BACKGROUND Remimazolam is characterized by rapid action and inactive metabolites.It is used as the general anesthetic for many clinical surgeries.In this study,we performed a meta-analysis to evaluate whether remimazo...BACKGROUND Remimazolam is characterized by rapid action and inactive metabolites.It is used as the general anesthetic for many clinical surgeries.In this study,we performed a meta-analysis to evaluate whether remimazolam is superior to propofol for gastroenteroscopy in older patients.AIM To compare the adverse events and efficacy of remimazolam and propofol during gastroenteroscopy in older adults.METHODS The PubMed,Web of Science,the Cochrane Library databases were queried for the relevant key words"remimazolam,""and propofol,""and gastrointestinal endoscopy or gastroscopy."The search scope was"Title and Abstract,"and the search was limited to human studies and publications in English.Seven studies wherein remimazolam and propofol were compared were included for the metaanalysis.RESULTS We selected seven randomized controlled trials involving 1445 cases for the analysis.Remimazolam reduced the hypotension(relative risk,RR=0.44,95%CI:0.29-0.66,P=0.000),respiratory depression(RR=0.46,95%CI:0.30-0.70,P=0.000),injection pain(RR=0.12,95%CI:0.05-0.25,P=0.000),bradycardia(RR=0.37,95%CI:0.24-0.58,P=0.000),and time to discharge[weighted mean difference(WMD)=-0.58,95%CI:-0.97 to-0.18,P=0.005],compared to those after propofol administration.No obvious differences were observed for postoperative nausea and vomiting(RR=1.09,95%CI:0.97-1.24,P=0.151),dizziness(RR=0.77,95%CI:0.43-1.36,P=0.361),successful sedation rate(RR=0.96,95%CI:0.93-1.00,P=0.083),or the time to become fully alert(WMD=0.00,95%CI:-1.08-1.08,P=0.998).CONCLUSION Remimazolam appears to be safer than propofol for gastroenteroscopy in older adults.However,further studies are required to confirm these findings.展开更多
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. Me...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.展开更多
Stiff-Person syndrome is a rare autoimmune neurologic disorder that affects the central nervous system by inhibiting production of the neurotransmitter gamma-aminobutyric acid. Painful muscle spasms and rigidity are t...Stiff-Person syndrome is a rare autoimmune neurologic disorder that affects the central nervous system by inhibiting production of the neurotransmitter gamma-aminobutyric acid. Painful muscle spasms and rigidity are the clinical manifestations of the disease. An ideal anesthetic technique has not been described for this patient population because of the rarity of the disease. This case report describes the successful use of total intravenous anesthesia in a patient with Stiff- Person Syndrome.展开更多
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 hos...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.展开更多
The safety and efficacy of the laryngeal mask airway (LMA) has been reported by numerous large-scale studies. However, they do not address the issue of whether an intravenous (IV) is required for pediatric general ane...The safety and efficacy of the laryngeal mask airway (LMA) has been reported by numerous large-scale studies. However, they do not address the issue of whether an intravenous (IV) is required for pediatric general anesthesia (GA) where access is challenging due to anatomical considerations and a lack of cooperation. The aims of this study are to determine whether pediatric GA by LMA without IV access affected placement rates, procedure times and rates of anesthetic complications. Children who met these criteria at the UIC Surgicenter in the two year period prior to August 30, 2005 were selected. A retrospective chart review was conducted to determine patient demographics, ASA class, procedure, placement success, IV placed if any, time to incision, and any anesthetic complications. 241 patients without IV access and 41 patients with IV access were included. No significant differences were found between the groups in the rates of LMA placement or anesthetic complications. Significant differences were found in times to incision overall and for ophthalmology exams under anesthesia and lacrimal duct probings. Pediatric GA by LMA without IV access demonstrated a similarly high placement rate, shorter procedure times and a low rate of complications in comparison with the control group.展开更多
BACKGROUND Although propofol generally reduces blood pressure,rarely,it causes hypertension.However,the mechanism by which propofol increases blood pressure has not been established,and so far,there are only a few rep...BACKGROUND Although propofol generally reduces blood pressure,rarely,it causes hypertension.However,the mechanism by which propofol increases blood pressure has not been established,and so far,there are only a few reported cases.CASE SUMMARY A 46-year-old woman,diagnosed with thyroid cancer,was administered general anesthesia with propofol and remifentanil for a thyroid lobectomy.An increase in the concentrations of intravenous anesthetics further increased her blood pressure.The blood pressure remained stable when anesthesia was maintained with sevoflurane and remifentanil after the interruption of propofol administration.CONCLUSION We concluded that propofol administration was the cause of increased blood pressure.展开更多
