Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have redu...Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.展开更多
Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our...Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion.展开更多
BACKGROUND The background of this study was analgesia in natural delivery.The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor,and combined spinal-epidural anesthesi...BACKGROUND The background of this study was analgesia in natural delivery.The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor,and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases.AIM To study the effects of combined spinal-epidural anesthesia on anxiety,labor analgesia,and motor blocks in parturients during natural delivery.METHODS A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included;a random number table approach was employed to divide the women into a control group and a joint group,with each group consisting of 60 women.The control group was given epidural anesthesia,while the joint group was given combined spinal-epidural anesthesia.The visual analog scale(VAS)was used to evaluate the degree of maternal pain.Comparisons were made between the two groups’conditions of childbirth and the duration of labor.Apgar scores were used to evaluate the status of the newborns at birth;Self-rating Anxiety Scale(SAS)and General Self-Efficacy Scale(GSES)scores,umbilical artery blood gas analysis indices and stress indices were compared between the two groups;and the frequencies of motor block and postpartum complications were analyzed.RESULTS In comparison to the control group,in the joint group,the VAS scores for the first,second,and third stages of labor were lower(P<0.05).The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group(P<0.05).No significant differences were observed in the Apgar score,the duration of the first stage of labor,or the total duration of labor between the two groups(P>0.05).The second and third stages of labor in the joint group were shorter than those in the control group(P<0.05).When compared to the control group,the postpartum SAS score of the joint group was lower,while the GSES score was greater(P<0.05).Between the control group and the joint group,the differences observed in pH,arterial carbon dioxide partial pressure,arterial oxygen partial pressure,or arterial hydrogen ion concentration were not significant(P>0.05).Nitric oxide,cortisol,and adrenaline levels were lower in the joint group than in the control group(P<0.05).There were no substantial differences in Bromage grade or rate of complications between the two groups(P>0.05).CONCLUSION For parturients during natural delivery,combined spinal-epidural anesthesia can reduce anxiety,provide labor analgesia,shorten labor time,and reduce postoperative stress levels but did not result in a motor block.展开更多
BACKGROUND Primary ciliary dyskinesia(PCD)is an inherited autosomal-recessive disorder of impaired mucociliary clearance characterized by chronic respiratory diseases,otolaryngological diseases,central nervous system ...BACKGROUND Primary ciliary dyskinesia(PCD)is an inherited autosomal-recessive disorder of impaired mucociliary clearance characterized by chronic respiratory diseases,otolaryngological diseases,central nervous system abnormalities,reproductive system abnormalities,and cardiac function abnormalities.General anesthesia in these patients is associated with a higher incidence of respiratory complications than in patients without the disease.CASE SUMMARY A 16-year-old male patient was referred to the emergency room complaining of right ankle pain due to distal tibiofibular fracture.Three years prior,he had been diagnosed with PCD.At that time,he had experienced several episodes of pneumonia,sinusitis,and chronic middle ear infections,for which he underwent surgical interventions.At the current admission,he presented with cough and sputum but no other respiratory symptoms.A chest computed tomography scan revealed centrilobular ground-glass opacities in both lower lobes and a calcified nodule in the left lower lobe.For the surgical procedure and postoperative pain management,combined spinal-epidural anesthesia was employed.The patient’s postoperative pain score was measured by the numerical rating scale(NRS).On the day of surgery,his NRS was 5 points.By the second postoperative day,the NRS score had decreased to 2–3 points.The epidural catheter was removed on the fourth day following the operation.The patient was subsequently discharged no respiratory complications.CONCLUSION We performed combined spinal-epidural anesthesia in a patient with PCD.The patient experienced no additional respiratory complications and was discharged with a low NRS score for pain.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
Dear Editor,We read with interest the article by Chen etaitlj on the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery. The authors reported that 93.3% of patients in the...Dear Editor,We read with interest the article by Chen etaitlj on the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery. The authors reported that 93.3% of patients in the study experienced loss of perception of light at least during one of the surgical steps after the contralateral eye was covered intraoperatively. Most of the patients （81%） reported losing light perception between 6min and 30min from the commencement of the surgery.展开更多
