Anesthesia Research Articles

Effects of mindfulness relaxation training on stress response and postoperative rehabilitation of patients undergoing general surgery

Objective To investigate the effects of mindfulness relaxation training on stress response and postoperative rehabilitation of patients undergoing general surgery. Methods A total of 110 patients who underwent general surgery were randomly divided into study group and control group, with 55 cases in each group. The control group received routine peri-operational period nursing, and the study group carried out mindfulness relaxation training on the basis of control group for 4 weeks. The levels changes of serum insulin, cortisol were detected between two groups. The psychological stress of two groups were evaluated with Symptom Checklist 90 (SCL-90). The off-bed activity time, anus exhaust time, bowel sounds recovery time and hospital stay time were recorded to evaluate the quality of patients′ postoperative rehabilitation. Results The levels of insulin, cortisol were at minimum on admission in two groups, and then increased, the highest level was at 2 hours after operation. There was no significant difference in insulin, cortisol level on admission in two groups (P>0.05), however, the insulin [(120.15±22.63) μg/L, (122.34±15.75) μg/L], cortisol [(10.41±3.07) mmol/L, (12.69±4.50) mmol/L] levels were significantly decreased in the study group compared to the control group [(129.85±15.43) μg/L, (131.34±22.79) μg/L and (11.69±2.99) mmol/L, (14.84±4.04) mmol/L] before anesthesia and at 2 hours after operation (t value was 2.206-2.638, P<0.05). After intervention, the total scores of SCL-90 (120.91±11.84), somatization (1.26±0.13), compulsion (1.43±0.08), depression (1.18±0.12), anxiety (1.14±0.10) and fear (1.34±0.08) were all lower in the study group than those in the control group (130.47±14.13, 1.83±0.53, 1.65±0.58, 1.71±0.12, 1.76±0.13, 1.41±0.12), and the differences were statistically significant (t value was 2.828-28.277, all P<0.05). Besides, off-bed activity time [(1.55±0.18) d] and hospital stay time[ (6.51±2.20) d] in the study group were significantly less than in the control group [(1.73±0.25) d and (7.65±2.19 d)] (t value was 2.737,4.592, P<0.05). Conclusion The mindfulness relaxation training in nursing general surgery patients during peri-operational period is helpful to ameliorate the patients′ degree of physiological and psychological stress reactions, and this mode has important significance in promoting the quality of patients' postoperative rehabilitation. Key words: Mindfulness relaxation training; Surgery; Physiological stress reaction; Psychological stress reaction

Fostering the conception of changing pediatric anesthesiologists into perioperative physician

With the rapid development of modern medicine, anesthesiology is moving towards perioperative medicine. Changing pediatric anesthesiologist into perioperative professionals should focus on training preoperative visits in pediatric anesthesia, intraoperative anesthetic skills, postoperative visits, perioperative pain management, and the prevention and treatment of psychological trauma on the premise of understanding children pathological physiology characteristics. It is the mission of every perioperative pediatrician to ensure children safely and comfortably go through the perioperative period, reduce postoperative complications and mortality, and improve the long-term prognosis. Key words: Pediatrics; Anesthesiologist; Perioperative professionals

Changes in Anesthetic and Postoperative Sedation-Analgesia Practice Associated with Early Extubation following Infant Cardiac Surgery: Experience from the Pediatric Heart Network Collaborative Learning Study

目的 儿科心脏网络赞助了多中心协作学习研究，该研究实施了一项临床实践指南以促进孤立性主动脉缩窄和法洛四联症修复术后婴儿早期拔管。本文试图比较在实施早期拔管指南前后手术室麻醉和ICU镇静镇痛管理的差异。 设计 对2013年1月至2015年4月一项多中心研究的数据进行二次分析，比较指南实施前后麻醉、镇静和镇痛暴露的预定义变量。倾向评分加权Logistic回归分析确定术中使用右美托咪啶对早期拔管的独立影响。 场所 5家儿童医院 对象 240例接受主动脉缩窄或法洛四联症修复术患儿(指南实施前119例和指南实施后121例)。 干预措施 无 测量方法与主要结果 临床实践指南实施后阿片类药物(49.7 mg/kg比24.0 mg/kg芬太尼等效物，P<0.001)和苯二氮卓类(1.0 mg/kg比0.4 mg/kg咪达唑仑等效物，P<0.001)术中总剂量降低，但中位挥发性麻醉剂暴露没有变化(1.3比1.5 MAC-hrs，P＝0.25)。校正其他协变量后，术中使用右美托咪啶与早期拔管相关(OR2.5，95%CI：1.02-5.99，P＝0.04)。ICU中更多患者接受右美托咪啶(43%比75%)，但同时苯二氮卓类暴露频率(66%比57%，P<0.001)和累积中位剂量(0.5 mg/kg比0.3 mg/kg，P＝0.003)在指南执行后均降低。 结论 早期拔管临床实践指南减少了阿片类药物和苯二氮卓类药物剂量，而不改变手术室使用的挥发性麻醉剂。术中使用右美托咪啶与早期拔管独立相关。术后早期苯二氮卓类暴露总量减少。

