels of CD3 +,CD4 +,CD4+/CD8+ and natural killer cells were significantly decreased at T2 in group Ⅱ,while the levels of natural killer cells were decreased at T2 in group Ⅲ as compared with the baseline at T0,and were significantly lower than those in group Ⅰ.The levels of CD3+ and CD4+ were significantly lower at T2 in group Ⅱ than in group Ⅲ.Conclusion Intravenous anesthesia with midazolam,propofol,sufentanil,remifentanil and vecuronium has less inhibitory effect on perioperative cellular immune function than inhalational anesthesia and combined intravenous-inhalational anesthesia in patients undergoing laparoscopic surgery for colorectal cancer.

术前并存疾病对老年颈椎手术围术期并发症的影响

AIM:To investigate the effects of preoperative other diseases on the complications of senile cervical vertebral operation in perioperative period.METHODS:800 senile cervical vertebral cases were divided into two group: group A included the cases without other comorbidities,and group B included the cases with hypertension, diabetes mellitus,coronary heart disease(CHD) or chronic obstructive pulmonary disease(COPD).We retrospectively analyzed the changes of BP,oxygen saturation(SaO2) and the incidence of cardiac arrhythmia during operation of group A and B.RESULTS:In perioperative period, the incidence of BP reduction or rising and cardiac arrhythmia in group B was more than that of group A.Incidence of SaO2 decreasing increases apparently in each stage and incidence of cerebrovascular, pulmonary complications and asphyxia led by incision bleeding increases apparently.CONCLUSION:The hypertension, CHD, diabetes mellitus and COPD were the main reasons of complications of the heart,the cerebral vessels and the lung, kidney and the incision bleeding in perioperative period of senile patients.

The first successful demonstrations of clinically useful anesthesia took place a little over 150 years ago. Although both of these public demonstrations were made by dentists, Horace Wells (nitrous oxide) and William Morton (ether), the events revolutionized surgery. Up until that time a surgeon's skill was dependent on how fast he could operate but anesthesia allowed surgeons to take a slower and more careful approach which in turn has allowed surgical innovation and development. Initially anesthesia was given by the most junior person on the surgical team but deaths and an increasing choice of drugs resulted, by the early part of the 20th century, in the development of anesthesia as a separate and distinct medical speciality.