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Influencing factors and risk prediction model for emergence agitation after general anesthesia for primary liver cancer

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2194-2201页

作者： Shu-Shu Song Li Lin Li Li Xiao-Dong Han Department of anesthesia and Surgery Wenzhou Central HospitalWenzhou 325099Zhejiang ProvinceChina

BACKGROUND general anesthesia is commonly used in the surgical management of gastrointestinal tumors;however,it can lead to emergence agitation(EA).EA is a common complication associated with general anesthesia,often characterized by behaviors,such as crying,struggling,and involuntary limb movements in *** treatment is delayed,there is a risk of incision cracking and bleeding,which can significantly affect surgical ***,having a proper understanding of the factors influencing the occurrence of EA and implementing early preventive measures may reduce the incidence of agitation during the recovery phase from general anesthesia,which is beneficial for improving patient *** To analyze influencing factors and develop a risk prediction model for EA occurrence following general anesthesia for primary liver *** Retrospective analysis of clinical data from 200 patients who underwent hepatoma resection under general anesthesia at Wenzhou Central Hospital(January 2020 to December 2023)was ***-surgery,the Richmond Agitation-Sedation Scale was used to evaluate EA presence,noting EA incidence after general *** were categorized by EA presence postoperatively,and the influencing factors were analyzed using logistic regression.A nomogram-based risk prediction model was constructed and evaluated for differentiation and fit using receiver operating characteristics and calibration *** EA occurred in 51(25.5%)*** analysis identified advanced age,American Society of Anesthesiologists(ASA)grade Ⅲ,indwelling catheter use,and postoperative pain as risk factors for EA(P<0.05).Conversely,postoperative analgesia was a protective factor against EA(P<0.05).The area under the curve of the nomogram was 0.972[95%confidence interval(CI):0.947-0.997]for the training set and 0.979(95%CI:0.951-1.000)for the test ***-Lemeshow test showed a good fit(χ^(2)=5.483,P=0.705),and calibration curves showed

关键词： Primary hepatocellular carcinoma resection general anesthesia Emergence agitation Risk factors Forecast Nomograph

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Observation of the Effects of anesthesia Recovery Nursing Combined with Heat Preservation Measures in Patients Undergoing general anesthesia Surgery

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Journal of Clinical and Nursing Research 2024年第7期8卷 91-96页

作者： Zhilong Sun Yulin Bu The First Affiliated Hospital of Xi’an Jiaotong University Xi’an 710061Shaanxi ProvinceChina

Objective:To observe the application effects of anesthesia recovery nursing with heat preservation measures in patients undergoing general anesthesia ***: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 *** control group adopted conventional care,while the observation group was given anesthesia recovery care and heat preservation measures on the basis of conventional *** wake-up time,extubation time,hospitalization time,and the incidence of adverse reactions were compared between the two groups and statistically ***: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(Pgeneral 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.

关键词： anesthesia recovery nursing Heat preservation general anesthesia

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Postoperative Analgesia and Cesarean Section under general anesthesia: Multicenter Study

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Open Journal of Anesthesiology 2024年第1期14卷 1-12页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo Pascal Christian Nze Obiang Stéphane Oliveira Jean-Marcel Mandji-Lawson Romain Tchoua Department of anesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of anesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of anesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon

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 4th 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

关键词： Cesarean general anesthesia Morphine Parietal Infiltration Epidural Catheter Transversus Abdominis Plane Block Intravenous Analgesia

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general anesthesia versus local anesthesia for penetrating keratoplasty: a prospective study

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International Journal of Ophthalmology(English edition) 2014年第2期7卷 278-282页

作者： Xu Wang Guang-Fu Dang Ying-Mei Li Wei-Fan Li Xin-Yi Wu Department of Ophthalmology Qianfoshan HospitalMedical School of Shandong University Department of Ophthalmology Jinan No.2 Hospital Department of Anesthesiology Jinan No.2 Hospital Department of Ophthalmology Qilu Hospital Medical School of Shandong University

AIM:To examine which anesthesia general or local is more effective for penetrating keratoplasty(PKP).METHODS:Patients with indications for PKP(n=141)were enrolled in a prospective study and randomly divided into general anesthesia group(group A,70 eyes)and local anesthesia group(group B,71 eyes).Patients received optical PKP(group A1,30 eyes;group B1,30eyes)or therapeutic PKP(group A2,40 eyes;group B2,41 eyes).Measurement of anterior chamber treatment time(T)for PKP patients and the ratio(R)of the area of the pupils to that of recipient graft region.T and R values,as well as perioperative and postoperative complications,were compared between groups A and B using t-test orχ***:Patients were followed for 2wk after PKP.T was(13.45±8.64)min for group A and(7.36±5.24)min for group B,a statistically significant difference(Pgeneral anesthesia,pupils remaine stable during PKP and perioperative complications are *** anesthesia gives more time to treat pathological changes in the anterior chamber and treatment success rate is higher.

