Stress Reaction In Patients Research Articles

Remazolam combined with transversus abdominis plane block in gastrointestinal tumor surgery: Have we achieved better anesthetic effects?

Laparoscopic surgery is the main treatment method for patients with gastrointestinal malignant tumors. Although laparoscopic surgery is minimally invasive, its tool stimulation and pneumoperitoneum pressure often cause strong stress reactions in patients. On the other hand, gastrointestinal surgery can cause stronger pain in patients, compared to other surgeries. Transversus abdominis plane block (TAPB) can effectively inhibit the transmission of nerve impulses caused by surgical stimulation, alleviate patient pain, and thus alleviate stress reactions. Remazolam is an acting, safe, and effective sedative, which has little effect on hemodynamics and is suitable for most patients. TAPB combined with remazolam can reduce the dosage of total anesthetic drugs, reduce adverse reactions, reduce stress reactions, and facilitate the rapid postoperative recovery of patients.

Effect of remifentanil co-administered with propofol on stress response and postoperative complications in patients with cerebral hemorrhage undergoing surgical anesthesia

Purpose: To determine the anesthetic effect and related indicators following concurrent administration of remifentanil and propofol in cerebral hemorrhage surgery patients.Methods: A total of 88 cerebral hemorrhage patients admitted in Lishui People’s District Hospital, Nanjing, China, from December 2019 to December 2020, were assigned to two groups, viz, control group which received fentanyl and propofol for anesthesia, while study group was administered remientanil combined with propofol for anesthesia There were 44 patients in each group. Hemodynamic index, brain injury marker index, stress response index, awakening condition, propofol dosage, anesthetic effect, and adverse reactions were assessed and recorded.Results: Heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP) at T2 and T3 of the two groups were less than those at T1. At T3, the study group’s HR, DBP, and SBP were substantially higher than those of control group (p < 0.05); At 12 and 24 h after operation, brain injury markers and stress response indices in study group were significantly lower compared to control group (p < 0.05), while in comparison to control group (79.55 %), the degree of anesthesia in the study group was higher (95.45 %; p < 0.05). The incidence of adverse reactions in the study group (15.91 %) was lower than in control group (43.18 %; p < 0.05).Conclusion: Remifentanil, when combined with propofol anesthesia, stabilizes hemodynamics, protects against brain injury, and reduces stress reactions in patients undergoing cerebral hemorrhage surgery. The combination is also highly effective and safe. However, validation of these findings in larger clinical trials is required.

The effect of non-invasive sequential ventilation treatment based on the use of an invasive ventilator on the arterial blood gas and inflammatory stress reaction in patients with severe pneumonia with respiratory failure

To investigate the impact of non-invasive sequential ventilation treatment based on the use of an invasive ventilator on the arterial blood gas and inflammatory stress reaction in patients with severe pneumonia with respiratory failure. Ninety patients with severe pneumonia and respiratory failure were equally separated into two groups via a random number table: a conventional treatment group (subjected to invasive mechanical ventilation) and a study group (subjected to invasive mechanical ventilation and non-invasive sequential ventilation treatment). We compared the two groups with respect to several key parameters before and after treatment, including mechanical ventilation time, invasive ventilation time, intensive care unit (ICU) stay, hospital stay, blood gas analysis indicators and the levels of inflammatory factors in the serum. We also compared the two groups with regards to complications. Mechanical ventilation time, invasive ventilation time, ICU stay and hospital stay in the study group were significantly shorter than that in the conventional treatment group (p < 0.05). Arterial Oxygen Saturation (SaO2), Partial Pressure of Oxygen (PaO2) and pH in the study group after intervention were significantly higher than those in the conventional treatment group after intervention (p < 0.05). Following intervention, white blood cell (WBC), serum c-reactive protein (CRP) and serum interleukin-6 (IL-6) were significantly lower than those in the conventional treatment group (p < 0.05). The total incidence of complications in the study group was markedly lower than in the conventional treatment group. Non-invasive sequential ventilation therapy based on an invasive ventilator had a significant treatment impact on patients with severe pneumonia and respiratory failure. This treatment effectively reduced the average treatment time, improved blood gas analysis indicators and reduced inflammatory stress, thus reducing the incidence of complications.

