AIM: To assess the use of dezocine combined with propofol for the anesthetization of patients undergoing indolent colonoscopy.METHODS: A cross-sectional survey of patients undergoing indolent colonoscopy in the Xinjia...AIM: To assess the use of dezocine combined with propofol for the anesthetization of patients undergoing indolent colonoscopy.METHODS: A cross-sectional survey of patients undergoing indolent colonoscopy in the Xinjiang people's Hospital was conducted from April 1 to April 30, 2015. The survey collected patient general information and anesthesia data, including overall medical experience and pain management. Thirty minutes after colonoscopy surgery, samples of venous blood were collected and the biochemical indicators of gastrointestinal function were analyzed. RESULTS: There were 98 female and 62 male respondents. Indolent colonoscopy was found to be more suitable for mid to older-aged patients. The necessary conditions for the diagnosis of digestive diseases were required in 65 of the 73 inpatients. Adverse reactions to the intraoperative process included two cases of body movement and two cases of respiratory depression. Gastrin and vasoactive intestinal peptide levels were slightly increased. However, somatostatin and endothelin levels were slightly decreased. CONCLUSION: This study revealed that dezocine combined with propofol can be successfully used for the anesthetization of indolent colonoscopy patients without pain and should be widely used.展开更多
Debates regarding the specific effects of general anesthesia on developing brains have persisted for over 30 years.A consensus has been reached that prolonged,repeated,high-dose exposure to anesthetics is associated w...Debates regarding the specific effects of general anesthesia on developing brains have persisted for over 30 years.A consensus has been reached that prolonged,repeated,high-dose exposure to anesthetics is associated with a higher incidence of deficits in behavior and executive function,while single exposure has a relatively minor effect on long-term neurological function.In this review,we summarize the dose-dependent neuroprotective or neurotoxic effects of gamma-aminobutyric acid type A receptor agonists,a representative group of sedatives,on developing brains or central nervous system diseases.Most preclinical research indicates that anesthetics have neurotoxic effects on the developing brain through various signal pathways.However,recent studies on low-dose anesthetics suggest that they may promote neurodevelopment during this critical period.These findings are incomprehensible for the general“dose-effect”principles of pharmacological research,which has attracted researchers'interest and led to the following questions:What is the threshold for the dual effects exerted by anesthetics such as propofol and sevoflurane on the developing brain?To what extent can their protective effects be maximized?What are the underlying mechanisms involved in these effects?Consequently,this issue has essentially become a“mathematical problem.”After summarizing the dose-dependent effects of gamma-aminobutyric acid type A receptor agonist sedatives in both the developing brain and the brains of patients with central nervous system diseases,we believe that all such anesthetics exhibit specific threshold effects unique to each drug.These effects range from neuroprotection to neurotoxicity,depending on different brain functional states.However,the exact values of the specific thresholds for different drugs in various brain states,as well as the underlying mechanisms explaining why these thresholds exist,remain unclear.Further in-depth exploration of these issues could significantly enhance the therapeutic translational value of these anesthetics.展开更多
The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic pro...The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic properties,an increasing body of research has uncovered neuroprotective efects of intravenous anesthetics in various animal and cellular models,as well as in clinical studies.However,there also exists conficting evidence pointing to the potential neurotoxic efects of these intravenous anesthetics.The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized.Considering the mentioned above,this work aims to ofer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system(CNS)and the peripheral nerve system(PNS)and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.展开更多
Cancer,potentially the second leading cause of mortality globally,poses a significant health challenge.The conventional treatment for solid tumors typically involves surgical intervention,followed by chemotherapy,radi...Cancer,potentially the second leading cause of mortality globally,poses a significant health challenge.The conventional treatment for solid tumors typically involves surgical intervention,followed by chemotherapy,radiotherapy,and targeted therapies.However,cancer recurrence and metastasis remain major issues.Anesthesia is essential for ensuring patient comfort and safety during surgery.Despite its crucial role in surgery,the precise effect of anesthesia on cancer patients'outcomes has not been clearly understood.This comprehensive review aims to elucidate perioperative anesthesia strategies for cancer patients and their potential effects on prognosis.Given the complexity of cancer treatments,understanding the relationship between anesthesia and cancer outcomes is crucial.By examining potential implications of anesthesia strategies for cancer prognosis,this review may help better understand treatment efficacy and risk factors for cancer recurrence and metastasis.Ultimately,a detailed analysis of anesthesia practices in cancer surgery may provide insights to refine existing anesthesia protocols and reduce risk factors for poor patient outcomes.展开更多
Researchers have discovered that mice instinctively exhibit rescue-like behavior towards anesthetized companions-a finding that suggests a biological basis for prosociality.The study,published in PNAS on April 23,2025...Researchers have discovered that mice instinctively exhibit rescue-like behavior towards anesthetized companions-a finding that suggests a biological basis for prosociality.The study,published in PNAS on April 23,2025,was led by Dr.HU Li from the Institute of Psychology of the Chinese Academy of Sciences(IPCAS)and Dr.CHEN Zhoufeng from Washington University School of Medicine and the Shenzhen Medical Academy of Research and Translation.展开更多
Anesthetic pharmacology,a specialized branch of pharmacology,differs significantly from the foundational pharmacology taught in undergraduate medical programs.A key challenge lies in effectively distinguishing and int...Anesthetic pharmacology,a specialized branch of pharmacology,differs significantly from the foundational pharmacology taught in undergraduate medical programs.A key challenge lies in effectively distinguishing and integrating these two courses to enhance students’theoretical understanding and foster their clinical anesthesia skills.This paper explores strategies for optimizing lesson preparation and delivery in anesthetic pharmacology,focusing on course positioning,student knowledge assessment,clinical integration,objective setting,content development,instructional design,innovative teaching tools,and classroom management.The ultimate aim is to enhance teaching effectiveness and train anesthesiology professionals with robust theoretical knowledge and practical competence.展开更多
