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
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
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
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: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 The use of an ultrasound-guided quadratus lumborum block(QLB)combined with general anesthesia for patients undergoing colorectal cancer surgery serves as a model for reducing the postoperative stress respon...BACKGROUND The use of an ultrasound-guided quadratus lumborum block(QLB)combined with general anesthesia for patients undergoing colorectal cancer surgery serves as a model for reducing the postoperative stress response,preserving metabolic stability,protecting renal function,and alleviating postoperative pain.AIM To compare QLB combined with general anesthesia vs general anesthesia alone in the perioperative stress response,metabolic and renal function,postoperative pain,and recovery outcomes among patients undergoing colorectal cancer surgery.METHODS Clinical data of 116 patients who underwent colorectal cancer surgery at our hospital between July 2023 and August 2024 were collected for retrospective analysis.According to the anesthesia protocol,the patients were divided into the control(general anesthesia,n=58)and experimental groups(QLB combined with general anesthesia,n=58).Physiological indicators such as blood glucose(GLU),lactic acid(LAC),blood urea nitrogen(BUN),and creatinine(CRE)were measured at T0(pre-surgery),T1(post-surgery),T2(6 hours post-surgery),T3(24 hours post-surgery),and T4(48 hours post-surgery).The differences between the two groups for each indicator were evaluated using repeated-measures analysis of variance.RESULTS The GLU levels from T1 to T4 in the experimental group were significantly lower than those in the control group(P<0.001),and the LAC levels were also significantly reduced(P<0.001).The experimental group exhibited superior renal protection based on postoperative BUN and CRE levels(P<0.05).Furthermore,the postoperative pain score in the experimental group was significantly lower than that in the control group[visual analogue scale(VAS)]scores differed significantly from T2 to T4,P<0.05.CONCLUSION Research has shown that QLB combined with general anesthesia can decrease postoperative GLU and LAC by 8%-15%and 10%-20%(P<0.001),respectively.It also enhances renal function markers(BUN,CRE,P<0.05)and lowers VAS scores by 15%-30%(P<0.05).Ultrasound-guided lumbar muscle block with general anesthesia outperforms general anesthesia alone in diminishing stress response,preserving metabolic balance and renal function,and alleviating postoperative pain.This approach offers a more efficient perioperative management strategy for patients undergoing colorectal cancer surgery.It is particularly advantageous for individuals with stress sensitivity,renal impairment,and heightened pain susceptibility.展开更多
BACKGROUND Subcutaneous implantable cardioverter-defibrillator(S-ICD)implantation requires effective anesthesia.General anesthesia(GA)carries risks like hemodynamic instability,while ultrasound-guided intercostal nerv...BACKGROUND Subcutaneous implantable cardioverter-defibrillator(S-ICD)implantation requires effective anesthesia.General anesthesia(GA)carries risks like hemodynamic instability,while ultrasound-guided intercostal nerve block(US-ICNB)may offer better pain control.This study hypothesized US-ICNB is superior in perioperative safety and pain management.AIM To compare perioperative outcomes of GA and US-ICNB in S-ICD implantation.METHODS This retrospective single-center study included 64 patients who received S-ICD implantation between February 2021 and December 2024.They were divided into GA and US-ICNB groups based on anesthesia type.Demographic data,perioperative parameters(operation time,pain scores,analgesic usage),and postoperative outcomes(complications,defibrillation events)were collected and analyzed.Statistical tests were used to compare the two groups.RESULTS This study included 64 patients(20 in the GA group and 44 in the US-ICNB group).Baseline left ventricular ejection fraction was significantly lower in the US-ICNB group(39.20%±12.00%vs 56.20%±11.50%in GA,P<0.001),while American Society of Anesthesiologists scores and comorbidities were comparable.US-ICNB showed superior pain control,with significantly lower numeric rating scale scores at 6-48 hours(P<0.001)and fewer patients requiring analgesics(P=0.02).The US-ICNB group had shorter operation times(P<0.001),total hospital stays(P<0.001),and later first analgesia times(P<0.001).No anesthesia-related complications occurred in either group.CONCLUSION Both anesthetic methods were safe in the short term.However,US-ICNB was superior in reducing operation and hospital stay times and alleviating peri-operative pain.It has high safety in S-ICD implantation and deserves further clinical promotion,though large-scale,multi-center,randomized controlled trials are needed to confirm these findings.展开更多
BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptom...BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.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 observe the application effects of anesthesia recovery nursing with heat preservation measures in patients undergoing general anesthesia surgery.Methods:300 cases of general anesthesia surgery patients in...Objective:To observe the application effects of anesthesia recovery nursing with heat preservation measures in patients undergoing general anesthesia surgery.Methods:300 cases of general anesthesia surgery patients in our hospital from March 2023 to February 2024 were selected and divided into the control group and the observation group according to the random number table method,each with 150 cases.The control group adopted conventional care,while the observation group was given anesthesia recovery care and heat preservation measures on the basis of conventional care.The wake-up time,extubation time,hospitalization time,and the incidence of adverse reactions were compared between the two groups and statistically analyzed.Results:The wake-up time of patients in the control group was 9.71±1.20 hours,and that of the observation group was 6.51±1.02 hours,with statistically significant differences(P<0.05);the extubation times of patients in the observation group and the control group after awakening were 8.52±0.41 min and 10.42±1.12 min,respectively,with statistically significant differences(P<0.05)The hospital stay after the operation in the observation group and the control group was 32.91±4.71 days and 37.24±3.34 days respectively,and the difference was statistically significant(P<0.05),and the incidence rate of adverse reactions after extubation in the observation group(3.33%)was significantly lower than that in the control group(10.00%)(P<0.05).Conclusion:In general anesthesia surgery patients,the implementation of anesthesia recovery nursing with heat preservation measures can significantly improve the physical condition of patients,effectively shorten the duration of surgery and patients’wake-up time,and improve their quality of life,which is worthy of clinical promotion and application.展开更多
