Background. Cerebral state index (CSI) has recently been introduced as an intra-operative monitor of anaesthetic depth. We compared the performance of the CSI to the bispectral index (BIS) in measuring depth of anaesthesia during target-controlled infusion (TCI) of propofol. Methods. Twenty Chinese patients undergoing general anaesthesia were recruited. CSI and BIS, and predicted effect-site concentration of propofol were recorded. The level of sedation was tested by Modified Observer's Assessment of Alertness/Sedation Scale (MOAAS) every 20s during stepwise increase (TCI, 0.5ugml-1) of propofol. The loss of verbal contact (LVC) and loss of response (LOR) were defined by MOAAS values of 2-3 and less than 2, respectively. Baseline variability and the prediction probability (PK) were calculated for the BIS and CSI. The values of BIS05 and CSI05, BIS50 and CSI50, BIS95 and CSI95 were calculated at each end-point (LVC and LOR). Results. Baseline variability of CSI was more than that of BIS. Both CSI and BIS showed a high prediction probability for the steps awake vs LVC, awake vs LOR, and LVC vs LOR, and good correlations with MOAAS values. Conclusion. Despite larger baseline variation, CSI performed as well as BIS in terms of PK values and correlations with step changes in sedation.

The present study investigated the expression patterns of glial cells and interleukin-1b (IL-1b) in the rat spinal cord after a surgical incision, which is closely related with clinical postoperative pain. Microglia and astrocytes became activated in the spinal cord following incision. Real-time polymerase chain reaction (PCR) and immunohistochemisty showed that IL-1b mRNA and protein level in the spinal cord was transiently upregulated after surgical incision. The increased IL-1b-immunoreactivity (IR) was mainly localized in neurons but not the activated microglia or astrocytes. Although obvious increase in IL-1b-IR could be observed in the lumbar segments of the spinal cord ipsilateral to a hind paw incision, significant upregulation of IL-1b was not detected in the lumbar segments following thoracic incision. The present study indicated that surgical incision could induce glial activation and segmental upregulation of IL-1b in the spinal cord. The activated glial cells and upregulated IL-1b, in turn, may be involved in the incision-induced pain hypersensitivity.

目的：观察鞘内泵入不同弃I量的吗啡对甲醛炎性疼痛大鼠免疫功能的影响方法：32只SD大鼠随机分为生理盐水对照组（NS组）和3个不同剂量吗啡组（M组），分别为l0g/h（M1），5g/h（M2），2.5g/h（M3），每组8只。采用改良Yaksh法进行鞘内置管，Alzet泵持续泵入吗啡、生理盐水。复制甲醛炎性疼痛模型，7d后采用疼痛加权评分（PIS）评价吗啡镇痛效应，分离脾脏单个核细胞进行原代培养，检测脾脏T淋巴细胞增殖水平、NK细胞活性，流式细胞仪检测睥脏T淋巴细胞亚群和NK细胞表型变化。结果：与对照组比较，M1，M2，M3组在甲醛炎性疼痛第一时相和第二时相的PIS差异有统计学意义（P<0.01），且有量效关系，但3组间比较差异无统计学意义（P>0.05）；泵入吗啡7d后Ml，M2，M3组脾脏指数、T淋巴细胞增殖转化水平和NK细胞活性降低（P<0.05）；CD3+，CD3+CD4，CD3+CD8数量及百分率降低，CD4/CD8降低，CD161数量及百分率降低（P<0.05）。结论：鞘内泵入吗啡对炎性疼痛大鼠具有明显的抗伤害作用；鞘内泵入不同剂量吗啡（10g/h，5g/h，2.5LLg/h）均可抑制大鼠细胞免疫功能，免疫抑制程度与剂量成正比。

目的：研究无手术刺激条件下地氟醚对老年人脑电双频谱指数（BIS）的影响，评估BIS在地氟醚吸入麻醉深度监测中的应用价值。方法：40例ASAI～Ⅲ级，拟择期在气管内全麻下手术患者，按年龄分为2组：老年组（年龄≥65岁，n=20例），中青年组（年龄18～55岁，n=20例）。环甲膜穿刺行气管内表面麻醉后予异丙酚2mg/kg、维库溴铵0.1 mg/kg静脉注射诱导，插管后吸入地氟醚维持麻醉，逐步调整吸入浓度，使地氟醚呼气末浓度依次维持在0.6MAC，1.0MAC，1.3MAC，每一浓度均稳定20min。观察指标包括MAP，HR和BIS。记录时点分别为麻醉前、注射异丙酚后2min、气管插管时、气管插管后2min、地氟醚呼气末浓度为0.6 MAC，1.0MAC，1.3MAC时。结果：在地氟醚麻醉期，当地氟醚呼气末浓度由0,6～1.3MAC递增时，2组患者MAP，HR无显著变化（P>0.05），MAP，HR的变化与地氟醚无量效关系。在地氟醚麻醉期，2组患者BIS在整个麻醉过程中的变化不同（P<0.05）。随着地氟醚呼气末浓度增加，BIS逐渐下降，但每组患者各浓度问BIS的变化差异无统计学意义（P>0.05）。BIS与地氟醚呼气末浓度呈高度相关，BIS与地氟醚在老年组、中青年组的相关系数分别为-0.996，-0.946（P<0.05）。结论：脑电双频谱指数与地氟醚呼气末浓度呈高度剂量相关性，可以较好地监测老年人与中青年人的地氟醚麻醉深度。在相同地氟醚呼气末浓度下，以脑电双频谱指数为指标反映出的麻醉深度在老年人与中青年人无明显差异。

目的 观察镇痛剂量吗啡鞘内泵入对大鼠细胞免疫功能的影响。方法 4J0只雄性SD大鼠随机分为5组（n=8）：假手术组（F组）、生理盐水组（Ns组）、M1、M2、M3组（吗啡泵入速率分别为2.5、5、10ug·h-1）。除F组外各组采用改良Yaksh法进行鞘内置管，置管后5d采用Alzet泵持续泵人生理盐水或吗啡，共7d。第7天各组大鼠进行福尔马林炎性疼痛实验，根据痛级（PIS）评分评价吗啡镇痛效应，处死大鼠后计算脾脏指数并分离脾脏单个核细胞进行培养，甲基-3H胸腺嘧啶核苷掺入法检测脾T淋巴细胞增殖水平，乳酸脱氢酶释放法检测自然杀伤细胞活性。结果 与Ns组比较，Ml、M2、M3组在福尔马林炎性疼痛第一时相和第二时相的PIS评分值、脾脏指数、脾脏T淋巴细胞增殖转化水平和NK细胞活性降低（P<0.05或0.01）；与Ml组比较，M2、M3组脾脏T淋巴细胞增殖转化水平及NK细胞活性降（P<0.05）；与M2组比较，M3组脾脏NK细胞活性降低（P<0.05）。结论 镇痛剂量吗啡鞘内泵入可抑制大鼠细胞免疫功能，且泵入速率越大，免疫抑制效应越明显。