32P-玻璃微球间质给药体内生物学分布与代谢

目的 观察32P-玻璃微球(32P-GMS)间质给药后体内生物学分布与代谢.方法 120只小鼠分别经肝脏或肌肉注射32P-GMS,每只(1.80±0.05)MBq/50μl,不同时间点处死取血及脏器计算每克组织百分注射剂量率(%ID/g);12只大鼠肝脏、肌肉每只注射(18.0±0.5)MBq/0.5 ml,收集排泄物测累积排泄率.结果 小鼠肝脏组给药肝叶%ID/g 0时最高为1.38,15 nin降至0.71,非给药肝叶峰值15 min为0.52,4 h之后左右肝叶无区别;肺组织计数率值1 h内上升,肝肺累积分流率为37.9%.肌肉组注射点%ID/g0时为31.47,15 nin～8 h为25.06～11.92(中值20.97),12 h为8.70,24 h～14 d为3.54～2.02(中值2.51),其他主要脏器放射性接近本底水平.大鼠肝脏组粪便和尿液14 d累积排泄率分别为0.0751%和0.0586%;肌肉组分别为0.0401%和0.0385%.结论 32P-GMS间质注射适用于除肝脏以外的体内组织脏器恶性实体瘤的治疗.     

黄蜂毒素1对内毒素/脂多糖所致小鼠急性肝损伤的影响

目的 了解黄蜂毒素1(MP-1)对LPS所致小鼠急性肝损伤的影响,探讨其作用机制.方法 将104只BALB/c小鼠按随机数字表法分为健康对照组(8只,不作任何处理)、LPS组(48只,尾静脉注射LPS 5 mg/kg)和MP-1组(48只,尾静脉注射LPS 5 mg/kg和MP-1 3 mg/kg).后2组小鼠于注射后2、6、12、24、48、72 h处死,每组每时相点8只,采集血和肝组织标本.动态比浊法鲎试验检测2组小鼠各时相点血浆LPS水平,酶联免疫吸附测定法检测血浆TNF-α和IL-6水平,全自动生化分析仪检测血清丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)水平,实时荧光定量RT-PCR检测肝组织Toll样受体4(TLR4)、TNF-α和IL-6 mRNA表达,观察注射药物后各时相点肝组织病理变化.另取健康对照组小鼠相同样本进行以上检测.结果 与健康对照组比较,LPS组小鼠血浆LPS和TNF-α水平在注射药物后2 h迅速升高,各为(18 320.50±2782.50)EU/mL和(988±130)ng/L,此后逐渐下降,72 h降至(1.80±0.80)EU/mL和(150±44)ng/L,接近健康对照组水平;IL-6、ALT和AST逐渐升高,12 h达峰值,随后下降,72 h接近健康对照组水平;LPS组小鼠肝组织TLR4、TNF-α和IL-6mRNA表达也在注射后明显增强,12～48 h时肝组织炎性反应性病理改变最为显著.与LPS组比较,MP-1组小鼠LPS、细胞因子和转氨酶水平在注射后不同程度地降低(P<0.05或P<0.01),肝组织相关基因表达受到抑制(P<0.05或P<0.01),病理改变较轻.结论 MP-1可能通过中和LPS,减少其诱导的炎性介质合成与释放,进而减轻小鼠肝组织的损伤.     

PET/CT检查注射~(18)F-FDG方法研究

目的比较PET/CT检查经留置针和头皮针注射~(18)F-2-氟-2-脱氧-D-葡萄糖(~(18)F-FDG)的差异,探讨预置留置针用于PET/CT检查的可行性。方法将120例行PET/CT检查患者按检查时间段分为对照组、模型1组和模型2组,对照组按常规方法采用头皮针注射18F-FDG,模型1组和模型2组采用留置针注射~(18)F-FDG,注射前生理盐水冲洗量均为3 mL,注射后分别为5 mL、5mL、10mL,比较三组残留放射性活度;同期选择45例已预置留置针的患者为实验组,采用留置针注射并不拔除留置针,注射前后生理盐水冲冼量分别为5mL、10mL,与对照组比较放射性浓聚、药物污染、受辐射时间的差异。结果对照组与实验组放射性浓聚及药物污染发生率、受辐射时间比较,差异无统计学意义(均P0.05);模型1组残留放射性活度显著高于对照组(P0.05)。结论 PET/CT检查可经预置留置针注射18F-FDG,使用时须增加冲洗管道的生理盐水量。     