Background: Spinal anesthesia with sedation is a common anesthetic technique in infraumbilical surgeries. Dexmedetomidine has been widely used as a sedative during spinal anesthesia, and is recognized as an adjuvant t...Background: Spinal anesthesia with sedation is a common anesthetic technique in infraumbilical surgeries. Dexmedetomidine has been widely used as a sedative during spinal anesthesia, and is recognized as an adjuvant that prolongs the duration of spinal anesthesia. We compared the effects of a continuous intravenous infusion of dexmedetomidine to provide intraoperative sedation on the duration of sensory and motor blockade induced by spinal anesthesia, with those of midazolam. Methods: A double-blind randomized controlled trial was performed on 40 patients, aged between 20 and 75 years, who requested intraoperative sedation, and were classified as American Society of Anesthesiologists (ASA) physical status I-II, and underwent elective surgeries under spinal anesthesia. After spinal anesthesia with 13 mg (2.6 ml) of 0.5% hyperbaric bupivacaine, patients were randomized to receive intravenous dexmedetomidine 3 μg/kg/h for 10 mins followed by an infusion of 0.5 μg/kg/h (Group D), or intravenous midazolam 0.15 mg/kg/h for 10 mins followed by an infusion of 0.025 mg/kg/h (Group M). Sedation was titrated to Observer’s Assessment of Alertness/Sedation (OAA/S) score of 3. Sensory and motor blockade was evaluated using the pinprick test and modified Bromage scale, respectively. Results: The time taken to achieve OAA/S score 3 was similar in the two groups. The maximal level of sensory blockade was 5.3 ± 1.3 min in group D and 4.1 ± 1.5 in group M (P = 0.03). No significant differences were observed in the time taken to achieve the maximal level or the two-segment regression time of sensory blockade between the two groups. The time to sensory regression to the L2 level was significantly longer in group D than in group M (234.6 ± 78.1 mins versus 172.4 ± 41.5 mins, respectively, P = 0.008). The time to motor regression to modified Bromage score 1 was significantly longer in group D than in group M (232.2 ± 79.3 versus 176.5 ± 48.8, respectively, P = 0.02). Conclusion: Continuous intravenous dexmedetomidine to provide sedation during spinal anesthesia significantly prolongs the duration of sensory and motor blockade induced by spinal anesthesia over that with midazolam.展开更多
Objective:To investigate the effect of Propofol Intravenous Anesthesia on hemorheology, hemodynamics and immune function in patients with colorectal cancer after radical operation.Method: A total of 100 patients with ...Objective:To investigate the effect of Propofol Intravenous Anesthesia on hemorheology, hemodynamics and immune function in patients with colorectal cancer after radical operation.Method: A total of 100 patients with colorectal cancer treated in our hospital from September 2015 to August 2017 were randomly divided into observation group and control group according to random number table. The control group was inhaled sevoflurane anesthesia, observation group propofol intravenous anesthesia. The changes of hemorheology, hemodynamics and immune function were compared between the two groups.Results: There was no significant difference in hemorheology index, hemodynamic index, T lymphocyte subsets CD45RA+, CD45RO+, CD45RA+/CD45RO+ levels between the two groups before anesthesia. Anesthesia 1.5 h after, the levels of LBV, HBV, PV, EAI and EDI in the two groups were significantly decreased, but there was no significant difference between the observation group and the control group. At 1.5 h after anesthesia induction, the HR and SBP levels of the observation group did not change significantly compared with anesthesia before, while the HR and SBP levels of the 1.5 h after anesthesia induction in the control group were significantly lower than those before anesthesia and significantly lower than the corresponding level HR level (86.43±13.25) times/min, SBP level (110.84±15.41) mmHg in the observation group. At the end of surgery, the levels of CD45RA+ and CD45RO+ in the observation group were significantly decreased, but increased at 72 h after operation.Conclusion: After operation, CD45RA+ and CD45RO+ levels in the control group were significantly decreased, and preoperatively, which can significantly improve the hemorheology and reduced hemodynamic effects, and contribute to the recovery of patients with immune function, is worth clinical promotion.展开更多