关键词： penetrating keratoplasty general anesthesia local anesthesia

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Administration of fentanyl via a slow intravenous fluid line compared with rapid bolus alleviates fentanyl-induced cough during general anesthesia induction

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2017年第11期18卷 955-962页

作者： Min-qiang LIU Feng-xian LI Ya-kun HAN Jun-yong HE Hao-wen SHI Li LIU Ren-liang HE Institute of Anesthesiology Shenzhen Third People's Hospital Institute of Anesthesiology Zhujiang Hospital of Southern Medical University

Objective： Fentanyl-induced cough （FIC） is a common complication with a reported incidence from 18.0% to 74.4% during general anesthesia induction. FIC increases the intrathoracic pressure and risks of postoper- ative nausea and vomiting, yet available treatments are limited. This study was designed to investigate whether ad- ministering fentanyl via a slow intravenous fluid line can effectively alleviate FIC during induction of total intravenous general anesthesia. Methods： A total number of 1200 patients, aged 18-64 years, were enrolled, all of whom were American Society of Anesthesiologists （ASh,） grade I or II undergoing scheduled surgeries. All patients received total intravenous general anesthesia, which was induced sequentially by midazolam, fentanyl, propofol, and cisatracurium injection. Patients were randomly assigned to receive fentanyl 3.5 pg/kg via direct injection （control group） or via a slow intravenous fluid line. FIC incidence and the severity grades were analyzed with the Mann-Whitney test. Other adverse reactions, such as hypotension, hypertension, bradycardia, tachycardia, hypoxemia, vomiting, and aspiration, during induction were also observed. The online clinical registration number of this study was ChiCTR-IOR-16009025. Re- sults： Compared with the control group, the incidence of FIC was significantly lower in the slow intravenous fluid line group during induction （9.1%, 95% confidence interval （CI）： 6.7%-11.4% vs. 55.9%, 95% CI： 51.8%-60.0%, P=0.000）, as were the severity grades （P=0.000）. There were no statistical differences between the two groups with regard to other adverse reactions （P〉0.05）. Conclusions： The administration of fentanyl via a slow intravenous fluid line can alleviate FIC and its severity during induction for total intravenous general anesthesia. This method is simple, safe, and reliable, and deserves clinical expansion.

关键词： general anesthesia Fentanyl-induced cough Slow intravenous fluid line Alleviate Induction

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Clinical experience of airway management and tracheal intubation under general anesthesia in patients with scar contracture of the neck

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Chinese Medical Journal 2008年第11期121卷 989-997页

作者： XUE Fu-shan LIAO Xu LI Cheng-wen XU Ya-chao YANG Quan-yong LIU Yi LIU Jian-hua LUO Mao-ping ZHANG Yan-ming Department of Anesthesiology Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing i00041 China

Background Because patients with scar contracture of the neck are at a high risk of loss of the airway control after anesthesia induction, awake intubation is usually recommended. This retrospective clinical study was designed to evaluate the possibility, safety and efficacy of airway management and tracheal intubation under general anesthesia in such patients. Methods This retrospective study included 1683 patients from January 1994 to December 2006 with scar contracture of the neck, aged 1.5--67.0 years, who were scheduled for elective plastic surgery under general anesthesia in Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Based on the results of the preoperative airway assessment, the patients were classified into group 1 （including 1375 patients with the atlanto-occipital extension of 〉20° and the Mallampatti＇s grade I or II） and group 2 （containing 308 patients with the atlanto-occipital extension of 〈20° and the Mallampatti＇s grade III or IV. In group 1, the intravenous induction and maintenance of anesthesia and succinylcholine for muscle relaxation were used. The intubation was done using a modified Macintosh technique. In group 2, the total intravenous anesthesia （TIVA） or the sevoflurane inhalation anesthesia was chosen and the spontaneous breathing was reserved during anesthesia. The intubation was performed by a fiberoptic stylet laryngoscope （FOSL）. The number of intubation attempts, intubation time and relative complications were observed and recorded in all patients. Results In group 1, the intubation was accomplished during the first attempt in 1279 cases （93%） and the intubation time was 〈3 minutes in 1304 cases （95%）. In group 2, the intubation was completed by the first attempt in 114 patients （37%） and 123 patients had an intubation time of 〈3 minutes （40%）. Tracheal intubation was successful by the second or third attempt in 96 patients in group 1 and 156 patients in group 2. Thirty-eight pa

