Background:Ketamine is a widely used anesthetic in animal research,but its use is strictly regulated in several countries,including Japan and China.As an alternative,the medetomidine-midazolam-butorphanol(MMB)combinat...Background:Ketamine is a widely used anesthetic in animal research,but its use is strictly regulated in several countries,including Japan and China.As an alternative,the medetomidine-midazolam-butorphanol(MMB)combination is commonly used in Japan.However,medetomidine is a racemic mixture containing the inactive Renantiomer,which may reduce anesthetic predictability and safety.Objective:The aim of the study was to evaluate the efficacy and safety of a modified anesthetic combination(d MMB),in which dexmedetomidine replaces medetomidine,across three commonly used mouse strains(ICR,C57BL/6,BALB/c).Methods:Male and female mice were administered either MMB or d MMB subcutaneously.Anesthetic depth,recovery profiles,heart rate,SpO_(2),body temperature,ocular opacity,and blood glucose levels were assessed.Atipamezole was used to reverse anesthesia,and thermoregulatory recovery was monitored postinjection.Results:d MMB produced similar anesthetic depth to MMB,with faster and more consistent recovery,particularly in males.Body temperature recovery was significantly enhanced in d MMB-treated B6 males.No significant differences in side effects(ocular opacity or blood glucose levels)were observed between protocols,though strainspecific glucose elevations were noted in d MMB-treated males.Conclusion:d MMB is a safe,effective,and ketamine-free injectable anesthetic protocol,offering advantages in recovery and thermoregulation.It may be a valuable alternative in research settings where ketamine is restricted and medetomidine may become unavailable.展开更多
Objective:To analyze the effects of combined spinal-epidural anesthesia and epidural anesthesia in patients undergoing appendicitis surgery.Methods:Seventy-eight patients who underwent surgical treatment for appendici...Objective:To analyze the effects of combined spinal-epidural anesthesia and epidural anesthesia in patients undergoing appendicitis surgery.Methods:Seventy-eight patients who underwent surgical treatment for appendicitis from February 2022 to February 2025 were selected as samples and randomly divided into two groups.The study group received combined spinal-epidural anesthesia,while the control group received epidural anesthesia.Anesthesia indicators,vital signs,and complication indicators were compared between the two groups.Results:The onset time of anesthesia in the study group was shorter than that in the control group,the visual analog scale(VAS)score was lower than that in the control group,and the highest plane of anesthesia block was lower than that in the control group(P<0.05).At 15 minutes after anesthesia induction and at the end of surgery,the heart rate(HR),mean arterial pressure(MAP),and blood oxygen saturation(SPO2)in the study group were significantly different from those in the control group(P<0.05).The complication rate in the study group was lower than that in the control group(P<0.05).Conclusion:Combined spinal-epidural anesthesia for appendicitis surgery can reduce the impact of anesthesia on vital signs,shorten the onset time of anesthesia,and is highly effective and feasible.展开更多
BACKGROUND In the field of anesthesia for procedure for prolapse and hemorrhoids(PPH)surgery,combined spinal-epidural(CSE)anesthesia has been a common approach.However,exploring new combinations to optimize patient ou...BACKGROUND In the field of anesthesia for procedure for prolapse and hemorrhoids(PPH)surgery,combined spinal-epidural(CSE)anesthesia has been a common approach.However,exploring new combinations to optimize patient outcomes remains crucial.Remimazolam,a short-acting benzodiazepine,shows potential for improving sedation and reducing patient anxiety.The effects of combining remimazolam with CSE anesthesia,compared to traditional CSE anesthesia alone,on patient anxiety,sedation depth,and hemodynamics during PPH surgery have not been fully elucidated.AIM To compare remimazolam-CSE vs CSE alone on State-Trait Anxiety Inventory-State scale(STAI-S)scores,sedation,and hemodynamics in PPH surgery.METHODS This study is a single-center,prospective,randomized controlled trial.Between November 23,2022,and August 6,2024,60 eligible patients were randomly assigned to the CSE anesthesia group or the remimazolam-combined CSE anesthesia group(30 patients each).STAI-S scores,Ramsay sedation scores,and hemodynamic parameters(systolic blood pressure,diastolic blood pressure,heart rate)were measured at multiple time points.Two-way mixed-effects ANOVA and posthoc analyses were performed.RESULTS The Combined group demonstrated significantly lower STAI-S scores before leaving the operating room[mean:28.80 vs 54.03,mean difference(95%CI):25.23(21.24-29.23),P<0.001]and 24 hours post-operation[mean:45.07 vs 54.53,mean difference(95%CI):9.47(6.29-12.64),P<0.001]than the CSE group.Moreover,the Combined group achieved a deeper sedation level during intraoperative maintenance[median:5.00(IQR:5.00-5.00)vs 2.00(IQR:2.00-2.00);median difference(95%CI):3.00(3.00-3.00),P<0.001].Regarding hemodynamics,a significant intergroup difference in systolic blood pressure was observed at the start of the surgery[mean:128.8 vs 114.7 for the Combined and CSE groups,mean difference(95%CI):14.17(0.77-27.57),adjusted P=0.033].CONCLUSION Remimazolam-combined anesthesia outperformed CSE anesthesia in reducing STAI-S scores,enhancing intraoperative sedation,and stabilizing systolic blood pressure at a critical stage,indicating its superiority in perioperative management.展开更多
BACKGROUND Current standard nursing practices demonstrate limited effectiveness in perioperative colorectal cancer(CRC)management,highlighting the need to explore alternative care strategies that improve clinical outc...BACKGROUND Current standard nursing practices demonstrate limited effectiveness in perioperative colorectal cancer(CRC)management,highlighting the need to explore alternative care strategies that improve clinical outcomes.AIM To investigate the impact of music therapy and anesthesia recovery care on anesthesia recovery in patients with CRC undergoing laparoscopic radical resection.METHODS One hundred and twenty patients scheduled for elective laparoscopic CRC radical resection at Affiliated Hospital of Jiangnan University from January 2022 to May 2024 were enrolled.The patients were assigned to control(n=60,receiving standard nursing care)and observation groups(n=60,receiving music therapy,anesthesia recovery care,and standard nursing care).We comparatively analyzed the time to regain consciousness,extubation time,and length of stay in the postanesthesia care unit;heart rate,systolic blood pressure,and diastolic blood pressure before anesthesia and during recovery;cortisol,aldosterone,norepinephrine,and adrenaline levels before anesthesia and 24 hours postoperatively;Postoperative Quality of Recovery Scale scores;and complication rates between the groups.RESULTS The observation group exhibited a significantly shorter time to regain consciousness,extubation time,and postanesthesia care unit stay than the control group(P<0.05).During the recovery period,heart rate,systolic blood pressure,and diastolic blood pressure significantly increased in both groups compared with preanesthesia levels,with the levels in the observation group being significantly lower than those in the control group(P<0.05).At 24 hours postoperatively,cortisol,aldosterone,norepinephrine,and adrenaline levels were elevated in both groups compared with preanesthesia levels,with levels in the observation group being significantly lower than those in the control group(P<0.05).The observation group achieved significantly higher Postoperative Quality of Recovery Scale scores than the control group(P<0.05).Moreover,the complication rate in the observation group was significantly lower than that in the control group(10.00%vs 40.00%,P<0.05).CONCLUSION Music therapy combined with anesthesia recovery care remarkably boosted the quality of anesthesia recovery in patients undergoing laparoscopic CRC radical resection,mitigated fluctuations in vital signs and stress responses,improved postoperative recovery quality,and reduced complication rates,demonstrating substantial clinical value.展开更多
BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for ...BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.AIM To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.METHODS In this retrospective study,94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia,admitted to Yiwu Central Hospital between May 2022 and May 2023,were divided into a control group(inhalation combined general anesthesia)and a treatment group(dexmedetomidine-assisted intrave-nous-inhalation combined general anesthesia).Perioperative indicators,analgesic effect,preoperative and postoperative 24-hours blood pressure(BP)and heart rate(HR),stress indicators,immune function levels,and adverse reactions were com-pared between the two groups.RESULTS Baseline data,including age,hernia location,place of residence,weight,monthly income,education level,and underlying diseases,were not significantly different between the two groups,indicating comparability(P>0.05).No significant difference was found in operation time and anesthesia time between the two groups(P>0.05).However,the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group(P<0.05).Preoperatively,no significant differences were found in the visual analog scale(VAS)scores between the two groups(P>0.05).However,at 12,18,and 24 hours postoper-atively,the treatment group had significantly lower VAS scores than the control group(P<0.05).Although no significant differences in preoperative hemodynamic indicators were found between the two groups(P>0.05),both groups experienced some extent of changes in postoperative HR,diastolic BP(DBP),and systolic BP(SBP).Nevertheless,the treatment group showed smaller changes in HR,DBP,and SBP than the control group(P<0.05).Preoperative immune function indicators showed no significant differences between the two groups(P>0.05).However,postoperatively,the treatment group demonstrated higher levels of CD3+,CD4+,and CD4+/CD8+and lower levels of CD8+than the control group(P<0.05).The rates of adverse reactions were 6.38%and 23.40%in the treatment and control groups,respectively,revealing a significant difference(χ2=5.371,P=0.020).CONCLUSION Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal hernia.It ensures stable blood flow,improves postoperative analgesic effects,reduces postoperative pain intensity,alleviates stress response,improves immune function,facilitates anesthesia recovery,and enhances safety.展开更多
BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the effic...BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the efficacy and safety of intrathecal hyper-baric bupivacaine vs hyperbaric ropivacaine for cesarean sections.AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials(RCTs)comparing intrathecal hyperbaric ropi-vacaine and hyperbaric bupivacaine during CSs.PubMed,Cochrane database,Google Scholar,and Scopus were searched,and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria.Studies were assessed for methodological quality,and data were extracted for time to adequate anesthesia(sensory and motor blockade),duration of sensory and motor block,hemodynamic changes and side effect profile.The standardized mean difference with 95%CI was used for continuous data.Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis.The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies.The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics.The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant(P=0.1586).However,the onset of motor blockade appeared to be faster with bupivacaine(P=0.03589).Additionally,the regression of sensory and motor blockade occurred earlier in the ropivacaine group.Furthermore,the duration of the first analgesic effect was shorter with a significance level of P<0.05.Regarding side effects profile,including hypotension,nausea,and shivering,the study did not observe any significant differences between the two groups.CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections.Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine,perhaps aiding early mobilization of parturient and facilitating mother-child bonding.Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.展开更多
Objective: This study evaluates the impact of handshake and information support on patients’ outcomes during laparoscopic cholecystectomy. It examines the effects on their physiological and psychological responses an...Objective: This study evaluates the impact of handshake and information support on patients’ outcomes during laparoscopic cholecystectomy. It examines the effects on their physiological and psychological responses and overall satisfaction with nursing care. Methods: A total of 84 patients scheduled for laparoscopic cholecystectomy were selected through convenient sampling and randomly assigned to either the control group or the intervention group using a random number table. Each group consisted of 42 patients. The control group received standard surgical nursing care. In addition to standard care, the intervention group received handshake and information support from the circulating nurse before anesthesia induction. Vital signs were recorded before surgery and before anesthesia induction. Anxiety levels were measured using the State-Trait Anxiety Inventory (STAI) and the State-Anxiety Inventory (S-AI), while nursing satisfaction was assessed using a numerical rating scale. Results: No significant differences were found between the two groups in systolic and diastolic blood pressures before surgery and anesthesia induction (P > 0.05). However, there was a significant difference in heart rate before anesthesia induction (P Conclusion: Providing handshake and information support before anesthesia induction effectively reduces stress, alleviates anxiety, and enhances comfort and satisfaction among patients undergoing laparoscopic cholecystectomy.展开更多
Objective: Anesthesia for laparoscopic surgery is particular because of the cardiopulmonary repercussions of pneumoperitoneum. This study reports the experience in secondary level hospital located in suburban environm...Objective: Anesthesia for laparoscopic surgery is particular because of the cardiopulmonary repercussions of pneumoperitoneum. This study reports the experience in secondary level hospital located in suburban environment. Methods: This is a cross-sectional study carried out at Monkole hospital from May 2016 to May 2023. It concerns patients anesthetized for laparoscopic surgery. Perianesthetic data were collected and analyzed with SPSS 26.0 for p Results: Eighty-four patients (4.2%) were selected out of 2000 eligible patients. The median age was 31 years, the range between 15 and 30 years (40.5%), female gender and approved patients (70.3%) predominated. Comorbidities were: sickle cell disease, high blood pressure, thinness and obesity. The ASA class was: I (35.2%), II (36.3%) and III (28.6%). Anesthesia was general with intubation for all patients. Generally, the surgery lasted less than two hours and the anesthesia lasted more than two hours. Postoperative analgesia used morphine in 27.5%. The operative indications were dominated by lithiasis with or without cholecystitis (48.4%) and appendicitis (16.5%). Intraoperative complications (18.7%) were: hypotension, allergy, spasm, accidental gallbladder and bile duct perforation. Postoperative complications (9.9%) were: anemia, digestive fistula, septic shock, multi-organ failure, acute lung edema and two deaths. Alcohol consumption was associated with intraoperative complications. Anesthesia duration greater than two hours, ASA3 class, alcohol consumption and cholecystectomy were associated with postoperative complications. Conclusion: Celiosurgery is not yet established in Monkole probably due to the lack of permanent surgeons and the higher cost than open surgery.展开更多
BACKGROUND Administering anesthesia to elderly patients undergoing gastroenteroscopy necessitates careful attention due to age-related physiological changes and an increased risk of complications.AIM To analyze the re...BACKGROUND Administering anesthesia to elderly patients undergoing gastroenteroscopy necessitates careful attention due to age-related physiological changes and an increased risk of complications.AIM To analyze the research trends in anesthesia management for elderly patients undergoing gastroenteroscopy.METHODS We performed a literature search using the Web of Science database to identify articles published between 2004 and 2023.Bibliometric and visual analyses were conducted using CiteSpace,R,and VOSviewer to explore the current research landscape of anesthesia administration in painless gastroenteroscopy for elderly patients and to identify future research directions by examining trends and emerging hotspots in this domain.RESULTS A total of 800 articles were examined,revealing a rising trend in annual pub-lication counts.The United States led with 181 articles,followed by China with 112,collectively contributing over 35%of the studies among the top ten countries.The majority of publications appeared in the United States journals,with the top three being Gastrointestinal Endoscopy[impact factor(IF)=7.7,H-index=26],Digestive Diseases and Sciences(IF=3.1),and Endoscopy(IF=9.3).Six primary research clusters were identified:Obstructive sleep apnea and airway manage-ment,surveillance and risk factors,colorectal cancer examination and treatment,sedation and safety of propofol and midazolam,patient satisfaction,and mortality and complications.These findings underscore the pivotal focus areas in anesthesia for elderly patients undergoing gastroenteroscopy.CONCLUSION A comprehensive understanding of current research trends and hotspots will aid anesthesiologists in developing more evidence-based practices,thereby improving the safety and outcomes for elderly patients undergoing gastroenteroscopy.展开更多
General anesthesia,pivotal for surgical procedures,requires precise depth monitoring to mitigate risks ranging from intraoperative awareness to postoperative cognitive impairments.Traditional assessment methods,relyin...General anesthesia,pivotal for surgical procedures,requires precise depth monitoring to mitigate risks ranging from intraoperative awareness to postoperative cognitive impairments.Traditional assessment methods,relying on physiological indicators or behavioral responses,fall short of accurately capturing the nuanced states of unconsciousness.This study introduces a machine learning-based approach to decode anesthesia depth,leveraging EEG data across different anesthesia states induced by propofol and esketamine in rats.Our findings demonstrate the model’s robust predictive accuracy,underscored by a novel intrasubject dataset partitioning and a 5-fold cross-validation method.The research diverges from conventional monitoring by utilizing anesthetic infusion rates as objective indicators of anesthesia states,highlighting distinct EEG patterns and enhancing prediction accuracy.Moreover,the model’s ability to generalize across individuals suggests its potential for broad clinical application,distinguishing between anesthetic agents and their depths.Despite relying on rat EEG data,which poses questions about real-world applicability,our approach marks a significant advance in anesthesia monitoring.展开更多
