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 ...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.展开更多
BACKGROUND The serratus anterior muscle,located in the lateral aspect of the thorax,plays a crucial role in shoulder movement and stability.Thoracoscopic surgery,while minimally invasive,often results in significant p...BACKGROUND The serratus anterior muscle,located in the lateral aspect of the thorax,plays a crucial role in shoulder movement and stability.Thoracoscopic surgery,while minimally invasive,often results in significant postoperative pain,complicating patient recovery and potentially extending hospital stays.Traditional anesthesia methods may not adequately address this pain,leading to increased complications such as agitation due to inadequate pain management.AIM To evaluate the application value of ultrasound-guided serratus anterior plane block(SAPB)in patients undergoing thoracoscopic surgery,focusing on its effects on postoperative analgesia and rehabilitation.METHODS Eighty patients undergoing thoracoscopic surgery between August 2021 and December 2022 were randomly divided into two groups:An observation group receiving ultrasound-guided SAPB and a control group receiving standard care without SAPB.Both groups underwent general anesthesia and were monitored for blood pressure,heart rate(HR),oxygen saturation,and pulse.The primary outcomes measured included mean arterial pressure(MAP),HR,postoperative visual analogue scale(VAS)scores for pain,supplemental analgesic use,and incidence of agitation.RESULTS The observation group showed significantly lower cortisol and glucose concentrations at various time points post-operation compared to the control group,indicating reduced stress responses.Moreover,MAP and HR levels were lower in the observation group during and after surgery.VAS scores were significantly lower in the observation group at 1 h,4 h,6 h,and 12 h post-surgery,and the rates of analgesic supplementation and agitation were significantly reduced compared to the control group.CONCLUSION Ultrasound-guided SAPB significantly improves postoperative analgesia and reduces agitation in patients undergoing thoracoscopic surgery.This technique stabilizes perioperative vital signs,decreases the need for supplemental analgesics,and minimizes postoperative pain and stress responses,underscoring its high application value in enhancing patient recovery and rehabilitation post-thoracoscopy.展开更多
BACKGROUND Transversus abdominis plane block(TAPB)is a block of the abdominal afferent nerve fibers between the internal oblique muscle and the transverse abdominal muscle achieved with local anesthetics.It can effect...BACKGROUND Transversus abdominis plane block(TAPB)is a block of the abdominal afferent nerve fibers between the internal oblique muscle and the transverse abdominal muscle achieved with local anesthetics.It can effectively block the conduction of the anterior nerve of the abdominal wall and exert a good analgesic effect.However,the effect of combining the block with remimazolam on anesthesia in patients undergoing gastrointestinal tumor surgery is still unclear.AIM To examine the effects of combining TAPB with remimazolam on the stress response and postoperative recovery of gastrointestinal tumor surgery patients.METHODS A retrospective analysis was conducted on the clinical data of 102 individuals diagnosed with gastrointestinal malignancies who underwent laparoscopic surgery under general anesthesia between April 2020 and June 2023.The patients were categorized into a control group(n=51),receiving remimazolam for general anesthesia,and an observation group(n=51),receiving TAPB combined with remimazolam for general anesthesia.A comparison was made between both groups in terms of hemodynamic parameters,stress markers,pain levels,recovery quality,analgesic effects,and adverse reactions during the perioperative period.RESULTS The observation group had significantly higher heart rates at time points 1 min after induction and upon leaving the operating room than the control group(P<0.05).The mean arterial pressure at time point T1 in the observation group was significantly higher than that in the control group(P<0.05).Five minutes after extubation,the levels of the hormones adrenaline and noradrenaline in the observation group were considerably lower than those in the control group(P<0.05).At 12 h,24 h,and 48 h following surgery,the visual analog scale scores of the observation group were considerably lower than those of the control group(P<0.05).The observation group had shorter awakening and extubation times and lower Riker sedation-agitation scale scores than the control group(P<0.05).The observation group exhibited considerably fewer effective pump presses,lower fentanyl dosages,and lower incidences of rescue analgesia within 24 h following surgery than the control group(P<0.05).CONCLUSION The application effect of TAPB combined with remimazolam general anesthesia in anesthesia of patients undergoing gastrointestinal tumor surgery is good,which is helpful to promote faster recovery after operation.展开更多