Effect of dexmedetomidine or epidural blockade combined with general anesthesia on perioperative inflammatory cytokines in lung cancer patients undergoing video-assisted thoracoscopic surgery

Objective To investigate the effect of dexmedetomidine (Dex) or epidural blockade combined with general anesthesia on perioperative inflammatory cytokines in lung cancer patients undergoing video-assisted thoracoscopic surgery. Methods Ninety lung cancer patients [American Society of Anesthesiologists (ASA) Ⅰ-Ⅲ , age<70 years] undergoing video-assisted thoracoscopic surgery were divided into three groups according to a random number table: a general anesthesia group (group G), an epidural blockade combined with general anesthesia group (group GE) and a Dex combined with general anesthesia group (group GD), with 30 patients in each group. Patients in group GE underwent epidural catheterization at T7-T8 before anesthesia induction, while groups G and GD was given normal saline or 1 μg/kg Dex via an intravenous infusion pump over 10 min after anesthesia induction. Before induction (T0), at the end of surgery (T1), and 24 h after surgery postoperatively (T3), blood samples from the right internal jugular vein were taken to measure the levels of interleukins (IL-1β, IL-6, and IL-10) and tumor necrosis factor-α (TNF-α) by a double antibody sandwich ABC-ELISA method. The scores of Prince-Henry Pain Scale were evaluated 2 h after surgery (T2) and T3. The incidences of intraoperative hypotension, bradycardia and postoperative nausea and vomiting were recorded. Results Compared with those at T0, there were significant increases in the levels of IL-1 β , IL-6, and TNF-α and sharp decreases in the levels of IL-10 at T1 and T3 in all groups (P 0.05). The scores of Prince-Henry Pain Scale in group GE were lower than those in other two groups (P< 0.05). The incidence of nausea in groups GD and GE was significant lower than that in group G (P<0.05). Conclusions For lung cancer patients undergoing video-assisted thoracoscopic surgery under general anesthesia, a combined use of 1 μg/kg Dex can significantly relieve inflammatory response, to an extent comparable to epidural blockade combined with general anesthesia. Key words: Dexmedetomidine; Anesthesia, epidural; Anesthesia, general; Inflammation; Thoracoscopes; Lung cancer

Effect of epidural anesthesia combined with general anesthesia on the expression of serum IL-6, IL-8 and CRP in patients undergoing hip replacement

Objective To investigate the clinical effect of epidural anesthesia combined with general anesthesia on the expression of serum interleukin 6(IL-6), interleukin 8(IL-8) and C-reactive protein (CRP) in patients undergoing hip replacement. Methods From February 2017 to February 2018, 82 patients who underwent hip replacement in Zhuji People's Hospital were selected in the research.According to the random table method, the patients were divided into two groups, with 41 patients in each group.The observation group was given epidural anesthesia combined with general anesthesia, while the control group was given general anesthesia.The extubation time and recovery time, the scores of MMSE and the changes of inflammatory factors at preoperation, postoperative 3h and postoperative 24h were compared between the two groups. Results The extubation time and recovery time of the observation group [(10.93±2.41)min and (17.85±3.24)min] were shorter than those of the control group [(16.29±2.73)min and (23.94±2.46)min] (t=9.425, 9.586, all P<0.05). The scores of MMSE in the observation group at postoperative 3h[(25.48±1.43)points] and postoperative 24h [(26.83±1.09)points] were higher than those in the control group [(23.09±1.60)poinrts and (25.32±1.42)points] (t=7.132, 5.401, all P<0.05). The serum levels of IL-6, IL-8 and CRP in the observation group at postoperative 3h [(28.93±3.54)ng/L, (37.92±6.73)ng/L, (18.93±3.25)mg/L] and postoperative 24h [(21.09±1.76)ng/L, (28.76±3.25)ng/L, (10.39±2.67)mg/L] were lower than those in the control group [3h after operation: (49.97±5.46)ng/L, (64.32±8.98)ng/L, (29.90±4.36)mg/L; 24h after operation: (34.52±3.49)ng/L, (43.65±5.61)ng/L, (18.89±2.34)mg/L] (3h after operation: t=20.704, 15.064, 12.917; 24h after operation: t=22.001, 14.706, 15.330, all P<0.05). Conclusion Epidural anesthesia combined with general anesthesia has better clinical effect than general anesthesia alone in patients with hip replacement, and can reduce the occurrence of cognitive dysfunction and inhibit the release of inflammatory reaction after operation, which is worthy of clinical reference. Key words: Anesthesia, epidural; Anesthesia, general; Hip replacement; Effect; Cognitive function; Interleukin-6; Interleukin-8; C-reactive protein

