Duration and recovery profile of cisatracurium after succinylcholine during propofol or isoflurane anesthesia

Study Objective: To determine the duration and recovery profile of maintenance doses of cisatracurium besylate following succinylcholine, and during propofol or isoflurane anesthesia.

Design: Randomized, open-label study.

Setting: Operating suite of a university-affiliated medical center.

Patients: Forty ASA physical status I and II adult patients having elective surgery with general anesthesia lasting longer than 90 minutes.

Interventions: Following a standardized induction sequence, a baseline electromyogram (EMG) was obtained. An intubating dose of intravenous (IV) succinylcholine 1.0 mg/kg was administered. Ventilation was maintained with a face mask until the first twitch (T₁) of the evoked train-of-four (TOF) reached 10% of control when tracheal intubation was performed. Spontaneous recovery from neuromuscular blockade was allowed to occur until the first twitch returned to 25% of control. Patients then were randomized to receive cisatracurium as follows. Group 1: 0.025 mg/kg [0.5 × 95% effective dose (ED₉₅)]; Group 2: 0.05 mg/kg (ED₉₅); Group 3: 0.05 mg/kg (ED₉₅); and Group 4: 0.1 mg/kg (2×ED₉₅). Anesthesia for Groups 1 and 2 were maintained with isoflurane 1% to 2%, 66% nitrous oxide (N₂O) in oxygen (O₂), and in Groups 3 and 4, anesthesia was maintained with propofol 80 to 160 μg/kg/min, 66% N₂O in O₂. The TOF-evoked EMG was recorded at 10-second intervals. The time for the evoked EMG to spontaneously return to 25%, 50%, and 75% of the original baseline was recorded.

Measurements and Main Results: There were 10 patients in each of the four groups. The duration of action of cisatracurium 0.05 mg/kg (ED₉₅) after an intubating dose of succinylcholine is 24.5 ± 10 minutes and 21.3 ± 9 minutes during anesthesia maintained with isoflurane and propofol, respectively. Doubling the dose of cisatracurium resulted in approximately twice the duration of action (40.2 ± 7 min) during propofol anesthesia. Following a dose of cisatracurium 0.025 mg/kg (0.5×ED₉₅), the T₁ of the EMG-evoked response did not decrease below 25% in 7 of 10 patients.

Conclusion: Following succinylcholine, the duration of action of a single dose of cisatracurium 0.05 mg/kg is 20 to 25 minutes during anesthesia maintained with propofol or isoflurane. The duration and recovery profile of cisatracurium is dose dependent during propofol and isoflurane anesthetics. Cisatracurium 0.025 mg/kg is an inadequate maintenance dose following recovery from succinylcholine and it fails to provide adequate surgical relaxation.     

Circadian rhythm of lithogenic substances in the urine

Summary After determination of the lithogenic and inhibitory substances in serum and urine of 18 healthy control subjects and 20 patients with calcium oxalate urolithiasis on an uncontrolled diet, the alteration of the parameters while taking a standard diet was investigated. After attainment of a steady state, the investigations were performed over 48h on 3-h aliquots of urine. Typical circadian rhythms were detected for all lithogenic parameters in the urine and normal ranges were established. This special investigation permits detection of peaks in the excretion of lithogenic substances which were masked in investigation of 24-h urine samples alone.     

中药药效方法学研究初探（I）

对目前中药药效的研究方法进行全面论述，找出存在问题，并对中药药效方法学进行初步探讨。提出中医学发展是中药药效方法学研究的基础和前提，尤其是藏象经络学说和中药的归经理论的现代研究的突破对中药药效方法学研究起着主导作用；中药药效方法学研究四维系统论，在药效作用物质基础和药物作用机制两维的基础上增加时间维和人体精神维。     

用HPLC法测定马来酸依那普利片的含量和有关物质

目的:采用改进的HPLC法测定马来酸依那普利片中马来酸依那普利和有关物质的含量。方法:采用HypersilBDS C8色谱柱(250 mm×4.0 mm,5μm ID);0.001 mol/L磷酸二氢铵溶液(用磷酸调节pH值至2.0)-甲醇(60:40);检测波长215 nm。结果:马来酸依那普利在0.1～0.3 mg/ml范围内线性关系良好(r=0.999 9);方法的平均回收率为99.8％。依那普利与有关物质之间分离良好。结论:本法有较高的回收率、精密度和重现性。     