Dear Editor,General anesthetics play a pivotal role in inducing a safe and reversible loss of consciousness in patients,the importance of which cannot be overstated[1].Among the intravenous anesthetics,propofol stands...Dear Editor,General anesthetics play a pivotal role in inducing a safe and reversible loss of consciousness in patients,the importance of which cannot be overstated[1].Among the intravenous anesthetics,propofol stands out for its rapid onset and swift systemic clearance,effectively eliminating the prolonged sedation associated with earlier agents[2].展开更多
[Objective] The aim of the study is to seek a good anesthetic to Fenneropenaeus chinensis. [Method] The anesthetic effect of eugenol to juvenile Fenneropenaeus chinensis was investigated. [Result] The juveniles could ...[Objective] The aim of the study is to seek a good anesthetic to Fenneropenaeus chinensis. [Method] The anesthetic effect of eugenol to juvenile Fenneropenaeus chinensis was investigated. [Result] The juveniles could be effectively anaesthetized by 50-400 mg/L eugenol aqueous solution with temperature of 24 ℃. Within the concentration range of 50-400 mg/L, the increase of the eugenol concentration could shorten the time required for anesthesia, meanwhile could prolong the time for recovery. The recovered rate of prawn reached 100% when the eugenol concentration was lower than 200 mg/L, while the recovered rate of prawn was just 66.67% when the eugenol concentration was higher than 400 mg/L. The survival rate of prawns in test group was 100% from the observation of three consecutive days. For the specific dose, the anesthetic effect enhanced with the increase of water temperature (18-27℃). [Conclusion] Eugenol is a safe and efficient anesthetics that can be applied in genetic breeding of prawn.展开更多
Purpose:to explore the effect of dexmedetomidine hydrochloride on early cognitive function in postoperative elderly patients.Methods:during December 2015 to November 2016,80 elderly patients who received surgical trea...Purpose:to explore the effect of dexmedetomidine hydrochloride on early cognitive function in postoperative elderly patients.Methods:during December 2015 to November 2016,80 elderly patients who received surgical treatment in our hospital were selected as research object.Result:patients were randomly divided into two groups(control group and research group).On the basis of routine anesthetic induction,patients in research group took dexmedetomidine,in comparison,patients in control group took an equal dose of sodium chloride solution.The goal was to evaluate the anesthetic effect of those two methods.One hour before surgery,there was no significant difference in the MMSE score between the two groups(P>0.05).In research group,the MMSE scores at postoperative 1d and 3d were(23.8±2.4)and(27.1±2.0)respectively.In control group,the MMSE scores at postoperative 1d and 3d were(20.5±3.2)and(24.6±3.4)respectively.The difference was statistically significant(P<0.05).There was no significant difference in anesthesia time,awake time and extubation time between those two groups(P>0.05).Conclusion:using dexmedetomidine in elderly patients after surgery can protect early cognitive function and improve the prognosis.展开更多
Objective The present study was aimed to investigate the pharmacological modulatory effects of ropivacaine,an amide-type local anesthetic,on rat Nav1.2（rNav1.2）and rNav1.5,the two Na＋channel isoforms heterologously...Objective The present study was aimed to investigate the pharmacological modulatory effects of ropivacaine,an amide-type local anesthetic,on rat Nav1.2（rNav1.2）and rNav1.5,the two Na＋channel isoforms heterologously expressed in Xenopus oocytes and in HEK293t cell line,respectively.Methods Two-electrode voltage-clamp（TEVC）and whole-cell patchclamp recordings were employed to record the whole-cell currents.Results Ropivacaine induced tonic inhibition of peak Na＋ currents of both subtypes in a dose-and frequency-dependent manner.rNav1.5 appeared to be more sensitive to ropivacaine.In addition,for both Na＋channel subtypes,the steady-state inactivation curves,but not the activation curves,were significantly shifted to the hyperpolarizing direction by ropivacaine.Use-dependent blockade of both rNav1.2 and rNav1.5 channels was induced by ropivacaine through a high frequency of depolarization,suggesting that ropivacaine could preferentially bind to the 2 inactivated Na＋channel isoforms.Conclusion The results will be helpful in understanding the pharmacological modulation by ropivacaine on Nav1.2 subtype in the central nervous system,and on Nav1.5 subtype abundantly expressed in the heart.展开更多
Background： Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined...Background： Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined. This double-blind, randomized, dose-response study determined the ED50 （50% effective dose） and ED95 （95% effective dose） of spinal hyperbaric ropivacaine for cesarean section anesthesia. Methods： Sixty parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. An epidural catheter was placed at the L1-L2 vertebral interspace then lumbar puncture was performed at the L3-L4 vertebral interspace, and parturients were randomized to receive spinal hyperbaric ropivacaine in doses of 10.5 mg, 12 mg, 13.5 mg, or 15 mg in equal volumes of 3 ml. Sensory levels （pinprick） were assessed every 2.5 min until a T7 level was achieved and motor changes were assessed by modified Bromage Score. A dose was considered effective if an upper sensory level to pin prick of T7 or above was achieved and no intraoperative epidural supplement was required. ED50 and ED95 were determined with use of a logistic regression model. Results： ED50 （95% confidence interval） of spinal hyperbaric ropivacaine was determined to be 10.37 （5.23-11.59） mg and ED95 （95% confidence interval） to be 15.39 （13.81-23.59） mg. The maximum sensory block levels and the duration of motor block and the rate of hypotension, but not onset of anesthesia, were significantly related to the ropivacaine dose. Conclusion： The ED50 and ED95 of spinal hyperbaric ropivacaine for cesarean delivery under the conditions of this study were 10.37 mg and 15.39 mg, respectively. Ropivacaine is suitable for spinal anesthesia in cesarean delivery.展开更多
AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODS: After obtaining approval of the research ethics committee and informed consent, 20...AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODS: After obtaining approval of the research ethics committee and informed consent, 200 patients were evaluated and referred for upper gastrointestinal endoscopy. Patients were randomized to receive propofol-fentanyl or midazolam-fentanyl (n = 100/group).We assessed the level of sedation using the observer's assessment of alertness/sedation (OAA/S) score and bispectral index (BIS). We evaluated patient and physician satisfaction, as well as the recovery time and complication rates. The statistical analysis was performed using SPSS statistical software and included the MannWhitney test, χ 2 test, measurement of analysis of variance, and the κ statistic. RESULTS: The times to induction of sedation, recovery, and discharge were shorter in the propofolfentanyl group than the midazolam-fentanyl group. According to the OAA/S score, deep sedation events occurred in 25% of the propofol-fentanyl group and 11% of the midazolam-fentanyl group (P = 0.014). Additionally, deep sedation events occurred in 19% of the propofol-fentanyl group and 7% of the midazolamfentanyl group according to the BIS scale (P = 0.039). There was good concordance between the OAA/S score and BIS for both groups (κ = 0.71 and κ = 0.63, respectively). Oxygen supplementation was required in 42% of the propofol-fentanyl group and 26% of the midazolam-fentanyl group (P = 0.025). The mean time to recovery was 28.82 and 44.13 min in the propofolfentanyl and midazolam-fentanyl groups, respectively (P < 0.001). There were no severe complications in either group. Although patients were equally satisfied with both drug combinations, physicians were more satisfied with the propofol-fentanyl combination. CONCLUSION: Deep sedation occurred with propofolfentanyl and midazolam-fentanyl, but was more frequent in the former. Recovery was faster in the propofol-fentanyl group.展开更多
Ischemic preconditioning and postconditioning distinctly attenuate ventricular arrhythmia after ischemia without affecting the severity of myocardial stunning. Therefore, we report the effects of sevofiurane precondit...Ischemic preconditioning and postconditioning distinctly attenuate ventricular arrhythmia after ischemia without affecting the severity of myocardial stunning. Therefore, we report the effects of sevofiurane preconditioning and postconditioning on stunned myocardium in isolated rat hearts. Isolated rat hearts were underwent 20 min of global ischemia and 40 min of reperfusion. After an equilibration period （20 min）, the hearts in the preconditioning group were exposed to sevoflurane for 5 min and next washout for 5 min before ischemia. Hearts in the sevoflurane postconditioning group underwent equilibration and ischemia, followed immediately by sevoflurane exposure for the first 5 min of reperfusion. The control group received no treatment before and after ischemia. Left ventricular pressure, heart rate, coronary flow, electrocardiogram, and tissue histology were measured as variables of ventricular function and cellular injury, respectively. There was no significant difference in the duration of reperfusion ventricular arrhythmias between control and sevoflurane preconditioning group （P=0.195）. The duration of reperfusion ventricular arrhythmias in the sevoflurane postconditioning group was significantly shorter than that in the other two groups （P〈0.05）. ＋（dPIdt）max in the sevoflurane preconditioning group at 5, 10, 15, 20, and 30 min after reperfusion was significantly higher than that in the control group （P〈0.05）, and there were no significant differences at 40 min after reperfusion among the three groups （P〉0.05）. As expected, for a 20-min general ischemia, infarct size in heart slices determined by 2,3,5-triphenyltetrazolium chloride staining among the groups was not obvious. Sevofiurane postconditioning reduces reperfusion arrhythmias without affecting the severity of myocardial stunning. In contrast, sevoflurane preconditioning has no beneficial effects on reperfusion arrhythmias, but it is in favor of improving ventricular function and recovering myocardial stunning. Sevoflurane preconditioning and postconditioning may be useful for correcting the stunned myocardium.展开更多
Although beneficial in acute and chronic pain management, the use of local anaesthetics is limited by itsduration of action and the dose dependent adverse effects on the cardiac and central nervous system. Adjuvants o...Although beneficial in acute and chronic pain management, the use of local anaesthetics is limited by itsduration of action and the dose dependent adverse effects on the cardiac and central nervous system. Adjuvants or additives are often used with local anaesthetics for its synergistic effect by prolonging the duration of sensory-motor block and limiting the cumulative dose requirement of local anaesthetics. The armamentarium of local anesthetic adjuvants have evolved over time from classical opioids to a wide array of drugs spanning several groups and varying mechanisms of action. A large array of opioids ranging from morphine, fentanyl and sufentanyl to hydromorphone, buprenorphine and tramadol has been used with varying success. However, their use has been limited by their adverse effect like respiratory depression, nausea, vomiting and pruritus, especially with its neuraxial use. Epinephrine potentiates the local anesthetics by its antinociceptive properties mediated by alpha-2 adrenoreceptor activation along with its vasoconstrictive properties limiting the systemic absorption of local anesthetics. Alpha 2 adrenoreceptor antagonists like clonidine and dexmedetomidine are one of the most widely used class of local anesthetic adjuvants. Other drugs like steroids(dexamethasone), anti-inflammatory agents(parecoxib and lornoxicam), midazolam, ketamine, magnesium sulfate and neostigmine have also been used with mixed success. The concern regarding the safety profile of these adjuvants is due to its potential neurotoxicity and neurological complications which necessitate further research in this direction. Current research is directed towards a search for agents and techniques which would prolong local anaesthetic action without its deleterious effects. This includes novel approaches like use of charged molecules to produce local anaesthetic action(tonicaine and n butyl tetracaine), new age delivery mechanisms for prolonged bioavailability(liposomal, microspheres and cyclodextrin systems) and further studies with other drugs(adenosine, neuromuscular blockers, dextrans).展开更多
AIM : To systematically evaluate the effect of intraperitoneal local anesthetic on pain characteristics after laparoscopic cholecystectomy(LC).METHODS: We searched MEDLINE, EMBASE, and the Cochrane Library. Randomized...AIM : To systematically evaluate the effect of intraperitoneal local anesthetic on pain characteristics after laparoscopic cholecystectomy(LC).METHODS: We searched MEDLINE, EMBASE, and the Cochrane Library. Randomized controlled trials in English that compared the effect of intraperitoneal administration of local anesthetics on pain with that of placebo or nothing after elective LC under general anesthesia were included. The primary outcome variables analyzed were the combined scores of abdominal, visceral, parietal, and shoulder pain after LC at multiple time points. We also extracted pain scores at resting and dynamic states.RESULTS: We included 39 studies of 3045 patients in total. The administration of intraperitoneal local anesthetic reduced pain intensity in a resting state after laparoscopic cholecystectomy: abdominal [standardized mean difference(SMD) =-0.741; 95%CI:-1.001 to-0.48, P < 0.001]; visceral(SMD =-0.249; 95%CI:-0.493 to-0.006, P = 0.774); and shoulder(SMD =-0.273; 95%CI:-0.464 to-0.082, P = 0.097). Application of intraperitoneal local anesthetic significantly reduced the incidence of shoulder pain(RR = 0.437; 95%CI: 0.299 to 0.639, P < 0.001). There was no favorable effect on resting parietal or dynamic abdominal pain.CONCLUSION: Intraperitoneal local anesthetic as an analgesic adjuvant in patients undergoing laparoscopic cholecystectomy exhibited beneficial effects on postoperative abdominal, visceral, and shoulder pain in a resting state.展开更多
