Role of combined propofol and sufentanil anesthesia in endoscopic injection sclerotherapy for esophageal varices

AIM To investigate the efficacy and safety of a combination of sufentanil and propofol injection in patients undergoing endoscopic injection sclerotherapy(EIS) for esophageal varices(EVs). METHODS Patients with severe EVs who underwent EIS with sufentanil and propofol anesthesia between April 2016 and July 2016 at our hospital were reviewed. Although EIS and sequential therapy were performed under endotracheal intubation, we only evaluated the efficacy and safety of anesthesia for the first EIS procedure. Patients were intravenously treated with 0.5-1 μg/kg sufentanil. Anesthesia was induced with 1-2 mg/kg propofol and maintained using 2-5 mg/kg per hour of propofol. Information, regarding age, sex, weight, American Association of Anesthesiologists(ASA) physical status, Child-Turcotte-Pugh(CTP) classification, indications, preanesthetic problems, endoscopic procedure, successful completion of the procedure, anesthesia time, recovery time, and anesthetic agents, was recorded. Adverse events, including hypotension, hypertension, bradycardia, and hypoxia, were also noted.RESULTS Propofol and sufentanil anesthesia was provided in 182 procedures involving 140 men and 42 women aged 56.1± 11.7 years(range, 25-83 years). The patients weighed 71.4 ± 10.7 kg(range, 45-95 kg) and had ASA physical status classifications of Ⅱ(79 patients) or Ⅲ(103 patients). Ninety-five patients had a CTP classification of A and 87 had a CTP classification of B. Intravenous anesthesia was successful in all cases. The mean anesthesia time was 33.1 ± 5.8 min. The mean recovery time was 12.3 ± 3.7 min. Hypotension occurred in two patients(1.1%, 2/182). No patient showed hypertension during the endoscopic therapy procedure. Bradycardia occurred in one patient(0.5%, 1/182), and hypoxia occurred in one patient(0.5%, 1/182). All complications were easily treated with no adverse sequelae. All endoscopic procedures were completed successfully.CONCLUSION The combined use of propofol and sufentanil injection in endotracheal intubation-assisted EIS for EVs is effective and safe.

Effects of Ropivacaine-sufentanil Epidural Analgesia on Labor and Maternal and Neonatal Outcomes

[Objectives]This study aimed to investigate the effects of ropivacaine-sufentanil epidural analgesia on labor and maternal and neonatal outcomes.[Methods]A total of 180 primiparas in full-term pregnancy were selected.They were randomly divided into treatment group(n=90)and control group(n=90).The primiparas in the treatment group were injected epidurally with ropivacaine and sufentanil for analgesia,and the primiparas in the control group were subjected to vaginal delivery.The VAS scores at 5,10,30 and 60 min of analgesia were observed.The vaginal bleeding amount,total labor duration,neonatal Apgar score and vaginal delivery rate of the two groups were compared.[Results]Compared with the control group,the VAS score in the treatment group differed insignificantly after 5 min of analgesia(P>0.05),and decreased significantly after 10,30 and 60 min of analgesia(P<0.05).The vaginal bleeding amount of the treatment group was significantly smaller than that of the control group(P<0.05).There was no significant difference in the neonatal Apgar score between the two groups(P>0.05).In the treatment group,the vaginal delivery rate increased(P<0.05),the second stage of labor was prolonged(P<0.05),and the first and third stages of labor did not change significantly(P>0.05).[Conclusions]Epidural analgesia with ropivacaine and sufentanil has a good analgesic effect and good safety,and is worthy of clinical promotion.

Effects of Dexmedetomidine combined with Sufentanil on the hemodynamics and stress state in the wake of general anesthesia in elderly patients with lower limb fracture surgery