BACKGROUND General anesthesia is commonly used in the surgical management of gastrointestinal tumors;however,it can lead to emergence agitation(EA).EA is a common complication associated with general anesthesia,often ...BACKGROUND General anesthesia is commonly used in the surgical management of gastrointestinal tumors;however,it can lead to emergence agitation(EA).EA is a common complication associated with general anesthesia,often characterized by behaviors,such as crying,struggling,and involuntary limb movements in patients.If treatment is delayed,there is a risk of incision cracking and bleeding,which can significantly affect surgical outcomes.Therefore,having a proper understanding of the factors influencing the occurrence of EA and implementing early preventive measures may reduce the incidence of agitation during the recovery phase from general anesthesia,which is beneficial for improving patient prognosis.AIM To analyze influencing factors and develop a risk prediction model for EA occurrence following general anesthesia for primary liver cancer.METHODS Retrospective analysis of clinical data from 200 patients who underwent hepatoma resection under general anesthesia at Wenzhou Central Hospital(January 2020 to December 2023)was conducted.Post-surgery,the Richmond Agitation-Sedation Scale was used to evaluate EA presence,noting EA incidence after general anesthesia.Patients were categorized by EA presence postoperatively,and the influencing factors were analyzed using logistic regression.A nomogram-based risk prediction model was constructed and evaluated for differentiation and fit using receiver operating characteristics and calibration curves.RESULTS EA occurred in 51(25.5%)patients.Multivariate analysis identified advanced age,American Society of Anesthesiologists(ASA)grade Ⅲ,indwelling catheter use,and postoperative pain as risk factors for EA(P<0.05).Conversely,postoperative analgesia was a protective factor against EA(P<0.05).The area under the curve of the nomogram was 0.972[95%confidence interval(CI):0.947-0.997]for the training set and 0.979(95%CI:0.951-1.000)for the test set.Hosmer-Lemeshow test showed a good fit(χ^(2)=5.483,P=0.705),and calibration curves showed agreement between predicted and actual EA incidence.CONCLUSION Age,ASA grade,catheter use,postoperative pain,and analgesia significantly influence EA occurrence.A nomogram constructed using these factors demonstrates strong predictive accuracy.展开更多
BACKGROUND Owing to the particularities of their physical characteristics,older patients undergoing surgery under general anesthesia experience great surgical traumas.Thus,exploring more refined and individualized nur...BACKGROUND Owing to the particularities of their physical characteristics,older patients undergoing surgery under general anesthesia experience great surgical traumas.Thus,exploring more refined and individualized nursing approaches is an urgent need to mitigate the negative effects of surgery on such patients.AIM To analyze the influence of preoperative comprehensive education on anxiety,depression,pain,and sleep in older patients who underwent surgery under general anesthesia.METHODS In total,163 older adults who underwent surgery under general anesthesia between June 2022 and November 2023 were selected,77 of them received routine nursing care(control group),and 86 received preoperative comprehensive education(research group).Subsequently,comparative analyses were performed from the following perspectives:Surgical indicators(operation time,time to complete regain of consciousness,and temperature immediately after the procedure and upon recovery from anesthesia)before and after nursing care;negative emotions[self-rating anxiety scale(SAS)/self-rating depression scale(SDS)];pain severity[visual analog scale(VAS)];sleep quality[Pittsburgh sleep quality index(PSQI)];incidence of sleep disturbances(difficulties in falling asleep for the first time,falling asleep again after waking up frequently at night,falling asleep again after waking up early,and falling asleep all night);and incidence of adverse events(airway obstruction,catheter detachment,aspiration,and asphyxia).RESULTS The research group had significantly lower operation time and time to complete regain of consciousness than the control group after nursing care and markedly better recovery of postoperative body temperature and body temperature at awakening.In addition,more notable decreases in SAS,SDS,VAS,and PSQI scores were observed in the research group than in the control group.Furthermore,the incidence rate of sleep disturbance(8.14%vs 29.87%)and adverse events(4.65%vs 19.48%)were lower in the research group than in the control group.CONCLUSION Preoperative comprehensive education in older patients who underwent surgery under general anesthesia can improve postoperative indicators,effectively reduce the occurrence of anxiety and depression,alleviate postoperative pain,and improve sleep quality.展开更多
