Effects of Total Intravenous Anesthesia and Static Aspiration Combined General Anesthesia on Postoperative Cognitive Function and Psychological State of Elderly Patients with Esophageal Cancer

Objective: To compare the effects of total intravenous anesthesia and static aspiration combined general anesthesia on postoperative cognitive function and psychological state of elderly esophageal cancer patients. Methods: From July 2020 to April 2021, 180 elderly patients who underwent radical esophageal cancer surgery in our hospital were randomly divided into 90 cases in the control group and 90 in the observation group. The control group used static aspiration compound general anesthesia, and the patients in the observation group used intravenous anesthesia to compare the cognitive function and psychological state of the two groups of patients. Results: There was no statistical difference in the cognitive function score of patients in the observation group 30 minutes before anesthesia, 1 h and 24 hours after anesthesia compared with that in the control group, P > 0.05;there was no statistical difference between the Hamilton Anxiety Scale (HAMA) scores 30 minutes before and 24 hours after anesthesia in the observation group compared with the control group, P > 0.05;the cognitive function score of patients in the observation group of 4 h after surgery and 12 h after operation was significantly higher than that of the control group;the HAMA scores of patients in the observation group of 1 h, 4 h and 12 h after surgery were significantly lower than that of the control group, P Conclusion: The application of total intravenous anesthesia in elderly patients with esophageal cancer surgery can reduce the impact of anesthesia on their cognitive function and psychological state, which is worth popularizing and applying in clinical practice.

Effect of epidural block combined intravenous general anesthesia stress on the stress response and T lymphocyte subsets in patients with breast cancer undergoing radical mastectomy

Objective: To investigate the effect of epidural block combined with intravenous anesthesia on stress response and T lymphocyte subsets in patients with breast cancer undergoing radical mastectomy. Methods: In our hospital from July 2016 to June 2017 undergoing radical mastectomy for breast cancer of 88 patients were randomly divided into observation group and control group of 44 cases, 2 patients underwent routine preoperative preparation, and routine blood pressure, heart rate, pulse, oxygen saturation, ECG monitoring, control group with intravenous anesthesia. The observation group was treated with epidural block combined with intravenous anesthesia. 2 groups of patients before anesthesia, 30 MIM (T0), 1 h after skin incision (T1), 4 h after operation (T2), 24 h after operation (T3), 48 h after operation (T4) from peripheral venous blood were measured by interleukin-8 (IL-8) and interferon gamma (IFN-γ), cortisol (Cor), prolactin (PRL), growth hormone (GH) and T lymphocyte subsets (CD3+, CD4+, CD8+), the calculation of CD4+/CD8+ value. Results: the serum IL-8 level of T1, T2, T3and T4 decreased gradually, were lower than at T0, and the control group at each time point had no significant difference, T1, T2, T3group, T4IL-8 levels lower than the control group;the 2 groups of serum IFN-γ levels T1 and T2had no significant change, T3and T4increased gradually, was higher than that of T0, but no significant difference between the 2 groups of IFN-γ levels. 2 serum Cor levels peaked at T1, decreased at T2, was higher than that of T0, T3, T4returned to T0, the observation group T1, T2Cor level lower than the control group;the serum PRL levels of 2 groups reached a peak at T1, T2, T3at the time of T4decreased gradually, was higher than that of T0, T1, T2, T3of the observation group at the PRL level is lower than the control group;the serum level of GH 2 in group T1increased gradually, reached a peak at T2, T3and T4 decreased gradually, was higher than that of T0, the observation group T1, T2, T3, T4, GH levels lower than the control group. 2 groups of CD3+ decreased gradually in T1, T2, were lower than T0, T3, T4returned to T0, the observation group T1, T2CD3+ was higher than the control group;group CD4+ decreased gradually in T1, T2, T3and T4were lower than control, T0when, and the observation group CD4+ in T1, T2, T3, T4, no significant changes were observed in group T1, T2, T3, T4and CD4+ higher than that of the control group;the 2 group CD8+ had no obvious changes in T1, T2, T3, T4;observation group CD4+/CD8+ decreased gradually in T1, T2, were lower than T0, T3, T4returned to T0, the observation group T1, T2CD4+/CD8+ was higher than the control group. Conclusion: epidural block combined with intravenous anesthesia for breast cancer radical mastectomy can effectively relieve the stress and inflammatory reaction, alleviate the immunosuppression, and help to restore the postoperative immune function.

右美托咪定联合静吸复合全身麻醉用于腹腔镜子宫肌瘤剜除术中对患者血压及麻醉效果的影响

目的探索腹腔镜子宫肌瘤剜除术中右美托咪定联合静吸复合全身麻醉应用价值以及麻醉效果。方法方便选取2021年1月—2023年9月镇江市妇幼保健院收治的93例腹腔镜子宫肌瘤患者为研究对象,以随机抽签法分为对照组(47例)和观察组(46例),对照组开展静吸复合全身麻醉,观察组开展右美托咪定联合静吸复合全身麻醉。对比两组患者恢复时间、应激指标、血流动力学指标、血压指标、不良反应发生率。结果术前,两组患者应激指标比较,差异无统计学意义(P>0.05)。术后,观察组恢复时间少于对照组,应激指标低于对照组,差异有统计学意义(P均<0.05)。T_(0)时间节点,两组患者舒张压、收缩压、平均动脉压与心率比较,差异无统计学意义(P均>0.05);T_(1)、T_(2)、T_(3)时间节点,观察组舒张压、收缩压、平均动脉压、心率低于对照组,差异有统计学意义(P均<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜子宫肌瘤剜除术中右美托咪定联合静吸复合全身麻醉应用具有较强的优势,麻醉效果更优,可以有效降低患者术后不良反应,安全性较高。

