The cardiovascular effects of vecuronium during halothane anaesthesia

In a double-blind, placebo-controlled, prospective randomized trial in 70 otherwise healthy patients undergoing elective surgery of the thyroid gland, the breast, the inguinal canal or the lower limbs, we studied the cardiovascular effects of vecuronium during halothane-nitrous oxide anaesthesia. Vecuronium was found to have no clinically significant influence on heart rate or mean arterial pressure, before or during surgery. Bradycardia was a rare event under the special conditions of the study design.     

Evaluation of hemostasis by the Clot Signature Analyzer: a potentially valuable device for the anesthesiologist

Rapid detection of hemostatic defects presents a challenge for the anesthesiologist who must balance anesthetic and surgical considerations for maintaining adequate platelet and coagulant factors, while keeping allogenic blood exposure to a minimum. The Clot Signature Analyzer®, a point-of-care device capable of rapid response and easy interpretation is described here. Its applicability in two obstetrical patients with platelet dysfunction is discusssed.     

Transient radicular irritation (TRI) after spinal anaesthesia in day-care surgery

Background : A high incidence of backache with radiating pains to the lower extremities, termed transient radicular irritation (TRI), has been reported following the use of 5% hyperbaric lidocaine. This has been attributed to a neurotoxic reaction.
Methods : A retrospective audit has been carried out in our hospital on the postoperative anaesthetic records of all patients from the 1st of January 1993 to the 1st of September 1996, who received spinal anaesthesia with either hyperbaric lidocaine or hyperbaric bupivacaine for day-care surgery.
Results : Backache was reported in 1.9% of patients (6/322) receiving hyperbaric lidocaine and in 2.4% of patients (1/41) receiving hyperbaric bupivacaine. This was not associated with any sensory, motor or sphincter disturbances. One patient complained of backache with bilateral pain referred to the gluteal area (TRI), which was assessed as acute facet joint syndrome. Unilateral accidental block of the femoral nerve was observed in 3 patients, sensory disturbances in the L2/3 dermatome was reported in a further 3 patients at 24 h, following wound infiltration with local anaesthetic during hernia repair.
Conclusions : The low incidence of backache at 24 h and the absence of associated symptoms of neurogenic pain, sensory and motor disturbances, does not support the hypothesis that TRI is a neurotoxic reaction, subsequent to the use of hyperbaric lidocaine.     

Thoracic epidural analgesia in aortocoronary bypass surgery II: effects on the endocrine metabolic response

Thoracic epidural analgesia (TEA) may offer haemodynamic benefits for patients with coronary heart disease going through major surgery. This may – in part – be secondary to an effect on the endocrine and metabolic response to surgery. We therefore investigated the effect of TEA on the endocrine metabolic response to aortocoronary bypass surgery (ACBS).
Thirty male patients (age < 65 years, ejection fraction > 0.5) were randomized into 3 groups; the HF group receiving a high dose fentanyl (55 μg–kg^-1) anaesthesia, the HF + TEA group with the same fentanyl dose + TEA with 10 ml bupivacain 5 mg ml^-1, followed by 4 ml every hour, and the LF + TEA group receiving fentanyl 15 μg kg^-1 + TEA. Adrenalin, noradrenalin, systemic vascular resistance (SVR), glucose, Cortisol, lactate and free fatty acids were followed during the operation and for 20 h postoperatively.
A significant increase in adrenalin, noradrenalin and SVR was found in the HF group whereas this increase was blocked in both epidural groups. An increase in glucose and Cortisol was noticed in all groups, but the increase was delayed in the epidural groups.
Our results suggest that a more effective blockade of the stress response during ACBS is obtained when TEA is added to general anaesthesia than with high dose fentanyl anaesthesia alone.     

