Function In Postoperative Patients Research Articles

Perioperative assessment of diaphragmatic dysfunction in cardiac surgery patients and its effect on outcome; a prospective observational study

Objectives: While the assessment of the diaphragm in different clinical scenarios is quite frequent, there remains a scarcity of studies focused on assessing diaphragm dysfunction using ultrasound in cardiac surgery patients. We investigated the impact of cardiopulmonary bypass (CPB) surgery on diaphragm function and evaluated its effects on mechanical ventilation. Methodology: A prospective cohort study, on 100 consecutive adult cardiac surgery patients, was conducted at National Heart Institute. Diaphragmatic displacement (DD) or excursion and diaphragmatic thickening fraction (DTF) were measured using motion-mode ultrasound during quite normal breathing pre-operatively (the day before surgery) and post-operatively on mechanical ventilation, while the patient was fully conscious and spontaneously breathing on continuous positive airway pressure (CPAP) mode + pressure support 10 cmH2O. Then, the results were correlated to CBP time and important patient outcomes. Results: Post-operative DD was significantly less as compared to the pre-operative reading; (1.39 ± 0.42 cm vs. 2.3 ± 0.52 cm; P < 0.001), as was DTF (23% ± 10% vs. 40% ± 13%; P < 0.001). The incidence of diaphragmatic dysfunction post-cardiac surgery was 17% by the definition of DD < 1 cm, and 49% by the definition of DTF ≤ 20%. DD was positively correlated with CBP time, as well as total ventilation time and ICU stay, indicating a negative impact on overall patient outcomes. Conclusion: The results suggest that diaphragmatic dysfunction is positively correlated with CPB time, total ventilation time and ICU stay, underscoring the importance of monitoring diaphragmatic function in post-operative patients, who are difficult to wean from mechanical ventilation with apparently normal chest X-ray, particularly those with prolonged CPB time. Keywords: cardiac surgery; cardiopulmonary bypass; diaphragm dysfunction; diaphragmatic displacement; diaphragm ultrasound; mechanical ventilation. Citation: Omara ISM, Nagi HK, Mohamed KAA, Abd El Haq HH, Awdallah FF. Perioperative assessment of diaphragmatic dysfunction in cardiac surgery patients and its effect on outcome; a prospective observational study. Anaesth. pain intensive care 2024;28(5):816−823; DOI: 10.35975/apic.v28i5.2555 Received: June 28, 2024; Reviewed: September 04, 2024; Accepted: September 06, 2024

Effects of Aerobic Exercise on Cardiopulmonary Function in Postoperative Patients with Congenital Heart Disease: A Meta-analysis.

This meta-analysis aimed to evaluate the impact of aerobic exercise on Peak VO2 (Oxygen Consumption) in postoperative patients with congenital heart disease (CHD). Besides this, we also tried to discover whether the improvement was influenced by patient ages, modes of supervision, types of exercise, the total dose of exercise, intervention periods, and types of CHD. Following the Population Intervention Comparison Outcome Study Design (PICOS) principle, a comprehensive search of the PubMed, Web of Science, Embase and Cochrane Library databases was conducted for randomized controlled trials (RCTs) evaluating the intervention effects of aerobic exercise on cardiopulmonary function in postoperative CHD patients until December 2023. This meta-analysis and publication bias tests were conducted using Stata 17.0, and the mean differences (MDs) with 95% confidence intervals (CIs) were used as effect sizes in statistics. A total of 15 RCTs (762 cases) were included in this meta-analysis, with 407 cases in the experimental group and 355 cases in the control group. Meta-analysis showed that aerobic exercise had a positive effect on Peak VO2 in postoperative CHD patients (MD = 2.14, 95% CI (1.34, 2.94), p 0.00001, I2 = 36%). The analysis of subgroups showed that intervention effects of aerobic exercise were superior to the control group when patients were 18 years old (MD = 2.53, p 0.00001), 18 years old (MD = 1.63, p = 0.01), under supervision (MD = 2.23, p 0.00001), unsupervised (MD = 2.06, p 0.00400), performing aerobic exercise (MD = 1.87, p = 0.0003), performing aerobic exercise combined with resistance training (MD = 2.57, p 0.00010), with a total dose of exercise 1440 minutes (MD = 2.45, p 0.00010), with the intervention period of 10-12 weeks (MD = 2.31, p 0.00001), with that 12 weeks (MD = 1.97, p = 0.00300), or with mixed types of CHD (MD = 2.34, p 0.00001). This meta-analysis did not deduct points for limitations, inconsistency, indirectness, imprecision, or publication bias, so the quality of evidence was graded as high. Aerobic exercise has a significantly positive impact on improving Peak VO2 in postoperative CHD patients. Moreover, it was found that for patients aged 18 and above, supervised aerobic exercise combined with resistance training, implemented for 10-12 weeks with a total dose of exercise 1440 minutes, had a better intervention effect on Peak VO2. This finding provided evidence-based medicine for the exercise rehabilitation of postoperative CHD patients, and explored the optimal exercise prescription for clinical practice as well. Registered on INPLASY No.202440016 (https://inplasy.com).

