The Effect of Refined Nursing on Postoperative Recovery and Inflammatory Cytokine Levels in Patients Undergoing Radical Prostatectomy for Prostate Cancer.

ObjectiveTo analyze the clinical value of predicting postoperative recovery in patients undergoing general anesthesia using an interpretable model based on swarm intelligence machine learning.MethodsThis study retrospectively collected data from 1,128 patients who underwent general anesthesia at Sir Run Run Shaw Hospital, affiliated with Zhejiang University School of Medicine, from January 2021 to January 2024. Based on predefined inclusion and exclusion criteria, a total of 1,128 patients were included in the study, comprising Dataset A. Additionally, patients meeting the same criteria from Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine Alar Hospital during the period January 2021 - January 2024 were selected, constituting Dataset B. Dataset a was used for model training and testing, and dataset b was used for external validation of the model. Patients who experienced at least one of the following conditions—hypothermia upon admission to the Post-Anesthesia Care Unit (PACU), delayed discharge from PACU, or delayed awakening—were classified into the poor postoperative recovery group. The remaining patients were classified into the good postoperative recovery group. Clinical data were analyzed using a swarm intelligence machine learning algorithm to develop a predictive model for postoperative recovery in patients undergoing general anesthesia. The value of the identified features was analyzed, and a visualization system was constructed.ResultsLASSO regression identified seven variables: surgery duration, anesthesia duration, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), serum creatinine, body mass index (BMI), and age. The swarm intelligence machine learning model, with XGBoost as the base learner, demonstrated the best performance. It achieved an F1 score of 0.8447 and an area under the curve (AUC) of 0.9265 on the training set, and an F1 score of 0.7735 and an AUC of 0.8808 on the test set. The validation results demonstrated that the model achieved: ROC-AUC: 0.8383, PR-AUC: 0.8241 This model can be used to predict postoperative recovery in patients undergoing general anesthesia.ConclusionThe application of an interpretable swarm intelligence machine learning model can assist in predicting postoperative recovery in patients undergoing general anesthesia, thereby aiding clinicians in formulating subsequent intervention plans.

Burn patients often face challenges such as delayed wound healing, high risk of postoperative infection, and poor psychological status. Accelerating the recovery process, improving scar quality, and reducing complications have become key issues in modern burn treatment. This study aimed to evaluate the overall effect of silver ion antibacterial gel combined with meticulous nursing on postoperative recovery in patients undergoing scar reconstruction after burn injury. In this retrospective study, 102 patients who underwent scar reconstruction after burn injury between January 2021 and December 2023 were enrolled. Patients were divided into an experimental group (n = 52) and a control group (n = 50) according to their treatment protocol. The experimental group received general treatment with meticulous nursing care plus silver ion antibacterial gel, while the control group received general treatment with meticulous nursing only. Evaluation indicators included postoperative recovery time, scar healing quality, postoperative infection rate, psychological status (depression and anxiety), and patient satisfaction. The experimental group had a significantly shorter postoperative recovery time than the control group (5.6 ± 1.1 months vs 6.3 ± 1.2 months, P < .05). In terms of scar healing, the VSS scores were significantly higher in the experimental group (8.7 ± 1.2 vs 6.5 ± 1.3, P < .05). The postoperative infection rate in the experimental group was 1.9%, significantly lower than 8.0% in the control group (P < .05). Scores for depression (Hamilton Depression Scale) and anxiety (Hamilton Anxiety Scale) were also significantly lower in the experimental group (P < .05). Patient satisfaction in the experimental group was 94.2%, notably higher than 86.0% in the control group (P < .05). Silver ion antibacterial gel combined with meticulous nursing can significantly shorten recovery time, improve scar healing quality, reduce infection rates, enhance psychological well-being, and increase overall patient satisfaction after burn surgery. This treatment approach offers an innovative strategy for postoperative recovery in burn patients and holds broad clinical application prospects.