BACKGROUND Compared with traditional open surgery,laparoscopic surgery is preferred due to the advantages of less trauma,less pain,and faster recovery.Nevertheless,many patients still suffer from postoperative pain re...BACKGROUND Compared with traditional open surgery,laparoscopic surgery is preferred due to the advantages of less trauma,less pain,and faster recovery.Nevertheless,many patients still suffer from postoperative pain resulting from the surgical incision and associated tissue injury.Many researchers have reported methods to improve postoperative pain control,but there is not a simple and effective method that can be clinically adopted in a widespread manner.We designed this study to prove the hypothesis that application of ropivacaine in the port site and operative site in patients is an effective and convenient method which can decrease postoperative pain and accelerate recovery.AIM To evaluate the effects of ropivacaine on pain control after laparoscopic hepatectomy and its contribution to patient recovery.METHODS From May 2017 to November 2018,146 patients undergoing laparoscopic hepatectomy were randomized to receive infiltration of either 7.5 mg/mL ropivacaine around the trocar insertions,incision,and cutting surface of the liver(with a gelatin sponge soaked with ropivacaine)at the end of surgery(ropivacaine group),or normal saline(5 mL)at the same sites at the end of surgery(control group).The degree of pain,nausea,vomiting,heart rate(HR),and blood pressure were collected.The length of postoperative hospitalization,complications,and the levels of stress hormones were also compared between the two groups.RESULTS Compared with the control group,the ropivacaine group showed reduced postoperative pain at rest within 12 h(P<0.05),and pain on movement was reduced within 48 h.The levels of epinephrine,norepinephrine,and cortisol at 24 and 48 h,HR,blood pressure,and cumulative sufentanil consumption in the ropivacaine group were significantly lower than those in the control group(P<0.05).In the ropivacaine group,hospitalization after operation was shorter,but the difference was not statistically significant.There were no significant differences in postoperative nausea,vomiting,or other complications,including hydrothorax,ascites,peritonitis,flatulence,and venous thrombus(P>0.05),although fewer patients in the ropivacaine group experienced these situations.CONCLUSION Infiltration with ropivacaine in the abdominal wound and covering the cutting surface of the liver with a gelatin sponge soaked with ropivacaine significantly reduce postoperative pain and the consumption of sufentanil.展开更多
AIM:To study the anesthetic management of patients undergoing small bowel enteroscopy in the World Gastroenterology Organization(WGO) Endoscopy Training Center in Thailand.METHODS:Patients who underwent small bowel en...AIM:To study the anesthetic management of patients undergoing small bowel enteroscopy in the World Gastroenterology Organization(WGO) Endoscopy Training Center in Thailand.METHODS:Patients who underwent small bowel enteroscopy during the period of March 2005 to March 2011 in Siriraj Gastrointestinal Endoscopy Center were retrospectively analyzed.The patients' characteristics,pre-anesthetic problems,anesthetic techniques,anesthetic agents,anesthetic time,type and route of procedure and anesthesia-related complications were assessed.RESULTS:One hundred and forty-four patients underwent this procedure during the study period.The mean age of the patients was 57.6 ± 17.2 years,andmost were American Society of Anesthesiologists(ASA) class Ⅱ(53.2%).Indications for this procedure were gastrointestinal bleeding(59.7%),chronic diarrhea(14.3%),protein losing enteropathy(2.6%) and others(23.4%).Hematologic disease,hypertension,heart disease and electrolyte imbalance were the most common pre-anesthetic problems.General anesthesia with endotracheal tube was the anesthetic technique mainly employed(50.6%).The main anesthetic agents administered were fentanyl,propofol and midazolam.The mean anesthetic time was 94.0 ± 50.5 min.Single balloon and oral(antegrade) intubation was the most common type and route of enteroscopy.The anesthesia-related complication rate was relatively high.The overall and cardiovascular-related complication rates including hypotension in the older patient group(aged ≥ 60 years old) were significantly higher than those in the younger group.CONCLUSION:During anesthetic management for small bowel enteroscopy,special techniques and drugs are not routinely required.However,for safety reasons anesthetic personnel need to optimize the patient's condition.展开更多
Objective： We compare the cardioprotective effects of anesthetic preconditioning by propofol and/or isoflurane in rats with ischemia-reperfusion injury. Methods： Male adult Wistar rats were subjected to 60 min of an...Objective： We compare the cardioprotective effects of anesthetic preconditioning by propofol and/or isoflurane in rats with ischemia-reperfusion injury. Methods： Male adult Wistar rats were subjected to 60 min of anterior descending coronary artery occlusion followed by 120 rain of reperfusion. Before the long ischemia, anesthetics were administered twice for 10 min followed by 5 min washout. Isoflurane was inhaled at 1 MAC （0.016） in I group, whereas propofol was inhaled intravenously at 37.5 mg/（kg.h） in P group. A combination ofisoflurane and propofol was administered simultaneously in I＋P group. Results： In control （without anesthetic preconditioning, C group）, remarkable myocardial infarction and apoptosis accompanied by an increased level of cardiac troponin T were noted 120 min aider ischemia-reperfusion. As compared to those of control group, I and P groups had comparable cardioprotection. In addition, I＋P group shares with I and P groups the comparable cardioprotective effects in terms of myocardial infarction and cardiac troponin T elevation. Conclusion： A combination of isoflurane and propofol produced no additional cardioprotection.展开更多
文摘AIM: To assess the use of dezocine combined with propofol for the anesthetization of patients undergoing indolent colonoscopy.METHODS: A cross-sectional survey of patients undergoing indolent colonoscopy in the Xinjiang people's Hospital was conducted from April 1 to April 30, 2015. The survey collected patient general information and anesthesia data, including overall medical experience and pain management. Thirty minutes after colonoscopy surgery, samples of venous blood were collected and the biochemical indicators of gastrointestinal function were analyzed. RESULTS: There were 98 female and 62 male respondents. Indolent colonoscopy was found to be more suitable for mid to older-aged patients. The necessary conditions for the diagnosis of digestive diseases were required in 65 of the 73 inpatients. Adverse reactions to the intraoperative process included two cases of body movement and two cases of respiratory depression. Gastrin and vasoactive intestinal peptide levels were slightly increased. However, somatostatin and endothelin levels were slightly decreased. CONCLUSION: This study revealed that dezocine combined with propofol can be successfully used for the anesthetization of indolent colonoscopy patients without pain and should be widely used.
