Effects Of Different Anesthesia Methods Research Articles

Anesthesia, Anesthetics, and Postoperative Cognitive Dysfunction in Elderly Patients.

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.

Effect of different anesthetic modalities with multimodal analgesia on postoperative pain level in colorectal tumor patients.

According to clinical data, a significant percentage of patients experience pain after surgery, highlighting the importance of alleviating postoperative pain. The current approach involves intravenous self-control analgesia, often utilizing opioid analgesics such as morphine, sufentanil, and fentanyl. Surgery for colorectal cancer typically involves general anesthesia. Therefore, optimizing anesthetic management and postoperative analgesic programs can effectively reduce perioperative stress and enhance postoperative recovery. The study aims to analyze the impact of different anesthesia modalities with multimodal analgesia on patients' postoperative pain. To explore the effects of different anesthesia methods coupled with multi-mode analgesia on postoperative pain in patients with colorectal cancer. Following the inclusion criteria and exclusion criteria, a total of 126 patients with colorectal cancer admitted to our hospital from January 2020 to December 2022 were included, of which 63 received general anesthesia coupled with multi-mode labor pain and were set as the control group, and 63 received general anesthesia associated with epidural anesthesia coupled with multi-mode labor pain and were set as the research group. After data collection, the effects of postoperative analgesia, sedation, and recovery were compared. Compared to the control group, the research group had shorter recovery times for orientation, extubation, eye-opening, and spontaneous respiration (P < 0.05). The research group also showed lower Visual analog scale scores at 24 h and 48 h, higher Ramany scores at 6 h and 12 h, and improved cognitive function at 24 h, 48 h, and 72 h (P < 0.05). Additionally, interleukin-6 and interleukin-10 levels were significantly reduced at various time points in the research group compared to the control group (P < 0.05). Levels of CD3+, CD4+, and CD4+/CD8+ were also lower in the research group at multiple time points (P < 0.05). For patients with colorectal cancer, general anesthesia coupled with epidural anesthesia and multi-mode analgesia can achieve better postoperative analgesia and sedation effects, promote postoperative rehabilitation of patients, improve inflammatory stress and immune status, and have higher safety.

Effects of different anesthesia methods on perioperative immune function and long-term regression of patients undergoing thoracoscopic radical esophagectomy for esophageal cancer

ObjectiveThis study investigated the effects of different anesthetic methods on perioperative immune function and long-term regression of patients undergoing thoracoscopic radical surgery for esophageal cancer. MethodsData from 147 patients undergoing thoracoscopic radical surgery for esophageal cancer in our hospital from January 2017 to June 2019 were selected for retrospective analysis. Patients were divided into control (intravenous anesthesia combined with an epidural block, n = 83) and observation (intravenous anesthesia combined with a thoracic paravertebral nerve block, n = 64) groups. The use of relevant drugs during the surgery, indexes of the peripheral blood T-lymphocyte subpopulation at different time points (before induction of anesthesia, at the completion of surgery, 24 h postoperatively, and 48 h postoperatively), and 3-year postoperative survival were compared between the two groups. ResultsData on propofol and remifentanil use during surgery were not significantly different (P > 0.05) between the two groups. The proportion of vasoactive drug use was lower in the observation group than in the control group (P < 0.05). Differences in data for CD3+, CD4+, and CD4+/CD8+ cells between time points were significant (F = 13.256, 20.307, 18.035, P < 0.05), while those between the two groups were not (F = 1.005, 1.135, 1.204, P > 0.05). There was no interaction between data processing factors and time between the control and observation groups in CD3+, CD4+, and CD4+/CD8+ cells (F = 0.358, 0.778, 1.107, P > 0.05). The median overall survival time was 21.988 (95 % confidence interval: 18.436–25.541) and 26.978 (95 % confidence interval: 20.124–33.833) months in the control and observation groups, respectively, with a significant difference between the two groups (Log-rank χ2 = 3.925, P < 0.05). ConclusionsBoth anesthetic methods achieve satisfactory anesthetic results and reduce postoperative stress and immunosuppression. However intravenous anesthesia combined with an epidural block can increase the incidence of intraoperative hypotension in the patients, thoracic paravertebral nerve block combined with general anesthesia is more favorable for maintaining intraoperative blood pressure and heart rate stability, as well as for postoperative survival.

