BACKGROUND Several techniques of nasogastric tube(NGT)insertion have been described in the literature with different success rates.AIM To systematically search the literature and conduct a meta-analysis comparing the ...BACKGROUND Several techniques of nasogastric tube(NGT)insertion have been described in the literature with different success rates.AIM To systematically search the literature and conduct a meta-analysis comparing the success rates,insertion time and complications associated with different techniques of NGT insertion in anesthetized and intubated patients.METHODS An electronic search of the PubMed,Scopus,CENTRAL(Cochrane Central Register of Controlled Trials),and Google Scholar databases were performed up to October 31,2019.We included 17 randomized controlled trials with 2500 participants in the meta-analysis.RESULTS As compared to the conventional method,successful insertion of the NGT on first attempt was higher with modified techniques such as the reverse Sellick’s maneuver[relative risk(RR)1.94;95%confidence interval(CI):1.62-2.31],use of a frozen NGT(RR 1.55;95%CI:1.13-2.13),inserting the NGT with neck flexion and lateral neck pressure(RR 1.64;95%CI:1.10-2.45),endotracheal tube-assisted(RR 1.88;95%CI:1.52-2.32)and video-assisted placements(RR 1.60;95%CI:1.31-1.95).All the modified techniques also led to comparatively higher insertion success rates than the conventional technique.CONCLUSION The use of modified techniques of NGT insertion such as the reverse Sellick’s maneuver,neck flexion with lateral neck pressure,frozen NGT,endotracheal tube-guided or video-assisted methods result in a significantly better chance of successful tube insertion at first attempt as compared to the conventional technique.All modified techniques also significantly improve the overall chance of successful NGT placement as compared to the conventional method.展开更多
BACKGROUND: Generally speaking, anesthesia is often used in gravid body and it has been already proved that many kind of medicine can result in malformation. OBJECTIVE: To explore embryonic skeleton development and ne...BACKGROUND: Generally speaking, anesthesia is often used in gravid body and it has been already proved that many kind of medicine can result in malformation. OBJECTIVE: To explore embryonic skeleton development and neonatal learning and memory of rats anesthetized with pentobarbital sodium in gravid rats. DESIGN: A randomized control trial. SETTING: Laboratory Animal Center of Xuzhou Medical College. MATERIALS: A total of 80 adult female SD rats, of clean grade and weighing 220-240 g, were selected in this study. The main reagents were detailed as follows: pentobarbital sodium (Shanghai Xingzhi Chemical Plant, batch number: 921019); MG-2 maze test apparatus (Zhangjiagang Biomedical Instrument Factory); somatotype microscope (Beijing Taike Instrument Co., Ltd.). METHODS: ① A total of 160 SD rats of half males and females were selected in this study. All rats were copulated. The day that the plug was checked out in the vagina next day was looked as the first day of pregnancy. Gravid rats were divided randomly into four groups, including early anesthesia group, second anesthesia group, late anesthesia group and control group with 20 in each group. Rats in the early anesthesia group were injected with 25 mg/kg soluble pentobarbitone on the 7th day of pregnancy for once; rats in the second anesthesia group were anesthetized with 25 mg/kg soluble pentobarbitone on the 7th and the 14th days of pregnancy for once; rats in the late anesthesia group were anesthetized with 25 mg/kg soluble pentobarbitone on the 14th day of pregnancy for once; rats in the control group did not treat with anything. The time of anesthetizing was controlled in 3 to 4 hours and ether was absorbed while the time was not enough. ② Half of each group was sacrificed on day 20th of pregnancy and the fetus was taken out to be stained with alizarin red S. After stained, the fetal skeleton was examined. The learning and memorizing of one-month rats that were given birth by the rest gravid rats were tested through electric mare method. Determine their study ability according to their correct rate of 90% or above of arrival at the safe area in 20 s. After they finally learned to arrive at the safe area correctly, test them once more in 24 hours and record the correct rate of 15 times. MAIN OUTCOME MEASURES: The rate of malformation in fetus and ability of learning and memory in one-month rats. RESULTS: A total of 80 female rats were anesthetized in this experiment. Totally 490 immature rats were tested with maze testing machine and 196 fetuses were stained with alizarin red S to observe the development of their skeleton. However, one of the 80 female rats was led to death because of overdose. ① Malformation experiment: Learning ability of second anesthesia group was evidently different from the control group while the other two groups were not in the electric mare method. The fetal skeleton malformation rate of three experimental groups was 87.0%, 60.9% and 17.9%, respectively, while it was 5.6% in the control group. ② Electric mare method: Times of rats which arrived at the safe regions were respectively 49.0±31.0, 68.0±35.0, 47.0±31.0 and 44.0±21.0 in early anesthesia group, second anesthesia group, late anesthesia group and control group; and then, there was significant difference between the second anesthesia group and the control group (P < 0.05). Exact rates of memory of rats were respectively (64.36±14.35)%, (62.15±18.33)%, (54.19±12.28)% and (68.24±15.91)% in early anesthesia group, second anesthesia group, late anesthesia group and control group; and then, there were no significant differences as compared with the control group (P > 0.05). CONCLUSION: The influence of anesthesia with pentobarbital sodium is obvious in fetal skeleton development and learning and memory ability.展开更多
Researchers have discovered that mice instinctively exhibit rescue-like behavior towards anesthetized companions-a finding that suggests a biological basis for prosociality.The study,published in PNAS on April 23,2025...Researchers have discovered that mice instinctively exhibit rescue-like behavior towards anesthetized companions-a finding that suggests a biological basis for prosociality.The study,published in PNAS on April 23,2025,was led by Dr.HU Li from the Institute of Psychology of the Chinese Academy of Sciences(IPCAS)and Dr.CHEN Zhoufeng from Washington University School of Medicine and the Shenzhen Medical Academy of Research and Translation.展开更多
