Effect of multiple respiratory gas monitoring (MRGM ) on inspiredconcentration of oxygen in circult system during closed anesthesia was studied in 5l adult patients scheduled for abdominal surgery. Required flow rate ...Effect of multiple respiratory gas monitoring (MRGM ) on inspiredconcentration of oxygen in circult system during closed anesthesia was studied in 5l adult patients scheduled for abdominal surgery. Required flow rate of fresh oxygen (OFR), inspired oxygen concentration (FiO2 ) and oxygen saturation of pulse oximeter (SpO2) were measured continu0usly. Patients were equally divided into three groups at randorn, group C (no MRGN used ), group M, (using MRGM with its tail gas returned to circuit system), group M2 (using MRGM without tail gas returned ). The results revealed that during 180 min of closed anesthesia, OFR required in group C and M, were about 200-230 ml/min, and in group M, it was ab0ut 400 ml/min. In group C FiO2 decreased by about 10 % after 60 min of closed anesthesia (P<0. 01, 60 min vs 0 min ) and then stayed stable at this level. In group M,, FiO2 decreased by 16% at 60 min and 34 % at 180 min and the decrease was significantly greater than that in gr0up C (P<0. 01). In group Me, FiO2 remained c0nstant during closed anesthesia, which was much high(Jr than those in group C and M,. The tail gas of Capnomac Ultima MRGM contained less oxygen than its sample gas drawn fr0m circuit system simuItaneously.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
Objective:To study the effect of intravenous inhalational anesthesia under Narcotrend monitor on the systemic traumatic reaction after laparoscopic cholecystectomy.Methods:A total of 116 patients with gallstone who re...Objective:To study the effect of intravenous inhalational anesthesia under Narcotrend monitor on the systemic traumatic reaction after laparoscopic cholecystectomy.Methods:A total of 116 patients with gallstone who received laparoscopic surgery in our hospital between July 2012 and April 2016 were collected and divided into the combined anesthesia group (n=65) who accepted intravenous inhalational anesthesia under Narcotrend monitor and the intravenous anesthesia group (n=51) who accepted total intravenous anesthesia after the anesthesia methods and relevant test results were reviewed. 1 d after operation, enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of pain mediators and inflammation mediators;automatic biochemical analyzer was used to detect the levels of oxidative stress indexes.Results:1 d after operation, serum pain mediators 5-HT, PGE2, NO and HT levels of observation group were lower than those of control group;serum oxidation indexes AOPPs and LHP levels of observation group were lower than those of control group while anti-oxidation indexes CAT and GSH-Px levels were higher than those of control group;serum pro-inflammatory factors IL-6, IL-8 and CRP levels of observation group were lower than those of control group while anti-inflammatory factors IL-4, IL-10 and IL-13 levels were higher than those of control group.Conclusion:Intravenous inhalational anesthesia under Narcotrend monitor can reduce the postoperative systemic traumatic reaction degree in patients with laparoscopic cholecystectomy.展开更多
Objective To assess the effect of combined spinal-epidural anesthesia (CSEA) for caesarean section on maternal and neonatal rennin-angiotensin-aldosterone system (RAAS). Methods Sixty ASA I primiparae aged 22-29 yr, w...Objective To assess the effect of combined spinal-epidural anesthesia (CSEA) for caesarean section on maternal and neonatal rennin-angiotensin-aldosterone system (RAAS). Methods Sixty ASA I primiparae aged 22-29 yr, weighing 46 - 83 kg, scheduled for elective caesarean section were randomized into epidural anesthesia group (EA, n = 30) and combined spinal-epidural anesthesia group ( CSEA, n = 30). All patients were premedicated with intramuscular atropine 0. 5 mg and phenolbarbital 100 mg. In CSEA group a 26 G/16 GChina Medical Abstracts (Surgery) single use spinal/epidural needle (B- D) was used. Spinal and/or epidural anesthesia was performed at L2-3 interspace and a catheter was threaded into the epidural space cephalad for 3 - 5 cm in both groups. In EA group a loading dose of 12 - 16 ml 2 % lidocaine was given and an additional 6-8 ml 2% lidocaine was injected when anesthesia became indadequate during the operation. In CSEA group 2.0-2.5 ml hyperbaric 0.5% bupivacaine (10 - 12.5 mg) was given展开更多