Correlation between Pain and Anal Defecation Function in Postoperative Patients with Colorectal Cancer and Related Factors Affecting Patients' Prognosis.

The degree of postoperative pain and defecation function in colorectal cancer will affect patients' prognosis. Therefore, exploring the correlation between postoperative pain and defecation function, and analyzing the related factors, will help to improve the quality of patients' prognosis. A total of 94 patients with colorectal cancer admitted to our hospital from March 2022 to June 2023 were retrospectively selected for study. The visual analog scale (VAS) was used to evaluate the pain level of the patients. The low anterior resection syndrome (LARS) scale was used to evaluate bowel function of the patients, and the incidence of LARS was recorded. The patients were grouped according to whether or not they had the complications of LARS, and they were divided into the groups of concurrent LARS and non-concurrent LARS. The patients' anorectal pressure was measured, and the measurements included maximum tolerated volume (MTV), anorectal resting pressure (ARP), and maximum squeeze pressure (MSP). Pearson's correlation coefficient was used to test associations between anal defecation function and postoperative pain and anorectal manometry. Logistic regression was used to test predictors of concurrent LARS, and the value of each of the indices for prediction of LARS was examined using the receiver operating characteristic (ROC). Patients' VAS scores were positively correlated with LARS scores (p < 0.05). A total of 22 patients with VAS score ≥20 points were found to have a LARS incidence of 23.40% based on the LARS score. The VAS score was higher in the concurrent LARS group than in the non-concurrent LARS group (p < 0.05). The concurrent LARS group had a higher percentage of patients with age ≥60 years, body mass index ≥24 kg/m2, anastomotic position <5 cm from the anal verge, preoperative radiotherapy, and anastomotic fistula than the non-current LARS group (p < 0.05). The levels of MTV, ARP, and MSP were lower in patients in the concurrent LARS group than in the non-current LARS group (p < 0.05). Patients' LARS scores were negatively correlated with MTV (r = -0.420), ARP (r = -0.300) and MSP (r = -0.220) levels (p < 0.05). Logistic regression analysis showed that anastomotic position <5 cm from the anal verge, preoperative radiotherapy, anastomotic fistula, high VAS level, and low MTV level were all significant predictors of concurrent LARS. Anastomotic position, whether or not radiotherapy was administered preoperatively, anastomotic fistula, VAS score, and MSP level all had high sensitivity and specificity for prediction of concurrent LARS, and the combined area under the curve (AUC) of each index was 0.921, sensitivity was 0.818, and specificity was 0.944. LARS is strongly associated with the patient's pain level, and factors such as anastomotic position <5 cm from the anal verge, preoperative radiotherapy, anastomotic fistula, high VAS level, and low MTV level will increase the risk of concurrent LARS in patients.