BACKGROUND Gastric cancer is a major global health issue,and the perioperative period critic-ally influences patient outcomes.The different effects of sevoflurane inhalation anesthesia and propofol total intravenous a...BACKGROUND Gastric cancer is a major global health issue,and the perioperative period critic-ally influences patient outcomes.The different effects of sevoflurane inhalation anesthesia and propofol total intravenous anesthesia on intraoperative stability,postoperative complications,and long-term oncologic outcomes in patients with gastric cancer undergoing radical gastrectomy remain unclear.AIM To compare the effects of sevoflurane inhalation anesthesia and propofol total in-travenous anesthesia on clinical outcomes,including intraoperative indicators,postoperative complications,adverse effects,pain scores,and survival.METHODS This single-center retrospective cohort study included 204 patients who underw-ent radical gastrectomy for gastric cancer from February 2019 to December 2022.Patients were assigned to either the sevoflurane group(n=103)or the propofol group(n=101)based on intraoperative anesthetic regimen.Standardized protoc-ols for anesthesia management,intraoperative monitoring,and postoperative analgesia were applied.Baseline characteristics;intraoperative metrics;adverse events;complications;Visual Analog Scale(VAS)scores at 2,4,6,24,and 48 hours;and survival outcomes were retrospectively collected.Group comparisons were performed usingχ2 for categorical variables,t test for continuous variables,RESULTS Baseline demographic and clinical characteristics were similar between groups.No significant differences were observed in intraoperative indicators or most 30-day postoperative outcomes,including length of stay,emergency department visits,and readmission rates.The propofol group showed elevated mean VAS pain score at 24 hours postoperatively,but no differences were found at other time points.The propofol group also had significantly higher postoperative nausea incidence and transiently higher systolic/diastolic blood pressure and heart rate at the time of incision than the sevoflurane group.No significant differences were seen in overall rates or severity of postoperative complications,intraoperative adverse events,or in overall survival and progression-free survival.CONCLUSION In patients undergoing radical gastrectomy for gastric cancer,sevoflurane and propofol anesthesia demonstrated similar profiles regarding intraoperative safety,postoperative complications,adverse events,postoperative pain,and long-term survival.The selection of anesthesia can be personalized without significantly affecting periop-erative or oncologic outcomes.展开更多
General anesthesia(GA)is a pharmacologically induced,reversible state characterized by unconsciousness,amnesia,analgesia,and immobility in response to noxious stimuli.Accumulating evidence from animal models has eluci...General anesthesia(GA)is a pharmacologically induced,reversible state characterized by unconsciousness,amnesia,analgesia,and immobility in response to noxious stimuli.Accumulating evidence from animal models has elucidated diverse mechanisms of the action underlying GA,including disruption of large-scale brain network connectivity,regulation of multiple neural pathways,and modulation of specific receptors and ion channels.Despite advances in dissecting the neurobiological basis of anesthetic action,the precise cellular and circuit-level processes remain incompletely understood,limiting the development of safer and more effective strategies.Recent studies in Drosophila melanogaster,a genetically tractable model organism offering robust genetic analysis,advanced imaging capabilities,and compact neural architecture,have yielded critical insights into the conserved neurobiological mechanisms of GA,offering translational value for mammalian systems.This review outlines:1)experimental paradigms used to evaluate anesthetic sensitivity and behavioral responses in Drosophila;2)molecular targets and their mechanistic roles in mediating GA;and 3)neural circuit architectures and activity patterns shared by GA and sleep.Cross-species comparisons are integrated to highlight conserved mechanisms that may guide the development of more refined anesthetic strategies.展开更多
Background:During the establishment of a model of acute kidney injury(AKI)in pigs,we observed a high prevalence of malignant hyperthermia(MH).These complications led us to refine the anesthetic protocol.This publicati...Background:During the establishment of a model of acute kidney injury(AKI)in pigs,we observed a high prevalence of malignant hyperthermia(MH).These complications led us to refine the anesthetic protocol.This publication describes the impact of the choice of anesthetics on the results obtained.Methods:Pigs were euthanized at the end of the procedure,without recovery from anesthesia.Three anesthetic protocols were used:sevoflurane inhalation(ProtocolA,n=5),a combination of ketamine,medetomidine and diazepam by intravenous infusion(ProtocolB,n=5),and a combination of ketamine,diazepam,medetomidine,glucose,and noradrenaline(ProtocolC,n=5).All pigs received morphine for analgesia.AKI was induced by interrupting renal perfusion for 90 min.MH was diagnosed based on clinical and biological parameters.Results:All MH pigs belonged to ProtocolA.MH pigs showed significantly higher maximum rectal temperature(p=0.04),maximum expired carbon dioxide(CO_(2);p=0.04),maximum heart rate(HR;p=0.03),plasma concentration of creatinine and potassium(p<0.0001).Protocol A pigs had a significantly higher maximum HR(p=0.01)and hyperkalemia compared to the two other groups(ProtocolB,p=0.005 and ProtocolC,p<0.0001).Pigs from ProtocolA had a significantly lower minimum mean arterial pressure(MAP)than ProtocolC group(p=0.03)and MAP remained below 60 mmHg for longer(p=0.004).In ProtocolB,minimum glycemia was lower than other groups(p=0.01).Conclusion:Sevoflurane use was associated with the occurrence of MH,hemodynamic alterations and changes in plasma concentration of creatinine and potassium.These modifications can have a major impact on the validation of an experimental AKI model.展开更多
Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfa...Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfaction Questionnaire scores,work pressure,and turnover intentions.Multiple linear regression analysis was used to examine factors influencing job satisfaction.The electronic survey was distributed to Chinese anesthesia graduates from December 2021 to January 2022.Results:A total of 595 questionnaires were distributed,with 318 valid responses,resulting in a response rate of 53.4%.The participants’overall job satisfaction score on the Minnesota Satisfaction Questionnaire was 75.85±12.57.Multiple linear regression analysis identified the following variables as significantly associated with job satisfaction:age,daily working hours,income,current position,and work pressure.Conclusions:Anesthesia graduates in China reported slightly higher-than-average overall job satisfaction.However,several issues remain.Attention should be given to the impact of factors such as youth,long working hours,low income,current position,and high work pressure on job satisfaction.The government should support anesthesiologists with improved training,job security,and benefits to enhance job satisfaction.展开更多
BACKGROUND Older patients often experience thirst after general anesthesia for gastrointestinal surgery,particularly during the post-anesthesia care unit(PACU)phase.Thirst not only compromises patient comfort but also...BACKGROUND Older patients often experience thirst after general anesthesia for gastrointestinal surgery,particularly during the post-anesthesia care unit(PACU)phase.Thirst not only compromises patient comfort but also induces anxiety,which may hinder recovery.Although previous studies have addressed postoperative thirst,research specifically examining thirst experiences and nursing needs in older patients remains limited.AIM To explore thirst experiences and nursing needs of older PACU patients following gastrointestinal surgery,aiming to inform targeted interventions.METHODS This study employed a phenomenological approach within a qualitative research framework.A purposeful sampling method was used to select 12 older patients who underwent gastrointestinal surgery under general anesthesia at a tertiary hospital in Shanghai between November and December 2024.Data were collected through semi-structured interviews and analyzed using Colaizzi’s seven-step method.Themes were extracted from the interview data.RESULTS Analysis of the interview data identified four main themes and eight subthemes:(1)Intense sensations of thirst post-surgery(subjective experience of thirst and duration of thirst);(2)Emotional experiences of thirst-related discomfort(anxiety,irritability,and helplessness);(3)Practical challenges in relieving thirst(limitations of current interventions and nursing response time);and(4)Patient expectations of nursing care(desire for more timely interventions and expectation for more proactive attention from nursing staff).CONCLUSION Older patients frequently experience substantial thirst discomfort after gastrointestinal surgery under general anesthesia.A multidisciplinary perioperative intervention plan is essential to alleviate these symptoms and enhance postoperative comfort.展开更多