Objective: To study the effect of intravenous inhalational anesthesia under monitoring on systemic traumatic response after laparoscopic cholecystectomy. Methods: A total of 80 cases of patients with chronic cholecyst...Objective: To study the effect of intravenous inhalational anesthesia under monitoring on systemic traumatic response after laparoscopic cholecystectomy. Methods: A total of 80 cases of patients with chronic cholecystitis who received laparoscopic cholecystectomy in our hospital between June 2016 and October 2016 were collected and divided into the control group who accepted total intravenous anesthesia and the observation group who accepted intravenous inhalational anesthesia after the anesthesia methods were reviewed. 6 h, 12 h and 24 h after operation, the RIA method was adopted to determine the serum contents of pain mediators, enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of inflammatory factors and stress hormones, and auto-coagulation analyzer was used to detect the plasma contents of coagulation function indexes. Results: 6 h, 12 h and 24 h after operation, serum pain mediators 5-HT, β-EP and NPY levels of observation group were lower than those of control group, inflammatory factors hs-CRP, IL-6, IL-8 and TNF-α levels were lower than those of control group, and stress hormones Cor, ALD and NE levels were lower than those of control group;plasma coagulation function indexes TXB2, D-D and PLT levels of observation group were lower than those of control group. Conclusion: Intravenous inhalational anesthesia under monitoring can reduce the systemic traumatic reaction after laparoscopic cholecystectomy and has positive clinical significance.展开更多
BACKGROUND Heart failure is generally regarded as a progressive and irreversible medical condition.The EVAHEART is an implantable left ventricular assist system.CASE SUMMARY We report the anesthesia management of a 56...BACKGROUND Heart failure is generally regarded as a progressive and irreversible medical condition.The EVAHEART is an implantable left ventricular assist system.CASE SUMMARY We report the anesthesia management of a 56-year-old male patient with dilated cardiomyopathy undergoing an EVAHEART implantation.Transesophageal echocardiography is crucial to ensure the correct positioning of the device and the proper aortic valve outflow.Because the continuous blood flow device functions best under low systemic and pulmonary vascular resistance,milrinone is the preferred drug.Our patient was accompanied by pulmonary hypertension,so during the operation,nitric oxide was used to reduce pulmonary artery pressure.CONCLUSION The cardiac output achieved by the patient with the assistance of EVAHEART can reach 4 L/min,which of course depends on the front load,rear load,and pump speed.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: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 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
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
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
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 Systematic review focuses on the visual patient avatar(VPA)technology,a tool designed to enhance situational awareness in anesthesia by transforming traditional numerical data into intuitive visual displays...BACKGROUND Systematic review focuses on the visual patient avatar(VPA)technology,a tool designed to enhance situational awareness in anesthesia by transforming traditional numerical data into intuitive visual displays.AIM To explore how VPA can improve perceptual performance,reduce cognitive load,and increase user acceptance,potentially leading to better patient outcomes.METHODS The review is based on 14 studies conducted between 2018 and 2023 in five different hospitals across Europe.RESULTS These studies demonstrate that VPA allows clinicians to perceive and recall vital signs more efficiently than conventional monitoring methods.The technology’s intuitive design helps reduce cognitive workload,indicating less mental effort required for patient monitoring.Users’feedback on VPA was generally positive,highlighting its potential to enhance monitoring and decision-making in highstress environments.However,some users noted the need for further development,particularly in visualization design and data integration.CONCLUSION Review concludes that VPA technology represents a significant advancement in patient monitoring,promoting better situational awareness and potentially improving safety in perioperative care.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: 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: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
文摘Effect of multiple respiratory gas monitoring (MRGM ) on inspiredconcentration of oxygen in circult system during closed anesthesia was studied in 5l adult patients scheduled for abdominal surgery. Required flow rate of fresh oxygen (OFR), inspired oxygen concentration (FiO2 ) and oxygen saturation of pulse oximeter (SpO2) were measured continu0usly. Patients were equally divided into three groups at randorn, group C (no MRGN used ), group M, (using MRGM with its tail gas returned to circuit system), group M2 (using MRGM without tail gas returned ). The results revealed that during 180 min of closed anesthesia, OFR required in group C and M, were about 200-230 ml/min, and in group M, it was ab0ut 400 ml/min. In group C FiO2 decreased by about 10 % after 60 min of closed anesthesia (P<0. 01, 60 min vs 0 min ) and then stayed stable at this level. In group M,, FiO2 decreased by 16% at 60 min and 34 % at 180 min and the decrease was significantly greater than that in gr0up C (P<0. 01). In group Me, FiO2 remained c0nstant during closed anesthesia, which was much high(Jr than those in group C and M,. The tail gas of Capnomac Ultima MRGM contained less oxygen than its sample gas drawn fr0m circuit system simuItaneously.
