Anesthesia is mainly a kind of reversible functional inhibition of the central nervous system and(or)peripheral nervous system through drugs or other methods.In modern clinical medicine,modern anesthesiology is a comp...Anesthesia is mainly a kind of reversible functional inhibition of the central nervous system and(or)peripheral nervous system through drugs or other methods.In modern clinical medicine,modern anesthesiology is a comprehensive subject,which mainly includes clinical anesthesia,pain diagnosis and treatment,intensive care treatment,first aid and resuscitation,etc.Electroacupuncture is developed based on acupuncture therapy which is an important part of traditional Chinese medicine.It uses the comprehensive efficacy of acupuncture and electrical stimulation to deliver electrical energy through acupoints to achieve therapeutic effects.It has been widely used in recent years in clinical.This article summarizes the analgesic mechanism of electroacupuncture and its application in different anesthesia methods,so that clinicians have a deeper understanding of the clinical application of electroacupuncture and promote its clinical application.展开更多
BACKGROUND Liver resection surgery has advanced greatly in recent years,and the adoption of fasttrack programs has yielded good results.Combination anesthesia (general anesthesia associated to epidural analgesia) is a...BACKGROUND Liver resection surgery has advanced greatly in recent years,and the adoption of fasttrack programs has yielded good results.Combination anesthesia (general anesthesia associated to epidural analgesia) is an anesthetic-analgesic strategy commonly used for the perioperative management of patients undergoing surgery of this kind,though there is controversy regarding the coagulation alterations it may cause and which can favor the development of spinal hematomas.AIM To study the postoperative course of liver resection surgery,an analysis was made of the outcomes of liver resection surgery due to colorectal cancer metastases in our centre in terms of morbiditymortality and hospital stay according to the anesthetic technique used (general vs combination anesthesia).METHODS A prospective study was made of 61 colorectal cancer patients undergoing surgery due to liver metastases under general and combination anesthesia between January 2014 and October 2015.The patient characteristics,intraoperative variables,postoperative complications,evolution of hemostatic parameters,and stay in intensive care and in hospital were analyzed.RESULTS A total of 61 patients were included in two homogeneous groups: general anesthesia (n = 30) and combination anesthesia (general anesthesia associated to epidural analgesia)(n = 31).All patients had normal coagulation values before surgery.The international normalized ratio (INR) in both the general and combination anesthesia groups reached maximum values at 2448 h (mean 1.37 and 1.45 vs 1.39 and 1.41,respectively),followed by a gradual decrease.There was less intraoperative bleeding in the combination anesthesia group (769 mL) than in the general anesthesia group (1200 mL)(P < 0.05).Of the 61 patients,38.8% in the general anesthesia group experienced some respiratory complication vs 6.6% in the combination anesthesia group (P < 0.001).The time to gastrointestinal tolerance was significantly correlated to the type of anesthesia,though not so the stay in critical care or the time to hospital discharge.CONCLUSION Epidural analgesia in liver resection surgery was seen to be safe,with good results in terms of pain control and respiratory complications,and with no associated increase in complications secondary to altered hemostasis.展开更多
目的探讨腹腔镜保留脾脏的胰体尾切除术的安全性以及围术期加速康复外科(enhanced recovery after surgery,ERAS)实施的策略和方法。方法回顾性收集2018年6月至2020年12月收治的38例胰体尾良性病变和低度恶性肿瘤行腹腔镜胰体尾切除术...目的探讨腹腔镜保留脾脏的胰体尾切除术的安全性以及围术期加速康复外科(enhanced recovery after surgery,ERAS)实施的策略和方法。方法回顾性收集2018年6月至2020年12月收治的38例胰体尾良性病变和低度恶性肿瘤行腹腔镜胰体尾切除术患者的临床资料,其中保脾组23例(实施Kimura法20例,Warshaw法3例),切脾组15例;围术期均实施ERAS措施,并分析患者术前影像学资料、手术时间、失血量、具体术式、ERAS实施方法、术后腹腔引流管拔除时间、术后住院时间、术后并发症和随访资料。结果保脾组和切脾组在肿瘤大小、手术时间、术中失血量、术后腹腔引流管拔除时间、术后住院时间及术后严重并发症方面,差异均无统计学意义(P>0.05)。全组中位引流管拔除时间为6(5~7)d,保脾组为7(4~7)d,切脾组为6(5~7)d;无死亡病例。随访时间3~18个月,无肿瘤复发转移。结论胰体尾良性和低度恶性肿瘤实施腹腔镜保留脾脏的胰体尾切除术安全可行,围术期可按照ERAS策略实施。展开更多
基金This study was supported by grants from the National Natural Science Foundation of China(No.81801175)the China Postdoctoral Science Foundation(No.2019M662179)+1 种基金the Anhui Province Postdoctoral Science Foundation(No.2019B324)the Fundamental Research Funds for the Central Universities(No.WK9110000044).