The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic pro...The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic properties,an increasing body of research has uncovered neuroprotective efects of intravenous anesthetics in various animal and cellular models,as well as in clinical studies.However,there also exists conficting evidence pointing to the potential neurotoxic efects of these intravenous anesthetics.The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized.Considering the mentioned above,this work aims to ofer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system(CNS)and the peripheral nerve system(PNS)and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.展开更多
P2X_(1) receptors and adrenoceptors are mainly responsible for vasoconstriction in a variety of blood vessels.However,previous studies have shown that α,β-methylene adenosine 5'-triphosphate(α,β-MeATP),a stabl...P2X_(1) receptors and adrenoceptors are mainly responsible for vasoconstriction in a variety of blood vessels.However,previous studies have shown that α,β-methylene adenosine 5'-triphosphate(α,β-MeATP),a stable analogue of ATP,can induce both pressor and depressor responses in la boratory animals.In this study,the effects of increasing intravenous doses of α,β-MeATP and noradrenaline(NA)(0-30 nmol/kg)administered at 20 min intervals on systolic(SBP),diastolic(DBP)and mean(MBP)blood pressure in groups of anesthetized mice(n=6)were compared.Both α,β-MeATP and NA caused transient,dose-dependent increases in SBP,DBP and MBP but the effect of α,β-MeATP was more rapid and significantly larger at doses of 10 and 30 nmol/kg(P<0.01).At the dose of 30 nmol/kg,α,β-MeATP increased SBP,DBP and MBP by 65.8±7.0,65.7±5.0 and 65.7±5.5 mmHg,respectively,compared to increases of 36.8±4.6,33.3±4.9 and 34.5±4.7 mmHg,respectively,produced by NA.These results indicate P2X_(1) receptors play an important role in BP regulation although purinergic vasoconstriction alone may not explain the more potent pressor response to α,β-MeATP in the anesthetized mouse.展开更多
Cancer,potentially the second leading cause of mortality globally,poses a significant health challenge.The conventional treatment for solid tumors typically involves surgical intervention,followed by chemotherapy,radi...Cancer,potentially the second leading cause of mortality globally,poses a significant health challenge.The conventional treatment for solid tumors typically involves surgical intervention,followed by chemotherapy,radiotherapy,and targeted therapies.However,cancer recurrence and metastasis remain major issues.Anesthesia is essential for ensuring patient comfort and safety during surgery.Despite its crucial role in surgery,the precise effect of anesthesia on cancer patients'outcomes has not been clearly understood.This comprehensive review aims to elucidate perioperative anesthesia strategies for cancer patients and their potential effects on prognosis.Given the complexity of cancer treatments,understanding the relationship between anesthesia and cancer outcomes is crucial.By examining potential implications of anesthesia strategies for cancer prognosis,this review may help better understand treatment efficacy and risk factors for cancer recurrence and metastasis.Ultimately,a detailed analysis of anesthesia practices in cancer surgery may provide insights to refine existing anesthesia protocols and reduce risk factors for poor patient outcomes.展开更多
Anesthetic pharmacology,a specialized branch of pharmacology,differs significantly from the foundational pharmacology taught in undergraduate medical programs.A key challenge lies in effectively distinguishing and int...Anesthetic pharmacology,a specialized branch of pharmacology,differs significantly from the foundational pharmacology taught in undergraduate medical programs.A key challenge lies in effectively distinguishing and integrating these two courses to enhance students’theoretical understanding and foster their clinical anesthesia skills.This paper explores strategies for optimizing lesson preparation and delivery in anesthetic pharmacology,focusing on course positioning,student knowledge assessment,clinical integration,objective setting,content development,instructional design,innovative teaching tools,and classroom management.The ultimate aim is to enhance teaching effectiveness and train anesthesiology professionals with robust theoretical knowledge and practical competence.展开更多
Dear Editor,General anesthetics play a pivotal role in inducing a safe and reversible loss of consciousness in patients,the importance of which cannot be overstated[1].Among the intravenous anesthetics,propofol stands...Dear Editor,General anesthetics play a pivotal role in inducing a safe and reversible loss of consciousness in patients,the importance of which cannot be overstated[1].Among the intravenous anesthetics,propofol stands out for its rapid onset and swift systemic clearance,effectively eliminating the prolonged sedation associated with earlier agents[2].展开更多
Debates regarding the specific effects of general anesthesia on developing brains have persisted for over 30 years.A consensus has been reached that prolonged,repeated,high-dose exposure to anesthetics is associated w...Debates regarding the specific effects of general anesthesia on developing brains have persisted for over 30 years.A consensus has been reached that prolonged,repeated,high-dose exposure to anesthetics is associated with a higher incidence of deficits in behavior and executive function,while single exposure has a relatively minor effect on long-term neurological function.In this review,we summarize the dose-dependent neuroprotective or neurotoxic effects of gamma-aminobutyric acid type A receptor agonists,a representative group of sedatives,on developing brains or central nervous system diseases.Most preclinical research indicates that anesthetics have neurotoxic effects on the developing brain through various signal pathways.However,recent studies on low-dose anesthetics suggest that they may promote neurodevelopment during this critical period.These findings are incomprehensible for the general“dose-effect”principles of pharmacological research,which has attracted researchers'interest and led to the following questions:What is the threshold for the dual effects exerted by anesthetics such as propofol and sevoflurane on the developing brain?To what extent can their protective effects be maximized?What are the underlying mechanisms involved in these effects?Consequently,this issue has essentially become a“mathematical problem.”After summarizing the dose-dependent effects of gamma-aminobutyric acid type A receptor agonist sedatives in both the developing brain and the brains of patients with central nervous system diseases,we believe that all such anesthetics exhibit specific threshold effects unique to each drug.These effects range from neuroprotection to neurotoxicity,depending on different brain functional states.However,the exact values of the specific thresholds for different drugs in various brain states,as well as the underlying mechanisms explaining why these thresholds exist,remain unclear.Further in-depth exploration of these issues could significantly enhance the therapeutic translational value of these anesthetics.展开更多