Progress in the clinical research on the effects of early anesthetic exposure on the development of neurological system function in children

The number of pediatric surgery grows every year. Some studies found that long or repeated exposure to general anesthetics may affect the development of neurological system function in children. This finding is supported by a large number of animal researches currently, without sufficient clinical evidence. This review was to explore the effects of early anesthetic exposure on long-term neurodevelopment in children, so as to provide guidance to determine treatment method and surgery time. This review summarized the latest research progresses, and analyzed the association between early anesthetic exposure in childhood and long-term neurodevelopmental deficits and the sensitive period of the age exposed to anesthesia. At present, clinical researches involve different age populations and types of outcomes. Therefore, the interpretation of outcomes needs the combination of the age exposed to anesthesia, duration of exposure, sample size, outcome indicators, and other factors. It is found that anesthesia exposure in early childhood is associated with long-term neurological deficits, and affected by the frequency of anesthetic exposure to some extent. Key words: Children; Anesthesia; Neurotoxicity; Neurodevelopment

Effect of acupuncture on hemodynamics in rats with chronic myocardial ischemia during induction of anesthesia with propofol

Objective To investigate the effect of acupuncture on hemodynamics in chronic myocardial ischemia rats during induction of anesthesia. Methods Forty five Sprague-Dawley rats, weight 200-250 g, were divided into three groups according to a random number table (n=15): a normal control group (group NC), a chronic myocardial ischemia group (group HR) and an acupuncture group (group A-HR). After acupuncture intervention of myocardial ischemia modeled animals for four weeks, the rats received induction of anesthesia with 0.1% propofol at 9 mg/kg via the jugular vein. Subsequently, the mean arterial pressure (MBP), left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), the maximal rate of rise/decline of left ventricula pressure (±dp/dt), heart rate, and superoxide dismutase (SOD), malondialdehyde (MDA), creatine kinase isoenzyme (CK-MB) and the morphological changes of myocardial tissues were measured. Results Compared with those in group NC, LVSP, ±dp/dt and MBP remarkably declined in group HR (P<0.05), while LVEDP and heart rate significantly increased in group HR (P<0.05). Compared with group HR, group A-HR presented significantly increased LVSP, +dp/dt and MBP (P<0.05) and significantly decreased heart rate (P<0.05). Compared with group HR, group A-HR produced remarkable decreases in MDA and CK-MB (P<0.05) and marked increases in SOD (P< 0.05). Conclusions Acupuncture pretreatment of rats with myocardial ischemia can regulate and control hemodynamic stabilities during induction of anesthesia, which may be done through inhibiting lipid peroxidation to improves cardiac micro-circulation and reducing the injury of cardiac muscles. Key words: Acupuncture; Myocardial ischemia; Propofol; Anesthesia induction; Hemodynamics

Characteristics of nalbuphine and its application in pediatric anesthesia

Nalbuphine hydrochloride is an agonist-antagonist opioid that has analgesic and sedative effects, which can be used in perioperative period of pediatric patient. Nalbuphine hydrochloride reverses the adverse effects of μ receptor agonist (e.g. nausea, vomiting, itching) without influencing its analgesic effects. Due to the ceiling effect, nalbuphine does not cause respiratory depression. Nalbuphine has a higher safety factor, which makes it one of the most commonly used analgesic in paediatric patients. The application of nalbuphine is more popular in the country, thus, the indications of using nalbuphine in pediatric anesthesia should be clearly defined. The pharmacological properties of nalbuphine, clinical application of pediatric anesthesia were summarized in this review. Key words: Nalbuphine; Pediatric anesthesia; Analgesia; Sedation; Application