Comparison of biomechanical effects of polyetheretherketone (PEEK) rods and titanium rods in lumbar long-segment instrumentation: a finite element study.

Polyetheretherketone (PEEK) lumbar fusion rods have been successfully used in short-segment posterior instrumentation to prevent adjacent segment degeneration. However, limited studies have reported their application in lumbar long-segment instrumentation. This study aimed to compare the biomechanical performances of PEEK rods and titanium rods in lumbar long-segment instrumentation using finite element (FE) models, with the expectation of providing clinical guidance. A lumbar FE model (A) and four lumbar fixation FE models (BI, CI, BII, CII) of the L1-S1 vertebral body were developed using CT image segmentation (A: intact model; BI: intact model with L2-S1 PEEK rod internal fixation; CI: intact model with L2-S1 titanium rod internal fixation; BII: intact model with L3-S1 PEEK rod internal fixation; CII: intact model with L3-S1 titanium rod internal fixation). A 150-N preload was applied to the top surface of L1, similar to the intact model. The stresses on the lumbar intervertebral disc, facet joint, pedicle screws, and rods were calculated to evaluate the biomechanical effect of the different fixation procedures in lumbar long-segment instrumented surgery. Under the four physiological motion states, the average stresses on the adjacent segment intervertebral disc and facet joint in all fixation models were greater than those in the intact model. Furthermore, the average stresses on the adjacent segment intervertebral disc and facet joint were greater in models CI and CII than in models BI and BII, respectively. The average stresses on the pedicle screws and rods were decreased in models BI and BII compared with models CI and CII under the four physiological motion states, respectively. The PEEK rod internal fixation system may have better biomechanical properties than the titanium rod internal fixation system in delaying adjacent segment degeneration, improving the lumbar function of postoperative patients, and reducing the risk of screw loosening and breakage in lumbar long-segment instrumentation.

Long-lasting decreased pain threshold negatively affects functional recovery after arthroscopic rotator cuff repair.

The relationship between sensitization and postoperative function in patients undergoing arthroscopic rotator cuff repair (ARCR). The purpose of this study was to evaluate the effect of pre-and postoperative reductions in the pressure pain threshold (PPT) on postoperative clinical outcomes in patients with ARCR and investigate changes in PPT and clinical outcomes resulting from postoperative administration of weak opioids activating the central inhibitory system. This retrospective study included patients who underwent primary ARCR, categorized into Group A (excellent/good Constant scores) and B (fair/poor Constant scores). In a complementary study, patients were randomized to the Control or Tramadol groups. Both studies evaluated the PPT, visual analog scale, active range of motion (ROM), Constant score, and retear rates pre-and postoperatively. In the primary study with 158 patients, those with poor clinical outcomes exhibited significantly lower PPT at the affected shoulder preoperatively at 3months postoperatively compared to those with good outcomes. The PPT of the affected side was lower than that of the uninvolved side not only at 1 and 3 months but also preoperatively and at 6 months in the poor outcome group. In the secondary study involving 96 patients, weak opioid administration was associated with increased PPT for 3 months, improved ROM at 3 months postoperatively, and reduced postoperative pain 1 year postoperatively. Patients experiencing poor postoperative clinical outcomes exhibited prolonged lowered PPT. Lowered PPT due to sensitization may adversely affect functional recovery and pain perception. Elevating PPT using weak opioids improved clinical outcomes during the acute perioperative period after ARCR. III.

The Effect of TSH Suppression Therapy on the Efficacy and Immune Function of Postoperative Patients with Thyroid Cancer