Patients with rectal cancer undergoing radical resection often have poor postoperative recovery due to preoperative fasting and water deprivation and the removal of diseased tissue, and have a high risk of complications. Therefore, it is of great significance to apply appropriate rehydration regimens to patients undergoing radical resection of rectal cancer during the perioperative period to improve the postoperative outcomes of patients. To analyze the effects of goal-directed fluid therapy (GDFT) with a preoperative glucose load regimen on postoperative recovery and complications in patients undergoing radical resection for rectal cancer. Patients with rectal cancer who underwent radical resection (n = 184) between January 2021 and December 2023 at our hospital were randomly divided into either a control group or an observation group (n = 92 in each group). Both groups received a preoperative glucose load regimen, and routine fluid replacement and GDFT were additionally implements in the control and observation groups, respectively. The operative conditions, blood levels of lactic acid and inflammatory markers, postoperative recovery, cognitive status, hemodynamic indicators, brain oxygen metabolism, and complication rates were compared between the groups. The colloidal fluid dosage, total infusion, and urine volume, as well as time to first exhaust, time to food intake, and postoperative length of hospital stay, were lower in the observation group (P < 0.05). No significant differences were observed between the two groups in terms of operation time, bleeding volume, crystalloid liquid consumption, time to tracheal extubation, complication rate, heart rate, or mean arterial pressure (P > 0.05). Compared with the control group, in the observation group the lactic acid level was lower immediately after the surgery (P < 0.05); the Mini-Mental State Examination score was higher on postoperative day 3 (P < 0.05); the pulse pressure variability (PPV) was lower at 30 min after pneumoperitoneum (P < 0.05), though the differences in the PPV of the two groups was not significant at the remaining time points (P > 0.05); tumor necrosis factor-α and interleukin-6 levels were lower on postoperative day 3 (P < 0.05); and the left and right regional cerebral oxygen saturation was higher immediately after the surgery and 30 min after pneumoperitoneum (P < 0.05). GDFT combined with the preoperative glucose load regimen is a safe and effective treatment strategy for improving postoperative recovery and risk of complications in patients with rectal cancer undergoing radical resection.

Effects of dexmedetomidine on CD42a+/CD14+, HLADR+/CD14+ and inflammatory cytokine levels in patients undergoing multilevel spinal fusion

To analyze the application value of dynamic and static complementary balance theory-based functional exercise combined with stepwise rehabilitation training in postoperative hip function recovery in patients undergoing total hip replacement (THR). The clinical data of 118 inpatients undergoing THR between June 2022 and June 2023 were retrospectively collected. Among the patients, 57 were given perioperative stepwise rehabilitation training (the control group), and 61 were given a combination of functional exercise based on static and dynamic complementary balance theory and stepwise rehabilitation training during the perioperative period (the combination group). The postoperative recovery status and the incidence of postoperative complications in the two groups were recorded. During postoperative recovery, the patients were assessed for pain with the visual analogue scale (VAS) and for self-efficacy with the Self-Efficacy for Rehabilitation Outcome Scale (SER). Hip function was measured and compared between the two groups at 2 weeks, 4 weeks and 8 weeks after surgery. With regard to the primary outcome indicator, the postoperative length-of-stay was (7.63±1.36) d in the combination group, which was shorter than the (8.22±1.48) d in the control group, and the difference was statistically significant (t=2.257, P=0.026). As for the secondary outcome indicators, no statistically significant difference was observed in the incidence of postoperative complications between the two groups (4.92% vs. 14.04%) (P>0.05). The perioperative VAS scores in the two groups showed an interaction effect according to the repeated measurement variance test (P<0.05). The postoperative VAS scores in both groups declined significantly compared to the preoperative scores (P<0.05), and the VAS score decreased gradually over time after surgery (P<0.05). The VAS scores in the combination group at 7 and 14 days after surgery were lower than those in the control group (P<0.05). At 14 days after surgery, the scores for the coping and the task dimensions and the total score of SER increased in both groups compared with those at 3 days after surgery (P<0.05), with the combination group showing higher scores than the control group did (P<0.05). After surgery, the scores for the dimensions of deformity, pain, function, and joint mobility and the total score of the Harris Hip Scale revealed interaction effects in the two groups according to the repeated measurement variance test (P<0.05), with these scores increasing gradually over time after surgery (P<0.05), and the scores in the combination group were higher at 4 and 8 weeks after surgery compared to those in the control group (P<0.05). The combination of functional exercise based on dynamic and static complementary balance theory and stepwise rehabilitation training shows an advantage over stepwise rehabilitation training alone in enhancing the self-efficacy of THR patients, relieving the postoperative pain, shortening the length-of-stay, and improving the hip function in patients.