125Ⅰ标记抗C-erbB-2单抗对荷人乳腺癌裸鼠的定位诊断及生物学分布

目的研究125I标记抗C-erbB-2单克隆抗体ICR12（简称125I-ICR12）及正常小鼠IgG（简称125I-mIgG）在荷入乳腺癌探鼠体内的分布,为放射免疫显像（RII）及临床应用提供依据。方法每鼠尾静脉注射抗体92．5KBq／0．1ml,于注射后24、48、96、120／小时分批处死,测定肿瘤和血液、肝、肺等重要脏器的单位重量放射性比值（T／NT）、各组织摄取百分比（％ID／g）及定位指数（LI）。结果125I-ICR12注射后24～120／小时内,肿瘤部位出现选择性放射性浓聚;T／NT在120／小时最高,为19．374。125I-mlgG未出现放射性浓聚,呈全身分布。结论ICR12在荷人乳腺癌裸鼠体内,对过度表达C-erbB-2的乳腺癌具有亲和力,可望用作乳腺癌诊断、预后判断的导向载体。     

32P-磷酸铬瘤体内注射治疗裸鼠人胰腺癌Pc-3移植瘤

目的　研究32 P 磷酸铬 ( 32 P胶体 )间质注射人胰腺癌Pc 3移植瘤后在荷瘤裸鼠体内的生物学分布及抗癌效应。方法　 5 4只荷瘤裸鼠分为 9组 :1～ 3组瘤体内注射32 P胶体 14 .8MBq ,给药后 12、2 4、72h处死 ;4～ 9组瘤体注射剂量分别为 3 .7、7.4、14 .8、18.5、2 9.6和 0MBq ,给药后 14d处死 ,每组 6只鼠。通过光镜、透射电镜及免疫组织化学检测等方法 ,观察体内放射性动态分布 ( %ID/g)及形态学改变 ,计算抑瘤率、PCNA指数 (PI)。 结果　32 P胶体注射后主要浓聚并较长时间滞留在瘤体内。各剂量组的抑瘤率依序为 2 0 .8%、3 8.3 %、5 0 .7%、70 .2 %和 82 .3 % (F=2 61.3 4,P <0 .0 1)。PI依序为 70 .2、65 .2、45 .2、2 0 .2、10 .3和 92 .0 (F =3 75 .3 2 ,P <0 .0 1)。结论　32 P胶体瘤体内注射是一种安全、有效治疗胰腺癌的核素介入疗法。     

髓系细胞触发受体1慢病毒载体对脆弱拟杆菌脓毒症小鼠促炎因子表达的影响

目的 了解髓系细胞触发受体1(TREM-1)基因重组慢病毒短发夹RNA(vshRNA)载体对脆弱拟杆菌脓毒症小鼠促炎因子表达及小鼠存活率的影响.方法 (1)构建TREM-1 vshRNA载体.经实验确定脓毒症小鼠模型制作条件:腹腔注射2.5×10<9CFU/mL灭活脆弱拟杆菌0.5 mL,刺激12 h.(2)115只小鼠按随机数字表法分为健康对照组(3只)和脓毒症模型组、绿色荧光蛋白(GFP)干扰组、TREM-1干扰组、TREM-1半量干扰组.后4组每组28只,先分别经尾静脉注射等渗盐水、GFP vshRNA、TREM-1 vshRNA 2×108TU、TREM-1 vshRNA 1×108TU;1 h后,将该4组小鼠制成脓毒症模型,健康对照组注射等体积等渗盐水.12 h后处死5组小鼠(每组3只),取血检测血浆TNF-α、IL-1β和IL-6含量;取肝组织标本检测TREM-1 mRNA及其蛋白的表达水平.后4组小鼠每组所余25只用于观察腹腔注射后72 h的存活率.(3)另建立脓毒症小鼠模型125只,其中100只分别于腹腔注射后1、2、4、6 h尾静脉注射TREM-1 vshRNA 2×108TU(每时相点25只),余下25只尾静脉注射等渗盐水为对照组.计算尾静脉注射后72 h小鼠存活率.结果 (1)与脓毒症模型组比较.TREM-1干扰组、TREM-1半量干扰组小鼠血浆TNF-α、IL-1β、IL-6含量均下降(P<0.05),以TREM-1干扰组下降最明显.GFP干扰组中各促炎因子含量与脓毒症模型组接近(P>0.05).(2)与GFP干扰组比较,TREM-1干扰组及其半量干扰组小鼠肝组织TREM-1 mRNA表达均明显下调(P<0.01),以TREM-1干扰组尤为明显(P<0.05).各组小鼠TREM-1蛋白表达情况与此一致.(3)脓毒症模型组、GFP干扰组小鼠腹腔注射后72 h存活率均为16%.TREM-1干扰组及其半量干扰组分别为76%和44%(P<0.05或P<0.01).(4)另建立的125只脓毒症小鼠模型中,对照组及腹腔注射后1、2、4、6 h组其尾静脉注射后72 h存活率分别为16%、72%、56%、40%、16%,其中1、2、4 h组明显高于对照组(P<0.05或P<0.01).结论 运用TREM-1 vshRNA干扰技术,可有效降低脆弱拟杆菌脓毒症小鼠肝组织TREM-1表达水平,抑制炎性反应,提高小鼠存活率.     