Objective: To investigate the efficacy and immune function of thyroid stimulating hormone (TSH) suppression therapy in postoperative thyroid cancer patients. Methods: Sixty thyroid cancer patients admitted from July 2020–July 2022 were recruited and randomly divided into two groups. The control group (30 patients) received hormone replacement therapy, while the study group (30 patients) received TSH suppression therapy. The thyroid function, clinical efficacy, immune function, and tumor markers of the two groups were compared. Results: After treatment, the levels of free triiodothyronine (FT3) and thyroxine (FT4) in both groups increased significantly, while TSH levels decreased significantly. Moreover, the magnitude of change in the study group was greater than that in the control group (P &lt; 0.05). The total effective rate in the study group was significantly higher as compared to the control group (P &lt; 0.05). After treatment, the levels of CD3+ and CD4+ cells in both groups of patients increased significantly, with the study group showing significantly higher levels than the control group, whereas the level of CD8+ cells decreased significantly, with the study group having lower levels than the control group (P &lt; 0.05). After treatment, the levels of Tg and CEA in both groups were significantly lowered as compared to before treatment, and the levels of Tg and CEA in the study group were significantly lower than the control group (P &lt; 0.05). Conclusion: TSH suppression therapy in postoperative thyroid cancer patients can improve thyroid function, suppress the levels of tumor markers, and enhance immune function, thereby achieving good clinical outcomes.

Functional State and Rehabilitation of Patients after Primary Brain Tumor Surgery for Malignant and Nonmalignant Tumors: A Prospective Observational Study

The aim of this study was to compare the pre- and postoperative function of patients qualifying for resection of malignant and nonmalignant primary brain tumors to determine the relationship among tumor type, function, and the course of rehabilitation after surgery. This single-center, prospective, observational study recruited 92 patients requiring prolonged postoperative rehabilitation during their inpatient stay, who were divided into a nonmalignant tumor group (n = 66) and a malignant tumor group (n = 26). Functional status and gait efficiency were assessed using a battery of instruments. Motor skills, postoperative complications, and length of hospital stay (LoS) were recorded and compared between groups. The frequency and severity of postoperative complications, the time needed to attain individual motor skills, and the proportion of patients losing independent gait (~30%) were similar between groups. However, paralysis and paresis were more frequent in the malignant tumor group before surgery (p < 0.001). While nonmalignant tumor patients deteriorated more according to all scales after surgery, patients with malignant tumors were still characterized by worse ADL, independence, and performance at discharge. Worse functional outcomes in the malignant tumor group did not affect LoS or rehabilitation. Patients with malignant and nonmalignant tumors have similar rehabilitation needs, and patient expectation-especially those with nonmalignant tumors-should be appropriately managed.

O105 The impact of experimental hyperchloraemic acidosis on porcine isolated visceral arterial contractility

Abstract Introduction Hyperchloraemic acidosis is known to be associated with impaired renal function in post-operative patients. We have experimentally investigated whether elevation in chloride and hydrogen ions have the potential to negatively impact the porcine renal vasculature. Methods Porcine renal (RA) and mesenteric (MA) arteries were placed in Krebs-Henseleit solution (K-H), gassed with 95%O2/5%CO2, and prepared for isometric tension recordings. 60mM KCl was used for standardized contractions and preparations were then exposed to the thromboxane-mimetic U46619, followed 6-18mM of either NaCl or Na Gluconate (NaGlu). Preparations were also exposed to increasing concentrations of noradrenaline in normal K-H (pH 7.4) and K-H pH 7.2. Results U46619 (10-20nM) produced stable contractions in RA and MA equivalent to 50% of that to 60mM KCl. 18mM NaCl caused a further contraction in RA (19.8±4.2%, n=9, p &amp;lt; 0.01), while 18mM NaGlu (3.8±4.4%, n=9) did not. Neither 6-18mM NaCl nor 6-18mM NaGlu caused responses in MA (&amp;lt; 4%, n=6). Noradrenaline produced concentration-dependent contractions in MA in normal K-H solution (logEC50 5.43±0.11: Max’ 226.8±24.6% 60mM KCl, n=6) that were significantly reduced (p &amp;lt; 0.05) in K-H pH 7.2 (logEC50 5.13±0.02: Max’ 174.4.8±3.3%, 60mM KCl, n=6). In contrast, in the RA noradrenaline contractions (logEC50 5.80±0.08: Max’ 162.8±12.0% 60mM KCl, n=11) were not affected (p &amp;gt; 0.05) by K-H solution pH 7.2 (logEC50 5.71±0.07: Max’ 177.8±15.3% 60mM KCl, n=11). Conclusion Elevation of chloride ions (experimental hyperchloraemia) selectively constricts porcine renal blood vessels, while corresponding elevation in hydrogen ions (acidosis) selectively dilates the mesenteric vasculature.

