Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have redu...Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.展开更多
BACKGROUND Elderly patients often display age-related physiological decline,which increases their susceptibility to complications during medical procedures.Therefore,it is clinically imperative to refine anesthetic pr...BACKGROUND Elderly patients often display age-related physiological decline,which increases their susceptibility to complications during medical procedures.Therefore,it is clinically imperative to refine anesthetic protocols for painless gastroscopy in this vulnerable population.AIM To explore the effects of the etomidate-propofol combination on anesthesia quality,compliance,and adverse reactions in elderly patients undergoing painless gastrointestinal endoscopy.METHODS A total of 103 elderly patients scheduled for painless gastrointestinal endoscopy at the Hospital of Wuhan Economic and Technological Development Zone(Hannan District)between October 2022 and October 2024 were enrolled.The participants were divided into a control group(n=50)receiving propofol anesthesia and an observation group(n=53)that received a combination of etomidate and propofol anesthesia.The anesthesia quality(including induction time,recovery time,and orientation recovery time),compliance,hemodynamic parameters(heart rate,oxygen saturation,systolic/diastolic blood pressure),adverse reactions(muscle tremors,injection pain,respiratory depression,hypotension,and nausea/vomiting),and analgesic and sedative effects[evaluated using the visual analog scale(VAS)and Ramsay score]were comparatively analyzed.RESULTS The observation group had significantly shorter anesthesia induction,recovery,and orientation recovery times than the control group.Moreover,the observation group showed higher compliance;greater hemodynamic stability at preanesthesia(T0),during anesthesia(T1),and postrecovery(T2)time points;and a significantly lower incidence of adverse reactions.The VAS and Ramsay scores at 5,30,and 60 minutes after anesthesia recovery were also significantly lower in the observation group than in the control group.CONCLUSION The etomidate-propofol combination for painless gastrointestinal endoscopy in elderly patients may provide superior anesthesia quality and improved compliance and safety,making it a promising approach for clinical application.展开更多
文摘Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.
文摘BACKGROUND Elderly patients often display age-related physiological decline,which increases their susceptibility to complications during medical procedures.Therefore,it is clinically imperative to refine anesthetic protocols for painless gastroscopy in this vulnerable population.AIM To explore the effects of the etomidate-propofol combination on anesthesia quality,compliance,and adverse reactions in elderly patients undergoing painless gastrointestinal endoscopy.METHODS A total of 103 elderly patients scheduled for painless gastrointestinal endoscopy at the Hospital of Wuhan Economic and Technological Development Zone(Hannan District)between October 2022 and October 2024 were enrolled.The participants were divided into a control group(n=50)receiving propofol anesthesia and an observation group(n=53)that received a combination of etomidate and propofol anesthesia.The anesthesia quality(including induction time,recovery time,and orientation recovery time),compliance,hemodynamic parameters(heart rate,oxygen saturation,systolic/diastolic blood pressure),adverse reactions(muscle tremors,injection pain,respiratory depression,hypotension,and nausea/vomiting),and analgesic and sedative effects[evaluated using the visual analog scale(VAS)and Ramsay score]were comparatively analyzed.RESULTS The observation group had significantly shorter anesthesia induction,recovery,and orientation recovery times than the control group.Moreover,the observation group showed higher compliance;greater hemodynamic stability at preanesthesia(T0),during anesthesia(T1),and postrecovery(T2)time points;and a significantly lower incidence of adverse reactions.The VAS and Ramsay scores at 5,30,and 60 minutes after anesthesia recovery were also significantly lower in the observation group than in the control group.CONCLUSION The etomidate-propofol combination for painless gastrointestinal endoscopy in elderly patients may provide superior anesthesia quality and improved compliance and safety,making it a promising approach for clinical application.