Surgery has been the primary treatment for breast cancer. However, instant postoperative complications, such as sleep disorder and pain, dramatically impair early postoperative quality of recovery, resulting in more extended hospital stays and higher costs. Recent clinical trials indicated that stellate ganglion block (SGB) could prolong sleep time and improve sleep quality in breast cancer survivors. Moreover, during the perioperative period, SGB enhanced the recovery of gastrointestinal functions in patients with laparoscopic colorectal cancer surgery and thoracolumbar spinal surgery. Furthermore, perioperative SGB decreased intraoperative requirements for anesthetics and analgesics in patients with complex regional pain syndrome. However, information is scarce regarding the effects of SGB on postoperative quality recovery in patients with breast cancer surgery. Therefore, we investigated the effects of SGB on the postoperative quality of recovery of patients undergoing breast cancer surgery. Sixty patients who underwent an elective unilateral modified radical mastectomy were randomized into two 30-patient groups that received either an ultrasound-guided right-sided SGB with 6 ml 0.25% ropivacaine (SGB group) or no block (control group). The primary outcome was the quality of postoperative recovery 24 hours after surgery, assessed with a Chinese version of the 40-item Quality of Recovery (QoR-40) questionnaire. Secondary outcomes were intraoperative requirements of propofol and opioids, rest pain at two, four, eight, and 24 hours after surgery, patient satisfaction score, and the incidence of postoperative abdominal distension. At 24 hours after surgery, global QoR-40 scores were higher in the SGB group than in the control group. Besides, in the SGB group, patients needed less propofol, had a lower incidence of postoperative abdominal bloating, and had higher satisfaction scores. Ultrasound-guided SGB could improve the quality of postoperative recovery in patients undergoing breast cancer surgery by less intraoperatively need for propofol and better postoperative recovery of sleep and gastrointestinal function.

Objective The study aimed to investigate the correlation between the severity of disease and postoperative neurological recovery in patients with cervical spondylotic myelopathy (CSM) combined with developmental spinal stenosis. Methods A retrospective analysis of the clinical data of 114 CSM patients combined with developmental spinal stenosis admitted to our hospital from June 2019 to June 2020 was performed. All of the patients who underwent posterior cervical unidoor vertebroplasty were divided into the mild, moderate, and severe groups according to the Torg–Pavlov ratio. The clinical data including patients' age, course of spinal cord high signal change, and first onset age were collected. The recovery time, preoperative, and postoperative Japanese Orthopaedic Association (JOA) scores of patients in each group were compared with the calculation of the improvement rate. The correlation between the severity of disease and postoperative neurological recovery in CSM patients combined with developmental spinal stenosis was analyzed by Pearson correlation. The factors influencing postoperative neurological recovery were analyzed using multivariate logistic regression analysis. The receiver operating characteristic curve (AUC) was used to evaluate the value of each influencing factor in predicting postoperative recovery. Results Significant differences were observed in the proportion of linear hyperintensity changes in the spinal cord, the age of first onset, the course of the disease, and the Torg–Pavlov ratio among the mild, moderate, and severe groups (P < 0.05). The postoperative recovery time of the moderate and severe groups was significantly higher than that of the mild group, while the preoperative JOA score was significantly lower than that of the mild group. On the other hand, the postoperative recovery time of the severe group was prominently higher than that of the moderate group, whereas the preoperative JOA score was observably lower than that of the moderate group (P < 0.05). Pearson correlation analysis showed that the postoperative recovery time was significantly negatively correlated with the Torg–Pavlov ratio, age at first onset, and disease course (r = −0.359, −0.502, −0.368, P < 0.05), while it was positively correlated with spinal cord linear high-signal changes (r = 0.641, P < 0.05). Multifactorial logistic regression analysis revealed that the Torg–Pavlov ratio, age at first onset, and disease course were protective factors, while spinal cord linear high-signal alterations were risk factors affecting the recovery time of postoperative neurological function (P < 0.05). The area under the curve (AUC) of the Torg–Pavlov ratio, linear hyperintensity changes in the spinal cord, age at first onset, and disease duration in predicting the postoperative neurological recovery time were 0.794, 0.767, 0.772, and 0.802, respectively. The AUC predicted by the combined detection of each factor was 0.876, which was better than the area under the curve of single prediction. Conclusion Patients with CSM combined with developmental spinal stenosis were characterized by younger age of onset, a short course of the disease, and linear changes in the spinal cord high signal. The degree of developmental spinal stenosis may affect the postoperative recovery time of neurological function in CSM patients but had little effect on postoperative neurological recovery. The Torg–Pavlov ratio, age of first onset, course of the disease, and changes in the spinal cord linear hyperintensity were the factors that affected postoperative neurological recovery, which may provide a basis for reasonably predicting a postoperative neurological recovery in patients with CSM combined with developmental spinal stenosis.