关键词： scar contracture of the neck limitation of head extension difficult intubation airway management general anesthesia

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Double balloon enteroscopy examinations in general anesthesia

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World Journal of Gastroenterology 2010年第27期16卷 3418-3422页

作者： Laszlo Zubek Lena Szabo Peter Laszlo Lakatos Janos Papp Janos Gal Gabor Elo Department of Anaesthesiology and Intensive Therapy Semmelweis University 2nd Department of Pediatrics Semmelweis University 1st Department of Medicine Semmelweis University

AIM:To demonstrate that the double balloon enteroscopy(DBE) can be safely performed in general anesthesia with ***:We performed a retrospective examination between August 2005 and November 2008 amongpatients receiving intubation narcosis due to DBE *** patients were grouped based on sex,age and physical *** records includedduration of anesthesia,quantity of medication usedand anesthesia-related *** determinedthe frequency of complications in the different groupsand their relation with the quantity of medication usedand the duration of ***:We compiled data for 108 cases of general anesthesia with *** did not observeany permanent anesthesia-related complications;themost frequent side effects of anesthesia were hypo-tension(30.55%),desaturation(21.29%),and apnea(17.59%).These complications were significantly more frequent among patients with multiple additional diseases [hypotension(23.1% vs 76.9%,P = 0.005),desaturation(12.3% vs 69.2%,P general anesthesia with intubation is definitely a viable option among DBE *** is highly recommended in patients with multiple additional diseases.

关键词： Double balloon enteroscopy general anesthesia Intubation Sedation Patient autonomy

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Cognitive function correlations with apolipoprotein Eε4 single nucleotide polymorphism in 1000 elderly patients following general anesthesia A randomized controlled study

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Neural Regeneration Research 2009年第4期4卷 316-320页

作者： Yingmin Cai Haitao Hu Rongliang Xue Pengbin Liu Gaifeng Feng Weijiang Dong Bin Yu Minggang Zhao Department of anesthesia Second Affiliated Hospital Medical College Xi'an Jiaotong University Xi'an 710004 Shaanxi Province China Department of Neuroanatomy Medical College Xi'an Jiaotong University Xi'an 710004 Shaanxi Province China Department of Forensic Medicine Medical College Xi'an Jiaotong University Xi'an 710004 Shaanxi Province China

BACKGROUND： Cognitive dysfunction occurs in elderly patients following general anesthesia, and this might be associated with genetics. Studies have shown that the ε4 allele gene is closely associated with senile dementia. OBJECTIVE： To compare and analyze the correlations between cognitive dysfunction and single nucleotide polymorphism of apolipoprotein E （ApoE） following inhalation or intravenous anesthesia. DESIGN, TIME AND SETTING： A randomized, controlled study was performed. The patients were recruited from the Department of anesthesia, Second Affiliated Hospital, Medical College, Xi＇an Jiaotong University, China between May 2005 and December 2008. Genetic analyses were conducted at the Departments of Neuroanatomy and Forensic Medicine, Medical Corlege, Xi＇an Jiaotong University, China. PARTICIPANTS： A total of t 000 patients of ASA I-II grade, without genetic connection, were enrolled in this study, comprising 520 males and 480 females, aged （70.1± 4.6） years and weighing （57.3 ± 7.5） kg. No patients suffered from cognitive dysfunction. METHODS： The patients were equally and randomly divided into intravenous anesthesia and gas anesthesia groups. Total intravenous anesthesia and inhaled anesthesia were used. Genomic DNA from whole blood was extracted. The ApoE gene was amplified by PCR. Restriction fragment length polymorphism of ApoE gene was analyzed. Cognitive function was evaluated by Mini-Mental State Examination （MMSE）. Patients scoring 〈 25 points were diagnosed with cognitive dysfunction. MAIN OUTCOME MEASURES： Correlation of ApoE gene frequency and ApoE ε 4 allele to MMSE scores was measured. RESULTS： MMSE scores in patients from the gas anesthesia group significantly decreased 3 days after surgery, compared with the intravenous anesthesia group. The proportion of patients that scored 〈 25 points was significantly greater in the gas anesthesia group compared with the intravenous anesthesia group 3 days after surgery. Reduced MMSE scores closely correla

