BACKGROUND Hypoxemia is a common complication in older patients during postoperative recovery and can cause pulmonary complications.Therefore,reducing the incidence of postoperative hypoxemia is a clinical concern.AIM...BACKGROUND Hypoxemia is a common complication in older patients during postoperative recovery and can cause pulmonary complications.Therefore,reducing the incidence of postoperative hypoxemia is a clinical concern.AIM To investigate the clinical efficacy of high-flow nasal cannula oxygen(HFNCO)in the resuscitation period of older orthopedic patients.METHODS In this prospective randomized controlled trial,60 older patients who underwent orthopedic surgery under general anesthesia were randomly divided into two groups:those who used conventional face mask and those who used HFNCO.All patients were treated with 60%oxygen for 1 h after extubation.Patients in the conventional face mask group were treated with a combination of air(2 L)and oxygen(2 L)using a traditional mask,whereas those in the HFNCO group were treated with HFNCO at a constant temperature of 34℃ and flow rate of 40 L/min.We assessed the effectiveness of oxygen therapy by monitoring the patients’arterial blood gas,peripheral oxygen saturation,and postoperative complications.RESULTS The characteristics of the patients were comparable between the groups.One hour after extubation,patients in HFNCO group had a significantly higher arterial partial pressure of oxygen(paO_(2))than that of patients in conventional face mask group(P<0.001).At extubation and 1 h after extubation,patients in both groups showed a significantly higher arterial partial pressure of carbon dioxide(paCO_(2))than the baseline levels(P<0.001).There were no differences in the saturation of peripheral oxygen,paO_(2),and paCO_(2) between the groups before anesthesia and before extubation(P>0.05).There were statistically significant differences in paO_(2) between the two groups before anesthesia and 1 h after extubation and immediately after extubation and 1 h after extubation(P<0.001).However,there were no significant differences in the oxygen tolerance score before leaving the room,airway humidification,and pulmonary complications 3 d after surgery between the two groups(P>0.05).CONCLUSION HFNCO can improve oxygen partial pressure and respiratory function in elderly patients undergoing orthopedic surgery under general endotracheal anesthesia.Thus,HFNCO can be used to prevent postoperative hypoxemia.展开更多
Objective: To analyze the effect of nursing intervention in operating room for gastric cancer patients in anesthesia recovery period. Methods: From June 2021 to December 2021, 78 patients who underwent gastric cancer ...Objective: To analyze the effect of nursing intervention in operating room for gastric cancer patients in anesthesia recovery period. Methods: From June 2021 to December 2021, 78 patients who underwent gastric cancer surgery in our hospital were selected for research. Combined with the random number table method, they were divided into the control group (providing routine nursing care in operating room) and the observation group (providing nursing intervention in operating room) with 39 patients in each group respectively. The body temperature of the two groups during operation, during abdominal closure and after operation, the time of leaving anesthesia room, extubation, postoperative wakefulness and hospitalization, degree of satisfaction with nursing work was compared. Results: Compared with the control group, the body temperature in the observation group tended to be more normal during operation, during abdominal closure and after operation (P 0.05). The time of leaving anesthesia room, extubation, postoperative wakefulness and hospitalization in the observation group were shorter than those in the control group (P 0.05). The satisfaction degree of the observation group with nursing work was higher than that of the control group (P 0.05). Conclusion: Nursing intervention in operating room is effective for gastric cancer patients in anesthesia recovery period, which can maintain their perioperative temperature stability, promote their postoperative recovery and enhance their satisfaction with nursing work. It is worth adopting.展开更多
BACKGROUND： Acupuncture anesthesia was created in the 1950＇s in China and continues to be used there today during most major surgeries. It is widely used in China for such complex operations as brain heart, and abdo...BACKGROUND： Acupuncture anesthesia was created in the 1950＇s in China and continues to be used there today during most major surgeries. It is widely used in China for such complex operations as brain heart, and abdominal surgery. It is popular in China because it is economical, practical, and beneficial to the patients. With acupuncture anesthesia there is less bleeding during surgery and there is also quicker post-operative recovery. OBJECTIVE： This randomized prospective study aims at comparing the effect of two acupoints （Yongquan, KI1 and Renzhong, DU26） with sham acupuncture and no acupuncture on the time to recovery of consciousness after general anesthesia by means of the Bispectral Index monitor （BIS） DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This is a prospective randomized controlled study. We randomly assigned 50 patients to 5 groups during recovery from surgical anesthesia. Four groups had acupuncture on KI1 （group A）, DU26 （groups B）, both KI1 and DU26 （group C）, and sham points （group D）, and one had no acupuncture （group E）. MAIN OUTCOME