Objective:To study the effects of Dexmedetomidine combined with Sufentanil on hemodynamics, stress state, helper T cytokines and pain degree during the waking period of general anesthesia in elderly patients with lower limb fracture surgery were studied.Methods:From June 2017 to July 2018, 95 elderly patients with lower limb fracture who visited First Affiliated Hospital of Xi 'an Jiaotong University and received fracture surgery and general anesthesia were collected. According to their different anesthesia methods, 46 patients were divided into the sufentanil maintenance anesthesia group (Sufentanil group), and 49 patients were divided into the metopidine combined with sufentanil maintenance anesthesia group (Joint group). Changes in hemodynamics (HR, SpO2, MAP) of the two groups were monitored at different times throughout the operation. Using enzyme-linked immunoassay detection of two groups of patients in maintain anesthesia and anesthesia to stress index (Cor, E, FIns and HOMA-IR). The the changes of pain mediators (NO,β-EP, SP) and helper T cytokines (IFN-γ, TNF-α) were compared between the two groups before and 24 hours after surgery. Results:In the combined group, HR, SpO2, MAP and sufentanil groups showed little change in SpO2 during anesthesia, with no significant difference. The HR and MAP of T2 and T3 in the sufentanil group were significantly higher than those in the combined group at T2 and T3. The stress indicators Cor, E, FIns and HOMA-IR in the anesthesia of the two groups were significantly higher than those in the anesthesia maintenance. The serum stress indexes of Cor, E, FIns and HOMA-IR were significantly lower in the combined group than in the sufentanil group. The IFN-γ level of the combined group was significantly higher than that of the sufentanil group, and the TNF-α level was significantly lower than that of the control group. Serum levels of NO,β-EP and SP were significantly higher in the two groups 24 h after surgery. Serum pain mediators NO,β-EP and SP in the combined group were significantly lower than those in the sufentanil group before and 24 h after surgery.Conclusion: Combined anesthesia with Remifentanil and Propofol can stabilize the hemodynamic state of patients undergoing craniotomy, reduce cardiovascular stress response and inflammatory response, reduce nerve damage, and play a role in brain protection.

Efficacy and safety of different doses of ropivacaine + sufentanil for epidural labor analgesia

Objective:To study the efficacy and safety of different doses of ropivacaine and sufentanil for epidural labor analgesia.Methods: The primiparae with single birth and cephalic presentation who underwent vaginal delivery in Chengde Maternal and Child Health Hospital between March 2015 and February 2018 were selected and randomly divided into the group A who received subarachnoid injection of sufentanil 4 μg, the group B who received injection of sufentanil 4 μg + ropivacaine 2 mg and the group C who received injection of sufentanil 4 μg+ ropivacaine 3 mg. During childbirth, serum was collected at the first, second and third stages of labor respectively to detect the secretion of pain mediators and oxidative stress mediators;after childbirth, the placenta was collected to determine the expression of stress molecules. Results: At first, second and third stages of labor, serum SP, DYN, NE, PGE2, TNF-α, COR, AT-II and MDA secretion of group B and group C were significantly lower than those of group A whereas SOD and GSH-Px secretion were significantly higher than those of group A, and serum SP, DYN, NE, PGE2, TNF-α, COR, AT-II and MDA secretion of group C were significantly lower than those of group B whereas SOD and GSH-Px secretion were significantly higher than those of group B;after childbirth, GRP78, CHOP, Bax and Caspase-3 mRNA expression in placenta of group B and group C were significantly lower than those of group A whereas Bcl-2 mRNA expression were significantly higher than that of group A, and GRP78, CHOP, Bax and Caspase-3 mRNA expression in placenta of group C were significantly lower than those of group B whereas Bcl-2 mRNA expression was significantly higher than that of group B.Conclusion: The analgesic effect of sufentanil 4 μg + ropivacaine 3 mg for epidural labor analgesia is the most significant.

Investigating the application value of propofol combined with sufentanil and dexmedetomidine in cosmetic anesthesia

Objective:To investigate the effects of propofol combined wit h s u f e n t a n i l a n d dexmedetomidine in cosmetic anesthesia.Methods:The clinical data of 40 plastic surgery patients admitted to the hospital from June to November 2019 were retrospectively analyzed.According to the different anesthesia methods during surgery,they were divided into control group(propofol combined with sufentanil and normal saline,20 cases)and was compared with the observation group(propofol combined with sufentanil and dexmedetomidine,20 cases).The anesthetic effect,total dosage of propofol,spontaneous breathing recovery time,and adverse reactions were compared between the two groups.Results:The total dosage of propofol in the observation group was less than that in the control group,and the spontaneous breathing recovery time was shorter than that in the control group.The difference was statistically significant(P<0.05).There was no significant difference in the anesthetic effect and adverse reaction rate between the two groups(P>0.05).Conclusion:The application of propofol in combination with sufentanil and dexmedetomidine in cosmetic anesthesia can reduce the dosage of propofol,speed up the anesthesia recovery,and have better anesthetic effect and safety.