Comparison of effects of different anesthesia methods on immune function and liver function of liver cancer patients after operation

ABSTRACT Liver cancer, one of the most common malignant tumors, has seriously threatened people’s physical and mental health. The paper was conducted to investigate the functions of two different anesthesia methods on Tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and T lymphocyte subsets in patients undergoing liver cancer resection, and to explore the liver function impact of patients undergoing liver cancer surgery. 80 liver cancer patients were split into propofol intravenous anesthesia group and sevoflurane inhalation anesthesia group. The patient’s operation-related indicators and changes in TNF-α, CRP and T lymphocyte subsets before anesthesia, after anesthesia, 1 day after anesthesia, and 3 days after anesthesia were calculated. The levels of TNF-α and CRP in the two groups after operation were clearly higher than those before anesthesia, but there was no obvious difference between the two groups. After operation, the TNF-α of the propofol intravenous anesthesia group was lower than the sevoflurane inhalation anesthesia group. The CD3+, CD4+ and CD4+/CD8+ levels in both groups recovered to the pre-anaesthesia level 3 days after the operation. The levels of ALT, AST, ALB and TBIL returned to normal at d4 in both propofol intravenous anesthesia and sevoflurane inhalation anesthesia groups. Compared with evoflurane inhalation anesthesia for patients with liver cancer, intravenous anesthesia with propofol can reduce the body’s inflammatory response to a certain extent, has weak inhibitory effect on T lymphocyte immune function, and a smaller effect on liver function.

Effects of different anesthesia methods on postoperative immune function in patients undergoing gastrointestinal tumor resection

To investigate the effects of different anesthetic methods on postoperative immune function in patients undergoing gastrointestinal tumor resection. Ninety patients undergoing laparoscopic gastrointestinal tumor resection were divided into 3 groups. Patients in the GA group were anesthetized by total intravenous anesthesia. The GE group was anesthetized by general anesthesia combined with epidural anesthesia. The GN group was anesthetized by general anesthesia combined with bilateral Transversus Abdominis Plane block (TAP) and rectus sheath nerve blocks. General anesthesia is total intravenous anesthesia in all three groups. Blood samples were taken to test the changes of peripheral lymphocyte subtype analysis, and levels of plasma cortisol, epinephrine, norepinephrine. Also, the dosage of anesthetic drugs, recovery time, and visual analog scale (VAS) scores were recorded. Postoperative immune indexes, including CD4 count, CD8 count, B, and NK cells, in the GE group were significantly higher than those in NA and GA groups (P < 0.01). Perioperative stress indices, including epinephrine levels, norepinephrine level and aldosterone level, in the GE group were significantly lower than in the GA group and GN group (P < 0.01). The intraoperative/total sufentanil dosage and remifentanil dosage in the GE group were significantly lower than those in the GA and GN groups (P < 0.01). The VAS scores in the GE group were significantly better than those in GA and GN groups (P < 0.01). General anesthesia combined with epidural anesthesia attenuates the increase in inflammatory mediators. Its possible mechanisms include reducing perioperative stress response and reducing perioperative opioid use.

Effect of Different General Anesthesia Methods on the Prognosis of Patients with Breast Cancer after Resection: A Systematic Review and Meta-analysis.

Background The effect of total intravenous anesthesia (TIVA) and inhalation anesthesia (IA) on the prognosis of breast cancer patients has been controversial. The study is aimed at exploring the effects of different anesthesia methods on the postoperative prognosis of breast cancer patients. Methods Literature retrieval was conducted in PubMed, EMBASE, MEDLINE, Embase, CENTRAL, and CNKI databases. The literature topic was to compare the effects of TIVA and IA on the prognosis of patients undergoing breast cancer resection. Two researchers extracted data from the literature independently. This study included randomized controlled trials that evaluated for risk of bias according to the “Risk assessment Tool for Bias in Randomized Trials” in the Cochrane Manual. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias in observational studies. The chi-square test was used for the heterogeneity test. Publication bias was assessed using funnel plots and Egger's test. If heterogeneity existed between literature, subgroup analysis and sensitivity analysis were used to explore the source of heterogeneity. Sensitivity analysis was performed by excluding low-quality and different-effect models. Data were statistically analyzed using the Cochrane software RevMan 5.3. Hazard ratio (HR) and 95% confidence interval (CI) were used for statistical description. Results Seven literatures were selected for meta-analysis. There were 9781 patients, 3736 (38.20%) receiving TIVA and 6045 (61.80%) receiving inhalation anesthesia. There was no significant difference in overall survival (OS) between TIVA and IA breast cancer patients (HR = 1.05, 95% CI (0.91, 1.22), Z = 0.70, P = 0.49). There was no difference in the literature (χ2 = 6.82, P = 0.34, I2 = 12%), and there was no obvious publication bias. There was no significant difference in recurrence-free survival (RFS) between TIVA and IA patients (HR = 0.95, 95% CI (0.79, 1.13), Z = 0.61, P = 0.54). There was no heterogeneity in the literature (χ2 = 5.23, P = 0.52, I2 = 0%), and there was no significant publication bias. Conclusion There is no significant difference in OS and RFS between TIVA and IA patients during breast cancer resection. The prognostic effects of TIVA and IA were similar.