MEASURES： Bispectral Index （BIS）, time to spontaneous eye opening, time to tracheal extubation, and time to following commands were measured as the main outcome measures RESULTS： Time to spontaneous eye opening differed among groups （P=0.002）, as well as time to tracheal extubation （P〈0.000 1） and time to following commands （P=0.000 6）. BIS values differed significantly among groups both 5 and 10 min after the end of anesthesia （P〈0.000 1 and P=0.000 4, respectively）. BIS values of groups D and E were lower than those of the other groups and those of group C were higher. The same pattern was observed also 15 and 30 rain after the end of anesthesia although the difference among groups was not significant at these time points （P=0.164 and P=0.104 respectively）. CONCLUSION： Acupuncture on DU26 and KI 1 accelerates recovery of consciousness after general anesthesia. Moreover, a possible synergistic effect of DU26 and KI1 is suggested. This issue may play a role in the optimization of operating room management and raise interest about the usefulness of acupuncture on unconsciousness states of different nature.展开更多
BACKGROUND Peripheral regional block combined with general anesthesia might be a preferable anesthetic regimen for elderly patients undergoing total hip arthroplasty.AIM To investigate whether ultrasound-guided,direct...BACKGROUND Peripheral regional block combined with general anesthesia might be a preferable anesthetic regimen for elderly patients undergoing total hip arthroplasty.AIM To investigate whether ultrasound-guided,direct suprainguinal injection for fascia iliaca block accelerated recovery after general anesthesia and relieved postoperative pain after total hip arthroplasty.METHODS Patients who underwent total hip arthroplasty under general anesthesia in 2015 or 2019 at The Second Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed.The patients were grouped based on whether preoperative suprainguinal fascia iliaca block was performed or not.The time to tracheal extubation and time spent in the post-anesthesia care unit(PACU),intraoperative remifentanil dosage,fentanyl consumption in the PACU,postoperative cumulative fentanyl consumption within 48 h after operation,visual analogue scale at rest and during movement on the first and second days after surgery,and adverse reactions were compared.RESULTS Thirty-one elderly patients who underwent total hip arthroplasty were included in the study(block group,n=16;no-block group,n=15).The visual analog scale scores at rest and during movement on the first and second days were significantly lower in the block group than in the no-block group(all P<0.05).Compared with the no-block group,the intraoperative remifentanil dosage was lower,the time to tracheal extubation and the time spent in the PACU were shorter in the block group(all P<0.01).Fentanyl consumption in the PACU and postoperative cumulative fentanyl consumption in 48 h after operation were lower in the block group(all P<0.01).The incidence of dizziness was higher in the no-block group than in the block group(P=0.037).CONCLUSION Ultrasound-guided,direct suprainguinal injection for fascia iliaca block led to faster recovery after general anesthesia and early postoperative pain relief in elderly patients undergoing total hip arthroplasty.展开更多
文摘BACKGROUND Hypoxemia is a common complication in older patients during postoperative recovery and can cause pulmonary complications.Therefore,reducing the incidence of postoperative hypoxemia is a clinical concern.AIM To investigate the clinical efficacy of high-flow nasal cannula oxygen(HFNCO)in the resuscitation period of older orthopedic patients.METHODS In this prospective randomized controlled trial,60 older patients who underwent orthopedic surgery under general anesthesia were randomly divided into two groups:those who used conventional face mask and those who used HFNCO.All patients were treated with 60%oxygen for 1 h after extubation.Patients in the conventional face mask group were treated with a combination of air(2 L)and oxygen(2 L)using a traditional mask,whereas those in the HFNCO group were treated with HFNCO at a constant temperature of 34℃ and flow rate of 40 L/min.We assessed the effectiveness of oxygen therapy by monitoring the patients’arterial blood gas,peripheral oxygen saturation,and postoperative complications.RESULTS The characteristics of the patients were comparable between the groups.One hour after extubation,patients in HFNCO group had a significantly higher arterial partial pressure of oxygen(paO_(2))than that of patients in conventional face mask group(P<0.001).At extubation and 1 h after extubation,patients in both groups showed a significantly higher arterial partial pressure of carbon dioxide(paCO_(2))than the baseline levels(P<0.001).There were no differences in the saturation of peripheral oxygen,paO_(2),and paCO_(2) between the groups before anesthesia and before extubation(P>0.05).There were statistically significant differences in paO_(2) between the two groups before anesthesia and 1 h after extubation and immediately after extubation and 1 h after extubation(P<0.001).However,there were no significant differences in the oxygen tolerance score before leaving the room,airway humidification,and pulmonary complications 3 d after surgery between the two groups(P>0.05).CONCLUSION HFNCO can improve oxygen partial pressure and respiratory function in elderly patients undergoing orthopedic surgery under general endotracheal anesthesia.Thus,HFNCO can be used to prevent postoperative hypoxemia.