BACKGROUND Patients undergoing lumbar spine surgery usually suffer severe pain in the postoperative period.The erector spinae plane block(ESPB),first published in 2016,can anesthetize the ventral and dorsal rami of th...BACKGROUND Patients undergoing lumbar spine surgery usually suffer severe pain in the postoperative period.The erector spinae plane block(ESPB),first published in 2016,can anesthetize the ventral and dorsal rami of thoracic nerves and produce an extensive multi-dermatomal sensory block.AIM To assess whether bilateral ultrasound-guided ESPB at a lower thoracic level could improve pain control and quality of recovery in patients undergoing lumbar spine surgery.METHODS A total of 60 patients aged 18-80 years scheduled to undergo lumbar spine surgery with general anesthesia were randomly assigned to two groups:ESPB group(preoperative bilateral ultrasound-guided ESPB at T10 vertebral level)and control group(no preoperative ESPB).Both groups received standard general anesthesia.The main indicator was the duration to the first patient controlled intravenous analgesia(PCIA)bolus.RESULTS In the ESPB group,the duration to the first PCIA bolus was significantly longer than that in the control group(h)[8.0(4.5,17.0)vs 1.0(0.5,6),P<0.01],and resting and coughing numerical rating scale(NRS)scores at 48 h post operation were significantly lower than those in the control group(P<0.05).There was no significant difference between the two groups regarding resting and coughing NRS scores at 24 h post operation.Sufentanil consumption during the operation was significantly lower in the ESPB group than in the control group(P<0.01),while there was no significant difference between the two groups regarding morphine consumption at 24 or 48 h post operation.In the ESPB group,Modified Observer’s Assessment of Alertness/Sedation score within 20 min after extubation was higher and duration in the post-anesthesia care unit was shorter than those in the control group(P<0.01).CONCLUSION In patients undergoing lumbar spine surgery,ultrasound-guided ESPB at a lower thoracic level improves the analgesic effect,reduces opioid consumption,and improves postoperative recovery.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">In...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">In this retrospective observational study, we evaluated patients who underwent elective lumbar stenosis surgery between February 1, 2019, and April 1, 2019. Patients who underwent surgery for lumbar spinal stenosis under general anesthesia alone were compared with those who underwent general anesthesia combined with erector spinae plane block.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Aims:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We aimed to retrospectively evaluate whether erector spinae plane block reduced opioid consumption following surgery for spinal stenosis.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Study Design:</span></b><span style="font-family:Verdana;"> A retrospective observational study</span><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We collected data on the pain scores, time for the first requirement for patient-controlled analgesia with tramadol, the cumulative patient-controlled analgesia dose, requirement for rescue analgesia, time to first stand up postoperatively and the incidence of postoperative nausea and vomiting.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Sixty patients were included in the study. The numerical rating scale</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s pain scores were significantly lower in the erector spinae plane group at 1, 2, 4, 6, 12 and 24 hours than in the general anesthesia group. The cumulative dose of patient-controlled analgesia with tramadol was higher in the general anesthesia group than in the ESP group [212.0 (6.6) mg, vs. 107.3 (36.9 mg), (p <0.001)]. The time to first stand up after surgery was significantly longer in the general anesthesia group (p = 0.011).</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> ESP block appear to be an effective method to relieve pain after lumbar surgery.</span>展开更多
【目的】探究超声引导浅层胸骨旁肋间平面阻滞对胸骨切开心脏手术患者术后恢复质量和镇痛效果的影响。【方法】本研究共纳入64例胸骨切开心脏手术患者,随机分为接受浅层胸骨旁肋间平面阻滞使用罗哌卡因(罗哌卡因组)或生理盐水(生理盐水...【目的】探究超声引导浅层胸骨旁肋间平面阻滞对胸骨切开心脏手术患者术后恢复质量和镇痛效果的影响。【方法】本研究共纳入64例胸骨切开心脏手术患者,随机分为接受浅层胸骨旁肋间平面阻滞使用罗哌卡因(罗哌卡因组)或生理盐水(生理盐水组)两组。主要研究指标为患者术后24 h恢复质量评分(QoR-15评分),其次为术后24 h疼痛评分和阿片药物使用情况。【结果】与生理盐水组比较,罗哌卡因组术后24 h QoR-15评分显著提高[(89.60±13.24)vs(81.18±12.78),P=0.012],静息数字疼痛评分显著降低[(3.03±0.72)vs(4.26±0.93),P<0.001],咳嗽数字疼痛评分显著降低[(4.40±0.89)vs(5.44±1.05),P<0.001]。同时,罗哌卡因组患者术后24 h阿片药物使用总量明显减少[14.15(4.95~30.00)mg vs 40.50(19.25~68.18)mg,P=0.002],补救镇痛需求亦明显减少[0.00(0.00~0.00)mg vs 0.00(0.00~100.00)mg,P=0.007]。【结论】超声引导浅层胸骨旁肋间平面阻滞可通过提升术后镇痛效果及减少阿片药物使用量,提高胸骨切开心脏手术患者术后24 h的总体恢复质量,利于术后早期康复。展开更多
基金Supported by Health Commission of Hebei Province,China,No.20240074Scientific Research Project of Hebei Provincial Administration of Traditional Chinese Medicine,China,No.2024317.