Objective:To study the effect of epidural anesthesia combined with total intravenous anesthesia on stress response and coagulation function in and after laparoscopic surgery. Methods: A total of 219 cases of patients ...Objective:To study the effect of epidural anesthesia combined with total intravenous anesthesia on stress response and coagulation function in and after laparoscopic surgery. Methods: A total of 219 cases of patients who underwent laparoscopic cholecystectomy in our hospital between August 2014 and February 2017 were collected and divided into control group (n=125) who accepted total intravenous anesthesia alone and observation group (n=94) who accepted epidural anesthesia combined with total intravenous anesthesia after the anesthesia scheme was reviewed. Perioperative stress response and coagulation function were compared between two groups of patients.Results: Before operation, differences in the serum stress index contents and peripheral blood coagulation index levels were not statistically significant between two groups of patients. In operation and 2 h after operation, serum stress indexes Cor, Ang-Ⅰ, Ang-Ⅱ and NE contents of observation group were significantly lower than those of control group;peripheral blood coagulation indexes PT, TT and APTT levels were significantly higher than those of control group while TXA2, TXB2 and FBG levels were significantly lower than those of control group.Conclusions: Epidural anesthesia combined with total intravenous anesthesia can effectively alleviate the systemic stress response and reduce the hypercoagulable state in and early after laparoscopic surgery.展开更多
Objective:To study the effect of intravenous inhalational anesthesia under Narcotrend monitor on the systemic traumatic reaction after laparoscopic cholecystectomy.Methods:A total of 116 patients with gallstone who re...Objective:To study the effect of intravenous inhalational anesthesia under Narcotrend monitor on the systemic traumatic reaction after laparoscopic cholecystectomy.Methods:A total of 116 patients with gallstone who received laparoscopic surgery in our hospital between July 2012 and April 2016 were collected and divided into the combined anesthesia group (n=65) who accepted intravenous inhalational anesthesia under Narcotrend monitor and the intravenous anesthesia group (n=51) who accepted total intravenous anesthesia after the anesthesia methods and relevant test results were reviewed. 1 d after operation, enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of pain mediators and inflammation mediators;automatic biochemical analyzer was used to detect the levels of oxidative stress indexes.Results:1 d after operation, serum pain mediators 5-HT, PGE2, NO and HT levels of observation group were lower than those of control group;serum oxidation indexes AOPPs and LHP levels of observation group were lower than those of control group while anti-oxidation indexes CAT and GSH-Px levels were higher than those of control group;serum pro-inflammatory factors IL-6, IL-8 and CRP levels of observation group were lower than those of control group while anti-inflammatory factors IL-4, IL-10 and IL-13 levels were higher than those of control group.Conclusion:Intravenous inhalational anesthesia under Narcotrend monitor can reduce the postoperative systemic traumatic reaction degree in patients with laparoscopic cholecystectomy.展开更多
Objective: To study the effect of intravenous inhalational anesthesia under monitoring on systemic traumatic response after laparoscopic cholecystectomy. Methods: A total of 80 cases of patients with chronic cholecyst...Objective: To study the effect of intravenous inhalational anesthesia under monitoring on systemic traumatic response after laparoscopic cholecystectomy. Methods: A total of 80 cases of patients with chronic cholecystitis who received laparoscopic cholecystectomy in our hospital between June 2016 and October 2016 were collected and divided into the control group who accepted total intravenous anesthesia and the observation group who accepted intravenous inhalational anesthesia after the anesthesia methods were reviewed. 6 h, 12 h and 24 h after operation, the RIA method was adopted to determine the serum contents of pain mediators, enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of inflammatory factors and stress hormones, and auto-coagulation analyzer was used to detect the plasma contents of coagulation function indexes. Results: 6 h, 12 h and 24 h after operation, serum pain mediators 5-HT, β-EP and NPY levels of observation group were lower than those of control group, inflammatory factors hs-CRP, IL-6, IL-8 and TNF-α levels were lower than those of control group, and stress hormones Cor, ALD and NE levels were lower than those of control group;plasma coagulation function indexes TXB2, D-D and PLT levels of observation group were lower than those of control group. Conclusion: Intravenous inhalational anesthesia under monitoring can reduce the systemic traumatic reaction after laparoscopic cholecystectomy and has positive clinical significance.展开更多