Objective:To investigate the suppressive effect of dexmedetomidine on the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia and its impact on vital signs.Methods:A total of 60...Objective:To investigate the suppressive effect of dexmedetomidine on the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia and its impact on vital signs.Methods:A total of 60 pediatric patients undergoing elective surgery admitted to our hospital from January to August 2025 were selected and randomly divided into an observation group and a control group,with 30 cases in each group,using a random number table method.The control group received an intravenous infusion of 0.9% sodium chloride injection 30 minutes before the end of surgery,while the observation group received an intravenous pump infusion of dexmedetomidine(1μg/kg,diluted to 4μg/ml with normal saline).The severity of cough(graded from 0 to 3)and vital signs,including heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse oxygen saturation(SpO₂),were recorded 5 minutes before extubation,at the time of extubation,and 5 minutes after extubation in both groups.Results:The severity of cough in the observation group was significantly milder than that in the control group(P<0.05),with a significantly higher proportion of grade 0 cough in the observation group(23.33%vs 3.33%).At extubation and five minutes post-extubation,the observation group exhibited significantly lower HR,SBP,and DBP than the control group(P<0.05).In contrast,SpO_(2)levels remained comparable between the groups(P>0.05).Conclusion:Dexmedetomidine can effectively suppress the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia,reduce the severity of cough,stabilize hemodynamic parameters,and has no significant impact on respiratory function,demonstrating good clinical safety.展开更多
Objective:This study primarily analyzes the effectiveness of thermal insulation nursing(empowered by temperature intervention)in urological stone patients during the general anesthesia recovery period.Methods:A total ...Objective:This study primarily analyzes the effectiveness of thermal insulation nursing(empowered by temperature intervention)in urological stone patients during the general anesthesia recovery period.Methods:A total of 76 urological stone patients who underwent surgical treatment as the preferred option were selected as the research subjects.The earliest consultation time was May 2024,and the latest was May 2025.The patients were randomly divided into two groups using the random number table method,namely the observation group and the control group,with 38 patients in each group.The intervention indicators of the patients were compared.Results:The overall satisfaction rate in the observation group was higher than that in the control group,and the incidence of adverse reactions was lower,with p<0.05.At 0.5 hours,1 hour after surgery,and at the end of surgery,the body temperature in the observation group was significantly different from that in the control group,with p<0.05.Postoperatively,various hemodynamic indicators in the observation group were significantly different from those in the control group,with p<0.05.The time to clench the first upon verbal command,the time to open the eyes upon verbal command,the extubating time,and the recovery retention time in the observation group were all shorter than those in the control group,with p<0.05.Postoperative stress indicators and agitation scores at different time points in the observation group were significantly different from those in the control group,with p<0.05.Conclusion:For urological stone patients during the general anesthesia recovery period,actively implementing thermal insulation nursing combined with temperature intervention not only enhances hemodynamic stability but also effectively reduces the risk of adverse reactions such as hypothermia and shivering.It optimizes the recovery condition,significantly improves the stress state,and increases nursing satisfaction.展开更多
BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the corr...BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the correlation between sleep quality and depression symptoms in patients after laparoscopic hysterectomy under general anesthesia and explore factors associated with postoperative sleep disturbances and depression.METHODS This retrospective case-control study included 102 females who underwent laparoscopic hysterectomy under general anesthesia at our hospital between January 2022 and June 2024,excluding those with severe cardiovascular/cerebrovascular disease,liver/kidney dysfunction,or other underlying conditions.Sleep quality and depressive symptoms were evaluated preoperatively and at 1-week,1-month,and 3-months postoperatively using the Pittsburgh Sleep Quality Index(PSQI)and the Hamilton Depression Rating Scale(HAMD).Physiological indicators(heart rate,blood pressure,and oxygen saturation)and laboratory parameters were monitored.Pearson correlation and logistic regression analyses were performed to examine the association between sleep quality and depressive symptoms.RESULTS Mean age of participants was(52.30±8.39)years,with a body mass index of(23.56±2.79)kg/m².Preoperative comorbidities included hypertension(25.49%),diabetes(14.71%),and heart disease(9.80%).Patients with poor preoperative sleep quality(higher PSQI scores)exhibited significantly more severe depressive symptoms(P<0.05).Postoperative PSQI scores improved at 1-week,1-month,and 3-months compared to baseline(P<0.05).HAMD scores decreased at 1-week and 1-month postoperatively but returned to near preoperative levels at 3-months.Physiological indicators remained within normal ranges,and the postoperative complication rate was<5%.Logistic regression showed that poor postoperative sleep quality was an independent predictor of depressive symptoms(odds ratio=1.64,95%CI:1.22-2.20,P<0.05).CONCLUSION Sleep quality was significantly correlated with depressive symptoms after laparoscopic hysterectomy under general anesthesia.Patients with poor postoperative sleep quality were more prone to depression.Early interventions for sleep disturbances are potentially beneficial for mitigating depression and improve mental health.展开更多
Objective:To investigate the effects of intraspinal anesthesia combined with acupoint injection at Zusanli(ST36)and Sanyinjiao(SP6)on labor progression and delivery outcomes in full-term primiparas.Methods:A retrospec...Objective:To investigate the effects of intraspinal anesthesia combined with acupoint injection at Zusanli(ST36)and Sanyinjiao(SP6)on labor progression and delivery outcomes in full-term primiparas.Methods:A retrospective analysis was conducted on 303 full-term primiparas who delivered between July and December 2023.According to the analgesic method,the participants were divided into an observation group(n=110)and a control group(n=193).Maternal general characteristics,mode of delivery,duration of each labor stage,incidences of uterine inertia,urinary retention,and intrapartum fever,as well as neonatal outcomes,were compared between the two groups.Results:The rate of vaginal delivery in the observation group was significantly higher than that in the control group(p<0.05).The duration of the first stage of labor was significantly shorter(p<0.05).The incidences of uterine inertia and urinary retention were both significantly lower in the observation group than in the control group(p<0.05).There were no significant differences in neonatal Apgar scores or neonatal intensive care unit(NICU)transfer rates between the two groups(p>0.05).Conclusion:Intraspinal anesthesia combined with acupoint injection at Zusanli and Sanyinjiao can increase the rate of vaginal delivery,shorten the first stage of labor,and reduce obstetric interventions in full-term primiparas,without increasing adverse maternal or neonatal outcomes.展开更多