Effect of sulfentanyl and tropisetron postoperative analgesia pump on perioperative IL-6, TNF-α and insulin resistance in patients undergoing abdominal general anesthesia

Objective To investigate the effect of sulfentanyl and tropisetron postoperative analgesia pump on perioperative interleukin 6(IL-6), tumor necrosis factor (TNF-α) and insulin resistance in patients undergoing abdominal general anesthesia. Methods From March 2016 to March 2017, 120 patients undergoing elective abdominal surgery in our hospital were selected, all patients were treated with general anesthesia.The patients were randomly divided into control group and observation group according to the digital table, with 60 cases in each group.The control group was treated with on-demand delivery analgesia.The observation group was treated with sulfentanyl and tropisetron postoperative analgesia pump for postoperative analgesia.The BCS score, VAS score, Ramsay score at the end of operation and after operation were compared.The TNF-α, ISI, IL-6, insulin levels and blood glucose levels of preoperation and postoperation were compared between the two groups. Results Compared with the control group, the BCS score and Ramsay score of postoperative 0.5d[(2.78±0.57)points, (2.27±0.39)points], postoperative 1d[(3.04±0.48)points, (2.36±0.50)points], postoperative 1.5d[(3.24±0.51)points, (2.43±0.49)points], postoperative 2d[(3.35±0.43)points, (2.51±0.42)points] in the observation group increased (t=-18.604, -8.65, -8.204, -3.967, t=-9.634, -4.864, -4.610, -2.604, all P<0.05), the VAS scores of postoperative 0.5d[(2.4±1.1)points], postoperative 1 d[(1.8±0.8)points], postoperative 1.5d[(1.7±0.5)points], postoperative 2d[(1.7±0.9)points] in the observation group were lower (t=2.082, 4.834, 7.934, 3.098, all P<0.05). Compared with the control group, the insulin, blood sugar, TNF-α, IL-6 of postoperative 0.5d[(7.26±2.17)mU/L, (5.63±0.58)mmol/L, (148.96±20.31)g/L, (120.54±22.27)pg/mL], postoperative 1d[(7.37±1.74)mU/L, (5.34±0.50)mmol/L, (121.35±21.07)μg/L, (116.35±21.01)pg/mL], postoperative 1.5d[(6.57±2.14)mU/L, (5.11±0.50)mmol/L, (114.36±23.99)μg/L, (113.14±18.05)pg/mL], postoperative 2d[(5.87±1.84)mU/L, (4.87±0.51)mmol/L, (100.02±18.13)μg/L, (91.37±14.88)pg/mL] in the observation group were lower (t=9.374, 11.698, 6.455, 10.161, t=8.557, 13.027, 9.990, 8.541, t=6.730, 7.917, 7.811, 2.326, t=8.003, 7.225, 3.839, -7.618, all P<0.05). Compared with the control group, the ISI of postoperative 0.5d[(24.77±0.26)×1 000], postoperative 1d[(25.03±0.21)×1 000], postoperative 1.5d[(29.65±0.17)×1 000], postoperative 2d[(34.54±0.19)×1 000] in the observation group were increased (t=-281.912, -442.121, -248.226, -431.857, all P<0.05). Conclusion The analgesic effect of sulfentanyl and tropisetron postoperative analgesia pump is good, it can reduce the postoperative stress response and the levels of IL-6 and TNF-α, and reduce the degree of insulin resistance, and can be widely used in clinical. Key words: Analgesia; Anesthesia, general; Analgesics, opioid; Tumor necrosis factor; Interleukin 6; Insulin resistance; Sulfentanyl; Tropisetron

The changes of dynorphin in the peripheral white blood cells and plasma of diabetic patients during the perioperative period

