Objective: To observe the effects of epidural anesthesia with lidocaine combined low dose ropivacaine in elective cesarean section, and to provide more effective and simple anesthetic methods for obstetrics.Methods: 60 women undergoing elective cesarean section were randomly divided into two groups, combined spinal-epidural anesthesia group (CSEA group, n=27), and lidocaine and ropivacaine group (LR group, n=33). Combined spinal-epidural anesthesia with hyperbarci ropivacaine was used in CSEA group, and epidural anesthesia with lidocaine combined low dose ropivacaine was used in LR group. Monitoring and recording basic SBP, DBP and HR of all cases (T0). The lowest SBP, DBP and the fastest HR were recorded (T1), and the SBP, DBP and HR of 30min after anesthesia (T2) were recorded too. The anesthetic effects were evaluated by Anesthetic Effect Score and modified Bromage score. Meanwhile adverse reactions were recorded.Results: There was no difference on SBP, DBP and HR of T0 and T2 of two groups (P>0.05). Compared to CSEA group, SBP and DBP of T1 of LR group were increased significantly (P<0.05), and HR of T1 in two group was similar (P>0.05). The lowest SBP in both groups were on T1, the highest SBP of two groups were on T0, following T2. DBP and HR in two groups on T0 and T2 were similar. But DBP on T1 was the lowest in two group, and HR on T1 was the highest in two groups. There was no difference on Anesthetic Effect Score in two groups. Compared to CSEA group, modified Bromage score of LR group was reduced significantly at the end of anesthesia and the end of operation (P<0.05). Compared to CSEA group, the duration of anesthesia manuevre was reduced significantly, meanwhile, the onset of operation was reduced significantly (P<0.05). The cases of nausea were significantly reduced in LR groups compared to CSEA group (P<0.05). The scores of Apgar of two groups in 1min and 5min were indifferent (P>0.05). Conclusion:The clinical effect of epidural anesthesia with lidocaine combined low dose ropivacaine was reliable. With this anesthesia, circulation of maternity was more stable, adverse reaction and the extents of movement blocked were reduced too. So it was more effective and simple anesthesia method for cesarean section.

Objectives: Peripheral intravenous access is a common clinical procedure. It is wellknown that venodilation improves success rate of peripheral intravenous cannulation. Elastic tourniquet and blood pressure cuff are frequently applied to dilate peripheral veins. The objective of this study is to evaluate which maneuvers designed to dilate antecubital veins are more effective. Methods:This was a prospective non-random trail enrolling fifty healthy volunteers. Ultrasound was used to select an antecubital vein as a target vein. Its' diameter and cross-section area were measured sonograghically at the same position with different maneuvers, that was baseline, elastic tourniquet and blood pressure cuff with different inflation pressure. The blood pressure cuff was inflated with pressure from 30mmHg to 120mmHg, in 30mmHg increments. Time-intervals between each maneuver were longer enough and basic measurements were repeated to ensure the target vein recover to initial state. At the same time, volunteers' subjective feeling and degrees of tight under different maneuvers were recorded and evaluated by Visual Analogue Scale. Comparisons among different maneuvers were performed by Repeated Measurement test and Bonferroni test. Non-parametric test Kruskal-Wallis One-Way ANOVA was used to pairwise compare differences of volunteers' scores of Visual Analogue Scale. The differences of diameter and cross-section area between right and left arm were evaluated by Paired-Sample test.Results: All maneuvers dilated diameters and cross-section areas of target antecubital veins significantly from baseline (P=0.000). Target veins were dilated most significantly by blood pressure cuff with 60mmHg inflation pressure (P=0.000). Blood pressure cuff with 90mmHg inflation pressure resulted in the second largest increase in target vein size (P=0.000). Although there were no significant differences between blood pressure cuff with inflation of 30mmHg and 120mmHg pressure (P=1.000), elastic tourniquet significantly increases diameters and cross-section areas of target vein size when compared to them (P=0.000). Scores of Visual Analogue Scale of elastic tourniquet and blood pressure cuff with 120mmHg inflation pressure were not significantly different (P=0.581), but these were significantly higher than other maneuvers (P=0.000).Blood pressure cuff with 30mmHg inflation pressure significantly decreased the score of Visual Analogue Scale, when compared with maneuvers of 60mmHg and 90mmHg inflation pressure. Nevertheless, there was no significant difference between the scores of 60mmHg and 90mmHg inflation pressure (P=0.369). The differences of baseline of