靶控输注-全凭静脉麻醉与静吸复合麻醉对老年患者术后认知功能的影响

目的:分析靶控输注-全凭静脉麻醉(TCI-TIVA)与静吸复合麻醉对老年患者术后认知功能的影响。方法:选取2021年1月—2023年10月于遵义市播州区人民医院接受全身麻醉手术的老年患者80例作为研究对象,利用随机数字表法分为研究组(TCI-TIVA)与对照组(静吸复合麻醉),各40例。比较两组麻醉效果、术后认知情况及不良反应发生率。结果:研究组苏醒、自主呼吸恢复、拔管、定向力恢复时间均短于对照组,差异有统计学意义(P<0.001);术后3、6、12 h,两组简易智力状态检查量表(MMSE)评分均低于诱导前,研究组MMSE评分高于对照组,差异有统计学意义(P<0.05);研究组苏醒期不良反应发生率低于对照组,差异有统计学意义(P=0.021)。结论:在老年患者术中应用TCI-TIVA的效果优于静吸复合麻醉,可促进患者自主呼吸、定向力恢复,苏醒时间更短,拔管时间更早,且对患者术后认知功能的影响较小,麻醉安全性较高。

静吸复合麻醉与单纯静脉麻醉在腹腔镜子宫肌瘤切除术患者中的应用

目的探讨静吸复合麻醉与单纯静脉麻醉在腹腔镜子宫肌瘤切除术患者中的应用。方法依据随机数字表法将2019年11月至2022年12月南阳中心医院收治的206例腹腔镜子宫肌瘤切除术患者分为对照组(103例)和观察组(103例),对照组接受单纯静脉麻醉,观察组接受静吸复合麻醉,均观察至患者出院。比较两组苏醒指标及手术指标,不同时间点生命体征,术前、术后72 h血清S100β蛋白(S100β)、神经元特异性烯醇化酶(NSE)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平,视觉模拟评分(VAS),简易智力状态检查量表(MMSE)评分,术后72 h认知功能障碍(POCD)发生率,住院期间不良反应发生情况。结果T_(0)~T_(3)两组患者心率(HR)均呈先降低后升高趋势,平均动脉压(MAP)呈先降低后升高趋势,中心静脉压(CVP)则呈先升高后降低趋势;观察组的不良反应总发生率低于对照组(P<0.05)。术后72 h,两组VAS评分、血清NSE、IL-6、TNF-α及S100β水平与术前比较均升高,但观察组低于对照组;两组MMSE评分降低,但观察组高于对照组(P<0.05)。观察组POCD发生率低于对照组(P<0.05)。结论与单纯静脉麻醉进行比较,静吸复合麻醉可有效控制腹腔镜子宫肌瘤切除术患者术后的炎症反应,降低其在患者神经功能机理中的损伤作用,对患者生命体征稳定的影响较小,可改善患者的疼痛感以及认知功能,且具有良好的安全性。

静吸复合麻醉与全凭静脉麻醉对老年患者苏醒质量的比较分析

目的探究老年患者接受静吸复合麻醉与全凭静脉麻醉对其苏醒质量的影响。方法选取2017年1月~2018年10月老年手术患者100例,为本次研究对象,将其简单化分组,对照组行静吸复合麻醉,实验组行全凭静脉麻醉,分析2组老年手术患者麻醉的结果。结果实验组老年手术患者的睁眼时间、拔管时间、应答时间、自主呼吸恢复时间均低于对照组,差异有统计学意义(P<0.05);实验组VAS评分明显低于对照组,其苏醒质量评分高于对照组,差异有统计学意义(P<0.05)。结论老年手术患者接受静吸复合麻醉与全凭静脉麻醉,均可获得较好的麻醉效果,其中全凭静脉麻醉的实施,可将患者的睁眼时间、拔管时间、应答时间以及自主呼吸恢复时间缩短,提高苏醒的质量。

静-吸复合麻醉和全凭静脉麻醉对肝炎肝硬化患者围术期免疫功能的影响分析

目的观察静-吸复合麻醉和全凭静脉麻醉对肝炎肝硬化患者围术期免疫功能的影响。方法选取我院2016年4月~2017年4月接收的126例肝炎肝硬化患者作为研究对象,按照麻醉方式的不同分成两组,对照组61例行全凭静脉麻醉,实验组65例行静-吸复合麻醉,对比两组不同时点肝功能指标、免疫功能指标变化。结果实验组T_1、T_2时点ALB分别为(41.20±12.27)g/L、(39.52±9.64)g/L,高于对照组,且T_2时点ALT为(12.46±2.81)IU/L,低于对照组,差异具有统计学意义(P<0.05)。实验组T_2时点CD4+(32.85±3.65)%、CD4+/CD8+(1.20±0.14)高于对照组,差异具有统计学意义(P<0.05)。结论静-吸复合麻醉较之全凭静脉麻醉对肝炎肝硬化患者围术期肝功能、免疫功能影响显著减小。