Improvement of Negative Psychological Stress Response in Elderly Patients With Femoral Neck Fracture by Integrated High-Quality Nursing Model of Medical Care.

ObjectiveThe objective of this study was to explore the nursing effect and negative psychological stress response of elderly patients with femoral neck fracture by applying the high-quality nursing mode of medical care.MethodsA total of 130 elderly patients with femoral neck fractures hospitalized in our hospital from January 2020 to June 2021 were randomly divided into the control group and observation group, with 65 patients in each group. The control group adopted the conventional nursing mode, while the observation group adopted the high-quality nursing mode of medical care. The observation indexes selected in this study are nursing satisfaction, hip flexion activity on the 1, 15, and 30 days after the operation, the time when the affected limb was lifted off the bed actively, and the anxiety and depression of patients.ResultsOn the 1, 15, and 30 days after the operation, there were statistically significant differences between the two groups in hip flexion activity and the time when the affected limb was lifted off the bed (P < 0.05). The nursing satisfaction of the observation group was 95.38%, which was statistically significant compared with the 80.00% of the control group (P < 0.05). After treatment, the self rating depression scale (SDS) and self rating anxiety scale (SAS) scores in the observation group were lower than those in the control group (P < 0.05).ConclusionThe high-quality nursing model of medical care can effectively promote the rehabilitation of elderly patients with femoral neck fracture, reduce the negative psychological stress reaction of patients, and improve nursing satisfaction, which has important application value and guiding significance for the nursing of patients with femoral neck fracture.

Дексмедетомідин як компонент післяопераційної аналгоседації у хворих з тяжкою черепно-мозковою травмою

Як відомо, адекватна аналгоседація забезпечує антистресовий захист при проведенні інтенсивної терапії, у тому числі й у пацієнтів з тяжкою черепно-мозковою травмою. Тому метою нашого дослідження було вивчення впливу дексмедетомідину як компонента аналгоседації на напруженість стресорних реакцій організму у пацієнтів з тяжкою черепно-мозковою травмою. Проведено проспективне дослідження, що включало 80 пацієнтів з ізольованою тяжкою черепно-мозковою травмою у післяопераційному періоду. Хворим 1-ї групи (n = 40) аналгоседацію здійснювали за допомогою морфіну та натрію оксибутирату, у хворих 2-ї групи (n = 40) додатково застосовували α2-адреноміметик дексмедетомідин. На етапах дослідження (1-ша, 3-тя, 5-та та 7-ма доба) визначали рівень інсуліну, кортизолу, глюкози у сироватці крові, розраховували індекс HOMA. Вже на 3-тю добу вивчені маркери стресу мали вірогідно нижчий рівень у хворих 2-ї групи. Тому отримані результати дозволяють зробити висновок, що при додаванні дексмедетомідину як компонента аналгоседації зниження напруженості стресорних реакцій відбувається раніше.

Study of Butorphanol, Dezocine and Dexmedetomidine in the Field of Accelerated Recovery of Gynecological Malignancies

Reducing the adverse stress response of patients in the perioperative period is the most basic principle of accelerated rehabilitation. It is well known that surgery will prompt the body to produce a corresponding stress response, thereby stimulating the body to release various hormones and inflammatory mediators, resulting in enhanced catabolism, which is not conducive to the healing of incisions and wounds. However, a series of measures of accelerated recovery in the perioperative period are precisely to reduce the occurrence of adverse stress reactions in patients. The purpose of this study is to systematically evaluate the efficacy and safety of the concept of fast recovery surgery in the operation of gynecological malignant tumors with the help of Meta analysis method, and to evaluate the efficacy and safety of fast recovery surgery concept in gynecological malignant tumor surgery. The use in tumor patients provides a basis for clinical surgeons to explore the best perioperative treatment plan. The experimental results show that the heart rate wake-up period of patients who use butorphanol 2 mg and dexmedetomidine 0.5 μg is shorter. For dezocine 10 mg and dexmedetomidine 0.5 μg, the heart rate wake-up time of group A was 68.82 minutes and 71.23 minutes, respectively. Butorphanol 2 mg and dexmedetomidine 0.5 μg were used to accelerate the recovery of patients with gynecological malignant tumors. have a certain effect.