Coronary artery bypass grafting (CABG) is a common intervention for coronary artery disease, but postoperative myocardial microcirculation and recovery remain challenging. This study aimed to evaluate the effects of rosuvastatin calcium on myocardial microcirculation and postoperative outcomes in CABG patients. This retrospective cohort study included 216 patients who underwent CABG between February 2020 and February 2024. Participants were divided into a conventional treatment group (n = 111) and a rosuvastatin group (n = 105) receiving additional rosuvastatin calcium (10mg/day) from 7 days pre-surgery to 28 days post-surgery. Cardiac echocardiography, blood tests (inflammatory markers, lipids, and cardiac enzymes), and New York Heart Association (NYHA) functional classification were assessed preoperatively and 8 weeks postoperatively. Postoperative complications and mortality were monitored during a one-year follow-up. The rosuvastatin group showed significantly improved left ventricular remodeling, with reduced left ventricular end-diastolic diameter (LVEDD, P = 0.022), Left Ventricular Septal Thickness (LVST, P = 0.048), and Left Ventricular Posterior Wall Thickness (LVPWT, P = 0.019). Enhanced systolic function was evidenced by higher LVEF (P < 0.001) and Left Ventricular Fractional Shortening (LVFS, P < 0.001). Myocardial microcirculation parameters including Left Acceleration Time (AT), Pulsatility Index (PI), and Aortic Pre-Ejection Period (APT) also improved (all P < 0.05). Additionally, the rosuvastatin group had lower postoperative creatine kinase MB isoenzyme (CK-MB, P = 0.012), higher High-Density Lipoprotein Cholesterol (HDL-C, P = 0.003), and reduced incidence of atrial fibrillation (P = 0.007) and all-cause mortality (P = 0.026). Rosuvastatin calcium administration significantly improves myocardial microcirculation, cardiac function, and postoperative recovery in CABG patients.