General anesthesia plays a significant role in modern medicine.However,the precise mechanism of general anesthesia remains unclear,posing a key scientific challenge in anesthesiology.Advances in neuroscience technique...General anesthesia plays a significant role in modern medicine.However,the precise mechanism of general anesthesia remains unclear,posing a key scientific challenge in anesthesiology.Advances in neuroscience techniques have enabled targeted manipulation of specific neural circuits and the capture of brain-wide neural activity at high resolution.These advances hold promise for elucidating the intricate mechanisms of action of general anesthetics.This review aims to summarize our current understanding of the role of cortical and subcortical nuclei in modulating general anesthesia,providing new evidence of cortico-cortical and thalamocortical networks in relation to anesthesia and consciousness.These insights contribute to a comprehensive understanding of the neural network mechanisms underlying general anesthesia.展开更多
Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anest...Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4<sup>th</sup> post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.展开更多
Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eight...Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eighty patients diagnosed with tuberculous pyothorax,admitted to the hospital between January 2023 and September 2023,were randomly selected for this study.The patients were divided into control and study groups using a numerical table method.The control group underwent general anesthesia with bronchial intubation,while the study group received general anesthesia with bronchial intubation in conjunction with thoracic paravertebral nerve block.Subsequently,the patients were monitored to assess mean arterial pressure,heart rate variations,and adverse reactions to anesthesia.Results:The study group exhibited significantly lower mean arterial pressure and heart rate levels during the post-surgical incision,immediate end of surgery,and immediate extubation periods compared to the control group(P<0.05).Furthermore,the Ricker and Ramsay scores in the study group were significantly lower than those in the control group(P<0.05).Conclusion:The combined use of general anesthesia via bronchial intubation and thoracic paravertebral nerve block has been found to stabilize mean arterial pressure and heart rate while providing effective sedation for surgical treatment in patients with tuberculous septic thorax.展开更多
<b>Background:</b> Peripheral block techniques for total hip arthroplasty have been used as an analgesic strategy, only a few studies described it as an anesthetic technique, so the perioperative performan...<b>Background:</b> Peripheral block techniques for total hip arthroplasty have been used as an analgesic strategy, only a few studies described it as an anesthetic technique, so the perioperative performance and safety are poorly studied. <b>Methods:</b> 78 total hip arthroplasties were prospectively observed in our hospital. Divided into 2 groups: 1) General anesthesia;and 2) Lumbar sacral plexus block anesthesia. Variables measured in both groups were: demographics, conversion to general anesthesia, total opioid doses, surgical time, blood loss, postoperative pain, use and total dose of vasopressors drugs, transfusion and ICU transfer needs, postoperative ambulation time, and length of hospital stay. T student and chi-square tests were used upon the case. A significant difference was considered when a value of p < 0.05 was obtained. Descriptive statistics were performed in frequency, percentages, variance and standard deviation. <b>Results:</b> 3 patients (7.3%) anesthetized with combined lumbar sacral plexus block were converted to general anesthesia. When comparing peripheral nerve block and general anesthesia, less intraoperative (p = 0.000) and postoperative (p = 0.002) opioid consumption were noted, less postoperative pain in PACU (p = 0.002) and in the first 24 hours (p = 0.005), as well as earlier onset of ambulation (p = 0.008) and shorter hospital stay (p = 0.031). <b>Conclusions:</b> In our study, the lumbar and sacral plexus block anesthesia technique provided anesthetic conditions to perform hip joint arthroplasty and it was proved to be advantageous in comparison to general anesthesia.展开更多
BACKGROUND： Acupuncture anesthesia was created in the 1950＇s in China and continues to be used there today during most major surgeries. It is widely used in China for such complex operations as brain heart, and abdo...BACKGROUND： Acupuncture anesthesia was created in the 1950＇s in China and continues to be used there today during most major surgeries. It is widely used in China for such complex operations as brain heart, and abdominal surgery. It is popular in China because it is economical, practical, and beneficial to the patients. With acupuncture anesthesia there is less bleeding during surgery and there is also quicker post-operative recovery. OBJECTIVE： This randomized prospective study aims at comparing the effect of two acupoints （Yongquan, KI1 and Renzhong, DU26） with sham acupuncture and no acupuncture on the time to recovery of consciousness after general anesthesia by means of the Bispectral Index monitor （BIS） DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This is a prospective randomized controlled study. We randomly assigned 50 patients to 5 groups during recovery from surgical anesthesia. Four groups had acupuncture on KI1 （group A）, DU26 （groups B）, both KI1 and DU26 （group C）, and sham points （group D）, and one had no acupuncture （group E）. MAIN OUTCOME MEASURES： Bispectral Index （BIS）, time to spontaneous eye opening, time to tracheal extubation, and time to following commands were measured as the main outcome measures RESULTS： Time to spontaneous eye opening differed among groups （P=0.002）, as well as time to tracheal extubation （P〈0.000 1） and time to following commands （P=0.000 6）. BIS values differed significantly among groups both 5 and 10 min after the end of anesthesia （P〈0.000 1 and P=0.000 4, respectively）. BIS values of groups D and E were lower than those of the other groups and those of group C were higher. The same pattern was observed also 15 and 30 rain after the end of anesthesia although the difference among groups was not significant at these time points （P=0.164 and P=0.104 respectively）. CONCLUSION： Acupuncture on DU26 and KI 1 accelerates recovery of consciousness after general anesthesia. Moreover, a possible synergistic effect of DU26 and KI1 is suggested. This issue may play a role in the optimization of operating room management and raise interest about the usefulness of acupuncture on unconsciousness states of different nature.展开更多