Achondroplasia is a genetic condition characterized by skeletal dysplasia that results in characteristic craniofacial and spinal abnormalities.It is the most common form of short-limbed skeletal dysplasia.A morbidly o...Achondroplasia is a genetic condition characterized by skeletal dysplasia that results in characteristic craniofacial and spinal abnormalities.It is the most common form of short-limbed skeletal dysplasia.A morbidly obese pregnant patient warrants specific anatomical and physiological considerations,such as a difficult airway with potential hypoxia,full stomach precautions,and a reduced functional residual capacity.Achondroplasia increases the risks of maternal and fetal complications.Although neuraxial techniques are generally preferred for cesarean sections,there is no consensus among patients with achondroplasia.We aimed to discuss the anesthetic challenges in an achondroplastic patient and report our regional anesthesia approach for an elective cesarean section.展开更多
In the present paper, the authors make a review on the progresses of acupuncture anesthesia (AA) from ① historical development, ② research on acupuncture combined with local anesthesia; ③ research on acupuncture co...In the present paper, the authors make a review on the progresses of acupuncture anesthesia (AA) from ① historical development, ② research on acupuncture combined with local anesthesia; ③ research on acupuncture combined with epidural anesthesia; and ④ research on acupuncture combined with general anesthesia. Compound acupuncture anesthesia provides a new anesthetic measure for surgical operations and has a definite analgesic effect and many advantages, and should be investigated further.展开更多
Objective: To find out whether high resection rate and low incidence of disability can be obtained from operations for tumors on cerebral functional areas by applying “combined acupuncture-drug anesthesia”Methods: A...Objective: To find out whether high resection rate and low incidence of disability can be obtained from operations for tumors on cerebral functional areas by applying “combined acupuncture-drug anesthesia”Methods: According to the route of entry of operations, two different groups of acupoints for body acupuncture combined with ear acupuncture therapy were applied.Results: Among the 80 patients operated on, 20 were suffering from tumors in the speech center, 60 in the sensorimotor center. Good result was obtained from all the operations. Grade 1 effective rate of acupuncture anesthesia reached 100%. None of the patients experienced aggravation of dysphasia or dysfunction. Five patients showed aggravation of myasthenia and dysesthesia, but all of them recovered within 2-4 weeks.Conclusions: High resection rate and low incidence of disability may result from operations performed with “combined acupuncture-drug anesthesia;” so this kind of anesthesia can be used as a routine anesthetic method for operations.展开更多
Objective To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy. Methods Eighty cases of sup...Objective To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy. Methods Eighty cases of supratentorial tumor resection were randomly divided into a group A and a group S, 40 cases in each group. All the patients were anesthetized with 2% Sevoflurane. The patients in group A received eleetroacupuneture at Hegu （合谷 LI 4） and Waiguan （外关 TE 5）, Jinmen （金门 BL 63） and Taichong （太冲 LR 3）, Zusanli （足三里 ST 36） and Qiuxtu（丘墟 GB 40） from anesthesia beginning to the end of operation, and in group S without electroacupuncture. tidal Sevoflurane concentration, minimum alveolar concentration （MAC）, bispectral index （BIS） and the information during anesthesia recovery stage were recorded, respectively. Results The end-tidal concentration and MAC of Sevoflurane in group A at all times were significant lower than those in group S （P〈0.05, P〈0.01） with a Sevoflurane saving of 9.62% on average. The BIS in group A during a few phases were higher than that in group S （all P〈0.05）. During anesthesia recovery stage, the time of each phase in group A was significantly shorter than that in group S （all P〈0.01）. No dysphoria and one case with nausea and vomiting were shown in group A, but in group S, 2 patients had dysphoria and 3 patients had nausea and vomiting. Conclusion Electroacupuncture combined with Sevoflurane anesthesia can decrease the dosage of Sevoflurane, shorten the recovery time of anesthesia and improve the quality of anesthesia recovery of the patients undergoing resection of supratentorial tumor.展开更多