关键词： general anesthesia cognitive function apolipoprotein E polymorphism elderly

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Effects of general anesthesia on the Results of Cardiac Catheterization in Pediatric Patients with Ventricular Septal Defect

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Congenital Heart Disease 2023年第2期18卷 235-243页

作者： Kiyotaka Go Taichi Kato Machiko Kito Yoshihito Morimoto Satoru Kawai Hidenori Yamamoto Yoshie Fukasawa Kazushi Yasuda Department of Pediatric Cardiology Aichi Children’s Health and Medical CenterObu474-8710Japan Department of Pediatrics Nagoya University Graduate School of MedicineNagoya466-8560Japan

Background:There is no gold standard sedation method for pediatric cardiac *** congenital heart diseases with intracardiac shunts,hemodynamic parameters are prone to change depending on the ventilation conditions and anesthetics,although few studies have examined these *** purpose of this study was to investigate the effects of two different sedation methods on the hemodynamic ***:This study retrospectively evaluated consecutive patients with ventricular septal defect(VSD)below 1 year of age who underwent cardiac catheterization at Aichi Children’s Health and Medical Center,who were divided into age-and VSD diameter-matched general anesthesia(GA)and monitored anesthesia care(MAC)under the natural airway groups(n=40 each),for comparison of hemodynamic ***:In the GA group,arterial blood pH and arterial partial pressure of oxygen were significantly higher(p<0.01),whereas arterial partial pressure of carbon dioxide was significantly lower than in the MAC group(p<0.01).Mean pulmonary artery pressure(p<0.05)and systemic blood pressure(p<0.01)were lower in the GA *** vascular resistance index(p<0.01)and systemic vascular resistance index(p<0.01)were also significantly lower in the GA group than the MAC *** were no significant differences in pulmonary blood flow index,systemic blood flow index,and pulmonary/systemic blood flow ratio between the two ***:Cardiac catheterization under GA in VSD patients results in different hemodynamic parameters compared to that under *** particular,when using pulmonary artery pressure and pulmonary vascular resistance measured under GA for judgment regarding the surgical indications or perioperative management,consideration should be given to the fact that these parameters might be lower compared to those measured under MAC.

关键词： Ventricular septal defect cardiac catheterization general anesthesia monitored anesthesia care

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Corneal injury and its protection using hydro-gel patch during general anesthesia

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International Journal of Ophthalmology(English edition) 2014年第6期7卷 964-967页

作者： Ting Wan Yan Wang Xiu-Ming Jin Eye Center the Second Affiliated Hospital of Zhejiang University School of Medicine Zhejiang Provincial Key Lab of Ophthalmology Nursing Department the Second Affiliated Hospital of Zhejiang University School of Medicine

AIM: To evaluate corneal injury during general anesthesia and analyze the protective effect of medical hydro-gel eye patch in ***:Seventy-sixpatientswith152 eyesundergoing general anesthesia were included. None had positive corneal fluorescein staining before surgery. Both eyes of each patient were analyzed, with one randomly allocated to receive medical hydro-gel eye patch, and the other to receive common adhesive tape as a control. Corneal injuries were evaluated by scoring fluorescein staining under a hand-held slit lamp immediately after surgery in postanesthesia care unit and 24 h thereafter. Patients’ discomforts were also ***: Twelve eyes(15.8%) in the hydro-gel patch group and 30 eyes(39.5%) in the adhesive tape group showed corneal injury immediately after surgery. The eyes protected with hydro-gel patch showed statistically less corneal fluorescein staining than the control *** eyes in hydro-gel patch group and 6 eyes in adhesive tape group suffered discomfort immediately after surgery without intergroup difference and all discomforts disappeared after 24h(P =0.257). No side effect was observed in hydro-gel patch group, while 5eyes had brow avulsion and 2 got skin itching in adhesive tape ***: Corneal injury complication was morefrequent than we thought following general *** medical hydro-gel eye patch can protect the occurrence of corneal injury following general anesthesia.

关键词： general anesthesia corneal injury fluorescein staining hand-held slit lamp hydro-gel

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