BACKGROUND: Preemptive analgesia involves introducing an analgesic prior to the onset of pain stimulation to prevent sensitizing the nervous system to subsequent stimuli that could amplify pain. OBJECTIVE: To treat ps...BACKGROUND: Preemptive analgesia involves introducing an analgesic prior to the onset of pain stimulation to prevent sensitizing the nervous system to subsequent stimuli that could amplify pain. OBJECTIVE: To treat psychiatric patients with intravenous (i.v.) injection of butorphanol prior to modified electroconvulsive therapy, and to observe its effect on alleviating myalgia after treatment and adverse reactions. DESIGN: A randomized controlled observation. SETTING: Renmin Hospital of Wuhan University. PARTICIPANTS: A total of 120 psychiatric patients, who accepted modified electroconvulsive therapy, were selected from the Mental Health Center of Wuhan University from June to September in 2006. All patients corresponded to the Chinese Classification and Diagnostic Criteria of Mental Disorders, and those with diseases of heart, liver, lung and kidney, glaucoma, intracranial hypertension, hyperthyreosis, and hyperkalemia were excluded. The patients were randomly divided into a control group (n = 60) and treatment group (n = 60). In the control group, there were 42 males and 18 females, aged 17-50 years, with a mean age of (34 ± 11) years. The patients weighed 50-70 kg, with a mean body mass of (63 ± 18) kg. In the treatment group, there were 40 males and 20 females, aged 20-54 years, with a mean age of (36 ± 13) years. The patients weighed 48-72 kg, with a mean body mass of (64 ± 16) kg. Approval was obtained from the Hospital's Ethics Committee. Informed consents were obtained from the patients' relatives. A SPECTRUM5000Q multifunctional mobile electroconvulsive therapy apparatus (CORPERATION, USA) was used. METHODS: ① Treatments: In the control group, the patients were anesthetized by i.v. injection of propofol (AstraZeneca, Italy, No.CN309) containing 0.075% efedrina, and then modified electroconvulsive therapy was performed. Circulation, respiration, and firing of brain electrical activity were continuously monitored. In the treatment group, the patients were i.v. injected with 1 mg of butorphanol tartrate parenteral solution (Jiangsu Hengrui Medicine Co., Ltd., No.05100732) 5 minutes prior to anesthesia; the remaining treatments were the same as in the control group. ② Evaluations: myalgia conditions were assessed 6 hours after the patients opened their eyes. The patients were evaluated by a visual analogue scale and Ramsay sedation scale immediately, and at 3 minutes and 6 hours after they opened their eyes. MAIN OUTCOME MEASURES: ① Conditions of myalgia. ② Scores of visual analogue scale and Ramsay sedation scale. RESULTS: All 120 psychiatric patients were involved in the final analysis. ① Conditions of myalgia: 6 hours after modified electroconvulsive therapy, 22 patients in the control group and 1 patient in the treatment group complained of myalgia, which resulted in a significant difference between the two groups (P < 0.05). ② Scores of visual analogue scale and Ramsay sedation scale: the scores of visual analogue scale at 30 minutes and 6 hours after opening eyes were significantly lower in the treatment group than the control group (P < 0.05), and the scores of Ramsay sedation scale were not significantly different between the two groups (P > 0.05). CONCLUSION: Preemptive analgesia by butorphanol can effectively alleviate modified electroconvulsive therapy-induced myalgia, without adverse reactions.展开更多
A model of cerebral ischemia and reperfusion was established in mice.Mice were treated with ketamine via intraperitoneal injection immediately following ischemia or ischemia/reperfusion.Ketamine did not remarkably cha...A model of cerebral ischemia and reperfusion was established in mice.Mice were treated with ketamine via intraperitoneal injection immediately following ischemia or ischemia/reperfusion.Ketamine did not remarkably change infarct volume in mice immediately following ischemia,but injection immediately following ischemia/reperfusion significantly decreased infarct volume.Ketamine injection immediately after ischemia or ischemia/reperfusion inhibited c-Jun protein expression in mouse hippocampus,but nuclear factor kappa B expression was unaltered.In addition,the Longa scale score for neural impairment was not reduced in mice following cerebral ischemia/reperfusion.These results indicate that ketamine can protect mice against cerebral ischemia and reperfusion injury by modulating c-Jun protein expression in mouse hippocampus.展开更多
BACKGROUND: The stellate ganglion block (SGB) plays a protective role in focal cerebral ischemia/reperfusion injury. The human SGB can be simulated by transection of the cervical sympathetic trunk (TCST) in rats. OBJE...BACKGROUND: The stellate ganglion block (SGB) plays a protective role in focal cerebral ischemia/reperfusion injury. The human SGB can be simulated by transection of the cervical sympathetic trunk (TCST) in rats. OBJECTIVE: To observe the effects of TCST on inducible nitric oxide synthase (iNOS) levels and cerebral infarct volume in the hippocampus of rats with cerebral ischemia/reperfusion injury, and to analyze the mechanism of action. DESIGN, TIME AND SETTING: A completely randomized, controlled, neuropathological experiment was performed at the Institute of Neurological Disease, Taihe Hospital, Yunyang Medical College between March and September 2006. MATERIALS: A total of 93 Wistar rats, aged 17-18 weeks, of either gender, were used for this study. 