Analysis of the Effect of Nursing Intervention in Operating Room on Stress Reaction in Patients Undergoing Breast Cancer Surgery

Analysis of the Effect of Nursing Intervention in Operating Room on Stress Reaction in Patients Undergoing Breast Cancer Surgery

The Persian COVID stress scales (Persian-CSS) and COVID-19-related stress reactions in patients with obsessive-compulsive and anxiety disorders

The COVID Stress Scales (CSS) were designed to assess stress related to the COVID-19 pandemic. Emerging evidence indicates that people with anxiety disorders (ADs) and obsessive-compulsive disorder (OCD) may be more negatively impacted by COVID-19 than those with mood disorders or healthy individuals. Accordingly, this study sought to validate the Persian CSS (Persian-CSS) and to compare COVID-19-related stress reactions among patients with specific ADs and OCD. Patients with OCD (n = 300) and ADs (n = 310) completed the Persian-CSS and other scales developed to assess anxiety-related traits and COVID-19-related distress. The Persian-CSS replicated a five-factor structure similar to the original CSS in OCD and ADs. The total CSS and its scales had good reliability and validity. Patients with generalized anxiety disorder, panic disorder, and OCD had higher COVID-19 stress reactions than patients with social anxiety disorder and specific phobia. Patients with panic disorder had higher danger and contamination fears and xenophobia than patients with OCD. The study suggests that the Persian-CSS is a valid scale to be used in patients with OCD and ADs, each of whom differs in their specific patterns of COVID-19-related stress reactions.

The stress reactions in patients with breast, ovaries and cervix cancer before and after special treatments: а pilot studies

The stress reactions in patients with breast, ovaries and cervix cancer before and after special treatments: а pilot studies

ХАРАКТЕРИСТИКА АНТИОКСИДАНТНОГО СТАТУСА В ЗАВИСИМОСТИ ОТ ТЯЖЕСТИ ТЕЧЕНИЯ ПНЕВМОНИИ У ДЕТЕЙ

Introduction. Free radical processes are General biological mechanisms of protection and tissue damage, their role is described in a variety of diseases, but the number of studies on the status of oxidative stress in children with community-acquired pneumonia are rare.Objective. To establish the state of antioxidant status depending on the severity of pneumonia in children and to assess the effectiveness of the correction of oxidative stress reactions in patients with community-acquired pneumonia.Material and methods. The main group consisted of 51 children diagnosed with acute pneumonia. The evaluation of Imax, S, t parameters depending on the severity of the pathological process was carried out.Results. Threshold values (Imax, S, and t) for medium and severe pneumonia were determined by ROC-analysis to predict the course of the pathological process.Conclusion. There is a violation of the antioxidant status, depending on the severity of the pathological process. It is necessary to correct the antioxidant status of children who belong to the group of frequently ill children.

Psychological and psychophysiological mechanisms of mental stress reaction in patients with ‘hypertension at work’, as compared with ‘classical’ version of essential hypertension

Introduction‘Hypertension at work’ today is found one of the most frequent forms of stress-induced hypertension.ObjectivesTo inquire into the specifics of psychological and psychophysiological mechanisms of stress reaction in patients with ‘hypertension at work’, as compared with ‘classical’ essential hypertension (EH).Materials and methodsThe study developed simulation of emotional stress with the aspiration level (AL) modeling. The level of state anxiety (SA), BP values, urine catecholamine levels and levels of renin and angiotonin I in blood plasma were taken before and after the experiment. Eighty-five patients with ‘hypertension at work’ (mean age was 45.9 ± 2.8) and 85 patients with ‘classical’ EH (mean age was 47.4 ± 4.5 years) took part in the study.ResultsRates of ‘hypertension at work’ patients, when compared with second group patients, revealed a significant increase (Р &lt; 0.001) of systolic BP in response to stress loads (on average, for 16.1 ± 1.9 mmHg and 4.1 ± 0.7 mmHg, respectively). Initially ‘hypertension at work’ patients had significantly lower levels of catecholamines, than the second group, while the levels of renin and angiotensin I were comparable. During the experiment, the patients in the first group showed a significant decrease in all parameters. After the experiment, the patients with ‘HTN at work’ did not show increase of SA, but revealed more frequent inadequacy (69.4%) and instability (56.5%) on the AL. Patients with ‘classical’ EH more often demonstrate adequate AL and lower growth of BP after the experiment.ConclusionsPatients with ‘hypertension at work’ are more prone to repress their emotions. They reveal physiological features of chronic stress and psychophysiological exhaustion, if compared with second group patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The influence of general combined epidural anesthesia on stress reaction in patients with laparoscopic gallbladder resection