BACKGROUND Surgery is a common treatment for gastrointestinal tumors.General anesthesia(GA),while effective,can cause oxidative stress reactions and neuroinflammation,potentially leading to postoperative cognitive dys...BACKGROUND Surgery is a common treatment for gastrointestinal tumors.General anesthesia(GA),while effective,can cause oxidative stress reactions and neuroinflammation,potentially leading to postoperative cognitive dysfunction and gastrointestinal dysfunction.The stellate ganglion block(SGB)can reduce sympathetic excitability and stress responses.This study aims to investigate whether combining SGB with GA can mitigate these adverse effects in patients undergoing gastrointestinal surgery.AIM To analyze the effects of SGB plus GA on hemodynamic stability,oxidative stress,neuroinflammation,cognitive function,and gastrointestinal function in patients undergoing gastrointestinal surgery.METHODS Patients undergoing gastrointestinal surgery between October 2022 and December 2024 were divided into two groups:A single GA group and an SGB combined with GA group(40 patients each).Hemodynamics,oxidative stress response,laboratory indices,cognitive function,and gastrointestinal function were compared preoperatively and 24 hours postoperatively between the two groups.Pain levels and complications were also recorded.RESULTS Before anesthesia induction,no significant differences were found in various indexes(including hemodynamics,oxidative stress indicators,laboratory indices,cognitive function scores,and gastrointestinal function indicators)between the two groups(P>0.05).At tracheal intubation,3 minutes after,and extubation,the GA-only group had significantly higher mean arterial pressure and heart rate postoperatively than preoperatively and compared to the SGB-GA combined group(P<0.05).Twentyfour hours postoperatively,oxidative stress indicators(malondialdehyde and nitric oxide)were significantly higher and superoxide dismutase was significantly lower in the GA group than in the SGB-GA combined group(P<0.05).Cognitive function scores[Mini-Mental State Examination and Montreal Cognitive Assessment(MoCA)]and gastrointestinal function indicators(motilin)were also significantly better in the SGB-GA combined group(P<0.05).The 24-hour postoperative MoCA score was 0.98 points higher in the SGB-GA combined group.No significant differences were found in the time of first postoperative ambulation,catheter removal time,and 24-hour postoperative pain between groups(P>0.05).CONCLUSION Combining SGB with GA can maintain perioperative hemodynamic stability,reduce oxidative stress and neuroinflammatory injury,and attenuate postoperative cognitive decline and gastrointestinal dysfunction in patients undergoing gastrointestinal surgery.展开更多
文摘Background:Ketamine is a widely used anesthetic in animal research,but its use is strictly regulated in several countries,including Japan and China.As an alternative,the medetomidine-midazolam-butorphanol(MMB)combination is commonly used in Japan.However,medetomidine is a racemic mixture containing the inactive Renantiomer,which may reduce anesthetic predictability and safety.Objective:The aim of the study was to evaluate the efficacy and safety of a modified anesthetic combination(d MMB),in which dexmedetomidine replaces medetomidine,across three commonly used mouse strains(ICR,C57BL/6,BALB/c).Methods:Male and female mice were administered either MMB or d MMB subcutaneously.Anesthetic depth,recovery profiles,heart rate,SpO_(2),body temperature,ocular opacity,and blood glucose levels were assessed.Atipamezole was used to reverse anesthesia,and thermoregulatory recovery was monitored postinjection.Results:d MMB produced similar anesthetic depth to MMB,with faster and more consistent recovery,particularly in males.Body temperature recovery was significantly enhanced in d MMB-treated B6 males.No significant differences in side effects(ocular opacity or blood glucose levels)were observed between protocols,though strainspecific glucose elevations were noted in d MMB-treated males.Conclusion:d MMB is a safe,effective,and ketamine-free injectable anesthetic protocol,offering advantages in recovery and thermoregulation.It may be a valuable alternative in research settings where ketamine is restricted and medetomidine may become unavailable.
文摘Objective:To analyze the effects of combined spinal-epidural anesthesia and epidural anesthesia in patients undergoing appendicitis surgery.Methods:Seventy-eight patients who underwent surgical treatment for appendicitis from February 2022 to February 2025 were selected as samples and randomly divided into two groups.The study group received combined spinal-epidural anesthesia,while the control group received epidural anesthesia.Anesthesia indicators,vital signs,and complication indicators were compared between the two groups.Results:The onset time of anesthesia in the study group was shorter than that in the control group,the visual analog scale(VAS)score was lower than that in the control group,and the highest plane of anesthesia block was lower than that in the control group(P<0.05).At 15 minutes after anesthesia induction and at the end of surgery,the heart rate(HR),mean arterial pressure(MAP),and blood oxygen saturation(SPO2)in the study group were significantly different from those in the control group(P<0.05).The complication rate in the study group was lower than that in the control group(P<0.05).Conclusion:Combined spinal-epidural anesthesia for appendicitis surgery can reduce the impact of anesthesia on vital signs,shorten the onset time of anesthesia,and is highly effective and feasible.
基金Supported by the Health Commission of Hunan Province,No.202204115263the Fundamental Research Funds for the Central Universities of Central South University,No.2024XQLH027.
文摘BACKGROUND In the field of anesthesia for procedure for prolapse and hemorrhoids(PPH)surgery,combined spinal-epidural(CSE)anesthesia has been a common approach.However,exploring new combinations to optimize patient outcomes remains crucial.Remimazolam,a short-acting benzodiazepine,shows potential for improving sedation and reducing patient anxiety.The effects of combining remimazolam with CSE anesthesia,compared to traditional CSE anesthesia alone,on patient anxiety,sedation depth,and hemodynamics during PPH surgery have not been fully elucidated.AIM To compare remimazolam-CSE vs CSE alone on State-Trait Anxiety Inventory-State scale(STAI-S)scores,sedation,and hemodynamics in PPH surgery.METHODS This study is a single-center,prospective,randomized controlled trial.Between November 23,2022,and August 6,2024,60 eligible patients were randomly assigned to the CSE anesthesia group or the remimazolam-combined CSE anesthesia group(30 patients each).STAI-S scores,Ramsay sedation scores,and hemodynamic parameters(systolic blood pressure,diastolic blood pressure,heart rate)were measured at multiple time points.Two-way mixed-effects ANOVA and posthoc analyses were performed.RESULTS The Combined group demonstrated significantly lower STAI-S scores before leaving the operating room[mean:28.80 vs 54.03,mean difference(95%CI):25.23(21.24-29.23),P<0.001]and 24 hours post-operation[mean:45.07 vs 54.53,mean difference(95%CI):9.47(6.29-12.64),P<0.001]than the CSE group.Moreover,the Combined group achieved a deeper sedation level during intraoperative maintenance[median:5.00(IQR:5.00-5.00)vs 2.00(IQR:2.00-2.00);median difference(95%CI):3.00(3.00-3.00),P<0.001].Regarding hemodynamics,a significant intergroup difference in systolic blood pressure was observed at the start of the surgery[mean:128.8 vs 114.7 for the Combined and CSE groups,mean difference(95%CI):14.17(0.77-27.57),adjusted P=0.033].CONCLUSION Remimazolam-combined anesthesia outperformed CSE anesthesia in reducing STAI-S scores,enhancing intraoperative sedation,and stabilizing systolic blood pressure at a critical stage,indicating its superiority in perioperative management.
文摘BACKGROUND Current standard nursing practices demonstrate limited effectiveness in perioperative colorectal cancer(CRC)management,highlighting the need to explore alternative care strategies that improve clinical outcomes.AIM To investigate the impact of music therapy and anesthesia recovery care on anesthesia recovery in patients with CRC undergoing laparoscopic radical resection.METHODS One hundred and twenty patients scheduled for elective laparoscopic CRC radical resection at Affiliated Hospital of Jiangnan University from January 2022 to May 2024 were enrolled.The patients were assigned to control(n=60,receiving standard nursing care)and observation groups(n=60,receiving music therapy,anesthesia recovery care,and standard nursing care).We comparatively analyzed the time to regain consciousness,extubation time,and length of stay in the postanesthesia care unit;heart rate,systolic blood pressure,and diastolic blood pressure before anesthesia and during recovery;cortisol,aldosterone,norepinephrine,and adrenaline levels before anesthesia and 24 hours postoperatively;Postoperative Quality of Recovery Scale scores;and complication rates between the groups.RESULTS The observation group exhibited a significantly shorter time to regain consciousness,extubation time,and postanesthesia care unit stay than the control group(P<0.05).During the recovery period,heart rate,systolic blood pressure,and diastolic blood pressure significantly increased in both groups compared with preanesthesia levels,with the levels in the observation group being significantly lower than those in the control group(P<0.05).At 24 hours postoperatively,cortisol,aldosterone,norepinephrine,and adrenaline levels were elevated in both groups compared with preanesthesia levels,with levels in the observation group being significantly lower than those in the control group(P<0.05).The observation group achieved significantly higher Postoperative Quality of Recovery Scale scores than the control group(P<0.05).Moreover,the complication rate in the observation group was significantly lower than that in the control group(10.00%vs 40.00%,P<0.05).CONCLUSION Music therapy combined with anesthesia recovery care remarkably boosted the quality of anesthesia recovery in patients undergoing laparoscopic CRC radical resection,mitigated fluctuations in vital signs and stress responses,improved postoperative recovery quality,and reduced complication rates,demonstrating substantial clinical value.
