舒芬太尼对胃癌SGC-7901细胞活力的影响

目的通过不同浓度的舒芬太尼作用于胃癌SGC-7901细胞,研究舒芬太尼对胃癌细胞活力的影响。方法将对数生长期的胃癌细胞随机均分为对照组(C组)、舒芬太尼0.5nmol/L组(0.5nM组)、5nmol/L(5nM组)、50nmol/L(50nM组)和500nmol/L(500nM组)。分别以0、0.5、5、50、500nmol/L浓度的舒芬太尼作用于胃癌细胞,FDA/PI荧光双染观察染毒后的胃癌SGC-7901细胞存活情况;CCK-8试剂盒检测细胞活力;AnnexinV-FITC流式细胞术检测胃癌细胞的凋亡情况;最后运用细胞周期检测试剂盒分析胃癌细胞的细胞周期。结果 FDA/PI双染观察显示,随着舒芬太尼染毒浓度的增高,死亡的胃癌SGC-7901细胞比例不断增加,存活的正常细胞比例下降;CCK-8分析表明药物作用后的胃癌细胞的活力呈下降趋势,与C组比较,12h时500nM组和24、48h时50、500nM组细胞活力明显下降(P0.05或P0.01)。与C组比较,5nM组、50nM组和500nM组细胞凋亡率明显升高(P0.05或P0.01)。运用AnnexinV-FITC/PI凋亡实验发现胃癌细胞凋亡和死亡的数量也随药物浓度的增加而不断增多;最后通过检测染毒后的胃癌细胞,发现与C组比较,5nM、50nM和500nM组G2/M期细胞比例明显升高,S期细胞比例明显降低(P0.01)。结论舒芬太尼可以使胃癌SGC-7901细胞的活力下降,促进胃癌细胞凋亡。     

TNP-470对胃癌细胞株SGC-7901体外血管生成拟态的抑制作用

目的：研究TNP-470对胃癌细胞株SGC-7901体外血管生成拟态的影响。方法：将培养的SGC-7901细胞分为TNP-470组及对照组，应用克隆形成试验检测细胞增殖活性的变化。Transwell小室检测癌细胞体外侵袭力的变化，体外管状形成试验检测管道形成能力的变化。结果：TNP-470对SGC-7901细胞增殖没有明显抑制作用，可以显著降低SGC-7901细胞的体外侵袭能力，抑制体外管道形成。结论：TNP-470能够抑制SGC-7901细胞的体外血管生成拟态形成。     

二甲双胍对胃癌细胞株增生及Cyclin D1表达的影响

目的 观察二甲双胍在体外对人胃癌细胞株SGC-7901生长的作用,并初步探讨其作用机制.方法 体外培养胃癌SGC-7901细胞,MTT法测二甲双胍在不同浓度和不同作用时间对胃癌细胞增生的影响;Western blot法检测二甲双胍对胃癌细胞CycLn D1表达的影响.结果 MTT法结果显示:用不同浓度(50 mmol/L、100 mmol/L)的二甲双胍处理胃癌细胞SGC-7901在24h.48h、72h后,50 mmol/L二甲双胍对于胃癌细胞生长抑制率分别为32.93%、48.64%和61.40%.100 mmol/L二甲双胍对于胃癌细胞生长抑制率分别为35.34%、75.44%和88.30%,不同浓度的二甲双胍对于胃癌细胞生长抑制率与对照组相比具有显著性差异(P<0.05),100mmoL/L二甲双胍对于胃癌细胞生长抑制与50mmol/L二甲双胍对于胃癌细胞生长抑制率相比具有显著性差异(P<0.05)二甲双胍呈时间、浓度依赖性抑制胃癌细胞的增生.胃癌细胞高表达Cyclin D1,Western blot检测表明二甲双胍能显著降低Cycfin D1蛋白的表达,且呈一定时间、剂量依赖性.结论 二甲双胍可以下调胃癌细胞株SGC-7901 Cycfin D1的表达,抑制胃癌细胞的增生.     

miR-622在胃癌细胞中的表达及其功能的研究

目的 研究miR-622在胃癌细胞中的表达,探讨miR-622在胃癌中的生物学功能.方法 采用实时荧光定量PCR检测miR-622在胃癌细胞中的表达,以胃癌细胞SGC-7901和NCI-N87为模型瞬时转染miR-622寡核苷酸前体或抑制体,通过克隆形成、侵袭和划痕实验验证其在胃癌细胞中的功能.结果 荧光定量PCR实验结果表明:miR-622在胃癌细胞SGC-7901中相对表达量为1.29±0.58,而在NCI-N87细胞中相对表达量为10.96±1.02.在SGC-7901细胞中转染了miR-622 寡核苷酸前体,克隆形成率为76％.划痕试验中愈合能力为(11±7)μm,胃癌细胞侵袭能力为(732±3)个,与对照组相比差异均有统计学意义(均P＜0.05).结论 miR-622能够促进胃癌细胞克隆形成、迁移和侵袭.     