Postoperative cognitive dysfunction(POCD)remains a major issue that worsens the prognosis of elderly surgery patients.This article reviews the current research on the effect of different anesthesia methods and commonl...Postoperative cognitive dysfunction(POCD)remains a major issue that worsens the prognosis of elderly surgery patients.This article reviews the current research on the effect of different anesthesia methods and commonly utilized anesthetics on the incidence of POCD in elderly patients,aiming to provide an understanding of the underlying mechanisms contributing to this condition and facilitate the development of more reasonable anesthesia protocols,ultimately reducing the incidence of POCD in elderly surgery patients.展开更多
BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer.However,there is a debate concerning their differential effects on cognitiv...BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer.However,there is a debate concerning their differential effects on cognitive function,anxiety,and depression in patients undergoing this procedure.AIM To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function,anxiety,depression,and organ function in patients undergoing radical resection of gastric cancer.METHODS A total of 80 patients were involved in this research.The subjects were divided into two groups:Propofol group and sevoflurane group.The evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment(LOTCA),and anxiety and depression were assessed with the aid of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Hemodynamic indicators,oxidative stress levels,and pulmonary function were also measured.RESULTS The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane group.Additionally,the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol group.The sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol group.Moreover,the sevoflurane group displayed better pulmonary function and less lung injury than the propofol group.CONCLUSION Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric cancer.Propofol anesthesia has a minimal effect on patients'pulmonary function,consequently enhancing their postoperative recovery.Sevoflurane anesthesia causes less impairment on patients'cognitive function and mitigates negative emotions,leading to an improved postoperative mental state.Therefore,the selection of anesthetic agents should be based on the individual patient's specific circumstances.展开更多
Neuroscientists have recognized the importance of astrocytes in regulating neurological function and their influence on the release of glial transmitters.Few studies,however,have focused on the effects of general anes...Neuroscientists have recognized the importance of astrocytes in regulating neurological function and their influence on the release of glial transmitters.Few studies,however,have focused on the effects of general anesthetic agents on neuroglia or astrocytes.Astrocytes can also be an important target of general anesthetic agents as they exert not only sedative,analgesic,and amnesic effects but also mediate general anesthetic-induced neurotoxicity and postoperative cognitive dysfunction.Here,we analyzed recent advances in understanding the mechanism of general anesthetic agents on astrocytes,and found that exposure to general anesthetic agents will destroy the morphology and proliferation of astrocytes,in addition to acting on the receptors on their surface,which not only affect Ca^(2+)signaling,inhibit the release of brain-derived neurotrophic factor and lactate from astrocytes,but are even involved in the regulation of the pro-and anti-inflammatory processes of astrocytes.These would obviously affect the communication between astrocytes as well as between astrocytes and neighboring neurons,other neuroglia,and vascular cells.In this review,we summarize how general anesthetic agents act on neurons via astrocytes,and explore potential mechanisms of action of general anesthetic agents on the nervous system.We hope that this review will provide a new direction for mitigating the neurotoxicity of general anesthetic agents.展开更多
BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post...BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.展开更多
General anesthetic agents can impact brain function through interactions with neurons and their effects on glial cells.Oligodendrocytes perform essential roles in the central nervous system,including myelin sheath for...General anesthetic agents can impact brain function through interactions with neurons and their effects on glial cells.Oligodendrocytes perform essential roles in the central nervous system,including myelin sheath formation,axonal metabolism,and neuroplasticity regulation.They are particularly vulnerable to the effects of general anesthetic agents resulting in impaired proliferation,differentiation,and apoptosis.Neurologists are increasingly interested in the effects of general anesthetic agents on oligodendrocytes.These agents not only act on the surface receptors of oligodendrocytes to elicit neuroinflammation through modulation of signaling pathways,but also disrupt metabolic processes and alter the expression of genes involved in oligodendrocyte development and function.In this review,we summarize the effects of general anesthetic agents on oligodendrocytes.We anticipate that future research will continue to explore these effects and develop strategies to decrease the incidence of adverse reactions associated with the use of general anesthetic agents.展开更多