Objective Neuraxial block is the most common anesthesia method for cesarean section(CS).However,for some urgent and high-risk cesarean delivery,general anesthesia(GA)also plays a very important role.We aimed to find o...Objective Neuraxial block is the most common anesthesia method for cesarean section(CS).However,for some urgent and high-risk cesarean delivery,general anesthesia(GA)also plays a very important role.We aimed to find out the reasons of choosing GA for CS in our center and the factors that may be related to the maternal and fetal outcomes.Methods We retrospectively selected parturients who had CS procedures under GA in Peking Union Medical College Hospital from January 1,2014 to December 31,2016.Clinical data(baseline maternal status,preoperative status,perioperative information,maternal and fetal outcomes)of parturients and neonates were collected and analyzed.We summarized the common reasons for applying general anesthesia,and compared the back-to-ICU ratio and hospital stay time between parturients with different maternal American Society of Anesthesiologists(ASA)grade,gestational weeks and intraoperative blood loss,as well as the fetal one-minute Apgar score between different maternal ASA grade and gestational weeks.Results There were 98 cases of CS under GA enrolled in the study.Among the maternal and fetal factors,pregnancy with internal or surgical diseases is the most common reason(59 cases,60.2%)for choosing GA,followed by the placenta and fetal membrane abnormalities(38 cases,38.8%)and the pregnancy-specific disorders(36 cases,36.7%).ASA gradeⅢ-Ⅳof parturients(χ2=44.3,P<0.05),gestation period<37 weeks(χ2=23.4,P<0.05),and blood loss>800 ml(χ2=5.5,P<0.05)were related to the higher postoperative intensive care unit(ICU)rate in parturients.ASA gradeⅢ-Ⅳof parturients(t=-2.99,P<0.05),gestation period<37 weeks(t=2.47,P<0.05)were related to the longer hospital stay.ASA gradeⅢ-Ⅳof parturients(t=2.21,P=0.01)and gestation period<37 weeks(t=-3.21,P=0.002)were related to the lower one-minute Apgar score of neonates.Conclusion Pregnancy with internal or surgical diseases is the most common reason for choosing GA for CS.High ASA grade and short gestation period were the related factors of high postoperative ICU ratio for parturients and low one-minute Apgar score for neonates.展开更多
Objective： To investigate the dynamics of vascular volume and the plasma dilution of lactated Ringer＇s solution in patients during the induction of general and epidural anesthesia. Methods： The hemodilution of i.v....Objective： To investigate the dynamics of vascular volume and the plasma dilution of lactated Ringer＇s solution in patients during the induction of general and epidural anesthesia. Methods： The hemodilution of i.v. infusion of 1000 ml of lactated Ringer＇s solution over 60 min was studied in patients undergoing general （n=31） and epidural （n= 22） anesthesia. Heart rate, arterial blood pressure and hemoglobin （Hb） concentration were measured every 5 rain during the study. Surgery was not started until the study period had been completed. Results： General anesthesia caused the greater decrease of mean arterial blood pressure （MAP） （mean 15% versus 9%; P〈0.01） and thereby followed by a more pronounced plasma dilution, blood volume expansion （VE） and blood volume expansion efficiency （VEE）. A strong linear correlation between hemodilution and the reduction in MAP （r=-0.50;P〈0.01） was found. At the end of infusion, patients undergoing general anesthesia retained 47% （SD 19%） of the infused fluid in the circulation, while epidural anesthesia retained 29% （SD 13%） （P〈0.001）. Correspondingly, a fewer urine output （mean 89 ml versus 156 ml; P〈0.05） and extravascular expansion （454 ml versus 551 ml; P〈0.05） were found during general anesthesia. Conclusion： We concluded that the induction of general anesthesia caused more hemodilution, volume expansion and volume expansion efficiency than epidural anesthesia, which was triggered only by the lower MAP.展开更多
BACKGROUND In an effort to further reduce the morbidity and mortality profile of laparoscopic cholecystectomy,the outcomes of such procedure under regional anesthesia(RA)have been evaluated.In the context of cholecyst...BACKGROUND In an effort to further reduce the morbidity and mortality profile of laparoscopic cholecystectomy,the outcomes of such procedure under regional anesthesia(RA)have been evaluated.In the context of cholecystectomy,combining a minimally invasive surgical procedure with a minimally invasive anesthetic technique can potentially be associated with less postoperative pain and earlier ambulation.AIM To evaluate comparative outcomes of RA and general anesthesia(GA)in patients undergoing laparoscopic cholecystectomy.METHODS A comprehensive systematic review of randomized controlled trials with subsequent meta-analysis and trial sequential analysis of outcomes were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards.RESULTS Thirteen randomized controlled trials enrolling 1111 patients were included.The study populations in the RA and GA groups were of comparable age(P=0.41),gender(P=0.98)and body mass index(P=0.24).The conversion rate from RA to GA was 2.3%.RA was associated with significantly less postoperative pain at 4 h[mean difference(MD):-2.22,P<0.00001],8 h(MD:-1.53,P=0.0006),12 h(MD:-2.08,P<0.00001),and 24 h(MD:-0.90,P<0.00001)compared to GA.Moreover,it was associated with significantly lower rate of nausea and vomiting[risk ratio(RR):0.40,P<0.0001].However,RA significantly increased postoperative headaches(RR:4.69,P=0.03),and urinary retention(RR:2.73,P=0.03).The trial sequential analysis demonstrated that the meta-analysis was conclusive for most outcomes,with the exception of a risk of type 1 error for headache and urinary retention and a risk of type 2 error for total procedure time.CONCLUSION Our findings indicate that RA may be an attractive anesthetic modality for daycase laparoscopic cholecystectomy considering its associated lower postoperative pain and nausea and vomiting compared to GA.However,its associated risk of urinary retention and headache and lack of knowledge on its impact on procedure-related outcomes do not justify using RA as the first line anesthetic choice for laparoscopic cholecystectomy.展开更多
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.