Intranasal sufentanil combined with intranasal dexmedetomidine: A promising method for non-anesthesiologist sedation during endoscopic ultrasonography

Intranasal sufentanil combined with intranasal dexmedetomidine exhibited an estimated sedation success probability as high as 94.9%,higher satisfaction scores,and only minor adverse events during endoscopic ultrasonography(EUS).This is a promising method for EUS sedation that does not require the presence of an anesthesiologist.

Determination of the ED95 of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography

BACKGROUND Sedation during endoscopic ultrasonography(EUS)poses many challenges and moderate-to-deep sedation are often required.The conventional method to preform moderate-to-deep sedation is generally intravenous benzodiazepine alone or in combination with opioids.However,this combination has some limitations.Intranasal medication delivery may be an alternative to this sedation regimen.AIM To determine,by continual reassessment method(CRM),the minimal effective dose of intranasal sufentanil(SUF)when combined with intranasal dexmedetomidine(DEX)for moderate sedation of EUS in at least 95%of patients(ED95).METHODS Thirty patients aged 18-65 and scheduled for EUS were recruited in this study.Subjects received intranasal DEX and SUF for sedation.The dose of DEX(1μg/kg)was fixed,while the dose of SUF was assigned sequentially to the subjects using CRM to determine ED95.The sedation status was assessed by modified observer’s assessment of alertness/sedation(MOAA/S)score.The adverse events and the satisfaction scores of patients and endoscopists were recorded.RESULTS The ED95 was intranasal 0.3μg/kg SUF when combined with intranasal 1μg/kg DEX,with an estimated probability of successful moderate sedation for EUS of 94.9%(95%confidence interval:88.1%-98.9%).When combined with intranasal 1μg/kg DEX,probabilities of successful moderate sedation at each dose level of intranasal SUF were as follows:0μg/kg SUF,52.8%;0.1μg/kg SUF,75.4%;0.2μg/kg SUF,89.9%;0.3μg/kg SUF,94.9%;0.4μg/kg SUF,98.0%;0.5μg/kg SUF,99.0%.CONCLUSION The ED95 needed for moderate sedation for EUS is intranasal 0.3μg/kg SUF when combined with intranasal 1μg/kg DEX,based on CRM.

Effect of diazocine combined with sufentanil analgesia after radical operation for esophageal cancer on the release of neurotransmitters and stress mediators

Objective:To study the effect of diazocine combined with sufentanil analgesia after radical operation for esophageal cancer on release of neurotransmitters and stress mediators.Methods:A total of 170 cases of patients with primary esophageal cancer who underwent surgical treatment in this hospital between September 2015 and May 2017 were divided into control group (n=85) and study group (n=85) by random number table method. Control group received postoperative sufentanil analgesia, and study group received postoperative diazocine combined with sufentanil analgesia. The differences in the perioperative contents of monoamine neurotransmitters, amino acid neurotransmitters and stress mediators were compared between the two groups.Results: Before operation, there was no statistically significant difference in the serum contents of monoamine neurotransmitters, amino acid neurotransmitters and stress mediators between the two groups. 12 h after surgery, 24 h after surgery and 36 h after surgery, serum monoamine neurotransmitters DA, NE and 5-HT contents of study group were lower than those of control group;amino acid neurotransmitters Ach, GABA and Glu contents were higher than those of control group;serum stress mediators ACTH, ALD and Cor contents were lower than those of control group.Conclusion: diazocine combined with sufentanil analgesia after radical operation for esophageal cancer can effectively optimize the secretion of neurotransmitters and inhibit the synthesis of stress mediators to alleviate the patients' pain perception.