BACKGROUND Radical laparoscopic gastrectomy is an important treatment modality for gastric cancer.Surgery requires general anesthesia,and patients are susceptible to the effects of anesthetic drugs and carbon dioxide ...BACKGROUND Radical laparoscopic gastrectomy is an important treatment modality for gastric cancer.Surgery requires general anesthesia,and patients are susceptible to the effects of anesthetic drugs and carbon dioxide insufflation during the procedure,leading to inflammation or severe pain,which can affect patient outcome.AIM To explore the efficacy of combining dexmedetomidine(DEX)with nalbuphine in patients underwent laparoscopic radical gastrectomy for gastric cancer.METHODS Patients scheduled to undergo laparoscopic radical gastrectomy were selected and randomly assigned to A or B group.In A group,patients received an intravenous injection of nalbuphine 0.2 mg/kg+DEX 0.4μg/kg 10 min before the end of surgery;in B group,patients received only an intravenous injection of nalbuphine.The trends in hemodynamic parameter fluctuations,awakening quality during the recovery period,serum inflammatory markers,agitation scores,cough severity,incidence,and duration of postoperative delirium(POD)were compared.RESULTS The mean arterial pressure and heart rate in the A group were more stable(P<0.05).The A group had a lower average awakening time,extubation time,and agitation scores during recovery than the B group.Agitation control in the A group was more effective at different time points(P<0.05).Patients in the A group had lower serum interleukin(IL)-6,tumour necrosis factor alpha,and IL-10 levels at 1 h after surgery than the B group.The incidence of coughing and duration of POD were lower and shorter in the A group than in the B group.Adverse reactions caused by the two anesthesia methods were less frequent in the A group than in the B group(P<0.05).CONCLUSION The use of DEX and nalbuphine in patients undergoing laparoscopic radical gastrectomy for gastric cancer help reducing the inflammatory response,cough severity,and agitation and helps maintain hemodynamic stability.展开更多
Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical charact...Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical characteristics and perioperative care for PPGL. Pheochromocytoma in von Hippel-Lindau(VHL) disease exhibits heightened secretion activity without significant perioperative hemodynamic changes. Tumors in multiple endocrine neoplasia type 2(MEN2) have a stronger endocrine function, which may induce hemodynamic fluctuations during surgery. Therefore, pheochromocytoma screening is essential at all stages of MEN2. Neurofibromatosis type 1(NF1) often presents multisystem lesions and can result in difficult airway. Pheochromocytoma should be evaluated when NF1 patients present hypertension. Pheochromocytoma and paraganglioma type 5 may present multiple lesions of pheochromocytoma or paraganglioma. In summary, hereditary PPGLs may present with severe lesions in other systems, beyond tumor function. A multi-disciplinary team(MDT) approach is often invaluable in perioperative management.展开更多
The discovery and utilization of volatile anesthetics has significantly transformed surgical practices since their inception in the mid-19th century.Recently,a paradigm shift is observed as volatile anesthetics extend...The discovery and utilization of volatile anesthetics has significantly transformed surgical practices since their inception in the mid-19th century.Recently,a paradigm shift is observed as volatile anesthetics extend beyond traditional confines of the operating theatres,finding diverse applications in intensive care settings.In the dynamic landscape of intensive care,volatile anesthetics emerge as a promising avenue for addressing complex sedation requirements,managing refractory lung pathologies including acute respiratory distress syndrome and status asthmaticus,conditions of high sedative requirements including burns,high opioid or alcohol use and neurological conditions such as status epilepticus.Volatile anesthetics can be administered through either inhaled route via anesthetic machines/devices or through extracorporeal membrane oxygenation circuitry,providing intensivists with multiple options to tailor therapy.Furthermore,their unique pharmacokinetic profiles render them titratable and empower clinicians to individualize management with heightened accuracy,mitigating risks associated with conventional sedation modalities.Despite the amounting enthusiasm for the use of these therapies,barriers to widespread utilization include expanding equipment availability,staff familiarity and training of safe use.This article delves into the realm of applying inhaled volatile anesthetics in the intensive care unit through discussing their pharmacology,administration considerations in intensive care settings,complication considerations,and listing indications and evidence of the use of volatile anesthetics in the critically ill patient population.展开更多
Adverse rection to local anesthetic agents is uncommon with true hypersensitivity reaction less than 1%of all adverse reactions.Allergic reactions to local anesthetics are classified into type I(IgE-mediated)and type ...Adverse rection to local anesthetic agents is uncommon with true hypersensitivity reaction less than 1%of all adverse reactions.Allergic reactions to local anesthetics are classified into type I(IgE-mediated)and type IV(allergic contact dermatitis).Skin test can be used in evaluating type I allergic reaction while patch testing helps diagnosing allergic contact dermatitis.Physicians also need keep in mind that non-allergic reactions such as toxic effect,sympathetic stimulation,psychomotor reaction,and vasovagal syncope can occur in patients receiving local anesthetics.Perioperative hypersensitivity(POH)reactions have an incidence between 1:353 and 1:18,600 procedures.True anaphylaxis is estimated to occur in 1:3500 to1:20,000 surgeries with clinical manifestations varying from mild skin rash to cardiovascular collapse.Anaphylaxis has a mortality rate of 1.4–4.8%.Patient with perioperative anaphylaxis should be referred to allergist to identify the drug that led to reaction.Treatment of POH includes discontinuing any possible drugs,and with only skin involvement,using antihistamines,and in the presence of hypotension,tachycardia,bronchospasm,or gastrointestinal signs,based on severity treating with appropriate dose of epinephrine,and considering volume expansion and securing airway,if needed.展开更多