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: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 The use of an ultrasound-guided quadratus lumborum block(QLB)combined with general anesthesia for patients undergoing colorectal cancer surgery serves as a model for reducing the postoperative stress response,preserving metabolic stability,protecting renal function,and alleviating postoperative pain.AIM To compare QLB combined with general anesthesia vs general anesthesia alone in the perioperative stress response,metabolic and renal function,postoperative pain,and recovery outcomes among patients undergoing colorectal cancer surgery.METHODS Clinical data of 116 patients who underwent colorectal cancer surgery at our hospital between July 2023 and August 2024 were collected for retrospective analysis.According to the anesthesia protocol,the patients were divided into the control(general anesthesia,n=58)and experimental groups(QLB combined with general anesthesia,n=58).Physiological indicators such as blood glucose(GLU),lactic acid(LAC),blood urea nitrogen(BUN),and creatinine(CRE)were measured at T0(pre-surgery),T1(post-surgery),T2(6 hours post-surgery),T3(24 hours post-surgery),and T4(48 hours post-surgery).The differences between the two groups for each indicator were evaluated using repeated-measures analysis of variance.RESULTS The GLU levels from T1 to T4 in the experimental group were significantly lower than those in the control group(P<0.001),and the LAC levels were also significantly reduced(P<0.001).The experimental group exhibited superior renal protection based on postoperative BUN and CRE levels(P<0.05).Furthermore,the postoperative pain score in the experimental group was significantly lower than that in the control group[visual analogue scale(VAS)]scores differed significantly from T2 to T4,P<0.05.CONCLUSION Research has shown that QLB combined with general anesthesia can decrease postoperative GLU and LAC by 8%-15%and 10%-20%(P<0.001),respectively.It also enhances renal function markers(BUN,CRE,P<0.05)and lowers VAS scores by 15%-30%(P<0.05).Ultrasound-guided lumbar muscle block with general anesthesia outperforms general anesthesia alone in diminishing stress response,preserving metabolic balance and renal function,and alleviating postoperative pain.This approach offers a more efficient perioperative management strategy for patients undergoing colorectal cancer surgery.It is particularly advantageous for individuals with stress sensitivity,renal impairment,and heightened pain susceptibility.
文摘BACKGROUND Subcutaneous implantable cardioverter-defibrillator(S-ICD)implantation requires effective anesthesia.General anesthesia(GA)carries risks like hemodynamic instability,while ultrasound-guided intercostal nerve block(US-ICNB)may offer better pain control.This study hypothesized US-ICNB is superior in perioperative safety and pain management.AIM To compare perioperative outcomes of GA and US-ICNB in S-ICD implantation.METHODS This retrospective single-center study included 64 patients who received S-ICD implantation between February 2021 and December 2024.They were divided into GA and US-ICNB groups based on anesthesia type.Demographic data,perioperative parameters(operation time,pain scores,analgesic usage),and postoperative outcomes(complications,defibrillation events)were collected and analyzed.Statistical tests were used to compare the two groups.RESULTS This study included 64 patients(20 in the GA group and 44 in the US-ICNB group).Baseline left ventricular ejection fraction was significantly lower in the US-ICNB group(39.20%±12.00%vs 56.20%±11.50%in GA,P<0.001),while American Society of Anesthesiologists scores and comorbidities were comparable.US-ICNB showed superior pain control,with significantly lower numeric rating scale scores at 6-48 hours(P<0.001)and fewer patients requiring analgesics(P=0.02).The US-ICNB group had shorter operation times(P<0.001),total hospital stays(P<0.001),and later first analgesia times(P<0.001).No anesthesia-related complications occurred in either group.CONCLUSION Both anesthetic methods were safe in the short term.However,US-ICNB was superior in reducing operation and hospital stay times and alleviating peri-operative pain.It has high safety in S-ICD implantation and deserves further clinical promotion,though large-scale,multi-center,randomized controlled trials are needed to confirm these findings.
文摘BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.