Objective To investigate the changes of dynorphin A (DYN-A) in plasma and derived from peripheral white blood cells (WBCs) of diabetic patients during the perioperative period. Methods Patients scheduled for posterior lumbar interbody fusion (PLIF) under general anesthesia were selected and divided into two groups: a non-diabetes group (an NDM group, n=49) and a diabetes group (a DM group, n=23). The total number of peripheral WBCs and their classification such as lymphocytes, monocytes, and granulocytes were counted before and after operation. Before anesthesia (T1), and after awakening from anesthesia (T2), blood samples from the non-infusion sided elbow vein were collected. The plasma levels of DYN-A were measured by enzyme-linked immunosorbent assay(ELISA). Flow cytometry (FCM) was used to determine the percentage of DYN-A fluorescence positive cells and mean fluorescence intensity (MFI) of WBCs. Results In the NDM group, the total number of peripheral WBCs at T2 [(12.9±4.1)×109/L] was remarkably higher than the count at T1 [(6.3±1.6)×109/L](P 0.05). Conclusions The total number of peripheral WBCs significantly increases in the diabetic patients during the perioperative period, with the most obvious increase in granulocyte count. The percentage of DYN-A positive cells in leukocyte classification significantly decreases, while the level of DYN-A in plasma and derived from granulocytes also decreases. These changes are related to the perioperative stress and immune status of the diabetic patients. Key words: Diabetes; Perioperative period; White blood cell; Dynorphin

Effect of perioperative parecoxib sodium combined with dexmedetomidine on the gastrointestinal function of elderly patients after laparoscopic gastric cancer surgery

Objective To investigate the effect of perioperative parecoxib sodium combined with dexmedetomidine (Dex) on the gastrointestinal function of elderly patients after laparoscopic gastric cancer surgery. Methods Ninety gastric cancer patients scheduled for laparoscopic surgery, aged 65-85, American Society of Anesthesiologists (ASA) class Ⅰ or Ⅱ were enrolled. They were divided into three groups by the random number table method (30 patients in each group): a parecoxib sodium group (group P), a Dex group (group D), and a combination group (group PD). Then, 15 min before anesthesia induction, patients in groups P and PD were intravenously infused with parecoxib sodium 40 mg diluted with normal saline into 5 ml. Patients in groups D and PD were injected with Dex at a loading dose of 1 μg/kg for 10 min, which was maintained by 0.3 μg·kg-1·min-1 pump infusion, and the infusion was stopped 30 min before the end of operation. All patients were treated with sufentanil plus flurbiprofen injection for intravenous controlled analgesia. Blood samples were collected from the radial artery 15 min before anesthesia (T0), 1 h after the beginning of surgery (T1) and at the end of surgery (T2) respectively. Inflammatory factors [interleukin (IL)-2, IL-6, and tumor necrosis factor-α (TNF-α)] were detected by enzyme-linked immunosorbent assay (ELISA). The time of the first postoperative ventilation, time to take fluid diet, time of getting out of bed, postoperative length of hospitalization stay, hospitalization expenses, Visual Analogue Scale (VAS) scores at rest and during movement (2, 12 h and 24 h after surgery) and postoperative complications were recorded. Results Compared with those at T0, patients in the three groups produced remarkably increased levels of IL-6 and TNF-α as well as significantly decreased levels of IL-2 at T1 and T2 (P<0.05). At T1 and T2, group PD produced remarkably lower levels of IL-6 and TNF-α and higher levels of IL-2 than groups P and D (P<0.05). In the PD group, the time of the first postoperative ventilation, time to take fluid diet, time of getting out of bed, postoperative length of hospitalization stay and hospitalization expenses were all lower than those in groups P and D (P<0.05). The incidence of postoperative complications in the PD group was lower than those in groups P and D (P<0.05). Conclusions Parecoxib sodium combined with Dex can effectively relieve inflammatory stress response after laparoscopic gastric cancer surgery in elderly patients, facilitate rapid recovery of the gastrointestinal tract, and reduce postoperative length of hospitalization stay, hospitalization expenses and postoperative complications. Key words: Parecoxib sodium; Dexmedetomidine; Aged; Therapeutic laparoscopy; Gastrointestinal surgery

Clinical efficacy and safety analysis of retrograde intrarenal stone surgery for treatment of upper urinary calculi