双链蛋白聚糖对胃癌细胞生长作用研究

目的:研究双链蛋白聚糖(biglycan,BGN)对人胃癌细胞系SGC-7901的细胞增殖、周期及凋亡等生长作用影响。方法:构建重组质粒pIRES2-EGFP/BGN,转染胃癌细胞株SGC-7901,获得胃癌稳转细胞株SGC-7901/BGN。通过细胞增殖实验(CCK-8法)、平板克隆实验、流式细胞技术,分别检察BGN过表达对SGC-7901细胞增殖、克隆形成、周期及凋亡的影响。结果:SGC-7901/BGN组胃癌细胞较SGC-7901/空载组生长明显抑制(P<0.01),细胞培养板形成的克隆数明显减少[(209.7±12.6)比(326.0±15.1)];同时过表达BGN可促进胃癌细胞的凋亡[(10.7±1.5)%比(5.3±1.1)%],且将细胞周期阻止在G1期[(55.7±2.1)%比(37.6±1.8)%]。结论:胃癌细胞过表达BGN可抑制胃癌细胞的增殖、克隆形成。BGN可能通过将细胞周期阻滞在G1期、诱导细胞凋亡,从而发挥其生长抑制的生物学效应。     

VEGF—C基因高表达促进胃癌细胞增殖及克隆和小管形成的实验研究

目的：构建人血管内皮生长因子（VEGF）-C基因慢病毒表达载体,并研究其在胃癌细胞中的功能。方法：采用SYBRGreen相对定量逆转录聚合酶链反应（qRT—PCR）及蛋白免疫印迹法（Westernblot）检测6种不同类型的胃癌细胞系MKN-45、MKN-28、NCI—N87、BGC-823、AGS和SGC-7901中VEGF—CmRNA及其蛋白表达水平;通过构建VEGF—C基因慢病毒表达载体进行细胞增殖、克隆形成和内皮细胞管形成实验,按实验组（MKN-45-GV／C）、对照组（MKN-45-GV）和空白细胞组（MKN-45）加以比较。结果：qRT—PCR和Westernblot实验表明,在6种胃癌细胞中均可检测到VEGF～CmRNA及其蛋白的表达,其中在胃癌细胞MKN-45中表达最低（0．45±1．44）,SGC-7901中表达最高（31.13±0.75）;增殖实验结果显示,与对照组比较,实验组细胞增殖数量明显增加（P〈0．001）;克隆形成结果显示,实验组和对照组细胞在每平均视野形成克隆数分别为6．234±0．32和1．40±1．67,克隆形成率分别为85％和31％（P〈0．05）;内皮细胞管形成实验结果显示,实验组、对照组和空白细胞组小管数目分别为8．14土1．25、12．76±0．79和18．46±0．72（P〈0．01）,小管长度分别为98．56±3．71、105．17±134和151．62±2．51（P〈0．05）。结论：VEGF—C基因真核表达载体构建成功,VEGF—C基因促进胃癌细胞增殖、克隆形成和小管形成。     

TNF-α重组慢病毒对胃癌细胞自分泌杀伤作用的实验研究

目的探讨TNF-α重组慢病毒对胃癌细胞自分泌杀伤作用。方法 TNF-α重组慢病毒感染SGC-7901胃癌细胞为实验组,并设立阴性对照组以及空白对照组,采用RT-PCR检测3组细胞中TNF-αmR NA的表达情况,ELISA检测3组细胞上清液中TNF-α蛋白含量,流式细胞术检测3组细胞凋亡情况。结果 PCR实验观察到TNF-αmR NA荧光条带24h后稳定表达。测得三组培养液中TNF-α含量,实验组[(2.6926±0.7563)ng/ml]明显高于阴性对照组[(0.9326±0.3091)ng/ml]和空白对照组[(0.8552±0.2768)ng/ml],且差异均有统计学意义(P均0.01),而阴性对照组和空白对照组之间差别无统计学意义(P0.05)。在流式细胞实验中,实验组细胞凋亡率明显高于其他组,差异有统计学意义(P0.05),而阴性对照组和空白对照组差别无统计学意义(P0.05)。结论TNF-α重组慢病毒可以感染SGC-7901胃癌细胞,并在胃癌细胞中稳定表达并自分泌TNF-α,诱导杀伤胃癌细胞。     