The Effects of Different Anesthesia Methods on the Treatment of Parkinson's Disease by Bilateral Deep Brain Stimulation of the Subthalamic Nucleus.

BackgroundSubthalamic nucleus deep brain stimulation (STN–DBS) surgery for Parkinson’s disease (PD) is routinely performed at medical centers worldwide. However, it is debated whether general anesthesia (GA) or traditional local anesthetic (LA) is superior.PurposeThis study aims to compare the effects of LA and GA operation methods on clinical improvement in patients with PD, such as motor and non-motor symptoms, after STN–DBS surgery at our center.MethodA total of 157 patients with PD were retrospectively identified as having undergone surgery under LA (n = 81) or GA (n = 76) states. In this study, the Unified Parkinson’s Disease Rating Scale Motor Score (UPDRS-III) in three states, levodopa-equivalent-daily-dose (LEDD), surgical duration, intraoperative microelectrode recording (iMER) signal length, postoperative intracranial volume, electrode implantation error, neuropsychological function, quality of life scores, and complication rates were collected and compared. All patients with PD were routinely followed up at 6, 12, 18, and 24 months postoperatively.ResultOverall improvement in UPDRS-III was demonstrated at postoperative follow-up, and there was no significant difference between the two groups in medication-off, stimulation-off state and medication-off, stimulation-on state. However, UPDRS-III scores in medication-on, stimulation-on state under GA was significantly lower than that in the LA group. During postoperative follow-up, LEDD in the LA group (6, 12, 18, and 24 months, postoperatively) was significantly lower than in the GA group. However, there were no significant differences at baseline or 1-month between the two groups. The GA group had a shorter surgical duration, lower intracranial volume, and longer iMER signal length than the LA group. However, there was no significant group difference in electrode implantation accuracy and complication rates. Additionally, the Hamilton Anxiety Scale (HAMA) was significantly lower in the GA group than the LA group at 1-month follow-up, but this difference disappeared at longer follow-up. Besides, there was no significant group difference in the 39-item Parkinson’s Disease Questionnaire (PDQ-39) scale scores.ConclusionAlthough both groups showed overall motor function improvement without a significant postoperative difference, the GA group seemed superior in surgical duration, intracranial volume, and iMER signal length. As the accuracy of electrode implantation can be ensured by iMER monitoring, DBS with GA will become more widely accepted.

Effects of Different Anesthetic and Analgesic Methods on Cellular Immune Function and Stress Hormone Levels in Patients Undergoing Esophageal Cancer Surgery.

The change of perioperative immune function in patients with esophageal cancer is mainly caused by the joint action of surgical trauma and anesthesia. In our study, we aimed to investigate the effects of different anesthetic methods on the changes of T lymphocyte subsets and cytokines in peripheral blood of patients with esophageal cancer surgery. 50 patients with esophageal cancer were divided into the study group and the control group. Among them, the patients in the control group chose intravenous anesthesia and received self-controlled intravenous analgesia after surgery. Patients in the study group chose thoracic epidural anesthesia combined with general anesthesia, undergoing self-controlled epidural analgesia after surgery; serum interleukin-2 (IL-2) and soluble interleukin-2 receptor (sIL-2R) were measured by ELISA. Serum stress hormones GH and sIL-8 were measured by radioimmunoassay. Both groups of patients achieved significant postoperative analgesia, but the VAS score in the study group at the T2–T4 time point was lower than that in the control group. The serum GH concentration in the study group increased at T1 and reached its highest peak at T2, then decreased. The serum IL-8 concentration of the two groups showed a downward trend from T1 to T4. Thoracic epidural anesthesia combined with general anesthesia for postoperative epidural analgesia can relieve the degree of cellular immunosuppression during and after surgery. Moreover, the thoracic epidural block combined with general anesthesia for esophageal cancer surgery and epidural analgesia after surgery for patients are anesthetic and analgesic methods with clinically significant effects. Our research results have a positive effect on the promotion of postoperative rehabilitation in patients with malignant cell tumors.