Transcutaneous electrical acupoint stimulation for immunologic function after surgery in patients with gastrointestinal tumor: a meta-analysis

ABSTRACT There is no consensus on whether transcutaneous acupoint electrical stimulation can be used to improve the immune function of postoperative patients with gastrointestinal tumors. This meta-analysis aims to evaluate the effects of transcutaneous electrical acupoint stimulation (TEAS) on postoperative immune function of patients with gastrointestinal tumor and provide evidence-based basis for clinical evaluation. The method used in this study is to systematically searched English databases including PubMed, Cochrane Library (CENTRAL), Excerpta Medica Database (EMbase), Web of Science and Chinese databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang Data, VIP database and China Biomedical Literature Database (SinoMed). Relevant registration platform named Chinese Clinical Trial Registry (ChiCTR) was also searched. Manual search and document tracking are also performed. The aforementioned databases were retrieved for transcutaneous electrical acupoint stimulation for immunologic function after surgery in patients with gastrointestinal tumor randomized controlled trials (RCTs) from inception to 1 November 2022. Meta-analysis was conducted by RevMan5.4.1 software, and the evidence quality was evaluated using Cochrane risk bias evaluation form. In this study, a total of 18 trials with 1618 participants were analyzed. Only two studies were shown to be low risk. The results showed that there were significant differences in cellular immune and inflammatory factors and receptors, such as CD3+, CD4+, CD4+/CD8+, NK, IL-6, TNF-α, sIL-2 R, IL-2 and CRP, had significant effects (P < 0.05) after TEAS intervention on gastrointestinal tumor; however, CD8+ (P = 0.07) and IL-10 (P = 0.26) did not. Judging from the current evidence, TEAS was found to improve the immune function of patients with gastrointestinal tumors after surgery and reduce the level of inflammatory response, worthy of clinical promotion and use.

Effect of continuous nursing combined with respiratory exercise nursing on pulmonary function of postoperative patients with lung cancer.

Lung cancer is a malignant tumor with high morbidity and mortality among cancers. Surgery is currently one of the primary methods of treating lung cancer. Although it can slow down the progression of the disease by removing the lesion, this invasive surgery inevitably damages the integrity of the patient's chest. Moreover, the patient's pulmonary function may have a low compensatory capacity after surgery, causing various respiratory diseases such as atelectasis, respiratory function decline, and even serious cardiovascular disease. All of these have great negative impacts on the surgical effect and the prognosis of patients. With the continuous exploration and development of nursing, continuous nursing and respiratory exercise nursing have been gradually applied in the nursing of patients after lung cancer surgery, and have achieved good nursing results. To investigate the effect of continuous nursing combined with respiratory exercise nursing on the pulmonary function of postoperative patients with lung cancer. A total of 80 patients with lung cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the study subjects. All subjects were randomly divided into the control group (n = 40 cases) and the experimental group (n = 40 cases). Patients with lung cancer in the control group were given conventional nursing after surgery, while the experimental group was given continuous nursing combined with respiratory exercise nursing based on conventional nursing. The recovery of pulmonary function and respiratory symptoms was observed before and after 3 mo of intervention in both groups. The pulmonary function parameters, blood gas analysis, MD Anderson Symptom Inventory-lung cancer module (MDASI-LC) scores, incidence of pulmonary complications, and Morisky compliance scores were compared between the two groups before and after 3 mo of intervention. There was no significant difference in pulmonary function and blood gas analysis between the two groups before intervention (P > 0.05). 3 mo after the intervention, the pulmonary function parameters in the experimental group (SpO2, VC, MVV, FEV1, FEV1% pred, and FEV1/FVC) were higher than those in the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in blood gas analysis between the two groups before intervention (P > 0.05). PaO2 in the experimental group was significantly higher than that in the control group, and PaCO2 was significantly lower than that in the control group 3 mo after the intervention. The difference had statistical significance (P < 0.05). 3 mo after the intervention, the MDASI score of respiratory symptoms in the experimental group was significantly lower than that in the control group (P < 0.05), and the incidence of pulmonary complications was lower than that in the control group (P < 0.05). In addition, the treatment compliance and nursing satisfaction of patients in the experimental group were higher than those in the control group, and the differences were statistically significant (P < 0.05). Continuous nursing combined with respiratory exercise nursing can significantly accelerate the recovery of respiratory function in postoperative lung cancer patients, reduce the incidence of postoperative complications of lung cancer as well as improve the treatment compliance of patients.