[Objective] The aim of the study is to seek a good anesthetic to Fenneropenaeus chinensis. [Method] The anesthetic effect of eugenol to juvenile Fenneropenaeus chinensis was investigated. [Result] The juveniles could ...[Objective] The aim of the study is to seek a good anesthetic to Fenneropenaeus chinensis. [Method] The anesthetic effect of eugenol to juvenile Fenneropenaeus chinensis was investigated. [Result] The juveniles could be effectively anaesthetized by 50-400 mg/L eugenol aqueous solution with temperature of 24 ℃. Within the concentration range of 50-400 mg/L, the increase of the eugenol concentration could shorten the time required for anesthesia, meanwhile could prolong the time for recovery. The recovered rate of prawn reached 100% when the eugenol concentration was lower than 200 mg/L, while the recovered rate of prawn was just 66.67% when the eugenol concentration was higher than 400 mg/L. The survival rate of prawns in test group was 100% from the observation of three consecutive days. For the specific dose, the anesthetic effect enhanced with the increase of water temperature (18-27℃). [Conclusion] Eugenol is a safe and efficient anesthetics that can be applied in genetic breeding of prawn.展开更多
文摘BACKGROUND Several techniques of nasogastric tube(NGT)insertion have been described in the literature with different success rates.AIM To systematically search the literature and conduct a meta-analysis comparing the success rates,insertion time and complications associated with different techniques of NGT insertion in anesthetized and intubated patients.METHODS An electronic search of the PubMed,Scopus,CENTRAL(Cochrane Central Register of Controlled Trials),and Google Scholar databases were performed up to October 31,2019.We included 17 randomized controlled trials with 2500 participants in the meta-analysis.RESULTS As compared to the conventional method,successful insertion of the NGT on first attempt was higher with modified techniques such as the reverse Sellick’s maneuver[relative risk(RR)1.94;95%confidence interval(CI):1.62-2.31],use of a frozen NGT(RR 1.55;95%CI:1.13-2.13),inserting the NGT with neck flexion and lateral neck pressure(RR 1.64;95%CI:1.10-2.45),endotracheal tube-assisted(RR 1.88;95%CI:1.52-2.32)and video-assisted placements(RR 1.60;95%CI:1.31-1.95).All the modified techniques also led to comparatively higher insertion success rates than the conventional technique.CONCLUSION The use of modified techniques of NGT insertion such as the reverse Sellick’s maneuver,neck flexion with lateral neck pressure,frozen NGT,endotracheal tube-guided or video-assisted methods result in a significantly better chance of successful tube insertion at first attempt as compared to the conventional technique.All modified techniques also significantly improve the overall chance of successful NGT placement as compared to the conventional method.
文摘BACKGROUND: Generally speaking, anesthesia is often used in gravid body and it has been already proved that many kind of medicine can result in malformation. OBJECTIVE: To explore embryonic skeleton development and neonatal learning and memory of rats anesthetized with pentobarbital sodium in gravid rats. DESIGN: A randomized control trial. SETTING: Laboratory Animal Center of Xuzhou Medical College. MATERIALS: A total of 80 adult female SD rats, of clean grade and weighing 220-240 g, were selected in this study. The main reagents were detailed as follows: pentobarbital sodium (Shanghai Xingzhi Chemical Plant, batch number: 921019); MG-2 maze test apparatus (Zhangjiagang Biomedical Instrument Factory); somatotype microscope (Beijing Taike Instrument Co., Ltd.). METHODS: ① A total of 160 SD rats of half males and females were selected in this study. All rats were copulated. The day that the plug was checked out in the vagina next day was looked as the first day of pregnancy. Gravid rats were divided randomly into four groups, including early anesthesia group, second anesthesia group, late anesthesia group and control group with 20 in each group. Rats in the early anesthesia group were injected with 25 mg/kg soluble pentobarbitone on the 7th day of pregnancy for once; rats in the second anesthesia group were anesthetized with 25 mg/kg soluble pentobarbitone on the 7th and the 14th days of pregnancy for once; rats in the late anesthesia group were anesthetized with 25 mg/kg soluble pentobarbitone on the 14th day of pregnancy for once; rats in the control group did not treat with anything. The time of anesthetizing was controlled in 3 to 4 hours and ether was absorbed while the time was not enough. ② Half of each group was sacrificed on day 20th of pregnancy and the fetus was taken out to be stained with alizarin red S. After stained, the fetal skeleton was examined. The learning and memorizing of one-month rats that were given birth by the rest gravid rats were tested through electric mare method. Determine their study ability according to their correct rate of 90% or above of arrival at the safe area in 20 s. After they finally learned to arrive at the safe area correctly, test them once more in 24 hours and record the correct rate of 15 times. MAIN OUTCOME MEASURES: The rate of malformation in fetus and ability of learning and memory in one-month rats. RESULTS: A total of 80 female rats were anesthetized in this experiment. Totally 490 immature rats were tested with maze testing machine and 196 fetuses were stained with alizarin red S to observe the development of their skeleton. However, one of the 80 female rats was led to death because of overdose. ① Malformation experiment: Learning ability of second anesthesia group was evidently different from the control group while the other two groups were not in the electric mare method. The fetal skeleton malformation rate of three experimental groups was 87.0%, 60.9% and 17.9%, respectively, while it was 5.6% in the control group. ② Electric mare method: Times of rats which arrived at the safe regions were respectively 49.0±31.0, 68.0±35.0, 47.0±31.0 and 44.0±21.0 in early anesthesia group, second anesthesia group, late anesthesia group and control group; and then, there was significant difference between the second anesthesia group and the control group (P < 0.05). Exact rates of memory of rats were respectively (64.36±14.35)%, (62.15±18.33)%, (54.19±12.28)% and (68.24±15.91)% in early anesthesia group, second anesthesia group, late anesthesia group and control group; and then, there were no significant differences as compared with the control group (P > 0.05). CONCLUSION: The influence of anesthesia with pentobarbital sodium is obvious in fetal skeleton development and learning and memory ability.
