Low-dose remifentanil infusion with intermittent bolus injections can provide adequate sedation, amnesia and better analgesia than propofol infusion during colonoscopy. However, remifentanil-induced nausea and vomiting may be a problem during the recovery phase.

We have studied the ability of propofol and Intralipid to inhibit reactive oxygen species generated either by stimulated human leucocytes or cell-free systems using luminol chemiluminescence. Human leucocytes were stimulated by a chemotactic peptide, FMLP 1 mumol litre-1, or by a phorbol ester, PMA (protein kinase C activator) 0.1 mumol litre-1. In cell-free experiments, superoxide-hydrogen peroxide, hypochlorous acid or hydroxyl radical-induced chemiluminescence responses were initiated by xanthine 0.1 mmol litre-1 with xanthine oxidase 10 mu. ml-1, NaOCl 70 mumol litre-1 and FeSO4 3 mumol litre-1, respectively. Propofol with Intralipid, and to a lesser degree Intralipid alone, produced a concentration-dependent reduction in chemiluminescence from stimulated leucocytes. Similar attenuations were also observed using propofol with Intralipid on xanthine with xanthine oxidase-, HOCl- and ferrous iron-induced chemiluminescence. However, Intralipid produced a reduction only at high concentrations. Intralipid produced marked decreases in ferrous iron-induced chemiluminescence. This study suggests that propofol had a direct scavenging activity against HOCl, superoxide-hydrogen peroxide and hydroxyl radical in the concentrations used. These direct scavenging effects may contribute to the effect of propofol on human leucocyte chemiluminescence.

Adding 10 microg kg-1 alfentanil or 1 microg kg-1 remifentanil to reduced doses of propofol provided unconsciousness and increased seizure durations. For patients who need higher stimulus amplitudes for longer seizure durations, combining low-dose propofol with alfentanil or remifentanil may be good alternative regimens for ECT.

We conclude that 0.25% levobupivacaine and 0.25% bupivacaine have similar motor and sensory block onset times and qualities when used in posterior approach interscalene brachial plexus block, and provide comfortable anesthesia and analgesia for shoulder surgery.

Application of TEAS on sedated children is an easy, painless, reliable and effective method for the prophylaxis of postoperative retching and vomiting in pediatric tonsillectomy.

No abstract

No abstract

Intrathecal 4 mg bupivacaine + 25 μg fentanyl provided adequate spinal anesthesia with shorter block duration and postanesthesia care unit stay with stable hemodynamic profile than intrathecal 50 mg prilocaine + 25 μg fentanyl for day case transurethral resection of prostate surgery in geriatric patients.