Objective: To explore the effects of intravenous inhalational anesthesia on the hemodynamic homeostasis as well as postoperative brain function and Th1/Th2 immunity in elderly patients with femoral neck fracture. Meth...Objective: To explore the effects of intravenous inhalational anesthesia on the hemodynamic homeostasis as well as postoperative brain function and Th1/Th2 immunity in elderly patients with femoral neck fracture. Methods: A total of 176 elderly patients with femoral neck fracture who received hip replacement in our hospital between July 2016 and June 2017 were divided into the total intravenous anesthesia group (n=86) and the intravenous inhalational anesthesia group (n=90) according to the anesthesia solution. The differences in introperative hemodynamic parameter levels as well as postoperative brain function index and Th1/Th2 cytokine contents were compared between the two groups. Results: During operation, hemodynamic parameters MAP and HR levels in intravenous inhalational anesthesia group were lower than those in total intravenous anesthesia group. 24 h after operation, serum brain function indexes MBP, S100B and NSE contents in intravenous inhalational anesthesia group were lower than those in total intravenous anesthesia group;serum Th1 cytokines IFN-γand IL-2 contents were higher than those in total intravenous anaesthesia group whereas Th2 cytokines IL-4 and IL-13 contents were lower than those in total intravenous anesthesia group. Conclusion: The intravenous inhalational anesthesia can effectively stabilize the intraoperative hemodynamics and reduce the postoperative brain function and Th1/Th2 immune function injury in elderly patients with femoral neck fracture.展开更多
Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare...Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.展开更多
Objective:To observe the application effects of anesthesia recovery nursing with heat preservation measures in patients undergoing general anesthesia surgery.Methods:300 cases of general anesthesia surgery patients in...Objective:To observe the application effects of anesthesia recovery nursing with heat preservation measures in patients undergoing general anesthesia surgery.Methods:300 cases of general anesthesia surgery patients in our hospital from March 2023 to February 2024 were selected and divided into the control group and the observation group according to the random number table method,each with 150 cases.The control group adopted conventional care,while the observation group was given anesthesia recovery care and heat preservation measures on the basis of conventional care.The wake-up time,extubation time,hospitalization time,and the incidence of adverse reactions were compared between the two groups and statistically analyzed.Results:The wake-up time of patients in the control group was 9.71±1.20 hours,and that of the observation group was 6.51±1.02 hours,with statistically significant differences(P<0.05);the extubation times of patients in the observation group and the control group after awakening were 8.52±0.41 min and 10.42±1.12 min,respectively,with statistically significant differences(P<0.05)The hospital stay after the operation in the observation group and the control group was 32.91±4.71 days and 37.24±3.34 days respectively,and the difference was statistically significant(P<0.05),and the incidence rate of adverse reactions after extubation in the observation group(3.33%)was significantly lower than that in the control group(10.00%)(P<0.05).Conclusion:In general anesthesia surgery patients,the implementation of anesthesia recovery nursing with heat preservation measures can significantly improve the physical condition of patients,effectively shorten the duration of surgery and patients’wake-up time,and improve their quality of life,which is worthy of clinical promotion and application.展开更多
General anesthesia is widely applied in clinical practice.However,the precise mechanism of loss of consciousness induced by general anesthetics remains unknown.Here,we measured the dynamics of five neurotransmitters,i...General anesthesia is widely applied in clinical practice.However,the precise mechanism of loss of consciousness induced by general anesthetics remains unknown.Here,we measured the dynamics of five neurotransmitters,includingγ-aminobutyric acid,glutamate,norepinephrine,acetylcholine,and dopamine,in the medial prefrontal cortex and primary visual cortex of C57BL/6 mice through in vivo fiber photometry and genetically encoded neurotransmitter sensors under anesthesia to reveal the mechanism of general anesthesia from a neurotransmitter perspective.Results revealed that the concentrations of γ-aminobutyric acid,glutamate,norepinephrine,and acetylcholine increased in the cortex during propofol-induced loss of consciousness.Dopamine levels did not change following the hypnotic dose of propofol but increased significantly following surgical doses of propofol anesthesia.Notably,the concentrations of the five neurotransmitters generally decreased during sevoflurane-induced loss of consciousness.Furthermore,the neurotransmitter dynamic networks were not synchronized in the non-anesthesia groups but were highly synchronized in the anesthetic groups.These findings suggest that neurotransmitter dynamic network synchronization may cause anesthetic-induced loss of consciousness.展开更多
Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anest...Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4<sup>th</sup> post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.展开更多