Effects of Three Anesthesia Methods on Inflammation, Oxidative Stress, Analgesia and Cognition in Elderly Patients Receiving Hip Replacement

The study aimed to investigate the effects of different anesthesia methods on the analgesia, inflammation and oxidative stress levels and cognitive function in elderly patients undergoing hip replacement. 100 elderly patients requiring hip replacement and admitted to Tianjin Hospital from March 2017 to March 2019 were enrolled and divided into group A (n=35, general anesthesia with endotracheal intubation), group B (n=35, epidural anesthesia) and group C (n=30, general anesthesia with endotracheal intubation + epidural anesthesia). The basic vital signs, inflammatory factors, stress response indicators and cognitive function changes were compared among three groups. Additionally, the effects of three different anesthesia methods were analyzed based on the differences in postoperative analgesic effect, extubation time and recovery time. The vital signs [systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR)] were lower in group C than those in group A and group B after surgery (p<0.05). The VAS score at 12 h and 24 h after surgery was lower than that at 3 h after surgery (p<0.05). Group A and B had increased levels of these inflammatory factors after surgery compared with those before surgery. Postoperative extubation time, eye-opening time upon calling and recovery time were significantly shorter in group C than those in groups A and B (p<0.05). The oxidative stress indexes in group C were remarkably lower than those in groups A and B (p<0.05). The MMSE score was decreased in groups A and B after surgery compared with that before surgery (p<0.05). General anesthesia combined with epidural anesthesia applied in elderly patients undergoing hip replacement achieves a good anesthetic effect and is able to stabilize the vital signs and stress levels of patients and improve postoperative analgesic effect and cognitive function, which is worthy of popularization in clinical practice.

Effect of Combined Spinal-Epidural Anesthesia and Total Intravenous Anesthesia on Hemodynamics and Pregnancy Outcomes of Severe Preeclampsia Pregnant Patients Undergoing Cesarean Section.

Objective The purpose of the study was to investigate the effect of combined spinal-epidural anesthesia (CSEA) and total intravenous anesthesia (TIVA) on hemodynamics and pregnancy outcomes of severe preeclampsia pregnant patients undergoing cesarean section. Methods 126 patients with severe preeclampsia admitted to Zhangqiu District People's Hospital from August 2018 to August 2019 were selected as the study subjects and randomly divided into the experimental group (n = 63) and control group (n = 63). After undergoing cesarean section, the patients in the experimental group received CSEA, while those in the control group were given TIVA. After that, the effect of different anesthesia methods on the hemodynamics and pregnancy outcomes of pregnant women was compared. Results There were no significant differences in age, BMI value, weight, height, gestational weeks, SBP, DBP, and residence between the two groups (P > 0.05). The operation duration, the onset time of anesthesia, and delivery time in the experimental group were significantly shorter than those in the control group, with less intraoperative blood loss in the experimental group than that in the control group (P < 0.001). In both groups, MAP and SpO2 during delivery were significantly lower than those before anesthesia, and HR was significantly higher than that before anesthesia (P < 0.001). In the experimental group, MAP and HR during delivery were significantly lower than those in the control group, and SpO2 was significantly higher than that in the control group (P < 0.001). The total effective rate of anesthesia in the experimental group was significantly higher than that in the control group (P < 0.05). The Apgar scoring of the newborns in the experimental group was significantly higher than that in the control group (P < 0.001), and the total incidence of postoperative adverse reactions in the experimental group was significantly lower than that in the control group (P < 0.05). Conclusion CSEA is a reliable anesthesia method for improving the hemodynamics indicators in pregnant patients with severe preeclampsia; such strategy greatly increases the Apgar score of newborns and shortens the anesthesia onset time. Further research will be conducive to establishing a better anesthesia plan for such patients.

Effect of Different Anesthesia Methods on Emergence Agitation and Related Complications in Postoperative Patients with Osteosarcoma.