Objective To compare effects of combined acupuncture and general anesthesia （CAGA） and general anesthesia （GA） on immune function in patients of laparoscopic cholecystectomy （LC） in peri-operative period. Method...Objective To compare effects of combined acupuncture and general anesthesia （CAGA） and general anesthesia （GA） on immune function in patients of laparoscopic cholecystectomy （LC） in peri-operative period. Methods Thirty-nine cases undergoing LC were randomly divided into a CAGA group and a GA group. The CAGA group was treated with electroacupuncture at Hegu （合谷- LI 4）, Neiguan （内关PC 6）, Zusanli （足三里ST 36） and Yanglingquan （阳陵泉 GB 34） for 15-30 minutes followed by the general anesthesia, and the continuous electroacupuncture stimulation was given till the operation finished. The GA group was treated with simple general anesthesia. Changes of T cell subsets, tumor necrosis factor-alpha （TNF-α） and interleukin-6 （IL-6） were observed before anesthesia induction, and 2 hours, 1st and 3 rd day after operation, and the adverse reaction after operation was recorded. Results At 2 hours after operation, the percentages of CD3 and CDs in both groups were significantly lower than those before anesthesia induction （all P〈0.05）, and the percentage of CD4 in the GA group decreased significantly （P〈0.05）, while the percentage of CD： did not significantly change and CD4/CD8 increased significantly in the CAGA group （P〈0.05）. At 3 days after operation, the level of TNF-α in the ACGA group decreased significantly as compared with that before anesthesia induction （P〈0.05）. The cases with nausea after operation in the CAGA group were significantly less than those in the GA group （P〈0.05）. Conclusion Acupuncture combined with general anesthesia has a little effect on immune function in patients of LC with less adverse reactions.展开更多
Objective To observe postoperative effect of electroacupuncture（EA） of different frequencies in acupuncture anesthesia combined with drugs on patients undergoing thyroid surgery.Methods One hundred and twenty patien...Objective To observe postoperative effect of electroacupuncture（EA） of different frequencies in acupuncture anesthesia combined with drugs on patients undergoing thyroid surgery.Methods One hundred and twenty patients undergoing thyroid surgery were randomly divided into a 2Hz electroacupuncture anesthesia group（group A）,a 100 Hz electroacupuncture anesthesia group（group B）,a 2Hz/100 Hz electroacupuncture anesthesia group（group C） and a cervical plexus block group（group D） in accordance with the random number table method,with 30 patients in each group.In group A,group B and group C,electroacupuncture was applied at bilateral Futu（扶突 LI 18）,Hegu（合谷 LI 4） and Neiguan（内关 PC 6） at frequencies of 2 Hz,100 Hz and 2 Hz/100 Hz respectively for 30 min.The needles were retained till the end of the surgery.Dolantin and atropine were intramuscularly injected In group D,bilateral cervical plexus block was produced with a mixture of1%lidocaine and 0.375%bupivicaine.Before surgery,pain threshold and threshold of pain tolerance were determined;during surgery,the duration of surgery was recorded;and after surgery,QOLS（Quality Of Life Score） and PHS（Prince-Henry Score） were assessed.Results PHS in group A,group B and group C were lower than that in group D,respectively（0.20±0.41,0.17±0.38,0.10±0.31 vs 0.40±0.50,P〈0.01）,and PHS in group C was lower than those in group A and group B,respectively（both P〈0.01）.QOLS in group A,group B and group C were higher than that in group D,respectively（9.97±1.07,9.97±2.27,10.40±1.45 vs 9.73±1.41,P〈0.05,P〈0.01）,and QOLS in group C was higher than those in group A and group B,respectively（both P〈0.05）.Conclusion Acupuncture anesthesia combined with drugs has better postoperative effect than drug anesthesia.Electroacupuncture of different frequencies can significantly improve general quality of life of patients,so patients recover well after thyroid surgery.As patients in group C suffered from the slightest pain with the highest quality of life,they recovered best within the shortest time.Electroacupuncture at frequency of 2 Hz/100 Hz can better play postoperative analgesic effect.展开更多
Objective： To investigate tumor necrosis factor （TNF） of lung the regulation of acupuncture on γ-interteron （LNF-γ） and cancer-operative cases. Methods： to determine the INF-γ and TNF contents in the blood se...Objective： To investigate tumor necrosis factor （TNF） of lung the regulation of acupuncture on γ-interteron （LNF-γ） and cancer-operative cases. Methods： to determine the INF-γ and TNF contents in the blood serum of lung cancer patients by double antibody sandwich immunoenzymatic method （ELISA）; to measure the INF-γ and TNF contents of 30 lung cancer patients in the acupuncture anesthesia group and 30 lung cancer patients in general anesthesia group before the operation and at the 8th days, the 12th day after the operation respectively and make comparison between the two groups. Results. The pre-operation INF-γ contents of the two groups showed no significant difference （P〉 0.05）; the post operation INF-γ contents of the two groups showed significant difference at 8th day and 12th day after the operation （P〈 0.05）; the acupuncture anesthesia group was superior to the general anesthesia group; the self-comparison of the anesthesia group showed significant difference at the 12th day and 8th day after the operation （P〈 0.05）; the pre-operation TNF contents of the two groups showed no significant difference （P〉 0.05） and the post-operation TNF contents of the two groups showed significant difference at the 8th day and 12th day after the operation （P〈 0.05）. Conclusion：Acupuncture can increase the serum INF-γ and TNF contents of lung cancer patients and therefore regulate the immunity of the patients.展开更多
文摘Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.