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Objective:To study the effect of intravenous inhalational anesthesia under Narcotrend monitor on the systemic traumatic reaction after laparoscopic cholecystectomy.Methods:A total of 116 patients with gallstone who received laparoscopic surgery in our hospital between July 2012 and April 2016 were collected and divided into the combined anesthesia group (n=65) who accepted intravenous inhalational anesthesia under Narcotrend monitor and the intravenous anesthesia group (n=51) who accepted total intravenous anesthesia after the anesthesia methods and relevant test results were reviewed. 1 d after operation, enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of pain mediators and inflammation mediators;automatic biochemical analyzer was used to detect the levels of oxidative stress indexes.Results:1 d after operation, serum pain mediators 5-HT, PGE2, NO and HT levels of observation group were lower than those of control group;serum oxidation indexes AOPPs and LHP levels of observation group were lower than those of control group while anti-oxidation indexes CAT and GSH-Px levels were higher than those of control group;serum pro-inflammatory factors IL-6, IL-8 and CRP levels of observation group were lower than those of control group while anti-inflammatory factors IL-4, IL-10 and IL-13 levels were higher than those of control group.Conclusion:Intravenous inhalational anesthesia under Narcotrend monitor can reduce the postoperative systemic traumatic reaction degree in patients with laparoscopic cholecystectomy.
文摘Objective To assess the effect of combined spinal-epidural anesthesia (CSEA) for caesarean section on maternal and neonatal rennin-angiotensin-aldosterone system (RAAS). Methods Sixty ASA I primiparae aged 22-29 yr, weighing 46 - 83 kg, scheduled for elective caesarean section were randomized into epidural anesthesia group (EA, n = 30) and combined spinal-epidural anesthesia group ( CSEA, n = 30). All patients were premedicated with intramuscular atropine 0. 5 mg and phenolbarbital 100 mg. In CSEA group a 26 G/16 GChina Medical Abstracts (Surgery) single use spinal/epidural needle (B- D) was used. Spinal and/or epidural anesthesia was performed at L2-3 interspace and a catheter was threaded into the epidural space cephalad for 3 - 5 cm in both groups. In EA group a loading dose of 12 - 16 ml 2 % lidocaine was given and an additional 6-8 ml 2% lidocaine was injected when anesthesia became indadequate during the operation. In CSEA group 2.0-2.5 ml hyperbaric 0.5% bupivacaine (10 - 12.5 mg) was given
文摘Objective: To study the effect of intravenous inhalational anesthesia under monitoring on systemic traumatic response after laparoscopic cholecystectomy. Methods: A total of 80 cases of patients with chronic cholecystitis who received laparoscopic cholecystectomy in our hospital between June 2016 and October 2016 were collected and divided into the control group who accepted total intravenous anesthesia and the observation group who accepted intravenous inhalational anesthesia after the anesthesia methods were reviewed. 6 h, 12 h and 24 h after operation, the RIA method was adopted to determine the serum contents of pain mediators, enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of inflammatory factors and stress hormones, and auto-coagulation analyzer was used to detect the plasma contents of coagulation function indexes. Results: 6 h, 12 h and 24 h after operation, serum pain mediators 5-HT, β-EP and NPY levels of observation group were lower than those of control group, inflammatory factors hs-CRP, IL-6, IL-8 and TNF-α levels were lower than those of control group, and stress hormones Cor, ALD and NE levels were lower than those of control group;plasma coagulation function indexes TXB2, D-D and PLT levels of observation group were lower than those of control group. Conclusion: Intravenous inhalational anesthesia under monitoring can reduce the systemic traumatic reaction after laparoscopic cholecystectomy and has positive clinical significance.
文摘BACKGROUND Heart failure is generally regarded as a progressive and irreversible medical condition.The EVAHEART is an implantable left ventricular assist system.CASE SUMMARY We report the anesthesia management of a 56-year-old male patient with dilated cardiomyopathy undergoing an EVAHEART implantation.Transesophageal echocardiography is crucial to ensure the correct positioning of the device and the proper aortic valve outflow.Because the continuous blood flow device functions best under low systemic and pulmonary vascular resistance,milrinone is the preferred drug.Our patient was accompanied by pulmonary hypertension,so during the operation,nitric oxide was used to reduce pulmonary artery pressure.CONCLUSION The cardiac output achieved by the patient with the assistance of EVAHEART can reach 4 L/min,which of course depends on the front load,rear load,and pump speed.
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: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.
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 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.
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.
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 Systematic review focuses on the visual patient avatar(VPA)technology,a tool designed to enhance situational awareness in anesthesia by transforming traditional numerical data into intuitive visual displays.AIM To explore how VPA can improve perceptual performance,reduce cognitive load,and increase user acceptance,potentially leading to better patient outcomes.METHODS The review is based on 14 studies conducted between 2018 and 2023 in five different hospitals across Europe.RESULTS These studies demonstrate that VPA allows clinicians to perceive and recall vital signs more efficiently than conventional monitoring methods.The technology’s intuitive design helps reduce cognitive workload,indicating less mental effort required for patient monitoring.Users’feedback on VPA was generally positive,highlighting its potential to enhance monitoring and decision-making in highstress environments.However,some users noted the need for further development,particularly in visualization design and data integration.CONCLUSION Review concludes that VPA technology represents a significant advancement in patient monitoring,promoting better situational awareness and potentially improving safety in perioperative care.
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: 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: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.