Objective To evaluate efficacy and safety of retrograde intrarenal stone surgery for treatment of upper urinary calculi. Methods The clinical data of 640 patients with upper urinary tract calculi treated by retrograde intrarenal stone surgery (RIRS) in Renmin Hospital of Wuhan University from April 2016 to January 2019 were retrospectively analyzed. There were 424 males and 216 females. The awerage age was (46.2±12.8) years old, ranging 18 to 76 years old. The maximum diameter of the stone is (1.4±0.7) cm, ranging 0.6-3.2 cm. There were 126 cases with inferior calculi and 514 cases with non-lurgical calculi. There were 196 cases with unilateral ureteral calculi, 118 unilateral ureteral calculi cases with renal calculi, 236 cases with unilateral renal stones, and 90 cases with double kidney stones. 104 cases were placed with double J tube before operation and 496 cases were not placed before operation. There were 8 cases of horseshoe kidney, 30 cases of isolated kidney with renal insufficiency, 4 cases of pelvic ectopic kidney with dysplasia, 6 cases of congenital ureteral malformation and 2 cases of sponge kidney. Preoperative average hemoglobin was (133.2±5.6)g/L, ranging 126-188 g/L.And average serum creatinine was (84.4±12.2)μmol/L, ranging 74-242μmol/L before operation. All patients were treated with general anesthesia under the lithotomy position. The ureteroscopy combined with holmium laser lithotripsy was performed.The 200μm fiber was used, which the parameters were set as 12-45 W(0.5-1.5 J/10-30 Hz). The stone baskets were used to take stones according to actual conditions. The operation was performed by doctors of the same qualifications. Results All patients underwent successful operation. The mean operation time was (45.6±14.6)min. The average postoperative hospitalization was (4.8±1.5)d. The postoperative serious complication rate was 0.9%, including(2 cases of sepsis and 1 case of subcapsular hematoma. Of the 640 patients, 596 were admitted to the hospital for a double J tube and 44 were lost of follow-up. 552 patients met the stone removal criteria, 44 patients did not meet the stone removal criteria for other treatments, such as extracorporeal shock wave lithotripsy, ureteroscopy or observed regularly. The stone-free rate (SFR) was 92.6% (552/596) after 1-3 months. On the first postoperative day, serum creatinine was (76.0±10.6)(58-156) μmol/L, and postoperative hemoglobin was (126.4±9. 6)(120-176) g/L. There was no significant difference in preoperative and postoperative hemoglobin (t=2.02, P=0.064). Preoperative and postoperative creatinine (t=64.76, P<0.05) was statistically significant. Meanwhile, the stone size (χ2=29.569, P<0.05) and position (χ2=44.949, P<0.05) versus SFR the impact was statistically significant. Multivariate regression analysis showed that stone size was not an independent risk factor for stone clearance (P=0.639). The stone position was an independent risk factor for stone clearance (P=0.013). Conclusions RIRS is a reliable treatment for small and medium calculi patients of the upper urinary tract. The curative effect of stone removal is clear, the complications are few, the safety is high. However, there are certain limitations to the efficacy in the treatment of large stones and lower calculi. Lower calculi is the independent risk factor for the treatment of efficacy. Key words: Ureteroscopes; Flexible ureteroscopy; Holmium laser lithotripsy; Upper urinary calculi; Clinical efficacy

Effect of perioperative intravenous lidocaine infusion on postoperative early recovery quality in patients undergoing upper airway surgery

Objective To investigate the effect of perioperative intravenous lidocaine infusion on postoperative early recovery quality in patients undergoing upper airway surgery. Methods One hundred and twenty patients undergoing upper airway surgery were divided into two groups according to a random number table: a lidocaine group (group L) and a control group (group C), with 60 patients in each group. Group L was administered with 2.0 mg/kg lidocaine over 10 min before induction of anesthesia, followed by intravenous infusion at 2 mg·kg-1· h-1 until the end of surgery. Group C was given the same volume of normal saline. The 40-item Quality of Recovery Score (QoR-40 score) as well as the consumption of sufentanil and remifentanil during surgery and the incidence of postoperative nausea and vomiting (PONV) were recorded before surgery (T0), 24 h after surgery (T1) and 48 h after surgery (T2). Results The global QoR-40 scores and the scores for physical comfort, physical independence, psychological support and pain at T1 and T2 in two groups as well as the score for emotional state at T1 in group C were significantly lower than those at T0 (P<0.05). Compared with those in group C, the global QoR-40 scores and the scores for physical comfort, emotional state, and pain significantly increased in group L at T1 and T2 (P<0.05), where the score for physical independence in group L was superior to that in group C at T1 (P<0.05). Compared with those in group C, the dosage of remifentanil used during surgery and the incidence of PONV within 48 h in group L significantly reduced (P<0.05). Conclusions Perioperative intravenous lidocaine infusion can improve QoR-40 scores in patients two days after upper airway surgery, reduce the dosage of opioids and the incidence of PONV and improve postoperative early recovery quality. Key words: Lidocaine; Upper airway surgery; 40-item Quality of Recovery Score; Postoperative nausea and vomiting