文摘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.
文摘BACKGROUND The serratus anterior muscle,located in the lateral aspect of the thorax,plays a crucial role in shoulder movement and stability.Thoracoscopic surgery,while minimally invasive,often results in significant postoperative pain,complicating patient recovery and potentially extending hospital stays.Traditional anesthesia methods may not adequately address this pain,leading to increased complications such as agitation due to inadequate pain management.AIM To evaluate the application value of ultrasound-guided serratus anterior plane block(SAPB)in patients undergoing thoracoscopic surgery,focusing on its effects on postoperative analgesia and rehabilitation.METHODS Eighty patients undergoing thoracoscopic surgery between August 2021 and December 2022 were randomly divided into two groups:An observation group receiving ultrasound-guided SAPB and a control group receiving standard care without SAPB.Both groups underwent general anesthesia and were monitored for blood pressure,heart rate(HR),oxygen saturation,and pulse.The primary outcomes measured included mean arterial pressure(MAP),HR,postoperative visual analogue scale(VAS)scores for pain,supplemental analgesic use,and incidence of agitation.RESULTS The observation group showed significantly lower cortisol and glucose concentrations at various time points post-operation compared to the control group,indicating reduced stress responses.Moreover,MAP and HR levels were lower in the observation group during and after surgery.VAS scores were significantly lower in the observation group at 1 h,4 h,6 h,and 12 h post-surgery,and the rates of analgesic supplementation and agitation were significantly reduced compared to the control group.CONCLUSION Ultrasound-guided SAPB significantly improves postoperative analgesia and reduces agitation in patients undergoing thoracoscopic surgery.This technique stabilizes perioperative vital signs,decreases the need for supplemental analgesics,and minimizes postoperative pain and stress responses,underscoring its high application value in enhancing patient recovery and rehabilitation post-thoracoscopy.
文摘BACKGROUND Transversus abdominis plane block(TAPB)is a block of the abdominal afferent nerve fibers between the internal oblique muscle and the transverse abdominal muscle achieved with local anesthetics.It can effectively block the conduction of the anterior nerve of the abdominal wall and exert a good analgesic effect.However,the effect of combining the block with remimazolam on anesthesia in patients undergoing gastrointestinal tumor surgery is still unclear.AIM To examine the effects of combining TAPB with remimazolam on the stress response and postoperative recovery of gastrointestinal tumor surgery patients.METHODS A retrospective analysis was conducted on the clinical data of 102 individuals diagnosed with gastrointestinal malignancies who underwent laparoscopic surgery under general anesthesia between April 2020 and June 2023.The patients were categorized into a control group(n=51),receiving remimazolam for general anesthesia,and an observation group(n=51),receiving TAPB combined with remimazolam for general anesthesia.A comparison was made between both groups in terms of hemodynamic parameters,stress markers,pain levels,recovery quality,analgesic effects,and adverse reactions during the perioperative period.RESULTS The observation group had significantly higher heart rates at time points 1 min after induction and upon leaving the operating room than the control group(P<0.05).The mean arterial pressure at time point T1 in the observation group was significantly higher than that in the control group(P<0.05).Five minutes after extubation,the levels of the hormones adrenaline and noradrenaline in the observation group were considerably lower than those in the control group(P<0.05).At 12 h,24 h,and 48 h following surgery,the visual analog scale scores of the observation group were considerably lower than those of the control group(P<0.05).The observation group had shorter awakening and extubation times and lower Riker sedation-agitation scale scores than the control group(P<0.05).The observation group exhibited considerably fewer effective pump presses,lower fentanyl dosages,and lower incidences of rescue analgesia within 24 h following surgery than the control group(P<0.05).CONCLUSION The application effect of TAPB combined with remimazolam general anesthesia in anesthesia of patients undergoing gastrointestinal tumor surgery is good,which is helpful to promote faster recovery after operation.