Research on the evaluation of rectal function after LAR based on CEEMDAN‐Fast‐ICA algorithm

AbstractRectal cancer is one of the most common lower gastrointestinal diseases worldwide. Currently, the common treatment is low anterior resection (LAR) of the rectum, which preserves the anus of the patient. However, it is easy to cause low anterior resection syndrome after surgery, which has a significant negative impact on the life of patients, and there is no unified evaluation standard for postoperative rectal function. To solve this problem, a multi‐sensor fusion rectal information acquisition system is designed in this paper, and a rectal signal processing method is proposed to theoretically evaluate the rectal function of postoperative patients. The method uses the complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN) to decompose the one‐dimensional rectal signal to solve the underdetermined ICA problem, uses the Fast independent component analysis (Fast‐ICA) to separate the pure rectal signal, uses the wavelet packet to extract features, and uses the particle swarm optimization optimizes support vector machine (PSO‐SVM) to classify and evaluate postoperative function. According to the experimental results, the rectal signal preprocessing effect is good, the evaluation prediction rate is 99.5565%, and the algorithm classification results are accurate, which provides a certain preliminary theoretical basis and reference value for the evaluation of rectal function after LAR.

Retracted: Effects of the Ultrasound-Guided Stellate Ganglion Block on Hemodynamics, Stress Response, and Gastrointestinal Function in Postoperative Patients with Colorectal Cancer.

[This retracts the article DOI: 10.1155/2022/2056969.].

Effect of Arthroscopic Acromioplasty Combined with Rotator Cuff Repair in the Treatment of Aged Patients with Full-Thickness Rotator Cuff Tear and Rotator Cuff Injury.

Full-thickness rotator cuff tear and rotator cuff injury are frequently occurring diseases and widely exist in the social population. Surgical repair is the most effective treatment for rotator cuff tears and injuries. With the continuous development of arthroscopy, more and more surgeons choose arthroscopic acromioplasty plus rotator cuff repair for the treatment of rotator cuff injury. However, previously published systematic reviews or meta-analyses still cast doubt on the efficacy of such concomitant procedures for postoperative patient function and pain recovery. In this study, we analyzed the effects of parameters such as shoulder function and acromion morphology on aged patients with full-thickness rotator cuff tear combined with rotator cuff injury treated with arthroscopic acromion plasty and rotator cuff repair. The results showed that arthroscopic acromion plasty and rotator cuff repair helped to promote the joint function recovery of the aged patients with full-thickness rotator cuff tear combined with rotator cuff injury and alleviate the pain of the patients. Compared with simple rotator cuff repair, this technique can increase the postoperative AT and reduce the ACEA and to some extent reduce the risk of postoperative rotator cuff reinjury, which is worthy of promotion.

Bioprosthesis in aortic valve replacement: long-term inflammatory response and functionality

BackgroundThe evaluation of long-term inflammatory response and function in postoperative patients with aortic valve replacement (AVR) deserves special analysis because it is important to try to prevent reoperation and improve...