Objective To compare the effects of general anesthesia combined with epidural space block anesthesia and pure general anesthesia on intraoperative circulation and stress reaction in patients with laparoscopic cholecystectomy. Methods 60 patients undergoing elective surgery of laparoscopic cholecystectomy were randomly divided into general anesthesia compound epidural group (group A) and general anesthesia group (group B), 30 cases in each group.The MAP, HR, C-reactive protein (CRP), epinephrine (E) and norepinephrine (NE) concentrations in the two groups at 5 min before anesthesia (T0), 15min after the pneumoperitoneum (T1), and stop 10 min after pneumoperitoneum (T2) were compared. Results T1 MAP and HR in group B[ (95.4±4.6) mmHg, (90.5±12.2)times/min]were significantly higher than those in group A[(87.1±6.0)mmHg, (83.2±13.5)times/min] (t1=7.81, t2=6.98, all P<0.05). In group B, the E and NE levels at T1, T2 and CRP level at T2[(242.1±40.5)ng/L, (271.5±31.5)ng/L, (238.0±41.8)ng/L, (265.1±40.6)ng/L, (39.3±3.9)mg/L] were significantly higher than those of group A[(195.7±28.0)ng/L, (236.9±20.3)ng/L, (191.3±31.8)ng/L, (239.2±34.2)ng/L, (26.3±3.8)mg/L] (t1=10.02, t2=8.06, t3=9.42, t4=8.69, t5=9.48, all P<0.05). The sober and postoperative extubation time of group A[(7.2±0.8)min, (11.2±7.3)min] were significantly shorter than group B[(16.4±0.8)min, (18.8±0.4)min] (t1=9.81, t2=9.60, all P<0.05). Conclusion Compared with the pure general anesthesia, general anesthesia compound epidural block can inhibit the postoperative stress reaction. Key words: Cholecystectomy, laparoscopic; Anesthesia, epidural block; Anesthesia, general; Acute-phase reaction

Impact of nursing care program on psychological stress reaction in patients undergoing digestive endoscopy

Impact of nursing care program on psychological stress reaction in patients undergoing digestive endoscopy

Regression analysis for the relationship between hardiness personality and acute stress reaction among patients with traumatic amputation

Objective To investigate the relationships between hardiness personality and acute stress responses of patients with traumatic amputation. Methods A total of 104 patients with traumatic amputation were investigated using hardiness scale (HS) and acute stress response scale (ASRS). Results The mean score of hardiness personality of patients was (1.84±0.32). The mean score of acute stress responses of patients was (0.46±0.27). The results disclosed that hardiness personality was negative correlated with acute stress responses (P<0.05). Hardiness personality all dimensions as independent variables, acute stress reaction as the dependent variable to regression analysis, the results showed toughness, control, investment can challenge combined prediction of acute stress response variance of 34.1%. Conclusions Effective psychological nursing measures should be taken to improve the hardiness personality to alleviate the acute stress reaction of patients with traumatic amputation. Key words: Amputation, traumatic; Hardiness personality; Acute stress reaction

‘Hypertension at Work’: the Real Challenge or Much Ado About Nothing? Clinical and Psychological Study