文摘Debates regarding the specific effects of general anesthesia on developing brains have persisted for over 30 years.A consensus has been reached that prolonged,repeated,high-dose exposure to anesthetics is associated with a higher incidence of deficits in behavior and executive function,while single exposure has a relatively minor effect on long-term neurological function.In this review,we summarize the dose-dependent neuroprotective or neurotoxic effects of gamma-aminobutyric acid type A receptor agonists,a representative group of sedatives,on developing brains or central nervous system diseases.Most preclinical research indicates that anesthetics have neurotoxic effects on the developing brain through various signal pathways.However,recent studies on low-dose anesthetics suggest that they may promote neurodevelopment during this critical period.These findings are incomprehensible for the general“dose-effect”principles of pharmacological research,which has attracted researchers'interest and led to the following questions:What is the threshold for the dual effects exerted by anesthetics such as propofol and sevoflurane on the developing brain?To what extent can their protective effects be maximized?What are the underlying mechanisms involved in these effects?Consequently,this issue has essentially become a“mathematical problem.”After summarizing the dose-dependent effects of gamma-aminobutyric acid type A receptor agonist sedatives in both the developing brain and the brains of patients with central nervous system diseases,we believe that all such anesthetics exhibit specific threshold effects unique to each drug.These effects range from neuroprotection to neurotoxicity,depending on different brain functional states.However,the exact values of the specific thresholds for different drugs in various brain states,as well as the underlying mechanisms explaining why these thresholds exist,remain unclear.Further in-depth exploration of these issues could significantly enhance the therapeutic translational value of these anesthetics.
基金supported by the National Key Research and Development Program of China(2018YFC2001802)the National Natural Science Foundation of China(82303765 and 82071251)+4 种基金Hubei Province Key Research and Development Program(2021BCA145)Open Foundation of Hubei Key Laboratory of Regenerative Medicine and Multi-disciplinary Translational Research(2022zsyx008)Program of Scientifc and Technological Project in Guizhou Province(Qian Ke He Ji Chu ZK[2022]Yi Ban 516 and Qian Ke He Ji Chu ZK[2021]Yi Ban 559)the Science and Technology Talents Growth Project in Education Department of Guizhou Province(Qian Jiao He KY Zi[2021]4Y211)Research project of Guizhou Administration of Traditional Chinese Medicine(QZYY-2021-082).
文摘The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic properties,an increasing body of research has uncovered neuroprotective efects of intravenous anesthetics in various animal and cellular models,as well as in clinical studies.However,there also exists conficting evidence pointing to the potential neurotoxic efects of these intravenous anesthetics.The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized.Considering the mentioned above,this work aims to ofer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system(CNS)and the peripheral nerve system(PNS)and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.
基金Innovative and Entrepreneurial Team of Jiangsu Province(Grant No.JSSCTD202144)Nanjing Postdoctoral Program(Grant No.BSHNJ2023006)National Natural Science Foundation of China(Grant No.82201380)。
文摘Cancer,potentially the second leading cause of mortality globally,poses a significant health challenge.The conventional treatment for solid tumors typically involves surgical intervention,followed by chemotherapy,radiotherapy,and targeted therapies.However,cancer recurrence and metastasis remain major issues.Anesthesia is essential for ensuring patient comfort and safety during surgery.Despite its crucial role in surgery,the precise effect of anesthesia on cancer patients'outcomes has not been clearly understood.This comprehensive review aims to elucidate perioperative anesthesia strategies for cancer patients and their potential effects on prognosis.Given the complexity of cancer treatments,understanding the relationship between anesthesia and cancer outcomes is crucial.By examining potential implications of anesthesia strategies for cancer prognosis,this review may help better understand treatment efficacy and risk factors for cancer recurrence and metastasis.Ultimately,a detailed analysis of anesthesia practices in cancer surgery may provide insights to refine existing anesthesia protocols and reduce risk factors for poor patient outcomes.
文摘Researchers have discovered that mice instinctively exhibit rescue-like behavior towards anesthetized companions-a finding that suggests a biological basis for prosociality.The study,published in PNAS on April 23,2025,was led by Dr.HU Li from the Institute of Psychology of the Chinese Academy of Sciences(IPCAS)and Dr.CHEN Zhoufeng from Washington University School of Medicine and the Shenzhen Medical Academy of Research and Translation.
基金supported by Collaborative Education Project of the Ministry of Education of China(250101414020206)Planning Project of Shanghai Higher Education Association(2QYB24158).