文摘Researchers have discovered that mice instinctively exhibit rescue-like behavior towards anesthetized companions-a finding that suggests a biological basis for prosociality.The study,published in PNAS on April 23,2025,was led by Dr.HU Li from the Institute of Psychology of the Chinese Academy of Sciences(IPCAS)and Dr.CHEN Zhoufeng from Washington University School of Medicine and the Shenzhen Medical Academy of Research and Translation.
基金supported by the National Key Research and Development Program of China(2018YFC2001802)the National Natural Science Foundation of China(82303765 and 82071251)+4 种基金Hubei Province Key Research and Development Program(2021BCA145)Open Foundation of Hubei Key Laboratory of Regenerative Medicine and Multi-disciplinary Translational Research(2022zsyx008)Program of Scientifc and Technological Project in Guizhou Province(Qian Ke He Ji Chu ZK[2022]Yi Ban 516 and Qian Ke He Ji Chu ZK[2021]Yi Ban 559)the Science and Technology Talents Growth Project in Education Department of Guizhou Province(Qian Jiao He KY Zi[2021]4Y211)Research project of Guizhou Administration of Traditional Chinese Medicine(QZYY-2021-082).
文摘The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic properties,an increasing body of research has uncovered neuroprotective efects of intravenous anesthetics in various animal and cellular models,as well as in clinical studies.However,there also exists conficting evidence pointing to the potential neurotoxic efects of these intravenous anesthetics.The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized.Considering the mentioned above,this work aims to ofer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system(CNS)and the peripheral nerve system(PNS)and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.
文摘P2X_(1) receptors and adrenoceptors are mainly responsible for vasoconstriction in a variety of blood vessels.However,previous studies have shown that α,β-methylene adenosine 5'-triphosphate(α,β-MeATP),a stable analogue of ATP,can induce both pressor and depressor responses in la boratory animals.In this study,the effects of increasing intravenous doses of α,β-MeATP and noradrenaline(NA)(0-30 nmol/kg)administered at 20 min intervals on systolic(SBP),diastolic(DBP)and mean(MBP)blood pressure in groups of anesthetized mice(n=6)were compared.Both α,β-MeATP and NA caused transient,dose-dependent increases in SBP,DBP and MBP but the effect of α,β-MeATP was more rapid and significantly larger at doses of 10 and 30 nmol/kg(P<0.01).At the dose of 30 nmol/kg,α,β-MeATP increased SBP,DBP and MBP by 65.8±7.0,65.7±5.0 and 65.7±5.5 mmHg,respectively,compared to increases of 36.8±4.6,33.3±4.9 and 34.5±4.7 mmHg,respectively,produced by NA.These results indicate P2X_(1) receptors play an important role in BP regulation although purinergic vasoconstriction alone may not explain the more potent pressor response to α,β-MeATP in the anesthetized mouse.
基金Innovative and Entrepreneurial Team of Jiangsu Province(Grant No.JSSCTD202144)Nanjing Postdoctoral Program(Grant No.BSHNJ2023006)National Natural Science Foundation of China(Grant No.82201380)。
文摘Cancer,potentially the second leading cause of mortality globally,poses a significant health challenge.The conventional treatment for solid tumors typically involves surgical intervention,followed by chemotherapy,radiotherapy,and targeted therapies.However,cancer recurrence and metastasis remain major issues.Anesthesia is essential for ensuring patient comfort and safety during surgery.Despite its crucial role in surgery,the precise effect of anesthesia on cancer patients'outcomes has not been clearly understood.This comprehensive review aims to elucidate perioperative anesthesia strategies for cancer patients and their potential effects on prognosis.Given the complexity of cancer treatments,understanding the relationship between anesthesia and cancer outcomes is crucial.By examining potential implications of anesthesia strategies for cancer prognosis,this review may help better understand treatment efficacy and risk factors for cancer recurrence and metastasis.Ultimately,a detailed analysis of anesthesia practices in cancer surgery may provide insights to refine existing anesthesia protocols and reduce risk factors for poor patient outcomes.
基金supported by Collaborative Education Project of the Ministry of Education of China(250101414020206)Planning Project of Shanghai Higher Education Association(2QYB24158).
文摘Anesthetic pharmacology,a specialized branch of pharmacology,differs significantly from the foundational pharmacology taught in undergraduate medical programs.A key challenge lies in effectively distinguishing and integrating these two courses to enhance students’theoretical understanding and foster their clinical anesthesia skills.This paper explores strategies for optimizing lesson preparation and delivery in anesthetic pharmacology,focusing on course positioning,student knowledge assessment,clinical integration,objective setting,content development,instructional design,innovative teaching tools,and classroom management.The ultimate aim is to enhance teaching effectiveness and train anesthesiology professionals with robust theoretical knowledge and practical competence.
基金supported by grants from the National Natural Science Foundation of China(82101273)the Second Affiliated Hospital of the Army Medical University Incubation Program for Young Doctoral Talents(2023YQB007).
文摘Dear Editor,General anesthetics play a pivotal role in inducing a safe and reversible loss of consciousness in patients,the importance of which cannot be overstated[1].Among the intravenous anesthetics,propofol stands out for its rapid onset and swift systemic clearance,effectively eliminating the prolonged sedation associated with earlier agents[2].