Feasibility of a preoperative strengthening exercise program on postoperative function in patients undergoing hip or knee arthroplasty: a pilot randomized controlled trial

BackgroundThere are conflicting results on the effect of preoperative exercise programs on long-term function and little evidence on short-term function. The aim is to assess the feasibility of a preoperative strengthening exercise program in patients undergoing hip or knee joint arthroplasty in terms of trial design, recruitment, and follow-up rates.MethodsA randomized controlled feasibility study with patients undergoing hip or knee joint arthroplasty. Patients were randomized to a preoperative strengthening exercise program or standard of care. Feasibility outcome measures were recruitment rate (≥ 50%) and loss to follow-up (≤ 15%).ResultsOf the 129 eligible participants, 63 participants consented to participate in the study (49%), and 27 were successfully randomized prior to surgery (43%). All 27 participants completed the baseline assessment. Of these, 6 (22%) had surgery during the exercise period. Of the remaining 21 participants, 20 (95%) completed the pre-surgery assessment. The study was terminated before five participants could be eligible for the 6-month assessment. Sixteen (76%) participants completed the 6-week post-surgery assessment. Twelve participants completed the 6-month assessment (75%).ConclusionGiven the recruitment rate, randomization barriers, and study participant loss to follow-up, the study was discontinued since it was not considered feasible in this current form at our clinical site despite modifications made to the protocol. Future investigations into a modified intervention via telerehabilitation should be explored.Trial registrationClinicalTrials.gov, NCT03483519. Retrospectively registered in March 2018.

Effects of the Ultrasound-Guided Stellate Ganglion Block on Hemodynamics, Stress Response, and Gastrointestinal Function in Postoperative Patients with Colorectal Cancer.

Objective The aim of the study was to study the effects of the ultrasound-guided stellate ganglion block on hemodynamics, stressful response, and postoperative gastrointestinal functions in patients with colorectal cancer. Methods A total of 100 patients with colorectal cancer hospitalized from January 2021 to December 2021 were selected. After anesthesia induction, the right stellate ganglion block was performed under ultrasound guidance in the research group and the general anesthesia was performed in the control group. The heart rate (HR), mean arterial pressure (MAP), epinephrine, cortisol, self-rating anxiety scale (SAS), Ramsay sedation score (RSS), postoperative bowel sound recovery time, anal exhaust time, and the incidence of gastrointestinal adverse reactions 24 hours after operation were studied pre-and post-24-hour anesthesia induction. Results Following 24-hour operation, the HR and MAP values were largely reduced (p < 0.05). Following 24-hour operation, epinephrine and cortisol became obviously higher (p < 0.05). After 24-hour operation, the levels of epinephrine and cortisol in the research group were greatly lower. The score of the SAS in the study cohort was less than that of the controls (p < 0.05). The RSS of the research group was obviously increased (p < 0.05). The recovery time of intestinal sound and the anal exhaust time of the study cohort became remarkably shorter (p < 0.05). The incidence of gastrointestinal adverse reactions 24 hours after operation of the study cohort was much less common (p < 0.05). Conclusion The ultrasound-guided stellate ganglion block can reduce the fluctuation of blood circulation during radical resection of colorectal cancer, reduce postoperative gastrointestinal dysfunction and stress reaction, relieve patients' anxiety, and contribute to the recovery of gastrointestinal function.

Curative efficacy of surgical procedures for older patients with femoral neck fracture: a network meta-analysis and systematic review