文摘Anesthetic pharmacology,a specialized branch of pharmacology,differs significantly from the foundational pharmacology taught in undergraduate medical programs.A key challenge lies in effectively distinguishing and integrating these two courses to enhance students’theoretical understanding and foster their clinical anesthesia skills.This paper explores strategies for optimizing lesson preparation and delivery in anesthetic pharmacology,focusing on course positioning,student knowledge assessment,clinical integration,objective setting,content development,instructional design,innovative teaching tools,and classroom management.The ultimate aim is to enhance teaching effectiveness and train anesthesiology professionals with robust theoretical knowledge and practical competence.
基金supported by grants from the National Natural Science Foundation of China(82101273)the Second Affiliated Hospital of the Army Medical University Incubation Program for Young Doctoral Talents(2023YQB007).
文摘Dear Editor,General anesthetics play a pivotal role in inducing a safe and reversible loss of consciousness in patients,the importance of which cannot be overstated[1].Among the intravenous anesthetics,propofol stands out for its rapid onset and swift systemic clearance,effectively eliminating the prolonged sedation associated with earlier agents[2].
文摘[Objective] The aim of the study is to seek a good anesthetic to Fenneropenaeus chinensis. [Method] The anesthetic effect of eugenol to juvenile Fenneropenaeus chinensis was investigated. [Result] The juveniles could be effectively anaesthetized by 50-400 mg/L eugenol aqueous solution with temperature of 24 ℃. Within the concentration range of 50-400 mg/L, the increase of the eugenol concentration could shorten the time required for anesthesia, meanwhile could prolong the time for recovery. The recovered rate of prawn reached 100% when the eugenol concentration was lower than 200 mg/L, while the recovered rate of prawn was just 66.67% when the eugenol concentration was higher than 400 mg/L. The survival rate of prawns in test group was 100% from the observation of three consecutive days. For the specific dose, the anesthetic effect enhanced with the increase of water temperature (18-27℃). [Conclusion] Eugenol is a safe and efficient anesthetics that can be applied in genetic breeding of prawn.
文摘Purpose:to explore the effect of dexmedetomidine hydrochloride on early cognitive function in postoperative elderly patients.Methods:during December 2015 to November 2016,80 elderly patients who received surgical treatment in our hospital were selected as research object.Result:patients were randomly divided into two groups(control group and research group).On the basis of routine anesthetic induction,patients in research group took dexmedetomidine,in comparison,patients in control group took an equal dose of sodium chloride solution.The goal was to evaluate the anesthetic effect of those two methods.One hour before surgery,there was no significant difference in the MMSE score between the two groups(P>0.05).In research group,the MMSE scores at postoperative 1d and 3d were(23.8±2.4)and(27.1±2.0)respectively.In control group,the MMSE scores at postoperative 1d and 3d were(20.5±3.2)and(24.6±3.4)respectively.The difference was statistically significant(P<0.05).There was no significant difference in anesthesia time,awake time and extubation time between those two groups(P>0.05).Conclusion:using dexmedetomidine in elderly patients after surgery can protect early cognitive function and improve the prognosis.
基金supported by the National Basic Research Development Program of China(No. 2006CB500801,2010CB529806)the National Natural Science Foundation of China(No.30900422)+2 种基金the Natural Science Foundation of Shanghai Municipality,China(No.08JC1409500)State Key Laboratory of Medical Neurobiology,Fudan University(No.09-02)National Laboratory of Biomacro-molecules,Institute of Biophysics,Chinese Academy of Sciences(No.O5SY021097)
文摘Objective The present study was aimed to investigate the pharmacological modulatory effects of ropivacaine,an amide-type local anesthetic,on rat Nav1.2（rNav1.2）and rNav1.5,the two Na＋channel isoforms heterologously expressed in Xenopus oocytes and in HEK293t cell line,respectively.Methods Two-electrode voltage-clamp（TEVC）and whole-cell patchclamp recordings were employed to record the whole-cell currents.Results Ropivacaine induced tonic inhibition of peak Na＋ currents of both subtypes in a dose-and frequency-dependent manner.rNav1.5 appeared to be more sensitive to ropivacaine.In addition,for both Na＋channel subtypes,the steady-state inactivation curves,but not the activation curves,were significantly shifted to the hyperpolarizing direction by ropivacaine.Use-dependent blockade of both rNav1.2 and rNav1.5 channels was induced by ropivacaine through a high frequency of depolarization,suggesting that ropivacaine could preferentially bind to the 2 inactivated Na＋channel isoforms.Conclusion The results will be helpful in understanding the pharmacological modulation by ropivacaine on Nav1.2 subtype in the central nervous system,and on Nav1.5 subtype abundantly expressed in the heart.
文摘Background： Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined. This double-blind, randomized, dose-response study determined the ED50 （50% effective dose） and ED95 （95% effective dose） of spinal hyperbaric ropivacaine for cesarean section anesthesia. Methods： Sixty parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. An epidural catheter was placed at the L1-L2 vertebral interspace then lumbar puncture was performed at the L3-L4 vertebral interspace, and parturients were randomized to receive spinal hyperbaric ropivacaine in doses of 10.5 mg, 12 mg, 13.5 mg, or 15 mg in equal volumes of 3 ml. Sensory levels （pinprick） were assessed every 2.5 min until a T7 level was achieved and motor changes were assessed by modified Bromage Score. A dose was considered effective if an upper sensory level to pin prick of T7 or above was achieved and no intraoperative epidural supplement was required. ED50 and ED95 were determined with use of a logistic regression model. Results： ED50 （95% confidence interval） of spinal hyperbaric ropivacaine was determined to be 10.37 （5.23-11.59） mg and ED95 （95% confidence interval） to be 15.39 （13.81-23.59） mg. The maximum sensory block levels and the duration of motor block and the rate of hypotension, but not onset of anesthesia, were significantly related to the ropivacaine dose. Conclusion： The ED50 and ED95 of spinal hyperbaric ropivacaine for cesarean delivery under the conditions of this study were 10.37 mg and 15.39 mg, respectively. Ropivacaine is suitable for spinal anesthesia in cesarean delivery.
