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.

A combination therapy of ethanol injection and radiofrequency ablation under general anesthesia for the treatment of hepatocellular carcinoma

AIM: To summarize the effects of laparoscopic ethanol injection and radiofrequency ablation (L-EI-RFA), thora- coscopic (T-EI-RFA) and open-surgery assisted EI-RFA (O-EI-RFA) under general anesthesia for the treatment of hepatocellular carcinoma (HCC). METHODS: Time-lag performance of RFA after ethanol injection (Time-lag PEI-RFA) was performed in all cases. The volume of coagulated necrosis and the applied en- ergy for total and per unit volume coagulated necrosis were examined in the groups treated under general (group G) or local anesthesia (group L). RESULTS: The results showed that the total applied energy and the applied energy per unit volume of whole and marginal, coagulated necrosis were significantly larger in group G than those in the group L, resulting in a larger volume of coagulated necrosis in the group G. The rate of local tumor recurrence within one year was extremely low in group G. CONCLUSION: These results suggest that EI-RFA, un- der general anesthesia, may be effective for the treat- ment of HCC because a larger quantity of ethanol and energy could be applied during treatment under pain- free condition for the patients.

SURVEY ON CLINICAL STUDY OF COMPOUND ACUPUNCTURE ANESTHESIA IN RECENT 10 YEARS IN CHINA

In the present paper, the authors make a review on the progresses of acupuncture anesthesia (AA) from ① historical development, ② research on acupuncture combined with local anesthesia; ③ research on acupuncture combined with epidural anesthesia; and ④ research on acupuncture combined with general anesthesia. Compound acupuncture anesthesia provides a new anesthetic measure for surgical operations and has a definite analgesic effect and many advantages, and should be investigated further.

Effect of subarachnoid anesthesia combined with propofol targetcontrolled infusion on blood loss and transfusion for posterior total hip arthroplasty in elderly patients

Background:Intravertebral and general anesthesia(GA)are two main anesthesia approaches but both have defects.This study was aimed to evaluate the effect of subarachnoid anesthesia combined with propofol target-controlled infusion(TCI)on blood loss and transfusion for total hip arthroplasty(THA)in elderly patients in comparison with combined spinal-epidural anesthesia(CSEA)or GA.Methods:Totally,240 patients(aged>65 years,American Society of Anesthesiologists[ASA]I-III)scheduled for posterior THA were enrolled from September 1st,2017 to March 1st,2018.All cases were randomly divided into three groups to receive CSEA(group C,w=80),GA(group G,n=80),or subarachnoid anesthesia and propofol TCI(group T,w=80),respectively.Primary outcomes measured were intra-operative blood loss,autologous and allogeneic blood transfusion,mean arterial pressure at different time points,length of stay in post-anesthesia care unit(PACU),length of hospital stay,and patient satisfaction degree.Furthermore,post-operative pain scores and complications were also observed.The difference of quantitative index between groups were analyzed by one-way analysis of variance,repeated measurement generalized linear model,Student-Newman-Keuls test or rank-sum test,while ratio index was analyzed by Chi-square test or Fisher exact test.Results:Basic characteristics were comparable among the three groups.Intra-operative blood loss in group T(331.53±64.33 mL)and group G(308.03±64.90 mL)were significantly less than group C(455.40±120.48 mL,F=65.80,P<0.001).Similarly,the autologous transfusion of group T(130.99±30.36 mL)and group G(124.09±24.34 mL)were also markedly less than group C(178.31±48.68 mL,F=52.99,P<0.001).The allogenetic blood transfusion of group C(0[0,100.00])was also significantly larger than group T(0)and group G(0)(Z=2.47,P=0.047).Except for the baseline,there were significant differences in mean arterial blood pressures before operation(F=496.84,P<0.001),10-min after the beginning of operation(F=351.43,P<0.001),30-min after the beginning of operation(F=559.89,P<0.001),50-min after the beginning of operation(F=374.74,P<0.001),and at the end of operation(F=26.14,P<0.001)among the three groups.Length of stay in PACU of group T(9.41±1.19 min)was comparable with group C(8.83±1.26 min),and both were significantly shorter than group G(16.55±3.10 min,F=352.50,P<0.001).There were no significant differences among the three groups in terms of length of hospitalization and post-operative visual analog scale scores.Patient satisfaction degree of group T(77/80)was significantly higher than group C(66/80,%=7.96,P=0.004)and G(69/80,/2=5.01,P=0.025).One patient complained of post-dural puncture headache and two complained of low back pain in group C,while none in group T.Incidence of post-operative nausea and vomiting in group G(10/80)was significantly higher than group T(3/80,/2=4.10,P=0.043)and group C(2/80,x2=5.76,P=0.016).No deep vein thrombosis or delayed post-operative functional exercise was detected.Conclusions:Single subarachnoid anesthesia combined with propofol TCI seems to perform better than CSEA and GA for posterior THA in elderly patients,with less blood loss and peri-operative transfusion,higher patient satisfaction degree and fewer complications.Trial registration:chictr.org.cn:ChiCTR-IPR-17013461;http://www.chictr.org.cn/showproj.aspx?proj=23024.

连续静滴芬太尼、利多卡因和琥珀胆碱复合液用于小儿全麻的观察

我院将芬太尼、利多卡因和琥珀胆碱复合剂用于小儿全麻,观察50例,发现患儿用该法麻醉血流动力学平稳和基本平稳者占80%,大部分患儿在停用该复合剂三十分钟后自主呼吸恢复,且该法有镇痛强、作用快等作用.文中还就复合剂中药物的使用及注意事项作了说明,供临床参考.