بررسی همبستگی میزان بار کاری با تعارض کار- خانواده در تکنولوژیست های اتاق عمل و هوشبری شاغل در بیمارستان های آموزشی درمانی

بررسی همبستگی میزان بار کاری با تعارض کار- خانواده در تکنولوژیست های اتاق عمل و هوشبری شاغل در بیمارستان های آموزشی درمانی

Analgesia, Anaesthesia and Pregnancy, 4th ed

Analgesia, Anaesthesia and Pregnancy, 4th ed

Management of Corneal Foreign Body in a Dog

A nine-year-old male dog presented with blepharospasm and epiphora in the right eye was diagnosed to have a penetrating corneal foreign body. As the dog was non-cooperative, it was decided to remove the foreign body under general anesthesia. The ocular cul-de-sac was irrigated with 0.5% povidone iodine solution under general anesthesia and the foreign body was removed carefully using a fine needle tip. The cornea was checked for its intactness at the site of injury and found a small penetrating wound. Postoperative medication was given for seven postoperative days. The dog was able to close its eyelids partially by first operative day and the symptoms such as blepharospasm and epiphora were subsided by second postoperative day. Complete recovery was noticed by seventh postoperative day and no postoperative complications were recorded. Keywords: Blepharospasm, corneal foreign body, epiphora, surgical management, thorn Cite this Article V. Tejaswani, P. Ravi Kumar . Management of Corneal Foreign Body in a Dog Research & Reviews: Journal of Veterinary Science and Technology. 2019; 8( 3 ): 1 2 p.

Preoperative oral carb-electrolyte solution in elective laparoscopic total hysterectomy clinical effect observation

Objective To investigate the clinical effect of preoperative oral carb-electrolyte solution in selective laparoscopic total hysterectomy (TLH). Methods Using the judgment sampling method, 92 patients undergoing TLH surgery in the department of gynaecology of the hospital from May to November 2017 were selected as the study objects. They were randomly divided into the traditional fasting and no-drink group and the carbohydrate-electrolyte group, with 46 patients in each group.The Preoperative Self-perception Questionnaire designed by ourselves was used to investigate the self-perception of patients 1 hour before general anesthesia, and the 40-item postoperative recovery quality rating scale (QoR-40) was used to evaluate the postoperative recovery of patients. Binary Logistic regression analysis was used to explore the influencing factors of the total score of QoR-40. Results The rate of dry mouth, hunger, fatigue and anxiety in the carbohydrate-electrolyte group before operation were lower than those in the traditional fasting and no-drink group, and the differences were statistically significant(P<0.05). The results of t test showed that the total score of QoR-40, physical comfort, emotional state, self-care ability and psychological support of the subjects in the carbohydrate-electrolyte group were higher than those in the traditional fasting and no-drink group , and the differences were statistically significant(P<0.05). The recovery degree of the oral carbohydrate-electrolyte solution group was better than that of the traditional fasting and no-drink group 2 hours after surgery (OR=2.08). Conclusions Preoperative oral carb-electrolyte solution may improve the symptoms of hunger and dry mouth of TLH patients before surgery, and may promote the physical and mental recovery of TLH patients 2 hours after surgery. Key words: Carb-electrolyte solution; Laparoscopic total hysterectomy

Anesthesia Type and Outcomes of Thrombectomy for Stroke

For patients undergoing endovascular thrombectomy (EVT) for acute ischemic stroke, practices vary regarding anesthesia during the procedure. Some

Clinical effect of right subaxillary small incision approach on children with congenital heart disease