文摘BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.AIM To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.METHODS In this retrospective study,94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia,admitted to Yiwu Central Hospital between May 2022 and May 2023,were divided into a control group(inhalation combined general anesthesia)and a treatment group(dexmedetomidine-assisted intrave-nous-inhalation combined general anesthesia).Perioperative indicators,analgesic effect,preoperative and postoperative 24-hours blood pressure(BP)and heart rate(HR),stress indicators,immune function levels,and adverse reactions were com-pared between the two groups.RESULTS Baseline data,including age,hernia location,place of residence,weight,monthly income,education level,and underlying diseases,were not significantly different between the two groups,indicating comparability(P>0.05).No significant difference was found in operation time and anesthesia time between the two groups(P>0.05).However,the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group(P<0.05).Preoperatively,no significant differences were found in the visual analog scale(VAS)scores between the two groups(P>0.05).However,at 12,18,and 24 hours postoper-atively,the treatment group had significantly lower VAS scores than the control group(P<0.05).Although no significant differences in preoperative hemodynamic indicators were found between the two groups(P>0.05),both groups experienced some extent of changes in postoperative HR,diastolic BP(DBP),and systolic BP(SBP).Nevertheless,the treatment group showed smaller changes in HR,DBP,and SBP than the control group(P<0.05).Preoperative immune function indicators showed no significant differences between the two groups(P>0.05).However,postoperatively,the treatment group demonstrated higher levels of CD3+,CD4+,and CD4+/CD8+and lower levels of CD8+than the control group(P<0.05).The rates of adverse reactions were 6.38%and 23.40%in the treatment and control groups,respectively,revealing a significant difference(χ2=5.371,P=0.020).CONCLUSION Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal hernia.It ensures stable blood flow,improves postoperative analgesic effects,reduces postoperative pain intensity,alleviates stress response,improves immune function,facilitates anesthesia recovery,and enhances safety.
文摘BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the efficacy and safety of intrathecal hyper-baric bupivacaine vs hyperbaric ropivacaine for cesarean sections.AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials(RCTs)comparing intrathecal hyperbaric ropi-vacaine and hyperbaric bupivacaine during CSs.PubMed,Cochrane database,Google Scholar,and Scopus were searched,and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria.Studies were assessed for methodological quality,and data were extracted for time to adequate anesthesia(sensory and motor blockade),duration of sensory and motor block,hemodynamic changes and side effect profile.The standardized mean difference with 95%CI was used for continuous data.Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis.The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies.The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics.The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant(P=0.1586).However,the onset of motor blockade appeared to be faster with bupivacaine(P=0.03589).Additionally,the regression of sensory and motor blockade occurred earlier in the ropivacaine group.Furthermore,the duration of the first analgesic effect was shorter with a significance level of P<0.05.Regarding side effects profile,including hypotension,nausea,and shivering,the study did not observe any significant differences between the two groups.CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections.Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine,perhaps aiding early mobilization of parturient and facilitating mother-child bonding.Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.
文摘Objective: This study evaluates the impact of handshake and information support on patients’ outcomes during laparoscopic cholecystectomy. It examines the effects on their physiological and psychological responses and overall satisfaction with nursing care. Methods: A total of 84 patients scheduled for laparoscopic cholecystectomy were selected through convenient sampling and randomly assigned to either the control group or the intervention group using a random number table. Each group consisted of 42 patients. The control group received standard surgical nursing care. In addition to standard care, the intervention group received handshake and information support from the circulating nurse before anesthesia induction. Vital signs were recorded before surgery and before anesthesia induction. Anxiety levels were measured using the State-Trait Anxiety Inventory (STAI) and the State-Anxiety Inventory (S-AI), while nursing satisfaction was assessed using a numerical rating scale. Results: No significant differences were found between the two groups in systolic and diastolic blood pressures before surgery and anesthesia induction (P > 0.05). However, there was a significant difference in heart rate before anesthesia induction (P Conclusion: Providing handshake and information support before anesthesia induction effectively reduces stress, alleviates anxiety, and enhances comfort and satisfaction among patients undergoing laparoscopic cholecystectomy.
文摘Objective: Anesthesia for laparoscopic surgery is particular because of the cardiopulmonary repercussions of pneumoperitoneum. This study reports the experience in secondary level hospital located in suburban environment. Methods: This is a cross-sectional study carried out at Monkole hospital from May 2016 to May 2023. It concerns patients anesthetized for laparoscopic surgery. Perianesthetic data were collected and analyzed with SPSS 26.0 for p Results: Eighty-four patients (4.2%) were selected out of 2000 eligible patients. The median age was 31 years, the range between 15 and 30 years (40.5%), female gender and approved patients (70.3%) predominated. Comorbidities were: sickle cell disease, high blood pressure, thinness and obesity. The ASA class was: I (35.2%), II (36.3%) and III (28.6%). Anesthesia was general with intubation for all patients. Generally, the surgery lasted less than two hours and the anesthesia lasted more than two hours. Postoperative analgesia used morphine in 27.5%. The operative indications were dominated by lithiasis with or without cholecystitis (48.4%) and appendicitis (16.5%). Intraoperative complications (18.7%) were: hypotension, allergy, spasm, accidental gallbladder and bile duct perforation. Postoperative complications (9.9%) were: anemia, digestive fistula, septic shock, multi-organ failure, acute lung edema and two deaths. Alcohol consumption was associated with intraoperative complications. Anesthesia duration greater than two hours, ASA3 class, alcohol consumption and cholecystectomy were associated with postoperative complications. Conclusion: Celiosurgery is not yet established in Monkole probably due to the lack of permanent surgeons and the higher cost than open surgery.
文摘BACKGROUND Administering anesthesia to elderly patients undergoing gastroenteroscopy necessitates careful attention due to age-related physiological changes and an increased risk of complications.AIM To analyze the research trends in anesthesia management for elderly patients undergoing gastroenteroscopy.METHODS We performed a literature search using the Web of Science database to identify articles published between 2004 and 2023.Bibliometric and visual analyses were conducted using CiteSpace,R,and VOSviewer to explore the current research landscape of anesthesia administration in painless gastroenteroscopy for elderly patients and to identify future research directions by examining trends and emerging hotspots in this domain.RESULTS A total of 800 articles were examined,revealing a rising trend in annual pub-lication counts.The United States led with 181 articles,followed by China with 112,collectively contributing over 35%of the studies among the top ten countries.The majority of publications appeared in the United States journals,with the top three being Gastrointestinal Endoscopy[impact factor(IF)=7.7,H-index=26],Digestive Diseases and Sciences(IF=3.1),and Endoscopy(IF=9.3).Six primary research clusters were identified:Obstructive sleep apnea and airway manage-ment,surveillance and risk factors,colorectal cancer examination and treatment,sedation and safety of propofol and midazolam,patient satisfaction,and mortality and complications.These findings underscore the pivotal focus areas in anesthesia for elderly patients undergoing gastroenteroscopy.CONCLUSION A comprehensive understanding of current research trends and hotspots will aid anesthesiologists in developing more evidence-based practices,thereby improving the safety and outcomes for elderly patients undergoing gastroenteroscopy.
基金supported by grants from the Shanghai Municipal Health Commission(2023ZDFC0203)the National Natural Science Foundation of China(32171044).
文摘General anesthesia,pivotal for surgical procedures,requires precise depth monitoring to mitigate risks ranging from intraoperative awareness to postoperative cognitive impairments.Traditional assessment methods,relying on physiological indicators or behavioral responses,fall short of accurately capturing the nuanced states of unconsciousness.This study introduces a machine learning-based approach to decode anesthesia depth,leveraging EEG data across different anesthesia states induced by propofol and esketamine in rats.Our findings demonstrate the model’s robust predictive accuracy,underscored by a novel intrasubject dataset partitioning and a 5-fold cross-validation method.The research diverges from conventional monitoring by utilizing anesthetic infusion rates as objective indicators of anesthesia states,highlighting distinct EEG patterns and enhancing prediction accuracy.Moreover,the model’s ability to generalize across individuals suggests its potential for broad clinical application,distinguishing between anesthetic agents and their depths.Despite relying on rat EEG data,which poses questions about real-world applicability,our approach marks a significant advance in anesthesia monitoring.