BackgroundEndometriosis is a chronic gynecological condition characterized by the presence of endometrial tissue outside the uterine cavity, often leading to pain, infertility, and psychological distress. Effective perioperative care is crucial for promoting recovery and improving emotional well-being.ObjectiveTo explore the impact of the combined application of mindfulness-based motivational care during the perioperative period on postoperative recovery and negative emotions in patients with endometriosis.MethodsA total of 103 patients were divided into a control group receiving conventional nursing (n=51) and an observation group receiving mindfulness-based motivational care in addition to conventional nursing (n=52). Postoperative recovery indicators, sleep quality (PSQI), pain (NRS), comfort (GCQ), negative emotions (SAS, SDS), ability of daily living (ADL), and quality of life (SF-36) were evaluated.ResultsCompared with the control group, the observation group showed significantly shorter times to first ambulation, first flatus, and hospitalization (P<0.05). Improvements in PSQI, NRS, and GCQ scores were observed in both groups, but were more significant in the observation group (P<0.05). Similarly, SAS and SDS scores decreased in both groups, with greater reductions in the observation group (P<0.05), indicating superior efficacy in relieving anxiety and depression.ConclusionCompared with conventional nursing, the combined application of mindfulness-based motivational care during the perioperative period can more effectively promote postoperative recovery in patients with endometriosis, improve sleep quality and pain management, reduce negative emotions, enhance comfort, and improve quality of life.

BACKGROUNDHepatocellular carcinoma (HCC) is a common and frequently encountered malignancy in clinical practice. Patients who lack understanding of the disease and surgical treatment are prone to fear, depression, and other negative emotions, which further aggravate psychological stress. As such, less stimulating and minimally invasive surgical modalities, such as ultrasound-guided interventions, should be adopted to alleviate or eliminate negative perioperative psychological states, which can be evaluated using validated tools such as the Hamilton Anxiety Scale (HAM-A) and Hamilton Depression Scale (HAM-D).AIMTo investigate the impact of ultrasound-guided surgery on stress, complications, and recovery in patients with HCC and comorbid anxiety/depression.METHODSNinety patients with primary small HCC and comorbid anxiety/depression were randomly divided into 2 groups according to treatment (n = 45 each): Experimental (ultrasound-guided intervention); and control (conventional laparoscopic hepatectomy). The HAM-A and HAM-D were used to assess psychological states before and 1 week after surgery. C-reactive protein (CRP), vascular endothelial growth factor (VEGF), and superoxide dismutase (SOD) levels, in addition to specific liver-function indicators, complication rates, and postoperative metrics were measured. Recurrence rates were monitored for 6 months.RESULTSThere were no significant differences in preoperative HAM-A and HAM-D scores between the 2 groups (P > 0.05); however, scores in the study group were significantly lower postoperatively (P < 0.05). On postoperative day 1, there were no significant differences in serum levels of CRP, VEGF, or SOD between the groups (P > 0.05), whereas the levels in the intervention group were significantly lower than those in the control group on days 3 and 7 (P < 0.05). The incidence of postoperative complications in the study group (6.66%) was significantly lower than that in the control group [17.78% (P < 0.05)]. The study group also had a significantly shorter time to first flatus, oral intake, and postoperative hospital stay (P < 0.05). Postoperative serum alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels decreased in both groups compared with preoperative levels, although with significantly lower values in the study group (P < 0.05) but no differences preoperatively (P > 0.05). There was no statistical difference in tumor recurrence rates between the 2 groups during the six-month follow-up (P > 0.05).CONCLUSIONUltrasound-guided intervention for patients with primary small HCC and anxiety/depression effectively improves negative emotional states, reduce stress responses, decreases postoperative complications, promotes recovery, and enhances quality of life.

Objective:This study aimed to investigate the serum inflammatory cytokines levels in patients with COPD, pneumonia and lung cancer, and assess the correlation between the levels of inflammatory cytokines levels and development of these diseases.Methods:Two hundred thirty-two patients including 114 patients with pneumonia, 76 patients with chronic obstructive pulmonary disease (COPD) and 42 patients with lung cancer, and 62 age-matched healthy volunteers as controls were enrolled. The pro-inflammatory cytokine IL-6, IL-2, IFN-γ, TNF-α, anti-inflammatory cytokines IL-4 and IL-10 in serum were analyzed by flow cytometry microsphere array (CBA).Results:We found that the levels of TNF-α and IL-10 in patients with lung cancer, COPD and pneumonia were significantly higher than control group. The IL-6 in the lung cancer group were significantly increased compared with the controls and COPD group, pneumonia group. IFN-γ and IL-2 levels were lower in lung cancer compared with controls and COPD group, pneumonia group. TNF-α, IL-4 and IL-10 levels were increased in patients with COPD and pneumonia compared with controls. In addition, the concentrations of IFN-γ and IL-6 were increased in acute exacerbation COPD (AECOPD) group compared with stable COPD group.Conclusion:In conclusion, elevated TNF-α and IL-10 levels in serum may be related with lung diseases including lung cancer, COPD and pneumonia. Additionally, IFN-γ and IL-6 might be potential biomarkers for the further deterioration of lung disease patients. The increased concentrations of IFN-γ and IL-6 might be used to predict the exacerbation of COPD.