BackgroundFemoral neck fractures have a higher incidence in older people with poor prognosis, inducing serious social problems. Common treatment methods include total hip arthroplasty, bipolar hemiarthroplasty, double-screw fixation, multiple-screw fixation, and dynamic hip system.MethodsWe searched through four electronic databases, including PubMed, Web of Science, Cochrane Library, and Embase databases, for articles regarding femoral neck fractures, bone screw, and hip prosthesis published up to February 11, 2020. All included articles were used for quality evaluation and data extraction. Extracted data were expressed as odds ratios or weighted mean differences, with 95% confidence intervals. We conducted a network meta-analysis for Harris hip score, complications, 1-year mortality rate, reoperation rate, intraoperative blood loss, and duration of operation using STATA version 16.0 software.ResultsTwenty-two randomized controlled trials and nine cohort studies included in this study involved 3861 patients. Total hip arthroplasty significantly improved the postoperative function of patients with femoral neck fractures. The surface under the cumulative ranking curve value of the Harris hip score for more than 1 year after total hip arthroplasty was 98.2.ConclusionsThis meta-analysis indicated no significant difference in mortality among different treatment groups. Total hip arthroplasty can provide satisfactory outcomes in hip joint function, and double-screw fixation results in the lowest intraoperative risk. In general, total hip arthroplasty results in a lower incidence of adverse events and is especially recommended for patients with femoral neck fractures. This article has been retrospectively registered on the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) on November 27, 2020. Registration number: INPLASY2020110123.

Influence on TCM Nursing Acupoint Massage Combined with Evodiaevodiaacupoint Application on Recovery of Gastrointestinal Function in Postoperative Patients with Rectal Cancer

Influence on TCM Nursing Acupoint Massage Combined with Evodiaevodiaacupoint Application on Recovery of Gastrointestinal Function in Postoperative Patients with Rectal Cancer

The role of monitoring platelet function perioperatively and platelet transfusion for operated spontaneous intracerebral hemorrhage patients with long-term oral antiplatelet therapy: A case report.

Introduction and importanceSpontaneous intracerebral hemorrhage (SICH) with long-term oral antiplatelet therapy (LOAPT) is known as a dilemma in balancing the risk of postoperative rebleeding and ischemic events because of confused coagulation function. We herein describe a report of perioperative management of spontaneous intracerebral hemorrhage patient on long-term oral antiplatelet therapy.Case presentationA 42-year-old male patient on long-term oral antiplatelet therapy presented with coma, and he was diagnosed with spontaneous intracerebral hemorrhage. Considering the patient's clinical condition, despite the thromboelastography suggested that the inhibition of platelet function was high preoperatively, an emergency craniectomy were underwent. After platelet transfusion during surgery and taking control of the clotting and platelet function postoperatively, the patient was stable without rebleeding and new ischemic events in perioperative period and recovered satisfactorily.Clinical discussionRare studies have provided evidence for managing operated spontaneous intracerebral hemorrhage patients on long-term oral antiplatelet therapy, and whether platelet transfusion is recommended was controversial. In this case, we presented monitoring and taking control of clotting and platelet function postoperatively would help in preventing rebleeding and ischemic events in such patients; moreover, platelet transfusion may quickly and safely reverse platelet dysfunction for emergency surgery. This case was the first to report platelet function and coagulation function management in spontaneous intracerebral hemorrhage patients with long-term oral antiplatelet therapy.ConclusionMonitoring and maintaining coagulation and platelet function perioperatively are essential to balance the risk of postoperative rebleeding and ischemic events.

THE SIGNIFICANCE OF THE STUDY OF THE LIVER FUNCTION TEST WITHIN POST-TRANSPLANT PATIENTS

In recent years, the survival rate of patients after liver transplantation (LT) has improved significantly. However, successful transplantation is directly related to the proper management of the patient after surgery, including considering essential aspects based on the results of laboratory tests. Therefore, it is essential to study the laboratory characteristics to investigate the functional state of the liver. In the present study, we investigated the indicators of liver function in postoperative patients: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), albumin, total bilirubin, gamma-glutamyl transferase (GGT). Venous blood samples were used for investigation. A total of 10 post-transplant patients were studied. Appropriate research methods were used. P&lt;0.05 was considered statistically significant. Overall, our results have shown that intensive examinations of the liver panel in postoperative patients significantly contribute to the proper management of the complicated patient, which directly impacts the final results. Notably, the variability of GGT and ALP may be directly related to the transplanted chronic immune response of the liver and may be used as an early marker for the diagnosis of biliary complications.