Introduction Physicians discover more and more patients with Hypertension (HTN) whose blood pressure (BP) values during work appear to be higher than those values during free time. This form of HTN is called ‘HTN at work’ (Stork at al., 1992). Objectives To evaluate the specifics of psychophysiological mechanisms of stress reaction in patients with HTN at work, as compared with patients with essential HTN. Methods 170 patients with EAH, stage 1-2 took part in the study. Among them 85 patients with HTN at work (mean age is 44.7±4.3years) and 85 patients with essential HTN (mean age is 47.4±4.5 years). The research was carried out with the implication of methods of psychological experiment, psychological testing, and methods of physiological data registration. Results Patients with HTN at work, were characterized by reliably greater increase of Systolic BP (on the average by 16 and 4 mmHg respectively) as a reaction to emotional stress. The BP increase in this group was revealed in combination with a lowering of the level of anxiety, gradual decrease of catecholamines' level in urine and renin and angiotensin-1 in blood plasma during the experiment, the fluctuant aspirations' level, and scarcity of behavioral manifestations accompanied by an abundant variety of facial expressions. This psychophysiological combination is an indicator of repression of emotions, chronic stress and psychophysiological exhaustion. Conclusions Repression of emotions come as a significant pathogenetic factor in genesis of psychosomatic syndrome among patients with HTN at work, as opposed to patients with essential HTN.

Effect of preoperative consumption of high carbohydrate drink (Pre-Op®) on postoperative metabolic stress reaction in patients undergoing radical prostatectomy

To investigate the effects of oral carbohydrate solution consumed until 2 h before the surgery in the patients that would undergo open radical retropubic prostatectomy on postoperative metabolic stress, patient anxiety, and comfort. A total of 50 adult patients, who were in ASA I-II group and would undergo open radical retropubic prostatectomy, were included in the study. While Group 1 = CH (n = 25) received oral glucose solution, Group 2 = FAM (n = 25) was famished starting from 24:00 h. Blood glucose, insulin, and procalcitonin levels of the patients were recorded, and the patients completed state-trait anxiety inventory (STAI) test, which reflects the anxiety level of the patients, both before surgery and on the postoperative 24th hour. In order to evaluate patient comfort, senses of hunger, thirst, nausea, and cold were assessed in the morning prior to the surgery. No difference was observed between the two groups in terms of demographic data and insulin resistance levels (p > 0.05). Comparing with the preoperative levels, insulin resistance showed statistically significant elevation in both groups (p < 0.05). Procalcitonin levels were similarly increased in both groups in the postoperative period (p < 0.05). Preoperative and postoperative STAI state scores were similar in both groups (p > 0.05). With regard to preoperative patient comfort, sense of hunger was present in lesser number of subjects and at lower level in Group 1 (p < 0.05). Preoperative consumption of high carbohydrate drink (Pre-op) decreases insulin resistance and enhances patient comfort leading to lesser sense of hunger and thirst in the preoperative period in open radical retropubic prostatectomies.

Effect of preemptive analgesia with PCEA on stress reaction in patients at perioperative period

Objective To explore the effect of preemptive analgesia with PCEA on stress reaction in patients at perioperative period.Methods 80 ASA grades I and Ⅱ patients scheduled for upper abdominal surgery were randomly divided into two groups:preemptive analgesia group (group A) and postoperative analgesia group (group B),40 for each group.Mixed solution of 100 ml with sufentanil of 0.7 ug/ml and ropivacaine of 0.15％ was used for analgesia.Group A received mixed solution with an initial loading dose of 10 ml and continuous analgesia with a background dose of 2 ml/h using an analgesic pump; while group B received analgesia with PCEA postoperatively with the same method used in group A.Levels of cortisol (COR),adrenocorticotropic hormone (ACTH),and C-reactive protein (CRP) were measured in the two groups at l0 minutes after entering into the operating room (To),the beginning of surgery (T1),2 hours after surgery (T2),and 6 am on the next day (T3).Pain scores were recorded at hours 2,6,12,and 24 after surgery with VAS rating scale.Results Vital signs were stable in both groups at different periods.The effect of analgesia was better in group A than in group B at T2 (P＜0.01).Levels of COR,ACTH,and CRP were significantly increased in both groups at T1,T2 and T3,as compared with T0 (P＜0.01).Levels of COR,ACTH and CRP were significantly higher in group B than in group A at T1,T2,and T3 (P＜0.05).Conclusions Preemptive analgesia with PCEA using sufentanil of 0.7 ug/ml and ropivacaine of 0.15％ and conventional analgesia with PCEA have better analgetic effect in patients undergoing upper abdominal surgery.Preemptive analgesia with PCEA is more effective in control of stress reaction at at perioperative period than conventional analgesia with PCEA. Key words: Preemptive analgesia; Epidural analgesia; Perioperative period; Stress reaction

Psychophysiological mechanisms of mental stress reactions in patients with “hypertension at work” and patients with essential hypertension: a comparative analysis

Psychophysiological mechanisms of mental stress reactions in patients with “hypertension at work” and patients with essential hypertension: a comparative analysis. Established in 2008, the Russian Psychological Society's Journal «Psychology in Russia: State of the Art» publishes original articles.