BackgroundThe return of gastrointestinal function is an important sign of postoperative recovery in patients undergoing surgery with general anaesthesia. We aimed to summarize the effects of stellate ganglion block on the recovery of gastrointestinal function as a means of exploring methods through which anaesthesiologists can contribute to postoperative patient recovery.MethodsWe performed a quantitative systematic review of randomized controlled trials published between January 1, 1988, and November 11, 2019, in PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chinese VIP Information, and the Wanfang and SinoMed databases. Study quality was assessed by using the GRADE criteria and bias of included studies were assessed using the revised Cochrane risk-of-bias tool for randomized trials. The time to peristaltic sound resumption, flatus, postoperative eating and the incidence of abdominal bloating in the stellate ganglion block and control groups were compared. The control group consisted of either a stellate ganglion block with normal saline or no treatment. Meta-analysis was performed using Review Manager software.ResultsAfter searching for relevant articles, 281 studies were identified, and five articles with data on 274 patients were eligible. Regarding postoperative flatus time, stellate ganglion block resulted in a mean reduction of 15 h (P = 0.02); then a sensitivity analysis was performed, and the standard mean difference decreased to 6 h (P = 0.007). For gastrointestinal surgery, the mean reduction was 23.92 h (P = 0.0002). As for the evaluation of the recovery of peristaltic sounds, stellate ganglion block promoted the recovery of regular peristaltic bowel sounds an average of 14.67 h earlier than in the control (P = 0.0008). When it comes to nutrients, stellate ganglion block shortened the total parenteral nutrition time by more than 50 h in patients who had undergone gastrointestinal surgery (P<0.00001). Finally, stellate ganglion block prevented the occurrence of postoperative abdominal bloating (P = 0.001).) No complications related to stellate ganglion block were reported.ConclusionStellate ganglion block may promote postoperative gastrointestinal recovery in patients undergoing various surgeries under general anaesthesia. However, additional trials investigating the use of stellate ganglion block are necessary to confirm our finding.Trial registrationThis meta-analysis has been registered at the International Prospective Register of Systematic Reviews (registration number CRD42020157602).

PurposeTo investigate the effect of intravenous infusion of lidocaine compared with ultrasound-guided transverse abdominal plane (TAP) block on the quality of postoperative recovery and analgesic effect in patients undergoing bariatric surgery.Patients and MethodsNinety-nine ASA II–III patients scheduled for elective laparoscopic bariatric surgery were randomized into the lidocaine group (group L), transverse abdominal plane block group (group T), and control group (group C). Group L: a loading dose of 1.5 mg/kg lidocaine was given at induction, followed by 2 mg·kg−1·h−1 maintenance until the end of surgery. Group T: ultrasound-guided bilateral administration of 0.25% ropivacaine in the transverse abdominal plane was given after induction of general anesthesia. Group C: no additional treatment was performed. Quality of recovery-40 (QoR-40) was assessed at 24 h after surgery. Consumption of propofol and remifentanil, visual analog scale (VAS) pain scores at rest at 0, 6, 12, and 24 h postoperatively, time to return of intestinal function, use of remedial analgesics within 24 h after surgery, adverse reactions were recorded.ResultsCompared with Group C, Group L and Group T had higher QoR-40 scores at 24 h postoperatively, and the difference was statistically significant (P=0.002 and P=0.003, respectively). However, there was no difference between Group L and Group T (P=0.128). In addition, compared with those of Group T and Group C, VAS scores at 12 h and 24 h postoperatively were lower in Group L (P <0.0166).ConclusionBoth intravenous infusion of lidocaine and ultrasound-guided TAP block provided good postoperative recovery and postoperative analgesia for patients with bariatric surgery, and intravenous infusion of lidocaine provided better analgesia at 12 h and 24 h postoperatively compared with TAP block.