Purpose To explore the effect of different anesthesia methods on emergence agitation (EA) and related complications in postoperative patients with osteosarcoma. Methods According to the order of admission, 115 patients requiring osteosarcoma surgery treated in our hospital from January 2018 to December 2020 were selected as the research object and randomly divided into the control group (n = 57, accepted the general anesthesia with tracheal intubation) and the experimental group (n = 58, accepted the combined spinal-epidural anesthesia) to compare their anesthesia effect, incidence rates of agitation and complications, and other indexes. Results In terms of the hemodynamic indexes (MAP, HR, and CVP values), both groups had lower ones at T1 than at T0, but the decline of the experimental group was generally lesser than that of the control group; at T2, no statistical difference was shown within the experimental group's indexes when comparing with those at T1, but the control group obtained a significant increase; at T3 and T4, both groups had their hemodynamic indexes increased, but such increase within the experimental group showed no statistical difference when comparing with those at T0, while the control group achieved obviously higher values at T4 than at T0 (before the anesthesia); and the between-group difference in the hemodynamic indexes at T1 and T4 was significant. Compared with the control group, the experimental group achieved better VAS scores and anesthesia indexes and lower incidence rates of EA and complications such as the hypoxemia, cardiovascular response, delayed recovery, and headache. In addition, the differences in the incidence rates of hypotension and cognitive dysfunction between the two groups were not statistically significant. Conclusion When comparing with tracheal intubation general anesthesia, the combined spinal-epidural anesthesia has a better effect in osteosarcoma surgery, with less hemodynamics influence on patients, reduced postoperative pain and stress reaction, and lowered incidence rates of postoperative EA and complications, which is worthy of wide application in clinical treatment.

Effects of different anesthesia methods on maternal and neonatal outcomes in pregnant patients with pulmonary arterial hypertension: a meta-analysis.

To investigate the effects of different anesthesia methods on maternal and neonatal outcomes in pregnant patients with pulmonary arterial hypertension (PAH). We searched PubMed, Excerpta Medica Database (EMBASE), Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wanfang and QVIP for investigating the effects of general anesthesia (GA) and local anesthesia (LA) in pregnant patients with PAH. Results were expressed as weighted mean difference (WMD) or risk ratio (RR) with 95% confidence intervals (CIs). Publication bias was assessed by the Begg's test. Totally, 18 articles containing 628 LA and 481 GA patients were involved in our study. The postoperative blood oxygen saturation (WMD = - 4.040, 95%CI: - 5.505 to - 2.576) and maternal mortality rate (RR = 0.507, 95%CI: 0.300-0.858) were lower in LA group than those in GA group. The postoperative systolic blood pressure (WMD = 15.647, 95%CI: 13.294-18.000) and postoperative diastolic blood pressure (WMD = 6.758, 95%CI: 5.715-7.802) were high in LA group compared with those in GA group. The mechanical ventilation time (WMD = - 4.112, 95%CI: - 4.655 to - 3.569), ICU admission time (WMD = - 4.176, 95%CI: - 4.523 to - 3.828), length of stay (WMD = -7.289, 95%CI: -7.799-6.779) were shorter in LA group than those in GA group. All P values were < 0.05. LA is superior to GA in regards to the postoperative blood oxygen saturation, the postoperative systolic blood pressure, postoperative diastolic blood pressure, the mechanical ventilation time, ICU admission time, length of stay and the maternal mortality rate. osf.io/juybq ( https://osf.io/search/ ).

A randomised trial: effects of different anesthesia methods on early perioperative pain sensitivity and cellular immune function in patients undergoing radical mastectomy.