FasL、B7-1联合基因修饰的胃癌细胞诱导抗胃癌主动免疫的研究

目的 探讨FasL、B7-1联合基因转移是否具有协同的抗肿瘤效应。方法 采用重组腺病毒载体将FasL、B7-1基因导入人胃癌细胞SGC-7901,G418阳性克隆筛选,流式细胞分析,逆转录-聚合酶链反应(RT-PCR),显示FasL和B7-1的表达,并且通过Hoechst33342染色检测胃癌细胞凋亡;将携带 FasL和 B7-1基因的胃癌细胞(命名为 SGC-7901/FB-11)接种于 C57BL/6小鼠背部皮下,观测其致瘤性能;SGC-7901/FB-11致敏的小鼠对野生型瘤细胞是否具有免疫保护作用;用SGC-7901和 SGC-7901/FB-11细胞分别经腹腔免疫小鼠,得到腹腔浸润淋巴细胞及致敏脾细胞,MTT法检测其体外杀伤实验。结果 FasL和B7-1基因在胃癌细胞中获得高表达并可诱导胃癌细胞的凋亡,双基因转染的胃癌细胞的致瘤性明显下降;SGC-7901/FB-11诱导的细胞毒T淋巴细胞(CTL)对SGC-7901的杀伤活性显著高于野生型SGC-7901诱导的CTL对相同靶细胞的杀伤活性(P<0.05);SGC-7901/FB-11诱导的 CTL对 SGC-7901/FB-11的杀伤率显著高于对野生型 SGC-7901的杀伤率(P<0.05)。结论 FasL促进胃癌细胞凋亡,B7-1促进抗胃癌CTL的增殖、活化,在效应阶段两基因发挥着重要的协同作用。     

鱼藤素增加人胃癌细胞株SGC-7901对氟尿嘧啶的敏感性

目的 观察鱼藤素对胃癌细胞化疗敏感性的影响.方法 胃癌SGC-7901细胞以1 μmol/L鱼藤素处理24h后,噻唑蓝(MTT)比色法检测对其对氟尿嘧啶处理48 h的敏感性变化;经鱼藤素联合氟尿嘧啶(12.5 mg/L)处理后形态学观察进一步验证MTT结果;提取1μmol/L鱼藤素处理24 h后细胞总蛋白,Western blot法检测相关蛋白表达水平的变化.结果 鱼藤素预处理后可明显增强氟尿嘧啶对SGC-7901细胞的抑制作用,其IC50值降至7.86 mg/L(P＜0.05);增强氟尿嘧啶对SGC-7901细胞增殖抑制和凋亡诱导作用;鱼藤素可明显降低蛋白激酶B(Akt)的磷酸化水平.结论 鱼藤素可通过下调Akt的活性,增强SGC-7901细胞对氟尿嘧啶的敏感性,与化疗药物联用可能有助于提高抗肿瘤治疗效果.     

去甲基化剂5-氮杂-2''''-脱氧胞苷对胃癌细胞生物学行为的影响

目的:探讨去甲基化剂5氮杂2’脱氧胞苷(5AzaCdR)对胃癌细胞生物学行为的影响。方法:使用浓度5×106mol/L和105mol/L的5AzaCdR处理胃癌细胞株AGS、SGC7901、MKN28及MKN45。通过MTT、平板克隆实验观察处理前、后细胞的生长活性,RTPCR检测处理前、后抑癌基因RASSF1AmRNA表达的改变,并应用流式细胞仪进行细胞周期和凋亡率的分析。结果:4株胃癌细胞经不同浓度之5AzaCdR处理后,与对照组相比,生长速度出现不同程度减慢;实验组AGS细胞较对照组细胞克隆形成率显著降低(32.4%、28.5%比57.0%,P<0.01);5AzaCdR处理后,3株无RASSF1AmRNA表达的细胞(AGS、MKN28和SGC7901)均检出基因重新表达;处理前后4株胃癌细胞无明显G1期、G2/M期改变,AGS细胞凋亡率由0.6%增至18.6%和20.2%,MKN28细胞亦出现凋亡率由1.85%增至3.85%和6.61%。结论:去甲基化剂5AzaCdR对胃癌细胞生长周期无显著影响,可能系通过诱导抑癌基因再表达或凋亡等途径,间接抑制胃癌细胞的生长。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.