Non-small cell lung cancer (NSCLC) patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy often face postoperative complications and delayed recovery. While preoperative smoking cessation and respiratory training are known to improve outcomes, the potential benefits of integrating traditional Chinese medicine (TCM) interventions, such as LIUZIJUE, remain underexplored. This study aimed to evaluate the effects of preoperative respiratory training on perioperative outcomes in NSCLC patients undergoing VATS lobectomy, with a focus on peak expiratory flow (PEF), respiratory distress score (RPE), blood gas parameters, quality of recovery-15 (QOR-15), recovery room time, inflammatory markers (NLR, PLR), and postoperative complications. A single-center randomized controlled trial was conducted at Fujian Medical University Affiliated Second Hospital from April 2023 to June 2024. Smokers requiring a 2-week cessation period before surgery were randomized into three groups: Control Group (CG, standard care), Intervention Group 1 (IG1, standard care plus device-based respiratory training), and Intervention Group 2 (IG2, standard care plus respiratory training and LIUZIJUE practice). The combined intervention group (IG2) demonstrated significant improvements in multiple postoperative outcomes, including PEF, QOR-15, RPE, and SpO2, outperforming both IG1 and CG. Subgroup analyses revealed that patients over 60years old experienced more pronounced improvements in PEF, RPE, SpO2, and QOR-15 scores. Additionally, patients with comorbidities showed notable improvements in SpO2 and RPE, while those without comorbidities exhibited greater gains in SpO2, PEF, and QOR-15. Preoperative respiratory training combined with LIUZIJUE significantly enhances postoperative recovery in NSCLC patients, with particularly marked benefits for older patients and those without comorbidities. These findings highlight the clinical potential of this intervention for broader application in perioperative care.

Background: Maintaining intraoperative hemodynamic stability and ensuring smooth postoperative recovery are crucial in modern anesthesia. While fentanyl is a commonly used opioid for intraoperative analgesia, its side effects include respiratory depression, nausea, vomiting, and delayed recovery. Dexmedetomidine, an α2adrenergic receptor agonist, offers sedative, analgesic, and sympatholytic effects with minimal respiratory depression. Objective: To compare the effects of dexmedetomidine infusion versus fentanyl infusion on intraoperative hemodynamics and postoperative recovery in patients undergoing elective surgery under general anesthesia. Methods: A prospective, randomized, double-blind study was conducted on 98 patients (ASA I–II) undergoing elective surgeries. Patients were allocated into Group D (dexmedetomidine, n=49) and Group F (fentanyl, n=49). Intraoperative heart rate (HR), mean arterial pressure (MAP), anesthetic requirements, emergence time, sedation level, and postoperative recovery were assessed. Statistical analysis was performed using SPSS v25.0, with p&lt;0.05 considered significant. Results: Baseline demographics and hemodynamics were comparable. Group D showed significantly lower HR and MAP fluctuations during induction, intubation, and intraoperative stimulation (p&lt;0.05). Anesthetic and opioid requirements were reduced in Group D. Emergence and extubation times were shorter (7.6 ± 2.3 vs 10.9 ± 2.8 min, p&lt;0.001), and Modified Aldrete Scores ≥9 were achieved earlier in Group D. Postoperative sedation was calm and cooperative, with lower pain scores at 30 and 60 minutes (p&lt;0.05). Adverse events were minimal and manageable. Conclusion: Dexmedetomidine infusion provides superior intraoperative hemodynamic stability, reduced anesthetic consumption, and faster, smoother postoperative recovery compared to fentanyl infusion, suggesting it as a safer and more effective alternative in balanced anesthesia.