This study sought to investigate the effects of transversus thoracic muscle plane-pectoral nerves (TTP-PECS) block combined with propofol anesthesia on early perioperative pain sensitivity and cellular immune function in patients undergoing radical mastectomy. A total of 115 patients who underwent radical mastectomy for breast cancer at our hospital from January 2019 to January 2021 were selected as the study subjects. The patients were allocated to the control group (n=57) or observation group (n=58) using a random number method. The control group was given simple general anesthesia, and the observation group was given TTP-PECS block combined with propofol anesthesia. The recovery time, pain [visual analogue scoring (VAS)] scores, and incidences of adverse reactions were compared between the 2 groups. Hemodynamic indicators [i.e., heart rate (HR), mean arterial pressure (MAP)], stress indicators [i.e., blood glucose (GLU), epinephrine (E), cortisol (Cor)], and the cellular immune function ofthe2 groups before anesthesia (T0), at the end of operation (T1), 1day after operation (T2) and 3days after operation (T3) were recorded. The spontaneous respiration recovery time, time to full wakefulness and the extubation time of the observation group were shorter than those of the control group (P<0.05). The observation group had lower VAS scores than the control group at 2, 8, 12, and 24 h after operation (P<0.05). The levels of MAP, HR, GLU, E and Cor in the observation group at T1, T2, and T3 were lower than those in the control group (P<0.05). Compared to the control group, the observation group had increased cluster of differentiation (CD)3+, CD4+, and CD4+/CD8+ cells (P<0.05), but there were no significant differences in CD8+ and natural killer (NK) cells between the 2 groups (P>0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (8.62% vs. 24.56%) (P<0.05). TTP-PECS block combined with propofol anesthesia can relieve pain, shorten the recovery time, stabilize the hemodynamic level, and alleviate the stress responses of patients undergoing radical mastectomy with a slight suppression of cellular immune function and high safety. Chinese Clinical Trial Registration Center ChiCTR2100048438.

Clinical Observation of Intraosseous Anesthesia in Percutaneous Kyphoplasty.

Objective Percutaneous kyphoplasty (PKP) is an effective minimally invasive technique in spine surgery in recent years. General anesthesia and local anesthesia are the main ways of anesthesia in PKP, and epidural anesthesia is also applied to PKP to some extent. However, all these three anesthetic methods have their respective advantages and disadvantages. It is essential to compare and evaluate the effects of different anesthesia methods on PKP for treating spinal fractures. Method A total of 45 patients (53 vertebral bodies were included) were divided into two groups. Group A included 24 patients (29 vertebral bodies) with an average of 71 years old and Group B included 21 patients (24 vertebral bodies) with an average of 74 years old. Visual analogue scale (VAS) scores were recorded preoperatively; balloon expansion and bone cement injection were conducted intraoperatively. Then, they were recorded immediately after operation, 6 h postoperatively, to assess the pain level of the patient. Moreover, hospitalization time (days), operation duration (minutes), and bone cement injection amount (mL) had also been recorded. Results There was no significant difference in preoperative general information and VAS score. However, the VAS scores were statistically significant at both the moment of balloon expansion and injection of bone cement. At the moment of immediate postoperation, the VAS scores showed no statistically significant difference, while it showed a statistically significant difference 6 h postoperatively. Conclusion The anesthesia method by injection of 1% lidocaine hydrochloride (5 ml) into vertebral body can effectively relieve patients' pain in intraoperation and postoperation.

Effects of different anesthetic methods on immune function and oxidative stress in patients undergoing laparoscopic herniorrhaphy.

IntroductionThe influence of anesthetic method on the immune function and oxidative stress in patients receiving laparoscopic herniorrhaphy remains largely unknown.AimTo assess the effects of different anesthetic methods on the immune function and oxidative stress in patients undergoing laparoscopic herniorrhaphy.Material and methodsA total of 280 eligible patients were randomly divided into two groups to receive total intravenous anesthesia (TIVA group) and inhalation anesthesia (IA group). T lymphocyte subsets, oxidative stress response indices and inflammatory factor levels were measured before anesthesia, at the end of the operation, and 1 and 3 days after the operation. The incidence rates of adverse reactions were compared.ResultsAt the end of and 1 day after the operation, CD3+ and CD4+ T cells and CD4+/CD8+ decreased in both groups compared with those before anesthesia (p < 0.05). Three days after the operation, CD3+ and CD4+ T cells decreased in both groups compared with those before anesthesia, which were higher in the TIVA group (p < 0.05). Interleukin-6 and C-reactive protein levels were significantly lower in the TIVA group (p < 0.05). At the end of and 1 and 3 days after the operation, oxidative stress response indices superoxide dismutase, catalase and glutathione peroxidase declined in both groups compared with those before anesthesia, which were higher in the IA group (p < 0.05). The incidence rate of adverse reactions was significantly higher in the IA group (p = 0.002).ConclusionsCompared with IA, TIVA has less effect on the immune function and oxidative stress of patients undergoing laparoscopic herniorrhaphy, and controls the inflammatory response more effectively, accompanied by a lower incidence rate of adverse reactions.