Effect of sufentanil analgesia for hip replacement on pain mediator, stress hormone and inflammatory cytokine secretion

Objective:To study the effect of sufentanil analgesia for hip replacement on pain mediator, stress hormone and inflammatory cytokine secretion.Methods: Patients who underwent hip replacement in People's Hospital of Dongxihu District Wuhan between August 2015 and October 2017 were selected as the research subjects and randomly divided into the sufentanil group who accepted postoperative sufentanil analgesia and the fentanyl group who accepted postoperative fentanyl analgesia. The expression levels of pain mediators and inflammatory cytokines in peripheral blood as well as the levels of pain mediators, stress hormones and inflammatory cytokines in serum were measured 1 day and 3 days after surgery.Results:Serum PGE2, SP,β-EP, GH, COR, ACTH, INS, AT-II, TNF-α and ICAM-1 levels as well as peripheral blood MKP1, p38MAPK, Caspase-1, IL-1β and IL-18 expression intensity of sufentanil group 1 day and 3 days after surgery were significantly lower than those of fentanyl group.Conclusion: Sufentanil analgesia for hip replacement can be more effective than fentanyl to reduce the secretion of pain mediators, stress hormones and inflammatory cytokines.

Evaluation of Light Specific Gravity Ropivacaine Combined with Sufentanil in Hip Arthroplasty at An Advanced Age

combined with sufentanil in elderly patients undergoing hip replacement.Methods:89 elderly patients with hip arthroplasty from July 2019 to September 2020 were randomly divided into experimental group and control group.The experimental group was anesthetized with light specific gravity ropivacaine combined with sufentanil.The control group was anesthetized with equal specific gravity ropivacaine to compare the effect of anesthesia and the incidence of adverse reactions.Results:there was no significant difference in sensory recovery time and motor recovery time between the experimental group and the control group(P>0.05),and the incidence of adverse reactions between the two groups was low.The sensory block time in the experimental group was shorter than that in the control group(PP>0.05).Conclusion:ropivacaine combined with sufentanil subarachnoid anesthesia is more effective in elderly patients undergoing hip arthroplasty,and the safety of the anesthesia scheme is higher,which will not lead to serious adverse reactions during operation.Moreover,the application of the anesthesia scheme can effectively improve the analgesic effect during and after operation,and the clinical application value is high.

Effect of dezocine combined with sufentanil patient-controlled intravenous analgesia on general pain and inflammatory mediators after laparoscopic hepatectomy

Objective:To study the effect of dezocine combined with sufentanil patient-controlled intravenous analgesia on general pain and inflammatory mediators after laparoscopic hepatectomy.Methods: A total of 68 patients with primary liver cancer who received laparoscopic surgical treatment in our hospital between July 2014 and December 2016 were collected, the therapies were reviewed, and then patients were divided into the control group (n=35) who received sufentanil PCIA and the observation group (n=33) who received dezocine combined with sufentanil PCIA. Differences in serum levels of pain mediators, acute phase proteins and interleukins were compared between the two groups of patients before and after operation.Results: Before operation, the differences in serum levels of pain mediators, acute phase proteins and interleukins were not statistically significant between the two groups of patients. 6h after operation, serum pain mediators SP, NPY, DA and NE levels in observation group were lower than those in control group;acute phase proteins CRP, HP, CER and AAG levels were lower than those in control group;interleukins IL-1β, IL-6 and IL-8 levels were lower than those in control group.Conclusion: Dezocine combined with sufentanil PCIA after laparoscopic hepatectomy is effective in reducing the early postoperative pain mediator levels and relieving systemic inflammatory response.

Effects of sufentanil/fentanyl combined with propofol on the anesthesia of minimally invasive drainage for hypertensive cerebral hemorrhage

Objective: To compare the effects of sufentanil/fentanyl combined with propofol on the anesthesia of minimally invasive drainage for hypertensive cerebral hemorrhage. Methods:Patients with hypertensive cerebral hemorrhage who received minimally invasive drainage in Huanggang Cerebrovascular Hospital between June 2014 and February 2017 were selected and randomly divided into two groups, observation group received sufentanil combined with propofol anesthesia, and control group received fentanyl combined with propofol anesthesia. The serum contents of nerve injury, stress response, oxidation reaction and inflammatory response markers were measured during surgery and 12 h after surgery. Results: During surgery and 12 h after surgery, serum TF, NSE, GFAP, GLU, NE, E, ACTH, Cor, Ins, MDA, AOPP, 8-OHdG, NO, ICAM-1, TNF-α, IL-6, IL-17 and IL-23 levels of observation group were significantly lower than those of control group. Conclusion: Sufentanil combined with propofol for minimally invasive drainage of hypertensive cerebral hemorrhage is more effective than fentanyl combined with propofol to reduce the brain damage and inhibit the inflammatory response, stress response and oxidation reaction.