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 observe the application effects of anesthesia recovery nursing with heat preservation measures in patients undergoing general anesthesia surgery.Methods:300 cases of general anesthesia surgery patients in our hospital from March 2023 to February 2024 were selected and divided into the control group and the observation group according to the random number table method,each with 150 cases.The control group adopted conventional care,while the observation group was given anesthesia recovery care and heat preservation measures on the basis of conventional care.The wake-up time,extubation time,hospitalization time,and the incidence of adverse reactions were compared between the two groups and statistically analyzed.Results:The wake-up time of patients in the control group was 9.71±1.20 hours,and that of the observation group was 6.51±1.02 hours,with statistically significant differences(P<0.05);the extubation times of patients in the observation group and the control group after awakening were 8.52±0.41 min and 10.42±1.12 min,respectively,with statistically significant differences(P<0.05)The hospital stay after the operation in the observation group and the control group was 32.91±4.71 days and 37.24±3.34 days respectively,and the difference was statistically significant(P<0.05),and the incidence rate of adverse reactions after extubation in the observation group(3.33%)was significantly lower than that in the control group(10.00%)(P<0.05).Conclusion:In general anesthesia surgery patients,the implementation of anesthesia recovery nursing with heat preservation measures can significantly improve the physical condition of patients,effectively shorten the duration of surgery and patients’wake-up time,and improve their quality of life,which is worthy of clinical promotion and application.
文摘BACKGROUND General anesthesia is commonly used in the surgical management of gastrointestinal tumors;however,it can lead to emergence agitation(EA).EA is a common complication associated with general anesthesia,often characterized by behaviors,such as crying,struggling,and involuntary limb movements in patients.If treatment is delayed,there is a risk of incision cracking and bleeding,which can significantly affect surgical outcomes.Therefore,having a proper understanding of the factors influencing the occurrence of EA and implementing early preventive measures may reduce the incidence of agitation during the recovery phase from general anesthesia,which is beneficial for improving patient prognosis.AIM To analyze influencing factors and develop a risk prediction model for EA occurrence following general anesthesia for primary liver cancer.METHODS Retrospective analysis of clinical data from 200 patients who underwent hepatoma resection under general anesthesia at Wenzhou Central Hospital(January 2020 to December 2023)was conducted.Post-surgery,the Richmond Agitation-Sedation Scale was used to evaluate EA presence,noting EA incidence after general anesthesia.Patients were categorized by EA presence postoperatively,and the influencing factors were analyzed using logistic regression.A nomogram-based risk prediction model was constructed and evaluated for differentiation and fit using receiver operating characteristics and calibration curves.RESULTS EA occurred in 51(25.5%)patients.Multivariate analysis identified advanced age,American Society of Anesthesiologists(ASA)grade Ⅲ,indwelling catheter use,and postoperative pain as risk factors for EA(P<0.05).Conversely,postoperative analgesia was a protective factor against EA(P<0.05).The area under the curve of the nomogram was 0.972[95%confidence interval(CI):0.947-0.997]for the training set and 0.979(95%CI:0.951-1.000)for the test set.Hosmer-Lemeshow test showed a good fit(χ^(2)=5.483,P=0.705),and calibration curves showed agreement between predicted and actual EA incidence.CONCLUSION Age,ASA grade,catheter use,postoperative pain,and analgesia significantly influence EA occurrence.A nomogram constructed using these factors demonstrates strong predictive accuracy.
基金Supported by the Autonomous Region Key R&D Program Project“Research on the Prevention and Treatment System and Key Technologies of Elderly Related Diseases",No.2022B03009-4.
文摘BACKGROUND Owing to the particularities of their physical characteristics,older patients undergoing surgery under general anesthesia experience great surgical traumas.Thus,exploring more refined and individualized nursing approaches is an urgent need to mitigate the negative effects of surgery on such patients.AIM To analyze the influence of preoperative comprehensive education on anxiety,depression,pain,and sleep in older patients who underwent surgery under general anesthesia.METHODS In total,163 older adults who underwent surgery under general anesthesia between June 2022 and November 2023 were selected,77 of them received routine nursing care(control group),and 86 received preoperative comprehensive education(research group).Subsequently,comparative analyses were performed from the following perspectives:Surgical indicators(operation time,time to complete regain of consciousness,and temperature immediately after the procedure and upon recovery from anesthesia)before and after nursing care;negative emotions[self-rating anxiety scale(SAS)/self-rating depression scale(SDS)];pain severity[visual analog scale(VAS)];sleep quality[Pittsburgh sleep quality index(PSQI)];incidence of sleep disturbances(difficulties in falling asleep for the first time,falling asleep again after waking up frequently at night,falling asleep again after waking up early,and falling asleep all night);and incidence of adverse events(airway obstruction,catheter detachment,aspiration,and asphyxia).RESULTS The research group had significantly lower operation time and time to complete regain of consciousness than the control group after nursing care and markedly better recovery of postoperative body temperature and body temperature at awakening.In addition,more notable decreases in SAS,SDS,VAS,and PSQI scores were observed in the research group than in the control group.Furthermore,the incidence rate of sleep disturbance(8.14%vs 29.87%)and adverse events(4.65%vs 19.48%)were lower in the research group than in the control group.CONCLUSION Preoperative comprehensive education in older patients who underwent surgery under general anesthesia can improve postoperative indicators,effectively reduce the occurrence of anxiety and depression,alleviate postoperative pain,and improve sleep quality.
基金supported by the National Natural Science Foundation of China(82271292,82371286,and 82101350)the Foundation of Shanghai Municipal Science and Technology Medical Innovation Research Project(23Y21900600).