Objective To analyze the clinical effect of right subaxillary small incision approach on children with congenital heart disease (CHD). Methods Eighty-six patients with CHD admitted to Henan Children′s Hospital from January 2015 to September 2017 were enrolled in this study.The patients were randomly divided into the control group and the observation group with 43 cases each group.The control group underwent sternal median incision, and the observation group underwent right subaxillary small incision.The total effective rate, incision satisfaction, general conditions of surgery (cardiopulmonary bypass time, operation time, aortic occlusion time, intraoperative blood loss), postoperative related conditions (thoracic drainage volume, postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, hospitalization expenses), Wong-Baker facial expression scale (FPS-R) score, as well as the respiratory function index including the levels of peak inspiratory pressure (PIP) and alveolar-arterial oxygen pressure difference [p(A-a) (O2)]after anesthesia (T1), after operation (T2), at admission to intensive care unit (T3) and before extubation (T4) and complication rate between 2 groups were compared. Results (1)The incision satisfaction in the observation group [90.70% (39/43 cases)] was higher than that in the control group [62.79% (27/43 cases)], and the difference was statistically significant (χ2=9.382, P=0.002). (2)There was no significant difference in the the extracorporeal circulation time, operation time and aortic block time between the two groups [observation group: (68.94±8.26) min, (2.33±0.21) h, (28.79±7.32) min; control group: (67.11±9.11) min, (2.25±0.31) h, (30.02±6.88) min] (P>0.05). (3)The intraoperative blood loss [(89.87±11.25) mL] in the observation group was less than that in the control group [(105.91±31.01) mL], which difference was statistically significant (t=3.189, P=0.002). (4)Also there was significant difference in postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, thoracic drainage volume and hospitalization expenses between the two groups (the observation group: postoperative monitoring time (30.55±10.39) h, postoperative assisted ventilation time [(9.68±2.19) h, hospitalization time (9.61±2.17) d, thoracic drainage volume (90.36±26.14) mL, hospitalization expenses (36 956.15±1 097.84) yuan; the control group: (41.39±9.93) h, (12.72±3.81) h, (12.33±3.15) d, (163.24±29.36) mL and (45 271.97±1 134.55) yuan] (t=4.946, 4.536, 4.663, 12.157, 34.540, all P 0.05). There was no significant difference in the complication rate between the observation group [6.98% (3/43 cases)] and the control group [4.65% (2/43 cases)] (χ2=0.000, P>0.05). Conclusions Right subaxillary small incision approach does not affect the respiratory function of children with CHD, which can improve the satisfaction of incision, reduce the amount of blood loss, accelerate postoperative recovery of children, relieve postoperative pain, and reduce the financial burden of parents.Besides, intra-operative proficient and accurate operations can reduce or avoid the occurrence of related complications and ensure the safety of surgery. Key words: Minimally invasive; Sternal median incision; Congenital heart disease; Small incision in right axillary; Child; Open surgery

Effects of two anesthetic methods on cognitive function in elderly patients undergoing laparoscopic cervical cancer resection

Objective To investigate the effects of two anesthetic modes on cognitive function in elderly patients undergoing laparoscopic cervical cancer resection. Methods From August 2016 to April 2018, 60 elderly patients undergoing laparoscopic cervical cancer resection in the General Hospital of Armed Police were divided into control groupand observation group according to odd and even of bed number, with 30caese in each group.Intravenous anesthesia was used in the control group, and intravenous anesthesia combined with inhalation anesthesia was used in the observation group.The anesthetic effect, MMSE score, MoCA score and the incidence of cognitive dysfunction were compared between the two groups. Results The anesthesia effect time, extubation time and recovery time of the observation group were (1.62±0.30)min, (15.68±3.26)min, (8.69±3.68)min, respectively, which were significantly shorter than those of the control group[(4.68±0.91)min, (27.46±4.03)min, (20.36±4.58)min](all P 0.05). At 2 h, 6 h, 1 d after operation, the MoCA scores in the observation group were significantly higher than those in the control group (all P<0.05). The incidence of cognitive dysfunction in the observation group was 6.67%(2/30), which was significantly lower than 26.67%(8/30) in the control group (P<0.05). Conclusion Compared with intravenous anesthesia alone, intravenous anesthesia combined with inhalation anesthesia for elderly patients undergoing laparoscopic cervical cancer resection has a good anesthetic effect and can reduce the incidence of cognitive dysfunction, which is worthy of further application in clinical practice. Key words: Uterine cervical neoplasms; Cognition disorders; Laparoscopy; Anesthesia, intravenous; Anesthesia, inhalation; Propofol; Sevoflurane; Aged