Researchers and clinicians have long been interested in the mechanisms of pain,anesthesia,and addiction.The International Association for the Study of Pain(IASP)defines pain as an unpleasant sensory and emotional expe...Researchers and clinicians have long been interested in the mechanisms of pain,anesthesia,and addiction.The International Association for the Study of Pain(IASP)defines pain as an unpleasant sensory and emotional experience associated with,or resembling that associated with,actual or potential tissue damage(Raja et al.,2020).Drug addiction refers to a condition of reliance that develops from regular drug consumption,which may lead to withdrawal symptoms when use is halted.Anesthesia involves the complete loss of consciousness induced by an inhaled or intravenous anesthetic(Tosello et al.,2022).In this special collection,Zoological Research presents research findings focused on pain,addiction,and anesthesia.展开更多
Postoperative cognitive dysfunction(POCD)remains a major issue that worsens the prognosis of elderly surgery patients.This article reviews the current research on the effect of different anesthesia methods and commonl...Postoperative cognitive dysfunction(POCD)remains a major issue that worsens the prognosis of elderly surgery patients.This article reviews the current research on the effect of different anesthesia methods and commonly utilized anesthetics on the incidence of POCD in elderly patients,aiming to provide an understanding of the underlying mechanisms contributing to this condition and facilitate the development of more reasonable anesthesia protocols,ultimately reducing the incidence of POCD in elderly surgery patients.展开更多
文摘BACKGROUND Remimazolam is characterized by rapid action and inactive metabolites.It is used as the general anesthetic for many clinical surgeries.In this study,we performed a meta-analysis to evaluate whether remimazolam is superior to propofol for gastroenteroscopy in older patients.AIM To compare the adverse events and efficacy of remimazolam and propofol during gastroenteroscopy in older adults.METHODS The PubMed,Web of Science,the Cochrane Library databases were queried for the relevant key words"remimazolam,""and propofol,""and gastrointestinal endoscopy or gastroscopy."The search scope was"Title and Abstract,"and the search was limited to human studies and publications in English.Seven studies wherein remimazolam and propofol were compared were included for the metaanalysis.RESULTS We selected seven randomized controlled trials involving 1445 cases for the analysis.Remimazolam reduced the hypotension(relative risk,RR=0.44,95%CI:0.29-0.66,P=0.000),respiratory depression(RR=0.46,95%CI:0.30-0.70,P=0.000),injection pain(RR=0.12,95%CI:0.05-0.25,P=0.000),bradycardia(RR=0.37,95%CI:0.24-0.58,P=0.000),and time to discharge[weighted mean difference(WMD)=-0.58,95%CI:-0.97 to-0.18,P=0.005],compared to those after propofol administration.No obvious differences were observed for postoperative nausea and vomiting(RR=1.09,95%CI:0.97-1.24,P=0.151),dizziness(RR=0.77,95%CI:0.43-1.36,P=0.361),successful sedation rate(RR=0.96,95%CI:0.93-1.00,P=0.083),or the time to become fully alert(WMD=0.00,95%CI:-1.08-1.08,P=0.998).CONCLUSION Remimazolam appears to be safer than propofol for gastroenteroscopy in older adults.However,further studies are required to confirm these findings.
文摘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.
文摘Stiff-Person syndrome is a rare autoimmune neurologic disorder that affects the central nervous system by inhibiting production of the neurotransmitter gamma-aminobutyric acid. Painful muscle spasms and rigidity are the clinical manifestations of the disease. An ideal anesthetic technique has not been described for this patient population because of the rarity of the disease. This case report describes the successful use of total intravenous anesthesia in a patient with Stiff- Person Syndrome.
文摘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.
文摘The safety and efficacy of the laryngeal mask airway (LMA) has been reported by numerous large-scale studies. However, they do not address the issue of whether an intravenous (IV) is required for pediatric general anesthesia (GA) where access is challenging due to anatomical considerations and a lack of cooperation. The aims of this study are to determine whether pediatric GA by LMA without IV access affected placement rates, procedure times and rates of anesthetic complications. Children who met these criteria at the UIC Surgicenter in the two year period prior to August 30, 2005 were selected. A retrospective chart review was conducted to determine patient demographics, ASA class, procedure, placement success, IV placed if any, time to incision, and any anesthetic complications. 241 patients without IV access and 41 patients with IV access were included. No significant differences were found between the groups in the rates of LMA placement or anesthetic complications. Significant differences were found in times to incision overall and for ophthalmology exams under anesthesia and lacrimal duct probings. Pediatric GA by LMA without IV access demonstrated a similarly high placement rate, shorter procedure times and a low rate of complications in comparison with the control group.