2, 3, 5-triphenyl tetrazolium chloride was purchased from Changsha Hongyuan Biological Reagent Company, China. Rabbit iNOS antibody and goat anti-rabbit IgG antibody were the products of Wuhan Boster Biological Reagent Co., Ltd., China. METHODS: Ten rats were randomly selected for the sham-operated group. Cerebral ischemia/reperfusion injury was induced by middle cerebral artery occlusion (MCAO) using the suture method in the remaining rats. Forty successful rat models were randomly and equally divided into the following two groups: (1) TCST group: subsequent to TCST, MCAO was performed for 2 hours, followed by 24 hours reperfusion; (2) model group: rats underwent experimental procedures similar to the TCST group, with the exception of TCST. Rats in the sham-operated group were subjected to experimental procedures similar to the model group; however, the thread was only introduced to a depth of 10 mm. MAIN OUTCOME MEASURES: Following 24 hours of reperfusion, functional neurological deficits were scored. Brain tissue sections from ten rats of each group were used to measure cerebral infarct volume by TTC staining. Hippocampal tissue sections of an additional ten rats from each group were used to detect iNOS levels using the streptavidin-peroxidase immunohistochemistry method. Experimental data were expressed as absorbance values. RESULTS: Of the 93 selected rats, 50 were included in the final analysis. After MCAO for 2 hours, followed by 24 hours reperfusion, the absorbance values of iNOS-immunoreactive product were significantly greater in the model group compared to the TCST and sham-operated groups (P < 0.05). However, there was no difference between the TCST and sham-operated groups (P > 0.05). In addition, cerebral infarct volume in the model group was significantly greater compared to the TCST group (P < 0.05). The TCST group performed with lower total functional neurological scores compared to the model group (P < 0.05). CONCLUSION: TCST protects the brain against focal cerebral ischemia/reperfusion injury by possibly down-regulating hippocampal iNOS expression.展开更多
文摘BACKGROUND: Preemptive analgesia involves introducing an analgesic prior to the onset of pain stimulation to prevent sensitizing the nervous system to subsequent stimuli that could amplify pain. OBJECTIVE: To treat psychiatric patients with intravenous (i.v.) injection of butorphanol prior to modified electroconvulsive therapy, and to observe its effect on alleviating myalgia after treatment and adverse reactions. DESIGN: A randomized controlled observation. SETTING: Renmin Hospital of Wuhan University. PARTICIPANTS: A total of 120 psychiatric patients, who accepted modified electroconvulsive therapy, were selected from the Mental Health Center of Wuhan University from June to September in 2006. All patients corresponded to the Chinese Classification and Diagnostic Criteria of Mental Disorders, and those with diseases of heart, liver, lung and kidney, glaucoma, intracranial hypertension, hyperthyreosis, and hyperkalemia were excluded. The patients were randomly divided into a control group (n = 60) and treatment group (n = 60). In the control group, there were 42 males and 18 females, aged 17-50 years, with a mean age of (34 ± 11) years. The patients weighed 50-70 kg, with a mean body mass of (63 ± 18) kg. In the treatment group, there were 40 males and 20 females, aged 20-54 years, with a mean age of (36 ± 13) years. The patients weighed 48-72 kg, with a mean body mass of (64 ± 16) kg. Approval was obtained from the Hospital's Ethics Committee. Informed consents were obtained from the patients' relatives. A SPECTRUM5000Q multifunctional mobile electroconvulsive therapy apparatus (CORPERATION, USA) was used. METHODS: ① Treatments: In the control group, the patients were anesthetized by i.v. injection of propofol (AstraZeneca, Italy, No.CN309) containing 0.075% efedrina, and then modified electroconvulsive therapy was performed. Circulation, respiration, and firing of brain electrical activity were continuously monitored. In the treatment group, the patients were i.v. injected with 1 mg of butorphanol tartrate parenteral solution (Jiangsu Hengrui Medicine Co., Ltd., No.05100732) 5 minutes prior to anesthesia; the remaining treatments were the same as in the control group. ② Evaluations: myalgia conditions were assessed 6 hours after the patients opened their eyes. The patients were evaluated by a visual analogue scale and Ramsay sedation scale immediately, and at 3 minutes and 6 hours after they opened their eyes. MAIN OUTCOME MEASURES: ① Conditions of myalgia. ② Scores of visual analogue scale and Ramsay sedation scale. RESULTS: All 120 psychiatric patients were involved in the final analysis. ① Conditions of myalgia: 6 hours after modified electroconvulsive therapy, 22 patients in the control group and 1 patient in the treatment group complained of myalgia, which resulted in a significant difference between the two groups (P < 0.05). ② Scores of visual analogue scale and Ramsay sedation scale: the scores of visual analogue scale at 30 minutes and 6 hours after opening eyes were significantly lower in the treatment group than the control group (P < 0.05), and the scores of Ramsay sedation scale were not significantly different between the two groups (P > 0.05). CONCLUSION: Preemptive analgesia by butorphanol can effectively alleviate modified electroconvulsive therapy-induced myalgia, without adverse reactions.