脾切除和自体脾组织移植对肺吞噬功能的影响

本实验采用放射性Ⅰ标记的脂类乳剂测定肝、脾、肺的放射性活度和吞噬指数，并结合病理组织学检查动点观察脾切除和脾移植对肺吞噬功能的影响，结果发现，脾切除组动物肝的吞噬功能受到抑制，啼的吞噬功能代偿性增强，自体移植脾组织能部分恢复肺的吞噬功能。     

胃癌腹膜微转移与网膜乳斑的关系

目的 观察网膜乳斑在腹膜微转移中的作用.方法 将30只小鼠分成3组,向小鼠腹腔内打入1×106经Dil荧光标记的BS186MFC胃癌细胞,3组小鼠分别于24、48、72 h被杀死取其大网膜,免疫荧光标记大网膜乳斑中的巨噬细胞,在免疫荧光显微镜下观察乳斑区胃癌细胞的变化.结果 乳斑与非乳斑区在24、48、72 h不同时间点标记胃癌细胞比率分别为484:1、136:1、10:1.各时间点胃癌细胞在乳斑区的差异有统计学意义(P<0.05).标记细胞数在乳斑与非乳斑区之间的差异有统计学意义(P<0.01).结论 网膜乳斑对胃癌细胞的腹膜微转移有抑制和杀伤作用.     

重组人肝再生增强因子可增强大鼠肝星状细胞间质胶原酶基因的表达

目的：了解重组人肝再生增强因子（hALR)对大鼠肝星状细胞间质胶原酶（MMP13）基因表达的影响。方法：在培养的肝星状细胞系中加入200、20、2μg/L3种浓度的hALR，于8、24、48、72h4个时间点收集细胞，提取总RNA；用逆转宝量聚合酶链反应（PCR）方法测定MMP13的基因表达水平。结果：高、中、低浓度的hALR3组肝星状细胞MMP13基因表达水平在8、24、48、72h4个时间点均明显高于对照组；最高值均出现在24－48h，低剂量组为对照组的3倍，中剂量组为对照组的4倍，高剂量组达对照组的6倍。结论：重组人肝再生增强因子对大鼠肝星状细胞间质胶原酶基因表达有明显的促进作用。     

生长抑素对鼠大部肝切除术后肝再生的影响

目的　探讨生长抑素对肝切除术后肝再生的影响。　方法　 6 0只SD大鼠随机分为对照组及生长抑素组 ,按Higgins方法行 70 %肝切除术 ,术后给药并分批于术后 6、2 4、48、72、96h处死 ,作如下比较 :①残肝肝重 ;②增殖细胞核抗原 (PCNA)标记指数 ;③图像定量分析测量PCNA阳性产物面积。　结果　与对照组比较 ,生长抑素组残肝肝重在术后 48、72、 96h显著降低 (P <0 .0 5 ) ,PCNA标记指数、PCNA阳性产物面积在术后 2 4、48、72h显著降低 (P <0 .0 5 ) ,且以 2 4、 48h最为明显 (P <0 .0 1)。　结论　生长抑素能抑制肝再生 ,且肝再生程度越强 ,抑制效应越明显     

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.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

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.