文摘General anesthesia plays a significant role in modern medicine.However,the precise mechanism of general anesthesia remains unclear,posing a key scientific challenge in anesthesiology.Advances in neuroscience techniques have enabled targeted manipulation of specific neural circuits and the capture of brain-wide neural activity at high resolution.These advances hold promise for elucidating the intricate mechanisms of action of general anesthetics.This review aims to summarize our current understanding of the role of cortical and subcortical nuclei in modulating general anesthesia,providing new evidence of cortico-cortical and thalamocortical networks in relation to anesthesia and consciousness.These insights contribute to a comprehensive understanding of the neural network mechanisms underlying general anesthesia.
文摘Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4<sup>th</sup> post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.
基金Research Project of the Xi’an Municipal Health Commission(No.2023yb40,Project leader:Duan Chunyu)。
文摘Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eighty patients diagnosed with tuberculous pyothorax,admitted to the hospital between January 2023 and September 2023,were randomly selected for this study.The patients were divided into control and study groups using a numerical table method.The control group underwent general anesthesia with bronchial intubation,while the study group received general anesthesia with bronchial intubation in conjunction with thoracic paravertebral nerve block.Subsequently,the patients were monitored to assess mean arterial pressure,heart rate variations,and adverse reactions to anesthesia.Results:The study group exhibited significantly lower mean arterial pressure and heart rate levels during the post-surgical incision,immediate end of surgery,and immediate extubation periods compared to the control group(P<0.05).Furthermore,the Ricker and Ramsay scores in the study group were significantly lower than those in the control group(P<0.05).Conclusion:The combined use of general anesthesia via bronchial intubation and thoracic paravertebral nerve block has been found to stabilize mean arterial pressure and heart rate while providing effective sedation for surgical treatment in patients with tuberculous septic thorax.
文摘<b>Background:</b> Peripheral block techniques for total hip arthroplasty have been used as an analgesic strategy, only a few studies described it as an anesthetic technique, so the perioperative performance and safety are poorly studied. <b>Methods:</b> 78 total hip arthroplasties were prospectively observed in our hospital. Divided into 2 groups: 1) General anesthesia;and 2) Lumbar sacral plexus block anesthesia. Variables measured in both groups were: demographics, conversion to general anesthesia, total opioid doses, surgical time, blood loss, postoperative pain, use and total dose of vasopressors drugs, transfusion and ICU transfer needs, postoperative ambulation time, and length of hospital stay. T student and chi-square tests were used upon the case. A significant difference was considered when a value of p < 0.05 was obtained. Descriptive statistics were performed in frequency, percentages, variance and standard deviation. <b>Results:</b> 3 patients (7.3%) anesthetized with combined lumbar sacral plexus block were converted to general anesthesia. When comparing peripheral nerve block and general anesthesia, less intraoperative (p = 0.000) and postoperative (p = 0.002) opioid consumption were noted, less postoperative pain in PACU (p = 0.002) and in the first 24 hours (p = 0.005), as well as earlier onset of ambulation (p = 0.008) and shorter hospital stay (p = 0.031). <b>Conclusions:</b> In our study, the lumbar and sacral plexus block anesthesia technique provided anesthetic conditions to perform hip joint arthroplasty and it was proved to be advantageous in comparison to general anesthesia.
文摘BACKGROUND： Acupuncture anesthesia was created in the 1950＇s in China and continues to be used there today during most major surgeries. It is widely used in China for such complex operations as brain heart, and abdominal surgery. It is popular in China because it is economical, practical, and beneficial to the patients. With acupuncture anesthesia there is less bleeding during surgery and there is also quicker post-operative recovery. OBJECTIVE： This randomized prospective study aims at comparing the effect of two acupoints （Yongquan, KI1 and Renzhong, DU26） with sham acupuncture and no acupuncture on the time to recovery of consciousness after general anesthesia by means of the Bispectral Index monitor （BIS） DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This is a prospective randomized controlled study. We randomly assigned 50 patients to 5 groups during recovery from surgical anesthesia. Four groups had acupuncture on KI1 （group A）, DU26 （groups B）, both KI1 and DU26 （group C）, and sham points （group D）, and one had no acupuncture （group E）. MAIN OUTCOME MEASURES： Bispectral Index （BIS）, time to spontaneous eye opening, time to tracheal extubation, and time to following commands were measured as the main outcome measures RESULTS： Time to spontaneous eye opening differed among groups （P=0.002）, as well as time to tracheal extubation （P〈0.000 1） and time to following commands （P=0.000 6）. BIS values differed significantly among groups both 5 and 10 min after the end of anesthesia （P〈0.000 1 and P=0.000 4, respectively）. BIS values of groups D and E were lower than those of the other groups and those of group C were higher. The same pattern was observed also 15 and 30 rain after the end of anesthesia although the difference among groups was not significant at these time points （P=0.164 and P=0.104 respectively）. CONCLUSION： Acupuncture on DU26 and KI 1 accelerates recovery of consciousness after general anesthesia. Moreover, a possible synergistic effect of DU26 and KI1 is suggested. This issue may play a role in the optimization of operating room management and raise interest about the usefulness of acupuncture on unconsciousness states of different nature.
