In China, the number of regional anesthetic procedures has increased in recent years. This tremendous increase can be linked to the perception that regional anesthesia is associated with numerous advantages and with very few costs. This increase has been seen not only in obstetrics but also in other surgical departments. Numerous new techniques have been applied during the latest decades. However, like other anesthetic procedures, regional anesthesia can cause complications too like systemic local anesthetic toxicity, PDPH, CES, etc. Diagnosis and treatment of these complications are of great importance to anesthesia doctors. Unfortunately, there isn't a definite number about the incidence of neurological complications of regional anesthesia in China. Neither is a simple, effective way to treat neurological complications. Thus, we designed the following studies. Clinical Investigation on Complications of Regional Anesthesia—-Multipul centers,prospective study1 ObjectiveTo investigate neurological complications of regional anesthesia in 11 anesthesia centers.2 Methods11 professors from different hospitals attended a meeting hold up by anesthesia center of Xijing hospital and discussed the prospective design of this research. Clinical anesthesia doctors are in charge of filling in regional anesthesia investigation chart which is followed up by a special doctor for 1 week to 3 weeks according to the patient's condition. Those charts were put into an access 2007 data base. Datas were integrated and ananlysised by SQL server system finally. Incidences of different complications and OR were investigated then.
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3 ResultsWe investigated 24754 cases of patients who received regional anesthesia procedures no matter whether these procedures lead to successful anesthesia. These patients include 911 cases developed different kinds of complications include Horner's syndrome （8）, recurrent laryngeal nerve blockade （6）, toxicity of local anesthesia （10）, peripheral nerve injury （8）, cardiac arrest （1）, hematoma （1）, seizures （2）, back pain （693）, catheter break （1）, paraplegia （1）, Caudal equinea syndrome （1）, PDHD （116）, total spinal anesthesia （1）, TNS （103）. Thus the total incidence of complications of regional anesthesia is 3.68%.4 ConclusionMore complications than expected were found, probably as a result of a comprehensive prospective design. All the complications were checked exclusively from clinical files. This prospective design-retrospective study allows us to estimate the incidence of major complications related to anesthesia and to provide a detailed analysis of these complications.Effect of ginsenoside-Rd injection on central nervous system and cardiac toxicities of bupivacaine in rats1 ObjectiveTo investigate the effect of pretreatment of ginsenoside-Rd injection, a preparation of Chinese herbal medincine, on central nervous system（CNS） and systemic toxicities of bupivacaine in rats.2 MethodsExperimental animals were randomly assigned to 3 groups: control group （C）, ginsenoside-Rd group （R） and solvent group （S）, each group include 10 animals.
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Animals in the R group received ginsenoside-Rd injection 30 mg·kg ^-1 intraperitoneally 30 min before intravenous infusion of bupivacaine whereas rats in the C and S groups received equal volume of saline injection or ginsenoside-Rd solvent （propylene glycol） respectively. Lead II of the electrocardiogram （EEG） was continuously monitored by 3 needles sticked into the skin of both fore-limbs extremities and left hind-leg. The femoral artery was cannulated for direct measurement of arterial blood pressure and for drawing blood samples. The femoral vein was cannulated for the infusion of bupivacaine. After the basic parameters （arterial blood pressure, heart rate and arterial blood gases） were recorded, 0.5% bupivacaine was infused intravenously at a rate of 2mg·kg^-1·min^-1 to in both groups all animals until asystole. The time of bupivacaine-produced convulsions, arrhythmia （QRS prolongation in ECG）, circulation collapse （MAP≤40 mmHg） and asystole were determined, then the cumulative dose of bupivacaine was calculated at the corresponding timepoints respectively.3 ResultsThe MAP values were significantly increased and the HR was significantly decreased after bupivacaine infusion and the appearance of convulsion and arrhythmia in both groups. There was no significant difference in the MAP and HR at the same conditions between the 2 groups. When the MAP was 40 mmHg, the arterial PO2 in the Rd groups was remarkably higher than the bupivacaine group （P -1, respectively, which were significantly higher than those in the control group （13.77±1.31）, （13.40±4.73）（ 24.24±5.76） mg·kg^-1.
4 ConclusionPretreatment with ginsenoside-Rd injection can reduce the toxicity of bupivacaine to the central nervous and cardiac systems in rats. Research on the protective effect of ginsenoside-Rd injection pretreatment on central nervous system and cardiac toxicities of bupivacaine in rats1 ObjectiveTo study the possible mechanisms of the protective effect of ginsenoside-Rd injection, a preparation of Chinese herbal medincine, on central nervous system（CNS） and cardiac toxicities of bupivacaine in rats.2 MethodsThirty male Sprague-Dawley rats, weighing 280 to 320g, were randomly assigned to 3 groups: control group （C）, ginsenoside-Rd group （R） and solvent group （S） （n=10 each）. Animals in the R group received ginsenoside-Rd injection 30 mg/kg intraperitoneally 30 min before intravenous infusion of bupivacaine whereas rats in the C and S groups received equal volume of saline injection or ginsenoside-Rd solvent （propylene glycol） respectively. Lead II of the electrocardiogram （EEG） was continuously monitored by 3 needles sticked into the skin of both fore-limbs extremities and left hind-leg. The femoral artery was cannulated for direct measurement of arterial blood pressure and for drawing blood samples. The femoral vein was cannulated for the infusion of bupivacaine. After the basic parameters （arterial blood pressure, heart rate and arterial blood gases） were recorded, 0.5% bupivacaine was infused intravenously at a rate of 2 mg·kg^-1·min^-1 to in both groups all animals until asystole.
The time of bupivacaine-produced convulsions, arrhythmia （QRS prolongation in ECG）, circulation collapse （MAP≤40 mmHg） and asystole were determined, then the cumulative dose of bupivacaine was calculated at the corresponding timepoints respectively. At the time point of bupivacaine infusion, bupivacaine-produced convulsions, circulation collapse （MAP≤40 mmHg）, draw 1 ml blood sample and test the NO and NOS activity.3 ResultsIn the ginsenoside-Rd group, the cumulative doses of bupivacaine that produced convulsion, arrhythmia and circulation collapse were significantly more than those in the control group. The NOS activity was significantly decreased and the NO was significantly increased after the appearance of convulsion in both groups. The NOS and NO activity of R group are both significantly high than C group and S group at convulsion and circulation collapse.4 ConclusionPretreatment with ginsenoside-Rd injection reducing the toxicity of bupivacaine to the central nervous and cardiac systems in rats is probably by increase the NO and NOS activity.