文摘Debates regarding the specific effects of general anesthesia on developing brains have persisted for over 30 years.A consensus has been reached that prolonged,repeated,high-dose exposure to anesthetics is associated with a higher incidence of deficits in behavior and executive function,while single exposure has a relatively minor effect on long-term neurological function.In this review,we summarize the dose-dependent neuroprotective or neurotoxic effects of gamma-aminobutyric acid type A receptor agonists,a representative group of sedatives,on developing brains or central nervous system diseases.Most preclinical research indicates that anesthetics have neurotoxic effects on the developing brain through various signal pathways.However,recent studies on low-dose anesthetics suggest that they may promote neurodevelopment during this critical period.These findings are incomprehensible for the general“dose-effect”principles of pharmacological research,which has attracted researchers'interest and led to the following questions:What is the threshold for the dual effects exerted by anesthetics such as propofol and sevoflurane on the developing brain?To what extent can their protective effects be maximized?What are the underlying mechanisms involved in these effects?Consequently,this issue has essentially become a“mathematical problem.”After summarizing the dose-dependent effects of gamma-aminobutyric acid type A receptor agonist sedatives in both the developing brain and the brains of patients with central nervous system diseases,we believe that all such anesthetics exhibit specific threshold effects unique to each drug.These effects range from neuroprotection to neurotoxicity,depending on different brain functional states.However,the exact values of the specific thresholds for different drugs in various brain states,as well as the underlying mechanisms explaining why these thresholds exist,remain unclear.Further in-depth exploration of these issues could significantly enhance the therapeutic translational value of these anesthetics.
文摘Postoperative cognitive dysfunction(POCD)remains a major issue that worsens the prognosis of elderly surgery patients.This article reviews the current research on the effect of different anesthesia methods and commonly utilized anesthetics on the incidence of POCD in elderly patients,aiming to provide an understanding of the underlying mechanisms contributing to this condition and facilitate the development of more reasonable anesthesia protocols,ultimately reducing the incidence of POCD in elderly surgery patients.
文摘BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer.However,there is a debate concerning their differential effects on cognitive function,anxiety,and depression in patients undergoing this procedure.AIM To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function,anxiety,depression,and organ function in patients undergoing radical resection of gastric cancer.METHODS A total of 80 patients were involved in this research.The subjects were divided into two groups:Propofol group and sevoflurane group.The evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment(LOTCA),and anxiety and depression were assessed with the aid of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Hemodynamic indicators,oxidative stress levels,and pulmonary function were also measured.RESULTS The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane group.Additionally,the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol group.The sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol group.Moreover,the sevoflurane group displayed better pulmonary function and less lung injury than the propofol group.CONCLUSION Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric cancer.Propofol anesthesia has a minimal effect on patients'pulmonary function,consequently enhancing their postoperative recovery.Sevoflurane anesthesia causes less impairment on patients'cognitive function and mitigates negative emotions,leading to an improved postoperative mental state.Therefore,the selection of anesthetic agents should be based on the individual patient's specific circumstances.
基金supported by the National Natural Science Foundation of China,Nos.82171260,81641042,81471240the Natural Science Foundation of Zhejiang Province,Nos.LZ22H090002 and 2014C33170(all to ZH)。
文摘Neuroscientists have recognized the importance of astrocytes in regulating neurological function and their influence on the release of glial transmitters.Few studies,however,have focused on the effects of general anesthetic agents on neuroglia or astrocytes.Astrocytes can also be an important target of general anesthetic agents as they exert not only sedative,analgesic,and amnesic effects but also mediate general anesthetic-induced neurotoxicity and postoperative cognitive dysfunction.Here,we analyzed recent advances in understanding the mechanism of general anesthetic agents on astrocytes,and found that exposure to general anesthetic agents will destroy the morphology and proliferation of astrocytes,in addition to acting on the receptors on their surface,which not only affect Ca^(2+)signaling,inhibit the release of brain-derived neurotrophic factor and lactate from astrocytes,but are even involved in the regulation of the pro-and anti-inflammatory processes of astrocytes.These would obviously affect the communication between astrocytes as well as between astrocytes and neighboring neurons,other neuroglia,and vascular cells.In this review,we summarize how general anesthetic agents act on neurons via astrocytes,and explore potential mechanisms of action of general anesthetic agents on the nervous system.We hope that this review will provide a new direction for mitigating the neurotoxicity of general anesthetic agents.
文摘BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.
基金supported by the Natural Science Foundation of Zhejiang Province(LZ22H090002,2014C33170)National Natural Science Foundation of China(82171260,81641042,81471240)。
文摘General anesthetic agents can impact brain function through interactions with neurons and their effects on glial cells.Oligodendrocytes perform essential roles in the central nervous system,including myelin sheath formation,axonal metabolism,and neuroplasticity regulation.They are particularly vulnerable to the effects of general anesthetic agents resulting in impaired proliferation,differentiation,and apoptosis.Neurologists are increasingly interested in the effects of general anesthetic agents on oligodendrocytes.These agents not only act on the surface receptors of oligodendrocytes to elicit neuroinflammation through modulation of signaling pathways,but also disrupt metabolic processes and alter the expression of genes involved in oligodendrocyte development and function.In this review,we summarize the effects of general anesthetic agents on oligodendrocytes.We anticipate that future research will continue to explore these effects and develop strategies to decrease the incidence of adverse reactions associated with the use of general anesthetic agents.