高效液相色谱法测定三黄乳膏中黄芩苷的含量

目的建立高效液相色谱法测定三黄乳膏中黄芩苷含量的方法。方法采用Dikma C18（5μm，250mm×4．6mm）色谱柱；流动相为甲醇-水-磷酸（47：53：0．2）；检测波长为277nm。结果黄芩苷在0．40—2．40μg／ml浓度范围内与峰面积呈良好的线性关系（r=0．9998 n=6），精密度高，RSD：0．66％，平均回收率98．34％。结论该方法简便，结果准确，重现性好，可作为三黄乳膏的质量控制方法。     

采用在体分时取样法研究2种咪喹莫特乳膏的裸鼠皮肤药动学行为

目的:采用裸鼠在体分时取样法比较国产和进口2种咪喹莫特乳膏的皮肤药动学行为。方法:分别在裸鼠相同面积的皮肤上涂抹2种乳膏各约0.03g(n=32)后,于0.25、0.5、1、2、4、6、8、24h取皮制备匀浆,采用高效液相色谱法测定皮肤中的药物浓度,比较2种制剂的药动学参数并计算偏差以对该方法进行评价。结果:国产和进口乳膏的咪喹莫特cmax分别为(82.80±8.13)、(76.46±13.08)μg·g-1,tmax分别为(6.0±0.0)、(5.0±1.2)h,t1/2分别为(25.28±4.27)、(23.30±7.42)h,AUC0～24h分别为(992.27±226.55)、(1037.02±175.93)μg·h·g-1,二者比较均无统计学差异(P>0.05)。2种制剂cmax、tmax、AUC0～24h的RSD分别为9.8%、17.1%,0、24.0%,22.8%、17.0%。结论:2种乳膏的裸鼠皮肤药动学行为无显著性差异;主要药动学参数的RSD偏差较小,表明在体给药分时取样法能较好地反映药物在裸鼠体内的经皮代谢过程,适用于临床前外用药物的皮肤药动学筛选与评价研究。     

Anesthetic gases and occupationally exposed workers

The aim of this study is to estimate whether the occupational exposure to low dose anesthetic gases could cause alterations of blood parameters in health care workers. 119 exposed subjects and 184 not exposed controls were included in the study. Each worker underwent the complete blood count test (CBC), proteinaemia, leukocyte count, serum lipids, liver and kidney blood markers.The liver blood markers show statistically significant differences in health care workers compared with controls (p < 0.05), a statistically significant decrease in neutrophils and an increase of lymphocytes in health care workers compared with controls (p < 0.05). The prevalence of values outside the range for GPT, GGT, total bilirubin, lymphocytes and neutrophils was statistically significant in health care workers compared with controls (p < 0.05). The results suggest that occupational exposure to low dose anesthetic gases could influence some haematochemical hepatic and hematopoietic parameters in exposed health care workers.     

复方三酸散浸泡治疗足癣临床观察

目的 观察复方三酸散浸泡治疗足癣的临床疗效.方法 选取医院2016年2月至2019年2月收治的足癣患者102例,按随机数字表法分为观察组和对照组,各51例.对照组患者涂搽硝酸咪康唑乳膏,观察组患者给予复方三酸散加温水溶解后泡足,均治疗20 d.结果 治疗后,两组患者的中医证候积分均较治疗前显著降低(P<0.05),且观...     

双效麻醉药复方瑞芬太尼-丙泊酚微乳的制备及药效学评价

摘 要 目的： 制备复方瑞芬太尼 丙泊酚微乳双效麻醉药,并考察复方瑞芬太尼 丙泊酚微乳对成犬的麻醉效果。方法: 采用高压均质法制备复方瑞芬太尼 丙泊酚微乳,考察复方瑞芬太尼 丙泊酚微乳的粒径分布、Zeta电位、微观形态及复方瑞芬太尼 丙泊酚微乳对成犬的麻醉效果。结果: 复方瑞芬太尼 丙泊酚微乳平均粒径为(217.6±48.2) nm,多聚分散系数为(0.212±0.032),Zeta电位为(-31.2±3.8) mV,透射电镜显示微乳粒径均一。药效学研究表明复方瑞芬太尼 丙泊酚微乳对成犬部分脾切除手术的麻醉诱导和麻醉维持过程具有较好的效果。结论:双效麻醉药复方瑞芬太尼 丙泊酚微乳具有良好的镇静、镇痛效果,有望用于临床。     

HPLC法测定曲安奈德益康唑乳膏中的有关物质

目的:建立HPLC法测定曲安奈德益康唑乳膏中有关物质的方法.方法:采用高效液相色谱法,色谱条件为:色谱柱以十八烷基硅烷键合硅胶为填充剂(Kromasil 100-5 C18,4.6 mm×250 mm,5 μm),柱温为45 ℃;以0.077％醋酸铵缓冲液(用磷酸调节pH值至3.0)-甲醇(80:20)为流动相A;甲醇...