文摘Anesthesia is mainly a kind of reversible functional inhibition of the central nervous system and(or)peripheral nervous system through drugs or other methods.In modern clinical medicine,modern anesthesiology is a comprehensive subject,which mainly includes clinical anesthesia,pain diagnosis and treatment,intensive care treatment,first aid and resuscitation,etc.Electroacupuncture is developed based on acupuncture therapy which is an important part of traditional Chinese medicine.It uses the comprehensive efficacy of acupuncture and electrical stimulation to deliver electrical energy through acupoints to achieve therapeutic effects.It has been widely used in recent years in clinical.This article summarizes the analgesic mechanism of electroacupuncture and its application in different anesthesia methods,so that clinicians have a deeper understanding of the clinical application of electroacupuncture and promote its clinical application.
文摘BACKGROUND Liver resection surgery has advanced greatly in recent years,and the adoption of fasttrack programs has yielded good results.Combination anesthesia (general anesthesia associated to epidural analgesia) is an anesthetic-analgesic strategy commonly used for the perioperative management of patients undergoing surgery of this kind,though there is controversy regarding the coagulation alterations it may cause and which can favor the development of spinal hematomas.AIM To study the postoperative course of liver resection surgery,an analysis was made of the outcomes of liver resection surgery due to colorectal cancer metastases in our centre in terms of morbiditymortality and hospital stay according to the anesthetic technique used (general vs combination anesthesia).METHODS A prospective study was made of 61 colorectal cancer patients undergoing surgery due to liver metastases under general and combination anesthesia between January 2014 and October 2015.The patient characteristics,intraoperative variables,postoperative complications,evolution of hemostatic parameters,and stay in intensive care and in hospital were analyzed.RESULTS A total of 61 patients were included in two homogeneous groups: general anesthesia (n = 30) and combination anesthesia (general anesthesia associated to epidural analgesia)(n = 31).All patients had normal coagulation values before surgery.The international normalized ratio (INR) in both the general and combination anesthesia groups reached maximum values at 2448 h (mean 1.37 and 1.45 vs 1.39 and 1.41,respectively),followed by a gradual decrease.There was less intraoperative bleeding in the combination anesthesia group (769 mL) than in the general anesthesia group (1200 mL)(P < 0.05).Of the 61 patients,38.8% in the general anesthesia group experienced some respiratory complication vs 6.6% in the combination anesthesia group (P < 0.001).The time to gastrointestinal tolerance was significantly correlated to the type of anesthesia,though not so the stay in critical care or the time to hospital discharge.CONCLUSION Epidural analgesia in liver resection surgery was seen to be safe,with good results in terms of pain control and respiratory complications,and with no associated increase in complications secondary to altered hemostasis.
文摘目的探讨腹腔镜保留脾脏的胰体尾切除术的安全性以及围术期加速康复外科(enhanced recovery after surgery,ERAS)实施的策略和方法。方法回顾性收集2018年6月至2020年12月收治的38例胰体尾良性病变和低度恶性肿瘤行腹腔镜胰体尾切除术患者的临床资料,其中保脾组23例(实施Kimura法20例,Warshaw法3例),切脾组15例;围术期均实施ERAS措施,并分析患者术前影像学资料、手术时间、失血量、具体术式、ERAS实施方法、术后腹腔引流管拔除时间、术后住院时间、术后并发症和随访资料。结果保脾组和切脾组在肿瘤大小、手术时间、术中失血量、术后腹腔引流管拔除时间、术后住院时间及术后严重并发症方面,差异均无统计学意义(P>0.05)。全组中位引流管拔除时间为6(5~7)d,保脾组为7(4~7)d,切脾组为6(5~7)d;无死亡病例。随访时间3~18个月,无肿瘤复发转移。结论胰体尾良性和低度恶性肿瘤实施腹腔镜保留脾脏的胰体尾切除术安全可行,围术期可按照ERAS策略实施。