文摘AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODS: After obtaining approval of the research ethics committee and informed consent, 200 patients were evaluated and referred for upper gastrointestinal endoscopy. Patients were randomized to receive propofol-fentanyl or midazolam-fentanyl (n = 100/group).We assessed the level of sedation using the observer's assessment of alertness/sedation (OAA/S) score and bispectral index (BIS). We evaluated patient and physician satisfaction, as well as the recovery time and complication rates. The statistical analysis was performed using SPSS statistical software and included the MannWhitney test, χ 2 test, measurement of analysis of variance, and the κ statistic. RESULTS: The times to induction of sedation, recovery, and discharge were shorter in the propofolfentanyl group than the midazolam-fentanyl group. According to the OAA/S score, deep sedation events occurred in 25% of the propofol-fentanyl group and 11% of the midazolam-fentanyl group (P = 0.014). Additionally, deep sedation events occurred in 19% of the propofol-fentanyl group and 7% of the midazolamfentanyl group according to the BIS scale (P = 0.039). There was good concordance between the OAA/S score and BIS for both groups (κ = 0.71 and κ = 0.63, respectively). Oxygen supplementation was required in 42% of the propofol-fentanyl group and 26% of the midazolam-fentanyl group (P = 0.025). The mean time to recovery was 28.82 and 44.13 min in the propofolfentanyl and midazolam-fentanyl groups, respectively (P < 0.001). There were no severe complications in either group. Although patients were equally satisfied with both drug combinations, physicians were more satisfied with the propofol-fentanyl combination. CONCLUSION: Deep sedation occurred with propofolfentanyl and midazolam-fentanyl, but was more frequent in the former. Recovery was faster in the propofol-fentanyl group.
基金Project supported by the National Natural Science Foundation of China (No. 30772090)the Natural Science Foundation of Zhejiang Province (No. Y204141)+1 种基金the Foundation from Science and Tech-nology Department of Zhejiang Province (No. 2007R10034)the Foundation from the Health Bureau of Zhejiang Province (No. 2007QN007), China
文摘Ischemic preconditioning and postconditioning distinctly attenuate ventricular arrhythmia after ischemia without affecting the severity of myocardial stunning. Therefore, we report the effects of sevofiurane preconditioning and postconditioning on stunned myocardium in isolated rat hearts. Isolated rat hearts were underwent 20 min of global ischemia and 40 min of reperfusion. After an equilibration period （20 min）, the hearts in the preconditioning group were exposed to sevoflurane for 5 min and next washout for 5 min before ischemia. Hearts in the sevoflurane postconditioning group underwent equilibration and ischemia, followed immediately by sevoflurane exposure for the first 5 min of reperfusion. The control group received no treatment before and after ischemia. Left ventricular pressure, heart rate, coronary flow, electrocardiogram, and tissue histology were measured as variables of ventricular function and cellular injury, respectively. There was no significant difference in the duration of reperfusion ventricular arrhythmias between control and sevoflurane preconditioning group （P=0.195）. The duration of reperfusion ventricular arrhythmias in the sevoflurane postconditioning group was significantly shorter than that in the other two groups （P〈0.05）. ＋（dPIdt）max in the sevoflurane preconditioning group at 5, 10, 15, 20, and 30 min after reperfusion was significantly higher than that in the control group （P〈0.05）, and there were no significant differences at 40 min after reperfusion among the three groups （P〉0.05）. As expected, for a 20-min general ischemia, infarct size in heart slices determined by 2,3,5-triphenyltetrazolium chloride staining among the groups was not obvious. Sevofiurane postconditioning reduces reperfusion arrhythmias without affecting the severity of myocardial stunning. In contrast, sevoflurane preconditioning has no beneficial effects on reperfusion arrhythmias, but it is in favor of improving ventricular function and recovering myocardial stunning. Sevoflurane preconditioning and postconditioning may be useful for correcting the stunned myocardium.
文摘Although beneficial in acute and chronic pain management, the use of local anaesthetics is limited by itsduration of action and the dose dependent adverse effects on the cardiac and central nervous system. Adjuvants or additives are often used with local anaesthetics for its synergistic effect by prolonging the duration of sensory-motor block and limiting the cumulative dose requirement of local anaesthetics. The armamentarium of local anesthetic adjuvants have evolved over time from classical opioids to a wide array of drugs spanning several groups and varying mechanisms of action. A large array of opioids ranging from morphine, fentanyl and sufentanyl to hydromorphone, buprenorphine and tramadol has been used with varying success. However, their use has been limited by their adverse effect like respiratory depression, nausea, vomiting and pruritus, especially with its neuraxial use. Epinephrine potentiates the local anesthetics by its antinociceptive properties mediated by alpha-2 adrenoreceptor activation along with its vasoconstrictive properties limiting the systemic absorption of local anesthetics. Alpha 2 adrenoreceptor antagonists like clonidine and dexmedetomidine are one of the most widely used class of local anesthetic adjuvants. Other drugs like steroids(dexamethasone), anti-inflammatory agents(parecoxib and lornoxicam), midazolam, ketamine, magnesium sulfate and neostigmine have also been used with mixed success. The concern regarding the safety profile of these adjuvants is due to its potential neurotoxicity and neurological complications which necessitate further research in this direction. Current research is directed towards a search for agents and techniques which would prolong local anaesthetic action without its deleterious effects. This includes novel approaches like use of charged molecules to produce local anaesthetic action(tonicaine and n butyl tetracaine), new age delivery mechanisms for prolonged bioavailability(liposomal, microspheres and cyclodextrin systems) and further studies with other drugs(adenosine, neuromuscular blockers, dextrans).