文摘BACKGROUND Radical laparoscopic gastrectomy is an important treatment modality for gastric cancer.Surgery requires general anesthesia,and patients are susceptible to the effects of anesthetic drugs and carbon dioxide insufflation during the procedure,leading to inflammation or severe pain,which can affect patient outcome.AIM To explore the efficacy of combining dexmedetomidine(DEX)with nalbuphine in patients underwent laparoscopic radical gastrectomy for gastric cancer.METHODS Patients scheduled to undergo laparoscopic radical gastrectomy were selected and randomly assigned to A or B group.In A group,patients received an intravenous injection of nalbuphine 0.2 mg/kg+DEX 0.4μg/kg 10 min before the end of surgery;in B group,patients received only an intravenous injection of nalbuphine.The trends in hemodynamic parameter fluctuations,awakening quality during the recovery period,serum inflammatory markers,agitation scores,cough severity,incidence,and duration of postoperative delirium(POD)were compared.RESULTS The mean arterial pressure and heart rate in the A group were more stable(P<0.05).The A group had a lower average awakening time,extubation time,and agitation scores during recovery than the B group.Agitation control in the A group was more effective at different time points(P<0.05).Patients in the A group had lower serum interleukin(IL)-6,tumour necrosis factor alpha,and IL-10 levels at 1 h after surgery than the B group.The incidence of coughing and duration of POD were lower and shorter in the A group than in the B group.Adverse reactions caused by the two anesthesia methods were less frequent in the A group than in the B group(P<0.05).CONCLUSION The use of DEX and nalbuphine in patients undergoing laparoscopic radical gastrectomy for gastric cancer help reducing the inflammatory response,cough severity,and agitation and helps maintain hemodynamic stability.
文摘Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical characteristics and perioperative care for PPGL. Pheochromocytoma in von Hippel-Lindau(VHL) disease exhibits heightened secretion activity without significant perioperative hemodynamic changes. Tumors in multiple endocrine neoplasia type 2(MEN2) have a stronger endocrine function, which may induce hemodynamic fluctuations during surgery. Therefore, pheochromocytoma screening is essential at all stages of MEN2. Neurofibromatosis type 1(NF1) often presents multisystem lesions and can result in difficult airway. Pheochromocytoma should be evaluated when NF1 patients present hypertension. Pheochromocytoma and paraganglioma type 5 may present multiple lesions of pheochromocytoma or paraganglioma. In summary, hereditary PPGLs may present with severe lesions in other systems, beyond tumor function. A multi-disciplinary team(MDT) approach is often invaluable in perioperative management.
文摘The discovery and utilization of volatile anesthetics has significantly transformed surgical practices since their inception in the mid-19th century.Recently,a paradigm shift is observed as volatile anesthetics extend beyond traditional confines of the operating theatres,finding diverse applications in intensive care settings.In the dynamic landscape of intensive care,volatile anesthetics emerge as a promising avenue for addressing complex sedation requirements,managing refractory lung pathologies including acute respiratory distress syndrome and status asthmaticus,conditions of high sedative requirements including burns,high opioid or alcohol use and neurological conditions such as status epilepticus.Volatile anesthetics can be administered through either inhaled route via anesthetic machines/devices or through extracorporeal membrane oxygenation circuitry,providing intensivists with multiple options to tailor therapy.Furthermore,their unique pharmacokinetic profiles render them titratable and empower clinicians to individualize management with heightened accuracy,mitigating risks associated with conventional sedation modalities.Despite the amounting enthusiasm for the use of these therapies,barriers to widespread utilization include expanding equipment availability,staff familiarity and training of safe use.This article delves into the realm of applying inhaled volatile anesthetics in the intensive care unit through discussing their pharmacology,administration considerations in intensive care settings,complication considerations,and listing indications and evidence of the use of volatile anesthetics in the critically ill patient population.
文摘Adverse rection to local anesthetic agents is uncommon with true hypersensitivity reaction less than 1%of all adverse reactions.Allergic reactions to local anesthetics are classified into type I(IgE-mediated)and type IV(allergic contact dermatitis).Skin test can be used in evaluating type I allergic reaction while patch testing helps diagnosing allergic contact dermatitis.Physicians also need keep in mind that non-allergic reactions such as toxic effect,sympathetic stimulation,psychomotor reaction,and vasovagal syncope can occur in patients receiving local anesthetics.Perioperative hypersensitivity(POH)reactions have an incidence between 1:353 and 1:18,600 procedures.True anaphylaxis is estimated to occur in 1:3500 to1:20,000 surgeries with clinical manifestations varying from mild skin rash to cardiovascular collapse.Anaphylaxis has a mortality rate of 1.4–4.8%.Patient with perioperative anaphylaxis should be referred to allergist to identify the drug that led to reaction.Treatment of POH includes discontinuing any possible drugs,and with only skin involvement,using antihistamines,and in the presence of hypotension,tachycardia,bronchospasm,or gastrointestinal signs,based on severity treating with appropriate dose of epinephrine,and considering volume expansion and securing airway,if needed.
文摘[Objective] The aim of the study is to seek a good anesthetic to Fenneropenaeus chinensis. [Method] The anesthetic effect of eugenol to juvenile Fenneropenaeus chinensis was investigated. [Result] The juveniles could be effectively anaesthetized by 50-400 mg/L eugenol aqueous solution with temperature of 24 ℃. Within the concentration range of 50-400 mg/L, the increase of the eugenol concentration could shorten the time required for anesthesia, meanwhile could prolong the time for recovery. The recovered rate of prawn reached 100% when the eugenol concentration was lower than 200 mg/L, while the recovered rate of prawn was just 66.67% when the eugenol concentration was higher than 400 mg/L. The survival rate of prawns in test group was 100% from the observation of three consecutive days. For the specific dose, the anesthetic effect enhanced with the increase of water temperature (18-27℃). [Conclusion] Eugenol is a safe and efficient anesthetics that can be applied in genetic breeding of prawn.