文摘Objective: To analyze the effect of nursing intervention in operating room for gastric cancer patients in anesthesia recovery period. Methods: From June 2021 to December 2021, 78 patients who underwent gastric cancer surgery in our hospital were selected for research. Combined with the random number table method, they were divided into the control group (providing routine nursing care in operating room) and the observation group (providing nursing intervention in operating room) with 39 patients in each group respectively. The body temperature of the two groups during operation, during abdominal closure and after operation, the time of leaving anesthesia room, extubation, postoperative wakefulness and hospitalization, degree of satisfaction with nursing work was compared. Results: Compared with the control group, the body temperature in the observation group tended to be more normal during operation, during abdominal closure and after operation (P 0.05). The time of leaving anesthesia room, extubation, postoperative wakefulness and hospitalization in the observation group were shorter than those in the control group (P 0.05). The satisfaction degree of the observation group with nursing work was higher than that of the control group (P 0.05). Conclusion: Nursing intervention in operating room is effective for gastric cancer patients in anesthesia recovery period, which can maintain their perioperative temperature stability, promote their postoperative recovery and enhance their satisfaction with nursing work. It is worth adopting.
文摘BACKGROUND： Acupuncture anesthesia was created in the 1950＇s in China and continues to be used there today during most major surgeries. It is widely used in China for such complex operations as brain heart, and abdominal surgery. It is popular in China because it is economical, practical, and beneficial to the patients. With acupuncture anesthesia there is less bleeding during surgery and there is also quicker post-operative recovery. OBJECTIVE： This randomized prospective study aims at comparing the effect of two acupoints （Yongquan, KI1 and Renzhong, DU26） with sham acupuncture and no acupuncture on the time to recovery of consciousness after general anesthesia by means of the Bispectral Index monitor （BIS） DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This is a prospective randomized controlled study. We randomly assigned 50 patients to 5 groups during recovery from surgical anesthesia. Four groups had acupuncture on KI1 （group A）, DU26 （groups B）, both KI1 and DU26 （group C）, and sham points （group D）, and one had no acupuncture （group E）. MAIN OUTCOME MEASURES： Bispectral Index （BIS）, time to spontaneous eye opening, time to tracheal extubation, and time to following commands were measured as the main outcome measures RESULTS： Time to spontaneous eye opening differed among groups （P=0.002）, as well as time to tracheal extubation （P〈0.000 1） and time to following commands （P=0.000 6）. BIS values differed significantly among groups both 5 and 10 min after the end of anesthesia （P〈0.000 1 and P=0.000 4, respectively）. BIS values of groups D and E were lower than those of the other groups and those of group C were higher. The same pattern was observed also 15 and 30 rain after the end of anesthesia although the difference among groups was not significant at these time points （P=0.164 and P=0.104 respectively）. CONCLUSION： Acupuncture on DU26 and KI 1 accelerates recovery of consciousness after general anesthesia. Moreover, a possible synergistic effect of DU26 and KI1 is suggested. This issue may play a role in the optimization of operating room management and raise interest about the usefulness of acupuncture on unconsciousness states of different nature.
文摘BACKGROUND Peripheral regional block combined with general anesthesia might be a preferable anesthetic regimen for elderly patients undergoing total hip arthroplasty.AIM To investigate whether ultrasound-guided,direct suprainguinal injection for fascia iliaca block accelerated recovery after general anesthesia and relieved postoperative pain after total hip arthroplasty.METHODS Patients who underwent total hip arthroplasty under general anesthesia in 2015 or 2019 at The Second Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed.The patients were grouped based on whether preoperative suprainguinal fascia iliaca block was performed or not.The time to tracheal extubation and time spent in the post-anesthesia care unit(PACU),intraoperative remifentanil dosage,fentanyl consumption in the PACU,postoperative cumulative fentanyl consumption within 48 h after operation,visual analogue scale at rest and during movement on the first and second days after surgery,and adverse reactions were compared.RESULTS Thirty-one elderly patients who underwent total hip arthroplasty were included in the study(block group,n=16;no-block group,n=15).The visual analog scale scores at rest and during movement on the first and second days were significantly lower in the block group than in the no-block group(all P<0.05).Compared with the no-block group,the intraoperative remifentanil dosage was lower,the time to tracheal extubation and the time spent in the PACU were shorter in the block group(all P<0.01).Fentanyl consumption in the PACU and postoperative cumulative fentanyl consumption in 48 h after operation were lower in the block group(all P<0.01).The incidence of dizziness was higher in the no-block group than in the block group(P=0.037).CONCLUSION Ultrasound-guided,direct suprainguinal injection for fascia iliaca block led to faster recovery after general anesthesia and early postoperative pain relief in elderly patients undergoing total hip arthroplasty.