我院门诊病人处方中精神药品药物利用调查分析

目的 :了解我院精神药品 (psychotropicsubstances)使用情况 ,促进合理用药。方法 :采用限定日剂量和药物利用指数为指标对我院门诊精神药品的处方进行调查和分析。结果 ;平均药物利用指数在 1.0 0左右 ,用药时间大于 4wk的达 79.0 9% ,合并用药大于 2种药物的占 13.14 %。结论 :我院精神药品的使用基本合理 ,但用药时间较长 ,合并用药频度较高     

肠三叶因子对新生鼠缺氧肠损伤模型白细胞介素8、丙二醛的影响及意义

目的　研究肠三叶因子 (intestinaltrefoilfactor,ITF)对坏死性小肠结肠炎 (necrotizingenterocolitis,NEC)新生大鼠的肠粘膜中白细胞介素 8(interleukin 8,IL 8)及丙二醛 (malondialdehyde,MDA)含量的影响 ,探讨ITF对NEC是否有保护作用。　方法　建立NEC模型 ,对新生 1日龄Wistar大鼠予 10 0 %二氧化碳 ,5min后再予 10 0 %氧气 ,5min后放回母鼠身边喂养 ,第 4天处死大鼠取肠道组织待检。新生鼠 32只随机分为四组 ,A组为NEC模型后腹腔注射ITF 0 .5mg ;B组为NEC模型后皮下注射ITF 0 .2mg ;C组为NEC模型组 ;D组为正常对照组。取近回盲段 1～ 2cm肠道组织固定包埋、切片、HE染色光镜下作病理学检查 ,其他肠道组织制备组织匀浆取上清液用放射性免疫法检测IL 8,用生化法检测MDA的含量。　结果　A、B组IL 8的含量 [pg (mg·pro) ]各为 2 9.72 2± 7.134、30 .5 12± 8.2 30 ,均较C组 39.379± 4 .4 2 0低 (P <0 .0 5 ) ,而与D组 2 3.92 2± 6 .16 8比较 ,差异无显著性 (P >0 .0 5 ) ;A、B组MDA的含量 [nmol (mg·pro) ]各为 2 .2 6 7± 0 .2 6 7、2 .15 4± 0 .30 1,较C组 3.378± 0 .835低 (P <0 .0 1) ,与D组 2 .2 2 5± 0 .4 4 3比较 ,差异无显著性 (P >0 .0 5 )。C组HE染色切片见肠壁的损伤轻重不一 ,有的     

HPLC法测定硝呋拉呔的含量及有关物质的方法学研究

目的:采用高效液相色谱法测定硝呋拉呔的含量及有关物质。方法:采用ODSC_(18)色谱柱(5μm,4.6mm×250mm),以甲醇-水(45:55)为流动相,流速1.2 mL·min~(-1),紫外检测器于254 nm测定。结果:HPLC法测定的线性范围为0.01～0.4mg·mL~(-1),r=0.999 9,最低检测限0.2 ng;样品溶液在8 h内稳定,日内精密度和日间精密度(RSD<1.0％)良好。回收率为100.1％。结论:采用HPLC法测定硝呋拉呔及有关物质的方法简便,结果可靠。     

离子抑制色谱法测定琥乙红霉素含量及其有关物质

目的　建立离子抑制色谱法测定琥乙红霉素原料的含量及有关物质的方法 ,并研究其影响因素。方法　采用ZorbaxSB -C1 8色谱柱 ,以 0 .0 2mol·L- 1 KH2 PO4 乙腈 ( 4 5∶5 5 ,用氨试液调至pH 6 .8)为流动相 ,流速 1.2mL·min- 1 ,检测波长 2 10nm ,柱温 ( 30± 0 .5 )℃。结果　在选定固定相条件下 ,流动相对组分的洗脱和选择性影响最大 ,柱温次之 ,琥乙红霉素在乙腈中比较稳定。测定了有效主成分琥乙红霉素A的含量以及 7个有关物质的总含量 ,琥乙红霉素A的平均回收率为 99.4 5 %(RSD =2 .2 4 % ,n =5 )。结论　本方法可用于琥乙红霉素原料的含量测定和有关物质的检查。