基金supported by the Medical and Health Research Guidance Program of the Hubei Provincial Department of Health,No. 2001WZ01514
文摘A model of cerebral ischemia and reperfusion was established in mice.Mice were treated with ketamine via intraperitoneal injection immediately following ischemia or ischemia/reperfusion.Ketamine did not remarkably change infarct volume in mice immediately following ischemia,but injection immediately following ischemia/reperfusion significantly decreased infarct volume.Ketamine injection immediately after ischemia or ischemia/reperfusion inhibited c-Jun protein expression in mouse hippocampus,but nuclear factor kappa B expression was unaltered.In addition,the Longa scale score for neural impairment was not reduced in mice following cerebral ischemia/reperfusion.These results indicate that ketamine can protect mice against cerebral ischemia and reperfusion injury by modulating c-Jun protein expression in mouse hippocampus.
基金Supported by: the Excellent Middle-aged and Youth Talent Project of Education Department of Hubei Province, No. 2002B03001
文摘BACKGROUND: The stellate ganglion block (SGB) plays a protective role in focal cerebral ischemia/reperfusion injury. The human SGB can be simulated by transection of the cervical sympathetic trunk (TCST) in rats. OBJECTIVE: To observe the effects of TCST on inducible nitric oxide synthase (iNOS) levels and cerebral infarct volume in the hippocampus of rats with cerebral ischemia/reperfusion injury, and to analyze the mechanism of action. DESIGN, TIME AND SETTING: A completely randomized, controlled, neuropathological experiment was performed at the Institute of Neurological Disease, Taihe Hospital, Yunyang Medical College between March and September 2006. MATERIALS: A total of 93 Wistar rats, aged 17-18 weeks, of either gender, were used for this study. 2, 3, 5-triphenyl tetrazolium chloride was purchased from Changsha Hongyuan Biological Reagent Company, China. Rabbit iNOS antibody and goat anti-rabbit IgG antibody were the products of Wuhan Boster Biological Reagent Co., Ltd., China. METHODS: Ten rats were randomly selected for the sham-operated group. Cerebral ischemia/reperfusion injury was induced by middle cerebral artery occlusion (MCAO) using the suture method in the remaining rats. Forty successful rat models were randomly and equally divided into the following two groups: (1) TCST group: subsequent to TCST, MCAO was performed for 2 hours, followed by 24 hours reperfusion; (2) model group: rats underwent experimental procedures similar to the TCST group, with the exception of TCST. Rats in the sham-operated group were subjected to experimental procedures similar to the model group; however, the thread was only introduced to a depth of 10 mm. MAIN OUTCOME MEASURES: Following 24 hours of reperfusion, functional neurological deficits were scored. Brain tissue sections from ten rats of each group were used to measure cerebral infarct volume by TTC staining. Hippocampal tissue sections of an additional ten rats from each group were used to detect iNOS levels using the streptavidin-peroxidase immunohistochemistry method. Experimental data were expressed as absorbance values. RESULTS: Of the 93 selected rats, 50 were included in the final analysis. After MCAO for 2 hours, followed by 24 hours reperfusion, the absorbance values of iNOS-immunoreactive product were significantly greater in the model group compared to the TCST and sham-operated groups (P < 0.05). However, there was no difference between the TCST and sham-operated groups (P > 0.05). In addition, cerebral infarct volume in the model group was significantly greater compared to the TCST group (P < 0.05). The TCST group performed with lower total functional neurological scores compared to the model group (P < 0.05). CONCLUSION: TCST protects the brain against focal cerebral ischemia/reperfusion injury by possibly down-regulating hippocampal iNOS expression.