文摘BACKGROUND Although propofol generally reduces blood pressure,rarely,it causes hypertension.However,the mechanism by which propofol increases blood pressure has not been established,and so far,there are only a few reported cases.CASE SUMMARY A 46-year-old woman,diagnosed with thyroid cancer,was administered general anesthesia with propofol and remifentanil for a thyroid lobectomy.An increase in the concentrations of intravenous anesthetics further increased her blood pressure.The blood pressure remained stable when anesthesia was maintained with sevoflurane and remifentanil after the interruption of propofol administration.CONCLUSION We concluded that propofol administration was the cause of increased blood pressure.
文摘Background: Spinal anesthesia with sedation is a common anesthetic technique in infraumbilical surgeries. Dexmedetomidine has been widely used as a sedative during spinal anesthesia, and is recognized as an adjuvant that prolongs the duration of spinal anesthesia. We compared the effects of a continuous intravenous infusion of dexmedetomidine to provide intraoperative sedation on the duration of sensory and motor blockade induced by spinal anesthesia, with those of midazolam. Methods: A double-blind randomized controlled trial was performed on 40 patients, aged between 20 and 75 years, who requested intraoperative sedation, and were classified as American Society of Anesthesiologists (ASA) physical status I-II, and underwent elective surgeries under spinal anesthesia. After spinal anesthesia with 13 mg (2.6 ml) of 0.5% hyperbaric bupivacaine, patients were randomized to receive intravenous dexmedetomidine 3 μg/kg/h for 10 mins followed by an infusion of 0.5 μg/kg/h (Group D), or intravenous midazolam 0.15 mg/kg/h for 10 mins followed by an infusion of 0.025 mg/kg/h (Group M). Sedation was titrated to Observer’s Assessment of Alertness/Sedation (OAA/S) score of 3. Sensory and motor blockade was evaluated using the pinprick test and modified Bromage scale, respectively. Results: The time taken to achieve OAA/S score 3 was similar in the two groups. The maximal level of sensory blockade was 5.3 ± 1.3 min in group D and 4.1 ± 1.5 in group M (P = 0.03). No significant differences were observed in the time taken to achieve the maximal level or the two-segment regression time of sensory blockade between the two groups. The time to sensory regression to the L2 level was significantly longer in group D than in group M (234.6 ± 78.1 mins versus 172.4 ± 41.5 mins, respectively, P = 0.008). The time to motor regression to modified Bromage score 1 was significantly longer in group D than in group M (232.2 ± 79.3 versus 176.5 ± 48.8, respectively, P = 0.02). Conclusion: Continuous intravenous dexmedetomidine to provide sedation during spinal anesthesia significantly prolongs the duration of sensory and motor blockade induced by spinal anesthesia over that with midazolam.
文摘Objective:To investigate the effect of Propofol Intravenous Anesthesia on hemorheology, hemodynamics and immune function in patients with colorectal cancer after radical operation.Method: A total of 100 patients with colorectal cancer treated in our hospital from September 2015 to August 2017 were randomly divided into observation group and control group according to random number table. The control group was inhaled sevoflurane anesthesia, observation group propofol intravenous anesthesia. The changes of hemorheology, hemodynamics and immune function were compared between the two groups.Results: There was no significant difference in hemorheology index, hemodynamic index, T lymphocyte subsets CD45RA+, CD45RO+, CD45RA+/CD45RO+ levels between the two groups before anesthesia. Anesthesia 1.5 h after, the levels of LBV, HBV, PV, EAI and EDI in the two groups were significantly decreased, but there was no significant difference between the observation group and the control group. At 1.5 h after anesthesia induction, the HR and SBP levels of the observation group did not change significantly compared with anesthesia before, while the HR and SBP levels of the 1.5 h after anesthesia induction in the control group were significantly lower than those before anesthesia and significantly lower than the corresponding level HR level (86.43±13.25) times/min, SBP level (110.84±15.41) mmHg in the observation group. At the end of surgery, the levels of CD45RA+ and CD45RO+ in the observation group were significantly decreased, but increased at 72 h after operation.Conclusion: After operation, CD45RA+ and CD45RO+ levels in the control group were significantly decreased, and preoperatively, which can significantly improve the hemorheology and reduced hemodynamic effects, and contribute to the recovery of patients with immune function, is worth clinical promotion.