Effects of general anesthesia versus local anesthesia in primary hepatocellular carcinoma patients presenting for thermal ablation surgery: a multiple center retrospective cohort study with propensity score matching.

BackgroundWhether anesthesia methods affect the prognosis of tumor patients is controversial. With the aim of comparing the effects of general anesthesia (GA) and local anesthesia (LA) in primary hepatocellular carcinoma (HCC) patients presenting for elective thermal ablation (TA) surgeries, a multiple center retrospective cohort study was designed and implemented.MethodsPatients who received elective TA surgery under GA or LA from Jan. 2014 to Dec. 2016 and met the eligibility criteria were included. Survival analysis was used to identify the influence of anesthesia methods on recurrence-free survival (RFS) and overall survival (OS). Propensity score matching (PSM) was used to minimize the bias between the GA group and the LA group.ResultsA total of 244 patients with GA and 245 with LA were eligible for analysis. After PSM, 178 patients remained in each group. In the matched groups, GA showed a significantly higher recurrence rate compared with LA by both the Kaplan-Meier survival analyses (P=0.011) and multivariable Cox regression analyses (P=0.002). The multivariable Cox regression model also revealed that GA had a hazard ratio (HR) of 1.746 (P=0.036) for death compared with the LA group.ConclusionsGA is associated with decreased RFS and OS after surgery compared with LA in HCC patients undergoing TA surgery. Prospective trials exploring the effects of different anesthetic methods on cancer outcome in these patients are warranted.

Clinical analysis of different anesthesia methods for pulmonary infection after perioperative operation

The purpose is to explore the effect of different anesthesia methods on pulmonary infection after the operation. 120 patients who underwent surgery from January 2015 to August 2018 were selected in three groups: group A (n=40), group B (n=40), and group C (n=40). Group A was given inhalation anesthesia, group B was given total intravenous anesthesia, and group C was given epidural block combined with general anesthesia. In addition to lung imaging examination, the postoperative parameters of patients such as leukocyte count and mean arterial pressure were recorded. Through image analysis, the case of pulmonary infection after epidural block combined with general anesthesia was 1, while that of inhalation anesthesia and intravenous injection was 7 and 8. In terms of the fluctuation of heart rate and mean arterial pressure, patients in group C had lower levels of heart rate and mean arterial pressure, while patients in groups A and B had higher levels of these parameters. There was no significant difference between inhalation anesthesia and intravenous injection for pulmonary infection after the operation. Thus, it can be concluded that the negative effects of epidural block combined with general anesthesia are much less than those of the other two anesthesia methods, which has the smallest effect on pulmonary infection after the operation. Therefore, the epidural block combined with general anesthesia has the smallest effect on pulmonary infection after the operation. This study is of great significance, and more anesthesia methods can be further studied in subsequent works.

Effects of different anesthesia methods on cardiac function and postoperative complications in elderly patients undergoing thoracotomy

Objective To investigate the effects of ultrasound-guided continuous thoracic paravertebral nerve block combined with general anesthesia on cardiac function and postoperative complications in elderly patients undergoing thoracotomy. Methods A total of 108 elderly patients who underwent thoracotomy in our hospital from January 2017 to December 2018 were randomly divided into the general anesthesia group(receiving general anesthesia)and the combination group(receiving ultrasound-guided continuous thoracic paravertebral nerve block combined with general anesthesia)(n=54, each group). The anesthesia effect was compared between the two groups. Results The excellence rate of anesthesia was higher in the combination group than in the general anesthesia group(90.7% vs.72.2%, χ2=4.267, P=0.039). Stroke volume variability(SVV), stroke volume(SV), heart rate(HR)and mean artery pressure(MAP)had no significant difference between the two groups at T0(pre-anesthesia)(P>0.05). At T1(anesthesia), T2(intraoperative tissue traction), and T3(postoperative suture), there were significant differences in SVV, SV, HR and MAP between the two groups(P<0.05). The incidence of postoperative complications was lower in the combination group than in the general anesthesia group(7.4% vs.22.2%, χ2=4.696, P=0.000). Conclusions Ultrasound-guided continuous thoracic paravertebral nerve block combined with general anesthesia has good anesthetic effects, minor influence on cardiac function and a low incidence of postoperative complications in elderly patients undergoing thoracotomy. Key words: Anesthesia, general; Thoracotomy