基金Fund supported by the CAMS Innovation Fund for Medical Sciences(CIFMS:2016-12M-3-024)~~
文摘Objective Neuraxial block is the most common anesthesia method for cesarean section(CS).However,for some urgent and high-risk cesarean delivery,general anesthesia(GA)also plays a very important role.We aimed to find out the reasons of choosing GA for CS in our center and the factors that may be related to the maternal and fetal outcomes.Methods We retrospectively selected parturients who had CS procedures under GA in Peking Union Medical College Hospital from January 1,2014 to December 31,2016.Clinical data(baseline maternal status,preoperative status,perioperative information,maternal and fetal outcomes)of parturients and neonates were collected and analyzed.We summarized the common reasons for applying general anesthesia,and compared the back-to-ICU ratio and hospital stay time between parturients with different maternal American Society of Anesthesiologists(ASA)grade,gestational weeks and intraoperative blood loss,as well as the fetal one-minute Apgar score between different maternal ASA grade and gestational weeks.Results There were 98 cases of CS under GA enrolled in the study.Among the maternal and fetal factors,pregnancy with internal or surgical diseases is the most common reason(59 cases,60.2%)for choosing GA,followed by the placenta and fetal membrane abnormalities(38 cases,38.8%)and the pregnancy-specific disorders(36 cases,36.7%).ASA gradeⅢ-Ⅳof parturients(χ2=44.3,P<0.05),gestation period<37 weeks(χ2=23.4,P<0.05),and blood loss>800 ml(χ2=5.5,P<0.05)were related to the higher postoperative intensive care unit(ICU)rate in parturients.ASA gradeⅢ-Ⅳof parturients(t=-2.99,P<0.05),gestation period<37 weeks(t=2.47,P<0.05)were related to the longer hospital stay.ASA gradeⅢ-Ⅳof parturients(t=2.21,P=0.01)and gestation period<37 weeks(t=-3.21,P=0.002)were related to the lower one-minute Apgar score of neonates.Conclusion Pregnancy with internal or surgical diseases is the most common reason for choosing GA for CS.High ASA grade and short gestation period were the related factors of high postoperative ICU ratio for parturients and low one-minute Apgar score for neonates.
基金Project (No. 20051899) supported by Office of Education of Zheji-ang Province, China
文摘Objective： To investigate the dynamics of vascular volume and the plasma dilution of lactated Ringer＇s solution in patients during the induction of general and epidural anesthesia. Methods： The hemodilution of i.v. infusion of 1000 ml of lactated Ringer＇s solution over 60 min was studied in patients undergoing general （n=31） and epidural （n= 22） anesthesia. Heart rate, arterial blood pressure and hemoglobin （Hb） concentration were measured every 5 rain during the study. Surgery was not started until the study period had been completed. Results： General anesthesia caused the greater decrease of mean arterial blood pressure （MAP） （mean 15% versus 9%; P〈0.01） and thereby followed by a more pronounced plasma dilution, blood volume expansion （VE） and blood volume expansion efficiency （VEE）. A strong linear correlation between hemodilution and the reduction in MAP （r=-0.50;P〈0.01） was found. At the end of infusion, patients undergoing general anesthesia retained 47% （SD 19%） of the infused fluid in the circulation, while epidural anesthesia retained 29% （SD 13%） （P〈0.001）. Correspondingly, a fewer urine output （mean 89 ml versus 156 ml; P〈0.05） and extravascular expansion （454 ml versus 551 ml; P〈0.05） were found during general anesthesia. Conclusion： We concluded that the induction of general anesthesia caused more hemodilution, volume expansion and volume expansion efficiency than epidural anesthesia, which was triggered only by the lower MAP.
文摘BACKGROUND In an effort to further reduce the morbidity and mortality profile of laparoscopic cholecystectomy,the outcomes of such procedure under regional anesthesia(RA)have been evaluated.In the context of cholecystectomy,combining a minimally invasive surgical procedure with a minimally invasive anesthetic technique can potentially be associated with less postoperative pain and earlier ambulation.AIM To evaluate comparative outcomes of RA and general anesthesia(GA)in patients undergoing laparoscopic cholecystectomy.METHODS A comprehensive systematic review of randomized controlled trials with subsequent meta-analysis and trial sequential analysis of outcomes were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards.RESULTS Thirteen randomized controlled trials enrolling 1111 patients were included.The study populations in the RA and GA groups were of comparable age(P=0.41),gender(P=0.98)and body mass index(P=0.24).The conversion rate from RA to GA was 2.3%.RA was associated with significantly less postoperative pain at 4 h[mean difference(MD):-2.22,P<0.00001],8 h(MD:-1.53,P=0.0006),12 h(MD:-2.08,P<0.00001),and 24 h(MD:-0.90,P<0.00001)compared to GA.Moreover,it was associated with significantly lower rate of nausea and vomiting[risk ratio(RR):0.40,P<0.0001].However,RA significantly increased postoperative headaches(RR:4.69,P=0.03),and urinary retention(RR:2.73,P=0.03).The trial sequential analysis demonstrated that the meta-analysis was conclusive for most outcomes,with the exception of a risk of type 1 error for headache and urinary retention and a risk of type 2 error for total procedure time.CONCLUSION Our findings indicate that RA may be an attractive anesthetic modality for daycase laparoscopic cholecystectomy considering its associated lower postoperative pain and nausea and vomiting compared to GA.However,its associated risk of urinary retention and headache and lack of knowledge on its impact on procedure-related outcomes do not justify using RA as the first line anesthetic choice for laparoscopic cholecystectomy.