文摘BACKGROUND Gastric cancer is a major global health issue,and the perioperative period critic-ally influences patient outcomes.The different effects of sevoflurane inhalation anesthesia and propofol total intravenous anesthesia on intraoperative stability,postoperative complications,and long-term oncologic outcomes in patients with gastric cancer undergoing radical gastrectomy remain unclear.AIM To compare the effects of sevoflurane inhalation anesthesia and propofol total in-travenous anesthesia on clinical outcomes,including intraoperative indicators,postoperative complications,adverse effects,pain scores,and survival.METHODS This single-center retrospective cohort study included 204 patients who underw-ent radical gastrectomy for gastric cancer from February 2019 to December 2022.Patients were assigned to either the sevoflurane group(n=103)or the propofol group(n=101)based on intraoperative anesthetic regimen.Standardized protoc-ols for anesthesia management,intraoperative monitoring,and postoperative analgesia were applied.Baseline characteristics;intraoperative metrics;adverse events;complications;Visual Analog Scale(VAS)scores at 2,4,6,24,and 48 hours;and survival outcomes were retrospectively collected.Group comparisons were performed usingχ2 for categorical variables,t test for continuous variables,RESULTS Baseline demographic and clinical characteristics were similar between groups.No significant differences were observed in intraoperative indicators or most 30-day postoperative outcomes,including length of stay,emergency department visits,and readmission rates.The propofol group showed elevated mean VAS pain score at 24 hours postoperatively,but no differences were found at other time points.The propofol group also had significantly higher postoperative nausea incidence and transiently higher systolic/diastolic blood pressure and heart rate at the time of incision than the sevoflurane group.No significant differences were seen in overall rates or severity of postoperative complications,intraoperative adverse events,or in overall survival and progression-free survival.CONCLUSION In patients undergoing radical gastrectomy for gastric cancer,sevoflurane and propofol anesthesia demonstrated similar profiles regarding intraoperative safety,postoperative complications,adverse events,postoperative pain,and long-term survival.The selection of anesthesia can be personalized without significantly affecting periop-erative or oncologic outcomes.
基金supported by the National Natural Science Foundation of China(32371063,82341288,32071009)to C.L.Guangdong Basic and Applied Basic Research Foundation(2024A1515011500)to C.L.
文摘General anesthesia(GA)is a pharmacologically induced,reversible state characterized by unconsciousness,amnesia,analgesia,and immobility in response to noxious stimuli.Accumulating evidence from animal models has elucidated diverse mechanisms of the action underlying GA,including disruption of large-scale brain network connectivity,regulation of multiple neural pathways,and modulation of specific receptors and ion channels.Despite advances in dissecting the neurobiological basis of anesthetic action,the precise cellular and circuit-level processes remain incompletely understood,limiting the development of safer and more effective strategies.Recent studies in Drosophila melanogaster,a genetically tractable model organism offering robust genetic analysis,advanced imaging capabilities,and compact neural architecture,have yielded critical insights into the conserved neurobiological mechanisms of GA,offering translational value for mammalian systems.This review outlines:1)experimental paradigms used to evaluate anesthetic sensitivity and behavioral responses in Drosophila;2)molecular targets and their mechanistic roles in mediating GA;and 3)neural circuit architectures and activity patterns shared by GA and sleep.Cross-species comparisons are integrated to highlight conserved mechanisms that may guide the development of more refined anesthetic strategies.
文摘Background:During the establishment of a model of acute kidney injury(AKI)in pigs,we observed a high prevalence of malignant hyperthermia(MH).These complications led us to refine the anesthetic protocol.This publication describes the impact of the choice of anesthetics on the results obtained.Methods:Pigs were euthanized at the end of the procedure,without recovery from anesthesia.Three anesthetic protocols were used:sevoflurane inhalation(ProtocolA,n=5),a combination of ketamine,medetomidine and diazepam by intravenous infusion(ProtocolB,n=5),and a combination of ketamine,diazepam,medetomidine,glucose,and noradrenaline(ProtocolC,n=5).All pigs received morphine for analgesia.AKI was induced by interrupting renal perfusion for 90 min.MH was diagnosed based on clinical and biological parameters.Results:All MH pigs belonged to ProtocolA.MH pigs showed significantly higher maximum rectal temperature(p=0.04),maximum expired carbon dioxide(CO_(2);p=0.04),maximum heart rate(HR;p=0.03),plasma concentration of creatinine and potassium(p<0.0001).Protocol A pigs had a significantly higher maximum HR(p=0.01)and hyperkalemia compared to the two other groups(ProtocolB,p=0.005 and ProtocolC,p<0.0001).Pigs from ProtocolA had a significantly lower minimum mean arterial pressure(MAP)than ProtocolC group(p=0.03)and MAP remained below 60 mmHg for longer(p=0.004).In ProtocolB,minimum glycemia was lower than other groups(p=0.01).Conclusion:Sevoflurane use was associated with the occurrence of MH,hemodynamic alterations and changes in plasma concentration of creatinine and potassium.These modifications can have a major impact on the validation of an experimental AKI model.
基金supported by the Basic Medical Research Foundation of Naval Medical University(2022SK029 and 2023QN035).
文摘Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfaction Questionnaire scores,work pressure,and turnover intentions.Multiple linear regression analysis was used to examine factors influencing job satisfaction.The electronic survey was distributed to Chinese anesthesia graduates from December 2021 to January 2022.Results:A total of 595 questionnaires were distributed,with 318 valid responses,resulting in a response rate of 53.4%.The participants’overall job satisfaction score on the Minnesota Satisfaction Questionnaire was 75.85±12.57.Multiple linear regression analysis identified the following variables as significantly associated with job satisfaction:age,daily working hours,income,current position,and work pressure.Conclusions:Anesthesia graduates in China reported slightly higher-than-average overall job satisfaction.However,several issues remain.Attention should be given to the impact of factors such as youth,long working hours,low income,current position,and high work pressure on job satisfaction.The government should support anesthesiologists with improved training,job security,and benefits to enhance job satisfaction.
文摘BACKGROUND Older patients often experience thirst after general anesthesia for gastrointestinal surgery,particularly during the post-anesthesia care unit(PACU)phase.Thirst not only compromises patient comfort but also induces anxiety,which may hinder recovery.Although previous studies have addressed postoperative thirst,research specifically examining thirst experiences and nursing needs in older patients remains limited.AIM To explore thirst experiences and nursing needs of older PACU patients following gastrointestinal surgery,aiming to inform targeted interventions.METHODS This study employed a phenomenological approach within a qualitative research framework.A purposeful sampling method was used to select 12 older patients who underwent gastrointestinal surgery under general anesthesia at a tertiary hospital in Shanghai between November and December 2024.Data were collected through semi-structured interviews and analyzed using Colaizzi’s seven-step method.Themes were extracted from the interview data.RESULTS Analysis of the interview data identified four main themes and eight subthemes:(1)Intense sensations of thirst post-surgery(subjective experience of thirst and duration of thirst);(2)Emotional experiences of thirst-related discomfort(anxiety,irritability,and helplessness);(3)Practical challenges in relieving thirst(limitations of current interventions and nursing response time);and(4)Patient expectations of nursing care(desire for more timely interventions and expectation for more proactive attention from nursing staff).CONCLUSION Older patients frequently experience substantial thirst discomfort after gastrointestinal surgery under general anesthesia.A multidisciplinary perioperative intervention plan is essential to alleviate these symptoms and enhance postoperative comfort.