Effects of different anesthesia methods on cognitive function and inflammatory factors in elderly patients with lung cancer during perioperative period

Objective To explore the effects of different anesthesia methods on cognitive function and serum interleukin-6(IL-6), interleukin-8(IL-8) levels in elderly patients with lung cancer during perioperative period. Methods From March 2015 to March 2017, ninety elderly patients undergoing radical resection of lung cancer treated in Heji Hospital Affiliated to Changzhi Medical College were selected in the research.According to the different anesthesia methods, they were divided into inhalation anesthesia group(A group), general intravenous anesthesia group(B group) and epidural block anesthesia group(C group), with 30 cases in each group.The minimum mental state examination(MMSE) scores, cognitive dysfunction rate, serum IL-6 and IL-8 levels of the three groups before operation, one day after operation and three days after operation were compared. Results One day and three days after operation, the MMSE scores of C group were (25.62±2.11)points, (27.12±2.04)points, respectively, which were higher than those of group A[(22.61±2.75)points, (25.78±2.68)points] and B group[(22.34±2.01)points, (25.81±2.42)points], the differences were statistically significant(tA group=4.756, 2.179, tB group=6.165, 2.267, all P<0.05). One day and three days after operation, the cognitive dysfunction rates of C group were 26.67%(8/30), 6.67%(2/30), respectively, which were lower than those of A group[50.00%(15/30), 26.67%(8/30)] and B group[66.67%(20/30), 30.00%(9/30)], the differences were statistically significant(χA group2=3.455, 4.320, χB group2=9.643, 5.455, all P<0.05). One day and three days after operation, the serum IL-6 and IL-8 levels of C group[IL-6: (99.53±16.82)ng/mL, (83.24±8.34)ng/mL, IL-8: (50.43±7.84)ng/mL, (42.15±5.25)ng/mL] were lower than those of A group[IL-6: (122.43±18.41)ng/mL, (88.51±10.42)ng/mL, IL-8: (64.53±8.94)ng/mL, (55.62±6.78)ng/mL]and B group[IL-6: (124.52±20.10)ng/mL, (87.95±9.34)ng/mL, IL-8: (63.27±9.03)ng/mL, (54.62±6.30)ng/mL], the differences were statistically significant(IL-6: tA group=5.030, 2.163, tB group=5.222, 2.060, all P<0.05; IL-8: tA group=6.495, 8.604, tB group=5.881, 8.329, all P<0.05). Conclusion The influence of epidural block anesthesia on postoperative cognitive dysfunction in elderly patients with radical resection of lung cancer is minimal, which can inhibit the expression of inflammatory factors.It is better than the other two anesthesia methods, and it is worthy of radical operation for elderly patients with lung cancer. Key words: Lung neoplasms; Aged; Anesthesia, Inhalation; Anesthesia, General; Anesthesia, Epidural; Cognitive function; Inflammatory factors

Effects of different anesthetic methods on postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy

Objective To evaluate the effects of different anesthetic methods on postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy. Methods Fifty-four patients of both sexes, aged 18-64 yr, with body mass index of 20-28 kg/m2, of American Society of Anesthesiologists physical statusⅠor Ⅱ, scheduled for elective video-assisted thoracoscopic thymectomy, were allocated into 2 groups (n=27 each) using a random number table method: sevoflurane-based anesthesia group (group S) and propofol-based anesthesia group (group P). After routine anesthesia induction in two groups, anesthesia was maintained by inhaling sevoflurane and target-controlled infusion of remifentanil in group S and by target-controlled infusion of propofol and remifentanil in group P. Heart rate and mean arterial pressure were recorded before operation and at 5 and 10 min after extubation (T1, 2). The intensity of pain at T2 and visual analog scale (VAS) score and consumption of morphine at 1, 2, 4, 24 and 48 h after operation (T3-7) were recorded.The pressing times of analgesia pump, requirement for rescue analgesia and development of nausea and vomiting were recorded at T7. Results There were no significant differences in heart rate or mean arterial pressure at each time point between two groups (P>0.05). Compared with group S, the intensity of pain was significantly alleviated at T2, and VAS scores and morphine consumption were decreased at T3, 4 in group P (P 0.05). Conclusion Propofol-based anesthesia provides better efficacy in alleviating postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy. Key words: Propofol; Anesthetics, inhalation; Pain postoperative; Myasthenia gravis; Thoracoscopy; Thymectomy