文摘Objective:To study the effect of epidural anesthesia combined with total intravenous anesthesia on stress response and coagulation function in and after laparoscopic surgery. Methods: A total of 219 cases of patients who underwent laparoscopic cholecystectomy in our hospital between August 2014 and February 2017 were collected and divided into control group (n=125) who accepted total intravenous anesthesia alone and observation group (n=94) who accepted epidural anesthesia combined with total intravenous anesthesia after the anesthesia scheme was reviewed. Perioperative stress response and coagulation function were compared between two groups of patients.Results: Before operation, differences in the serum stress index contents and peripheral blood coagulation index levels were not statistically significant between two groups of patients. In operation and 2 h after operation, serum stress indexes Cor, Ang-Ⅰ, Ang-Ⅱ and NE contents of observation group were significantly lower than those of control group;peripheral blood coagulation indexes PT, TT and APTT levels were significantly higher than those of control group while TXA2, TXB2 and FBG levels were significantly lower than those of control group.Conclusions: Epidural anesthesia combined with total intravenous anesthesia can effectively alleviate the systemic stress response and reduce the hypercoagulable state in and early after laparoscopic surgery.
文摘Objective:To study the effect of intravenous inhalational anesthesia under Narcotrend monitor on the systemic traumatic reaction after laparoscopic cholecystectomy.Methods:A total of 116 patients with gallstone who received laparoscopic surgery in our hospital between July 2012 and April 2016 were collected and divided into the combined anesthesia group (n=65) who accepted intravenous inhalational anesthesia under Narcotrend monitor and the intravenous anesthesia group (n=51) who accepted total intravenous anesthesia after the anesthesia methods and relevant test results were reviewed. 1 d after operation, enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of pain mediators and inflammation mediators;automatic biochemical analyzer was used to detect the levels of oxidative stress indexes.Results:1 d after operation, serum pain mediators 5-HT, PGE2, NO and HT levels of observation group were lower than those of control group;serum oxidation indexes AOPPs and LHP levels of observation group were lower than those of control group while anti-oxidation indexes CAT and GSH-Px levels were higher than those of control group;serum pro-inflammatory factors IL-6, IL-8 and CRP levels of observation group were lower than those of control group while anti-inflammatory factors IL-4, IL-10 and IL-13 levels were higher than those of control group.Conclusion:Intravenous inhalational anesthesia under Narcotrend monitor can reduce the postoperative systemic traumatic reaction degree in patients with laparoscopic cholecystectomy.
文摘Objective: To study the effect of intravenous inhalational anesthesia under monitoring on systemic traumatic response after laparoscopic cholecystectomy. Methods: A total of 80 cases of patients with chronic cholecystitis who received laparoscopic cholecystectomy in our hospital between June 2016 and October 2016 were collected and divided into the control group who accepted total intravenous anesthesia and the observation group who accepted intravenous inhalational anesthesia after the anesthesia methods were reviewed. 6 h, 12 h and 24 h after operation, the RIA method was adopted to determine the serum contents of pain mediators, enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of inflammatory factors and stress hormones, and auto-coagulation analyzer was used to detect the plasma contents of coagulation function indexes. Results: 6 h, 12 h and 24 h after operation, serum pain mediators 5-HT, β-EP and NPY levels of observation group were lower than those of control group, inflammatory factors hs-CRP, IL-6, IL-8 and TNF-α levels were lower than those of control group, and stress hormones Cor, ALD and NE levels were lower than those of control group;plasma coagulation function indexes TXB2, D-D and PLT levels of observation group were lower than those of control group. Conclusion: Intravenous inhalational anesthesia under monitoring can reduce the systemic traumatic reaction after laparoscopic cholecystectomy and has positive clinical significance.
文摘Objective: To explore the effects of intravenous inhalational anesthesia on the hemodynamic homeostasis as well as postoperative brain function and Th1/Th2 immunity in elderly patients with femoral neck fracture. Methods: A total of 176 elderly patients with femoral neck fracture who received hip replacement in our hospital between July 2016 and June 2017 were divided into the total intravenous anesthesia group (n=86) and the intravenous inhalational anesthesia group (n=90) according to the anesthesia solution. The differences in introperative hemodynamic parameter levels as well as postoperative brain function index and Th1/Th2 cytokine contents were compared between the two groups. Results: During operation, hemodynamic parameters MAP and HR levels in intravenous inhalational anesthesia group were lower than those in total intravenous anesthesia group. 24 h after operation, serum brain function indexes MBP, S100B and NSE contents in intravenous inhalational anesthesia group were lower than those in total intravenous anesthesia group;serum Th1 cytokines IFN-γand IL-2 contents were higher than those in total intravenous anaesthesia group whereas Th2 cytokines IL-4 and IL-13 contents were lower than those in total intravenous anesthesia group. Conclusion: The intravenous inhalational anesthesia can effectively stabilize the intraoperative hemodynamics and reduce the postoperative brain function and Th1/Th2 immune function injury in elderly patients with femoral neck fracture.