文摘Objective:To investigate the suppressive effect of dexmedetomidine on the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia and its impact on vital signs.Methods:A total of 60 pediatric patients undergoing elective surgery admitted to our hospital from January to August 2025 were selected and randomly divided into an observation group and a control group,with 30 cases in each group,using a random number table method.The control group received an intravenous infusion of 0.9% sodium chloride injection 30 minutes before the end of surgery,while the observation group received an intravenous pump infusion of dexmedetomidine(1μg/kg,diluted to 4μg/ml with normal saline).The severity of cough(graded from 0 to 3)and vital signs,including heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse oxygen saturation(SpO₂),were recorded 5 minutes before extubation,at the time of extubation,and 5 minutes after extubation in both groups.Results:The severity of cough in the observation group was significantly milder than that in the control group(P<0.05),with a significantly higher proportion of grade 0 cough in the observation group(23.33%vs 3.33%).At extubation and five minutes post-extubation,the observation group exhibited significantly lower HR,SBP,and DBP than the control group(P<0.05).In contrast,SpO_(2)levels remained comparable between the groups(P>0.05).Conclusion:Dexmedetomidine can effectively suppress the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia,reduce the severity of cough,stabilize hemodynamic parameters,and has no significant impact on respiratory function,demonstrating good clinical safety.
文摘Objective:This study primarily analyzes the effectiveness of thermal insulation nursing(empowered by temperature intervention)in urological stone patients during the general anesthesia recovery period.Methods:A total of 76 urological stone patients who underwent surgical treatment as the preferred option were selected as the research subjects.The earliest consultation time was May 2024,and the latest was May 2025.The patients were randomly divided into two groups using the random number table method,namely the observation group and the control group,with 38 patients in each group.The intervention indicators of the patients were compared.Results:The overall satisfaction rate in the observation group was higher than that in the control group,and the incidence of adverse reactions was lower,with p<0.05.At 0.5 hours,1 hour after surgery,and at the end of surgery,the body temperature in the observation group was significantly different from that in the control group,with p<0.05.Postoperatively,various hemodynamic indicators in the observation group were significantly different from those in the control group,with p<0.05.The time to clench the first upon verbal command,the time to open the eyes upon verbal command,the extubating time,and the recovery retention time in the observation group were all shorter than those in the control group,with p<0.05.Postoperative stress indicators and agitation scores at different time points in the observation group were significantly different from those in the control group,with p<0.05.Conclusion:For urological stone patients during the general anesthesia recovery period,actively implementing thermal insulation nursing combined with temperature intervention not only enhances hemodynamic stability but also effectively reduces the risk of adverse reactions such as hypothermia and shivering.It optimizes the recovery condition,significantly improves the stress state,and increases nursing satisfaction.
文摘BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the correlation between sleep quality and depression symptoms in patients after laparoscopic hysterectomy under general anesthesia and explore factors associated with postoperative sleep disturbances and depression.METHODS This retrospective case-control study included 102 females who underwent laparoscopic hysterectomy under general anesthesia at our hospital between January 2022 and June 2024,excluding those with severe cardiovascular/cerebrovascular disease,liver/kidney dysfunction,or other underlying conditions.Sleep quality and depressive symptoms were evaluated preoperatively and at 1-week,1-month,and 3-months postoperatively using the Pittsburgh Sleep Quality Index(PSQI)and the Hamilton Depression Rating Scale(HAMD).Physiological indicators(heart rate,blood pressure,and oxygen saturation)and laboratory parameters were monitored.Pearson correlation and logistic regression analyses were performed to examine the association between sleep quality and depressive symptoms.RESULTS Mean age of participants was(52.30±8.39)years,with a body mass index of(23.56±2.79)kg/m².Preoperative comorbidities included hypertension(25.49%),diabetes(14.71%),and heart disease(9.80%).Patients with poor preoperative sleep quality(higher PSQI scores)exhibited significantly more severe depressive symptoms(P<0.05).Postoperative PSQI scores improved at 1-week,1-month,and 3-months compared to baseline(P<0.05).HAMD scores decreased at 1-week and 1-month postoperatively but returned to near preoperative levels at 3-months.Physiological indicators remained within normal ranges,and the postoperative complication rate was<5%.Logistic regression showed that poor postoperative sleep quality was an independent predictor of depressive symptoms(odds ratio=1.64,95%CI:1.22-2.20,P<0.05).CONCLUSION Sleep quality was significantly correlated with depressive symptoms after laparoscopic hysterectomy under general anesthesia.Patients with poor postoperative sleep quality were more prone to depression.Early interventions for sleep disturbances are potentially beneficial for mitigating depression and improve mental health.
文摘Objective:To investigate the effects of intraspinal anesthesia combined with acupoint injection at Zusanli(ST36)and Sanyinjiao(SP6)on labor progression and delivery outcomes in full-term primiparas.Methods:A retrospective analysis was conducted on 303 full-term primiparas who delivered between July and December 2023.According to the analgesic method,the participants were divided into an observation group(n=110)and a control group(n=193).Maternal general characteristics,mode of delivery,duration of each labor stage,incidences of uterine inertia,urinary retention,and intrapartum fever,as well as neonatal outcomes,were compared between the two groups.Results:The rate of vaginal delivery in the observation group was significantly higher than that in the control group(p<0.05).The duration of the first stage of labor was significantly shorter(p<0.05).The incidences of uterine inertia and urinary retention were both significantly lower in the observation group than in the control group(p<0.05).There were no significant differences in neonatal Apgar scores or neonatal intensive care unit(NICU)transfer rates between the two groups(p>0.05).Conclusion:Intraspinal anesthesia combined with acupoint injection at Zusanli and Sanyinjiao can increase the rate of vaginal delivery,shorten the first stage of labor,and reduce obstetric interventions in full-term primiparas,without increasing adverse maternal or neonatal outcomes.
文摘BACKGROUND Surgery is a common treatment for gastrointestinal tumors.General anesthesia(GA),while effective,can cause oxidative stress reactions and neuroinflammation,potentially leading to postoperative cognitive dysfunction and gastrointestinal dysfunction.The stellate ganglion block(SGB)can reduce sympathetic excitability and stress responses.This study aims to investigate whether combining SGB with GA can mitigate these adverse effects in patients undergoing gastrointestinal surgery.AIM To analyze the effects of SGB plus GA on hemodynamic stability,oxidative stress,neuroinflammation,cognitive function,and gastrointestinal function in patients undergoing gastrointestinal surgery.METHODS Patients undergoing gastrointestinal surgery between October 2022 and December 2024 were divided into two groups:A single GA group and an SGB combined with GA group(40 patients each).Hemodynamics,oxidative stress response,laboratory indices,cognitive function,and gastrointestinal function were compared preoperatively and 24 hours postoperatively between the two groups.Pain levels and complications were also recorded.RESULTS Before anesthesia induction,no significant differences were found in various indexes(including hemodynamics,oxidative stress indicators,laboratory indices,cognitive function scores,and gastrointestinal function indicators)between the two groups(P>0.05).At tracheal intubation,3 minutes after,and extubation,the GA-only group had significantly higher mean arterial pressure and heart rate postoperatively than preoperatively and compared to the SGB-GA combined group(P<0.05).Twentyfour hours postoperatively,oxidative stress indicators(malondialdehyde and nitric oxide)were significantly higher and superoxide dismutase was significantly lower in the GA group than in the SGB-GA combined group(P<0.05).Cognitive function scores[Mini-Mental State Examination and Montreal Cognitive Assessment(MoCA)]and gastrointestinal function indicators(motilin)were also significantly better in the SGB-GA combined group(P<0.05).The 24-hour postoperative MoCA score was 0.98 points higher in the SGB-GA combined group.No significant differences were found in the time of first postoperative ambulation,catheter removal time,and 24-hour postoperative pain between groups(P>0.05).CONCLUSION Combining SGB with GA can maintain perioperative hemodynamic stability,reduce oxidative stress and neuroinflammatory injury,and attenuate postoperative cognitive decline and gastrointestinal dysfunction in patients undergoing gastrointestinal surgery.