Effects of dexmedetomidine and sufentanil on hemorheology,stress response and inflammatory factors in patients undergoing laparoscopic repair of gastrointestinal perforation

Objective: To observe the clinical application of dexmedetomidine combined with sufentanil anesthesia in patients undergoing laparoscopic repair of gastrointestinal perforation, and the changes of hemodynamics, stress response and inflammatory factors were analyzed before and after operation. Methods: A total of 102 patients with laparoscopic gastrointestinal perforation were randomly divided into control group (n=51) and observation group (n=51) according to the lottery method. The control group was given anesthesia with sufentanil, and the observation group was given dexmedetomidine combined with sufentanil anesthesia, and the other anesthesia drugs were the same. The hemodynamics before anesthesia induction (T1), 10 min after medication (T2), pneumoperitoneum (T3), and tube drawing (T4), serum stress response and inflammatory factor levels before operation and after 24 h of operation were measured in all subjects. Results: At T1 and T2, there was no significant difference in hemodynamics between the two groups. At T3and T4, HR, SBP, and DBP in observation group were significantly lower than those in the control group at corresponding period, and compared with the observation group at T, there were no significant difference. At T3, and T4, the HR, SBP and DBP of the control group were significantly higher than those of T1. There was no significant difference in serum stress hormone between the two groups before surgery. After surgery 24 h, two groups of serum ACTH, Cor and ALD levels were higher than those of preoperative, and the observation group was significantly lower than those of the control group. There was no significant difference in serum inflammatory cytokines between the two groups before surgery. After surgery 24 h, the levels of serum IL-10 and TNF-毩 in the two groups were higher than those before operation, and the observation group was significantly lower than those of the control group. Conclusion: The combination of dexmedetomidine and sufentanil anesthesia can maintain hemodynamic stability of patients reduce the stress response and serum inflammatory factor concentration, which is one of the potential effective anesthesia method.

Effect of ropivacaine combined with sufentanil epidural labor analgesia on pain neurotransmitters as well as cytokine production and stress hormone secretion

Objective: To discuss the effect of ropivacaine combined with sufentanil epidural labor analgesia on pain neurotransmitters as well as cytokine production and stress hormone secretion. Methods: A total of 218 cases of puerperae who received caesarean section in the hospital between January 2015 and January 2017 were divided into control group (n=109) and observation group (n=109) by random table method. Control group received postpartum ropivacaine epidural analgesia alone, and observation group received postpartum ropivacaine combined with sufentanil epidural analgesia. The differences in serum levels of pain neurotransmitters, inflammatory factors and stress hormones were compared between the two groups immediately after childbirth (T0), 6 h after delivery (T1), 12 h after delivery (T2) and 24 h after delivery (T3). Results: At T0, the differences in serum levels of pain neurotransmitters, inflammatory factors and stress hormones were not statistically significant between the two groups. At T1, T2 and T3, serum NPY, β-EP and SP levels of observation group were lower than those of control group at corresponding points in time;serum IL-1β, hs-CRP and IL-6 levels of observation group were lower than those of control group at corresponding points in time;serum Cor, AngⅠ, AngⅡ and NE levels of observation group were lower than those of control group at corresponding points in time. Conclusion:Ropivacaine combined with sufentanil epidural analgesia after caesarean section can effectively inhibit the pain neurotransmitter expression and relieve the systemic inflammatory stress response in puerperae.

Effect of sufentanil on hemodynamics, oxidative stress and vascular endothelial function in patients undergoing laparoscopic cholecystectomy