文摘Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.
文摘Objective:To observe the application effects of anesthesia recovery nursing with heat preservation measures in patients undergoing general anesthesia surgery.Methods:300 cases of general anesthesia surgery patients in our hospital from March 2023 to February 2024 were selected and divided into the control group and the observation group according to the random number table method,each with 150 cases.The control group adopted conventional care,while the observation group was given anesthesia recovery care and heat preservation measures on the basis of conventional care.The wake-up time,extubation time,hospitalization time,and the incidence of adverse reactions were compared between the two groups and statistically analyzed.Results:The wake-up time of patients in the control group was 9.71±1.20 hours,and that of the observation group was 6.51±1.02 hours,with statistically significant differences(P<0.05);the extubation times of patients in the observation group and the control group after awakening were 8.52±0.41 min and 10.42±1.12 min,respectively,with statistically significant differences(P<0.05)The hospital stay after the operation in the observation group and the control group was 32.91±4.71 days and 37.24±3.34 days respectively,and the difference was statistically significant(P<0.05),and the incidence rate of adverse reactions after extubation in the observation group(3.33%)was significantly lower than that in the control group(10.00%)(P<0.05).Conclusion:In general anesthesia surgery patients,the implementation of anesthesia recovery nursing with heat preservation measures can significantly improve the physical condition of patients,effectively shorten the duration of surgery and patients’wake-up time,and improve their quality of life,which is worthy of clinical promotion and application.
基金supported by the National Natural Science Foundation of China(81870841 and 82171192 to X.S.L.,82101349 to G.L.Q.)。
文摘General anesthesia is widely applied in clinical practice.However,the precise mechanism of loss of consciousness induced by general anesthetics remains unknown.Here,we measured the dynamics of five neurotransmitters,includingγ-aminobutyric acid,glutamate,norepinephrine,acetylcholine,and dopamine,in the medial prefrontal cortex and primary visual cortex of C57BL/6 mice through in vivo fiber photometry and genetically encoded neurotransmitter sensors under anesthesia to reveal the mechanism of general anesthesia from a neurotransmitter perspective.Results revealed that the concentrations of γ-aminobutyric acid,glutamate,norepinephrine,and acetylcholine increased in the cortex during propofol-induced loss of consciousness.Dopamine levels did not change following the hypnotic dose of propofol but increased significantly following surgical doses of propofol anesthesia.Notably,the concentrations of the five neurotransmitters generally decreased during sevoflurane-induced loss of consciousness.Furthermore,the neurotransmitter dynamic networks were not synchronized in the non-anesthesia groups but were highly synchronized in the anesthetic groups.These findings suggest that neurotransmitter dynamic network synchronization may cause anesthetic-induced loss of consciousness.
文摘Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4<sup>th</sup> post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.
文摘Researchers and clinicians have long been interested in the mechanisms of pain,anesthesia,and addiction.The International Association for the Study of Pain(IASP)defines pain as an unpleasant sensory and emotional experience associated with,or resembling that associated with,actual or potential tissue damage(Raja et al.,2020).Drug addiction refers to a condition of reliance that develops from regular drug consumption,which may lead to withdrawal symptoms when use is halted.Anesthesia involves the complete loss of consciousness induced by an inhaled or intravenous anesthetic(Tosello et al.,2022).In this special collection,Zoological Research presents research findings focused on pain,addiction,and anesthesia.
文摘Postoperative cognitive dysfunction(POCD)remains a major issue that worsens the prognosis of elderly surgery patients.This article reviews the current research on the effect of different anesthesia methods and commonly utilized anesthetics on the incidence of POCD in elderly patients,aiming to provide an understanding of the underlying mechanisms contributing to this condition and facilitate the development of more reasonable anesthesia protocols,ultimately reducing the incidence of POCD in elderly surgery patients.