文摘BACKGROUND Patients undergoing lumbar spine surgery usually suffer severe pain in the postoperative period.The erector spinae plane block(ESPB),first published in 2016,can anesthetize the ventral and dorsal rami of thoracic nerves and produce an extensive multi-dermatomal sensory block.AIM To assess whether bilateral ultrasound-guided ESPB at a lower thoracic level could improve pain control and quality of recovery in patients undergoing lumbar spine surgery.METHODS A total of 60 patients aged 18-80 years scheduled to undergo lumbar spine surgery with general anesthesia were randomly assigned to two groups:ESPB group(preoperative bilateral ultrasound-guided ESPB at T10 vertebral level)and control group(no preoperative ESPB).Both groups received standard general anesthesia.The main indicator was the duration to the first patient controlled intravenous analgesia(PCIA)bolus.RESULTS In the ESPB group,the duration to the first PCIA bolus was significantly longer than that in the control group(h)[8.0(4.5,17.0)vs 1.0(0.5,6),P<0.01],and resting and coughing numerical rating scale(NRS)scores at 48 h post operation were significantly lower than those in the control group(P<0.05).There was no significant difference between the two groups regarding resting and coughing NRS scores at 24 h post operation.Sufentanil consumption during the operation was significantly lower in the ESPB group than in the control group(P<0.01),while there was no significant difference between the two groups regarding morphine consumption at 24 or 48 h post operation.In the ESPB group,Modified Observer’s Assessment of Alertness/Sedation score within 20 min after extubation was higher and duration in the post-anesthesia care unit was shorter than those in the control group(P<0.01).CONCLUSION In patients undergoing lumbar spine surgery,ultrasound-guided ESPB at a lower thoracic level improves the analgesic effect,reduces opioid consumption,and improves postoperative recovery.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">In this retrospective observational study, we evaluated patients who underwent elective lumbar stenosis surgery between February 1, 2019, and April 1, 2019. Patients who underwent surgery for lumbar spinal stenosis under general anesthesia alone were compared with those who underwent general anesthesia combined with erector spinae plane block.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Aims:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We aimed to retrospectively evaluate whether erector spinae plane block reduced opioid consumption following surgery for spinal stenosis.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Study Design:</span></b><span style="font-family:Verdana;"> A retrospective observational study</span><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We collected data on the pain scores, time for the first requirement for patient-controlled analgesia with tramadol, the cumulative patient-controlled analgesia dose, requirement for rescue analgesia, time to first stand up postoperatively and the incidence of postoperative nausea and vomiting.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Sixty patients were included in the study. The numerical rating scale</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s pain scores were significantly lower in the erector spinae plane group at 1, 2, 4, 6, 12 and 24 hours than in the general anesthesia group. The cumulative dose of patient-controlled analgesia with tramadol was higher in the general anesthesia group than in the ESP group [212.0 (6.6) mg, vs. 107.3 (36.9 mg), (p <0.001)]. The time to first stand up after surgery was significantly longer in the general anesthesia group (p = 0.011).</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> ESP block appear to be an effective method to relieve pain after lumbar surgery.</span>
文摘【目的】探究超声引导浅层胸骨旁肋间平面阻滞对胸骨切开心脏手术患者术后恢复质量和镇痛效果的影响。【方法】本研究共纳入64例胸骨切开心脏手术患者,随机分为接受浅层胸骨旁肋间平面阻滞使用罗哌卡因(罗哌卡因组)或生理盐水(生理盐水组)两组。主要研究指标为患者术后24 h恢复质量评分(QoR-15评分),其次为术后24 h疼痛评分和阿片药物使用情况。【结果】与生理盐水组比较,罗哌卡因组术后24 h QoR-15评分显著提高[(89.60±13.24)vs(81.18±12.78),P=0.012],静息数字疼痛评分显著降低[(3.03±0.72)vs(4.26±0.93),P<0.001],咳嗽数字疼痛评分显著降低[(4.40±0.89)vs(5.44±1.05),P<0.001]。同时,罗哌卡因组患者术后24 h阿片药物使用总量明显减少[14.15(4.95~30.00)mg vs 40.50(19.25~68.18)mg,P=0.002],补救镇痛需求亦明显减少[0.00(0.00~0.00)mg vs 0.00(0.00~100.00)mg,P=0.007]。【结论】超声引导浅层胸骨旁肋间平面阻滞可通过提升术后镇痛效果及减少阿片药物使用量,提高胸骨切开心脏手术患者术后24 h的总体恢复质量,利于术后早期康复。