Objective: To investigate the effect of sufentanil on hemodynamics, oxidative stress and vascular endothelial function in patients undergoing laparoscopic cholecystectomy. Methods:A total of 88 patients undergoing laparoscopic cholecystectomy were divided into control group (n=44) and observation group (n=44) according to random data table, the patients in the control group received fentanyl anesthesia, and the observation group patients were given sufentanil anesthesia, the levels of hemodynamic, oxidative stress and vascular endothelial function at three times before anesthesia induction (T0), pneumoperitoneum (T1) and at the end of surgery (T2) between the two groups were compared. Results: At T0 moment, the levels of T0, SBP, HR, DBP, CAT, SOD, NO, MDA and ET-1 in the two groups were not statistically significant;Compared with the level of T0 moment, the levels of HR, SBP, DBP, and MDA in the two groups at T1 and T2 moment were increased in different degrees, and the levels of T1 and T2 in the observation group were significantly lower than those in the control group;The levels of CAT and SOD in the two groups of T1 and T2 moment were lower than T0 moments in different degrees, and the observation group at two time levels were significantly higher than the control group;The levels of NO and ET-1 in the two groups of T1 moment were significantly increased, and in the observation group the level of NO was significantly higher and ET-1 was significantly lower than that in the control group, all differences were statistically significant;There was no significant difference of the NO and ET-1 levels at T2 between the two groups. Conclusion: Compared with fentanyl, sufentanil has less influence on hemodynamics in laparoscopic cholecystectomy. It can effectively reduce oxidative stress and protect vascular endothelial function, and is more conducive to recovery.

Evaluation of the efficacy of ropivacaine combined with sufentanil and ropivacaine alone for epidural labor analgesia

Objective: To study the efficacy of ropivacaine combined with sufentanil and ropivacaine alone for epidural labor analgesia. Methods: Primiparae who received vaginal delivery under epidural analgesia in Ankang People's Hospital between March 2015 and February 2017 were selected and randomly divided into accepting the group A who received ropivacaine combined with sufentanil for epidural analgesia and the group B who received ropivacaine alone for epidural analgesia. During the first, the second and the third stage of labor, the serum was collected to determine the levels of pain mediators SP, 5-HT and PGE2 as well as stress hormones NE, E, F-C, AT-II and INS;after delivery, the placenta tissue was collected to determine the expression of stress molecules GRP78, CHOP, Nrf-2 and ARE. Results: Serum SP, 5-HT, PGE2, NE, E, F-C, AT-II and INS levels of group A during the first, the second and the third stage of labor were significantly lower than those of group B;GRP78, CHOP, Nrf-2 and ARE mRNA expression in placental tissue of group A after delivery were significantly lower than those of group B. Conclusion: ropivacaine combined with sufentanil for epidural labor analgesia is more effective than ropivacaine alone in reducing pain and inhibiting stress response.

Anesthetic Effect of Sufentanil Combined with Remifentanil in Patients Undergoing Radical Gastrectomy

Objective:To explore and analyze the anesthetic effect of sufentanil combined with remifentanil in patients undergoing radical gastrectomy for gastric cancer.Methods:In this study,100 patients receiving radical gastrectomy for gastric cancer in our hospital were selected as the research subjects,and the period from June 2019 to February 2021 was divided into different anesthesia regimens.Fifty patients receiving remifentanil anesthesia were used as the control group,and 50 patients receiving remifentanil combined with sufentanil anesthesia were used as the research group.The anesthetic effect of the two groups of patients was analyzed and compared.Results:The HR and MAP of the study group at different time after intubation were lower than those of the control group(P<0.05).The changes of HR and MAP before and after intubation in two groups were significant compared with those before intubation(P<0.05).The postoperative VAS score of the study group was significantly better than that of the control group(P<0.05).Conclusions:In radical gastrectomy for gastric cancer,the choice of sufentanil and remifentanil as the anesthesia scheme can effectively stabilize the hemodynamics of patients,relieve the degree of postoperative pain,with obvious clinical value.

Short-term Ocular Toxicity and Eye Irritation Tests Following Application of Sufentanil in Rabbits