Protecting action of acupuncture-drug compound anesthesia with different frequency electroacupuncture on stress reaction in patients of pneumonectomy

ObjectiveTo observe the protective effect of acupuncture-drug compound anesthesia with different frequency electroacupuncture (EA) on stress reaction in patients of pneumonectomy and to explore potential mechanisms. MethodsEighty patients scheduled for pneumonectomy were randomly divided into four groups, group A, B, C and D, 20 cases in each group. General anesthesia and single lung protective mechanical ventilation were carried out in all the groups. Acupuncture was given at Hòuxī (▪ SI 3), Zhīgōu (▪ TE 6), Nèiguān (▪ PC 6), and Hégŭ (▪ LI 4) 30 min before general anesthesia, and the acupuncture needles were connected with Han's acupoint nerve stimulator (HANS-200) in all the groups, but the acupuncture needles without needle bodies were pasted on the acupoints and EA was not given in the group A. 2 Hz continuous wave, 100 Hz continuous wave and 2 Hz/100 Hz EA were given in the group B, C and D respectively. The supplementary amount of anesthesia medicine, heart rate (HR) and mean arterial pressure (MAP) during pneumonectomy, and CD+4/CDCD+8 in venous blood before and one day after the surgery, and the contents of epinephrine (E) and Cortisol (Cor) in plasma after entering the operating room and before turning out the operating room were detected. Results▪ During the operation, supplementary amounts of Fentanyl in the group B and C were lower than those in the group A and D (P<0.05, P<0.01). ▪ The MAP in the four groups at tracheal intubation (T1) all were higher than those before anesthesia (T0) (all P<0.01), and the ascending extents in the group B, C and D were lower than that in the group A (all P<0.01); HR at T1 in the group A was higher than that at T0 (P<0.05), while no significant change in the other groups (all P>0.05), and the ascending extents in the group B and D were lower than that in the group A (both P<0.05); MAP and HR at the other moments in all the groups were stable. ▪ CD+4/CD+8 in the group A after pneumonectomy was lower than that before the surgery (P<0.05), while no significant change in the other groups (all P>0.05). ▪ Contents of E and Cor after the operation were significantly increased in all the groups (all P<0.01), and the ascending extent of E content in the group D was lower than that in the group A (P<0.05); the ascending level of Cor in the group B and D was lower than that in the group A (P<0.01), and in the group B was lower that in the group C and D. ConclusionAcupuncture-drug compound anesthesia can attenuate the stress reaction so as to protect organs under the condition of less or same narcotic amount and can alleviate the fluctuation of MAP and HR at tracheal intubation and stabilize CD+4/CD+8 after pneumonectomy. Among them, 2 Hz and 2 Hz/100 Hz EA have better effects.

A control study of laparoscopic versus open hepatectomy: the stress reaction of patients

Objective:To investigate the influence of laparoscopic versus open hepatectomy on the stress reaction of patients.Methods Retrospectively 30 cases who received operation of laparoscopic and open left lateral lobectomy of liver for stones in bile ducts within left lobes of lives were selected form May 2006 to September 2010.The serum level of neutrocytes (N),adrenaline (AD),cortisol (Cor),blood glucose (BG),white blood cell (WBC),Natural killer cell ( NK cell),interleukin-6 (IL-6),C-reactive protein (CRP) were detected preoperatively as well as 24 h,28 h,72 h postoperatively.Results AD,Cor reached their peaks after operation,and N,BG,IL-6,CRP reached their peaks in 24 h postoperatively.There were significant difference between O and L groups (P＜0.05).NK cell sank to its lowest level in 24 h postoperatively,and there were no significant difference between the two groups (P＜0.05).Conclusion Laparoscopic and open left lateral lobectomy of liver are two methods curing stones in bile ducts within left lobes of lives,the former process can result in less stress reaction of patients than the latter. Key words: Laparoscopy; Open hepatectomy; Stress reaction