文摘AIM : To systematically evaluate the effect of intraperitoneal local anesthetic on pain characteristics after laparoscopic cholecystectomy(LC).METHODS: We searched MEDLINE, EMBASE, and the Cochrane Library. Randomized controlled trials in English that compared the effect of intraperitoneal administration of local anesthetics on pain with that of placebo or nothing after elective LC under general anesthesia were included. The primary outcome variables analyzed were the combined scores of abdominal, visceral, parietal, and shoulder pain after LC at multiple time points. We also extracted pain scores at resting and dynamic states.RESULTS: We included 39 studies of 3045 patients in total. The administration of intraperitoneal local anesthetic reduced pain intensity in a resting state after laparoscopic cholecystectomy: abdominal [standardized mean difference(SMD) =-0.741; 95%CI:-1.001 to-0.48, P < 0.001]; visceral(SMD =-0.249; 95%CI:-0.493 to-0.006, P = 0.774); and shoulder(SMD =-0.273; 95%CI:-0.464 to-0.082, P = 0.097). Application of intraperitoneal local anesthetic significantly reduced the incidence of shoulder pain(RR = 0.437; 95%CI: 0.299 to 0.639, P < 0.001). There was no favorable effect on resting parietal or dynamic abdominal pain.CONCLUSION: Intraperitoneal local anesthetic as an analgesic adjuvant in patients undergoing laparoscopic cholecystectomy exhibited beneficial effects on postoperative abdominal, visceral, and shoulder pain in a resting state.
基金Supported by the National Natural Science Foundation of China,No.81571367Technological Project of Shandong Province,No.2017GSF218021
文摘BACKGROUND Compared with traditional open surgery,laparoscopic surgery is preferred due to the advantages of less trauma,less pain,and faster recovery.Nevertheless,many patients still suffer from postoperative pain resulting from the surgical incision and associated tissue injury.Many researchers have reported methods to improve postoperative pain control,but there is not a simple and effective method that can be clinically adopted in a widespread manner.We designed this study to prove the hypothesis that application of ropivacaine in the port site and operative site in patients is an effective and convenient method which can decrease postoperative pain and accelerate recovery.AIM To evaluate the effects of ropivacaine on pain control after laparoscopic hepatectomy and its contribution to patient recovery.METHODS From May 2017 to November 2018,146 patients undergoing laparoscopic hepatectomy were randomized to receive infiltration of either 7.5 mg/mL ropivacaine around the trocar insertions,incision,and cutting surface of the liver(with a gelatin sponge soaked with ropivacaine)at the end of surgery(ropivacaine group),or normal saline(5 mL)at the same sites at the end of surgery(control group).The degree of pain,nausea,vomiting,heart rate(HR),and blood pressure were collected.The length of postoperative hospitalization,complications,and the levels of stress hormones were also compared between the two groups.RESULTS Compared with the control group,the ropivacaine group showed reduced postoperative pain at rest within 12 h(P<0.05),and pain on movement was reduced within 48 h.The levels of epinephrine,norepinephrine,and cortisol at 24 and 48 h,HR,blood pressure,and cumulative sufentanil consumption in the ropivacaine group were significantly lower than those in the control group(P<0.05).In the ropivacaine group,hospitalization after operation was shorter,but the difference was not statistically significant.There were no significant differences in postoperative nausea,vomiting,or other complications,including hydrothorax,ascites,peritonitis,flatulence,and venous thrombus(P>0.05),although fewer patients in the ropivacaine group experienced these situations.CONCLUSION Infiltration with ropivacaine in the abdominal wound and covering the cutting surface of the liver with a gelatin sponge soaked with ropivacaine significantly reduce postoperative pain and the consumption of sufentanil.
文摘AIM:To study the anesthetic management of patients undergoing small bowel enteroscopy in the World Gastroenterology Organization(WGO) Endoscopy Training Center in Thailand.METHODS:Patients who underwent small bowel enteroscopy during the period of March 2005 to March 2011 in Siriraj Gastrointestinal Endoscopy Center were retrospectively analyzed.The patients' characteristics,pre-anesthetic problems,anesthetic techniques,anesthetic agents,anesthetic time,type and route of procedure and anesthesia-related complications were assessed.RESULTS:One hundred and forty-four patients underwent this procedure during the study period.The mean age of the patients was 57.6 ± 17.2 years,andmost were American Society of Anesthesiologists(ASA) class Ⅱ(53.2%).Indications for this procedure were gastrointestinal bleeding(59.7%),chronic diarrhea(14.3%),protein losing enteropathy(2.6%) and others(23.4%).Hematologic disease,hypertension,heart disease and electrolyte imbalance were the most common pre-anesthetic problems.General anesthesia with endotracheal tube was the anesthetic technique mainly employed(50.6%).The main anesthetic agents administered were fentanyl,propofol and midazolam.The mean anesthetic time was 94.0 ± 50.5 min.Single balloon and oral(antegrade) intubation was the most common type and route of enteroscopy.The anesthesia-related complication rate was relatively high.The overall and cardiovascular-related complication rates including hypotension in the older patient group(aged ≥ 60 years old) were significantly higher than those in the younger group.CONCLUSION:During anesthetic management for small bowel enteroscopy,special techniques and drugs are not routinely required.However,for safety reasons anesthetic personnel need to optimize the patient's condition.
文摘Objective： We compare the cardioprotective effects of anesthetic preconditioning by propofol and/or isoflurane in rats with ischemia-reperfusion injury. Methods： Male adult Wistar rats were subjected to 60 min of anterior descending coronary artery occlusion followed by 120 rain of reperfusion. Before the long ischemia, anesthetics were administered twice for 10 min followed by 5 min washout. Isoflurane was inhaled at 1 MAC （0.016） in I group, whereas propofol was inhaled intravenously at 37.5 mg/（kg.h） in P group. A combination ofisoflurane and propofol was administered simultaneously in I＋P group. Results： In control （without anesthetic preconditioning, C group）, remarkable myocardial infarction and apoptosis accompanied by an increased level of cardiac troponin T were noted 120 min aider ischemia-reperfusion. As compared to those of control group, I and P groups had comparable cardioprotection. In addition, I＋P group shares with I and P groups the comparable cardioprotective effects in terms of myocardial infarction and cardiac troponin T elevation. Conclusion： A combination of isoflurane and propofol produced no additional cardioprotection.