Purpose:.To test the safe clinical application of sufentanil as topical ophthalmic drops by examining treated rabbit eyes for ophthalmic irritation signs or short-time toxic reactions.Methods:.Twenty-four rabbits were randomly divided into 8groups(n=3): The ocular toxicity at 14 d after eye drop administration was evaluated in groups 1 to 4, and at 30 d postadministration in groups 5 to 8..Groups 1 and 5 were treated with blank vehicle and served as normal controls..The left eyes of rabbits in groups 2 and 6 were exposed to low-dose sufentanil(5 μg, 2 drops within 5 min), groups 3 and 7 received moderate-dose sufentanil.(7.5 μg, 3 drops within 10 min),and groups 4 and 8 received high-dose sufentanil(10 μg,.4drops within 15 min). As self-controls, the right eyes of each rabbit were administered an equivalent amount of sodium chloride(9 g / L) at the same drop intervals. At 14 and 30 d after exposure to sufentanil,.ophthalmic irritation signs were evaluated and corneas were stained with fluorescein and observed by slit-lamp microscopy..Corneal endothelial counts were performed and toxic reactions were evaluated.Results: Multiple parameters were compared in the control and experimental groups by visual inspection and slit-lamp examination at 14 and 30 d after sufentanil administration..No evidence of irritation signs(including corneal opacity,.conjunctival congestion, or edema), eye secretions, iris abnormalities,.or temporal eye closure were noted..Corneal endothelial cell counts did not significantly differ between the control and experimental groups..Light microscopy revealed no pathological or morphological injury to the cornea, conjunctiva, iris, ciliary body, retina, or optic nerve in either group.The same observation outcomes were noted at 14 and 30 d after administration.Conclusion:.Single ocular administration of sufentanil at a dose of 5-10 μg in rabbits yields no ocular irritation or toxic responses at 14 or 30 d following eye drop delivery.

Impact of thoracic paravertebral block and sufentanil on outcomes and postoperative cognitive dysfunction in thoracoscopic lung cancer surgery

BACKGROUND Postoperative pain management and cognitive function preservation are crucial for patients undergoing thoracoscopic surgery for lung cancer(LC).This is achieved using either a thoracic paravertebral block(TPVB)or sufentanil(SUF)-based multimodal analgesia.However,the efficacy and impact of their combined use on postoperative pain and postoperative cognitive dysfunction(POCD)remain unclear.AIM To explore the analgesic effect and the influence on POCD of TPVB combined with SUF-based multimodal analgesia in patients undergoing thoracoscopic radical resection for LC to help optimize postoperative pain management and improve patient outcomes.METHODS This retrospective analysis included 107 patients undergoing thoracoscopic radical resection for LC at The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital between May 2021 and January 2023.Patients receiving SUF-based multimodal analgesia(n=50)and patients receiving TPVB+SUF-based multimodal analgesia(n=57)were assigned to the control group and TPVB group,respectively.We compared the Ramsay Sedation Scale and visual analog scale(VAS)scores at rest and with cough between the two groups at 2,12,and 24 h after surgery.Serum levels of epinephrine(E),angio-tensin Ⅱ(Ang Ⅱ),norepinephrine(NE),superoxide dismutase(SOD),vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),and S-100 calcium-binding proteinβ(S-100β)were measured before and 24 h after surgery.The Mini-Mental State Examination(MMSE)was administered 1 day before surgery and at 3 and 5 days after surgery,and the occurrence of POCD was monitored for 5 days after surgery.Adverse reactions were also recorded.RESULTS There were no significant time point,between-group,and interaction effects in Ramsay sedation scores between the two groups(P>0.05).Significantly,there were notable time point effects,between-group differences,and interaction effects observed in VAS scores both at rest and with cough(P<0.05).The VAS scores at rest and with cough at 12 and 24 h after surgery were lower than those at 2 h after surgery and gradually decreased as postoperative time increased(P<0.05).The TPVB group had lower VAS scores than the control group at 2,12,and 24 h after surgery(P<0.05).The MMSE scores at postoperative days 1 and 3 were markedly higher in the TPVB group than in the control group(P<0.05).The incidence of POCD was significantly lower in the TPVB group than in the control group within 5 days after surgery(P<0.05).Both groups had elevated serum E,Ang Ⅱ,and NE and decreased serum SOD levels at 24 h after surgery compared with the preoperative levels,with better indices in the TPVB group(P<0.05).Marked elevations in serum levels of VEGF,TGF-β1,TNF-α,and S-100β were observed in both groups at 24 h after surgery,with lower levels in the TPVB group than in the control group(P<0.05).CONCLUSION TPVB combined with SUF-based multimodal analgesia further relieves pain in patients undergoing thoracoscopic radical surgery for LC,enhances analgesic effects,reduces postoperative stress response,and inhibits postoperative increases in serum VEGF,TGF-β1,TNF-α,and S-100β levels.This scheme also reduced POCD and had a high safety profile.