基金Weifang Municipal Science and Technology Bureau(Medical)Project“Effects and Mechanisms of Oxycodone and Alfentanil on IgFs in Mouse Ovarian Granulosa Cells”(2021YX035)。
文摘Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion.
基金Changning District Health Commission Medical Key(Characteristic)Specialized Program,No.20192003.
文摘BACKGROUND The background of this study was analgesia in natural delivery.The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor,and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases.AIM To study the effects of combined spinal-epidural anesthesia on anxiety,labor analgesia,and motor blocks in parturients during natural delivery.METHODS A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included;a random number table approach was employed to divide the women into a control group and a joint group,with each group consisting of 60 women.The control group was given epidural anesthesia,while the joint group was given combined spinal-epidural anesthesia.The visual analog scale(VAS)was used to evaluate the degree of maternal pain.Comparisons were made between the two groups’conditions of childbirth and the duration of labor.Apgar scores were used to evaluate the status of the newborns at birth;Self-rating Anxiety Scale(SAS)and General Self-Efficacy Scale(GSES)scores,umbilical artery blood gas analysis indices and stress indices were compared between the two groups;and the frequencies of motor block and postpartum complications were analyzed.RESULTS In comparison to the control group,in the joint group,the VAS scores for the first,second,and third stages of labor were lower(P<0.05).The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group(P<0.05).No significant differences were observed in the Apgar score,the duration of the first stage of labor,or the total duration of labor between the two groups(P>0.05).The second and third stages of labor in the joint group were shorter than those in the control group(P<0.05).When compared to the control group,the postpartum SAS score of the joint group was lower,while the GSES score was greater(P<0.05).Between the control group and the joint group,the differences observed in pH,arterial carbon dioxide partial pressure,arterial oxygen partial pressure,or arterial hydrogen ion concentration were not significant(P>0.05).Nitric oxide,cortisol,and adrenaline levels were lower in the joint group than in the control group(P<0.05).There were no substantial differences in Bromage grade or rate of complications between the two groups(P>0.05).CONCLUSION For parturients during natural delivery,combined spinal-epidural anesthesia can reduce anxiety,provide labor analgesia,shorten labor time,and reduce postoperative stress levels but did not result in a motor block.
文摘BACKGROUND Primary ciliary dyskinesia(PCD)is an inherited autosomal-recessive disorder of impaired mucociliary clearance characterized by chronic respiratory diseases,otolaryngological diseases,central nervous system abnormalities,reproductive system abnormalities,and cardiac function abnormalities.General anesthesia in these patients is associated with a higher incidence of respiratory complications than in patients without the disease.CASE SUMMARY A 16-year-old male patient was referred to the emergency room complaining of right ankle pain due to distal tibiofibular fracture.Three years prior,he had been diagnosed with PCD.At that time,he had experienced several episodes of pneumonia,sinusitis,and chronic middle ear infections,for which he underwent surgical interventions.At the current admission,he presented with cough and sputum but no other respiratory symptoms.A chest computed tomography scan revealed centrilobular ground-glass opacities in both lower lobes and a calcified nodule in the left lower lobe.For the surgical procedure and postoperative pain management,combined spinal-epidural anesthesia was employed.The patient’s postoperative pain score was measured by the numerical rating scale(NRS).On the day of surgery,his NRS was 5 points.By the second postoperative day,the NRS score had decreased to 2–3 points.The epidural catheter was removed on the fourth day following the operation.The patient was subsequently discharged no respiratory complications.CONCLUSION We performed combined spinal-epidural anesthesia in a patient with PCD.The patient experienced no additional respiratory complications and was discharged with a low NRS score for pain.
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.
基金Supported by the National Healthcare Group Clinician Scientist Career Scheme Grant CSCS/12005
文摘Dear Editor,We read with interest the article by Chen etaitlj on the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery. The authors reported that 93.3% of patients in the study experienced loss of perception of light at least during one of the surgical steps after the contralateral eye was covered intraoperatively. Most of the patients （81%） reported losing light perception between 6min and 30min from the commencement of the surgery.
基金supported in part by the University of California Davis Health Department of Anesthesiology and Pain Medicine and an NIH grant(No.UL1 TR000002)from the University of California Davis Health.
文摘Achondroplasia is a genetic condition characterized by skeletal dysplasia that results in characteristic craniofacial and spinal abnormalities.It is the most common form of short-limbed skeletal dysplasia.A morbidly obese pregnant patient warrants specific anatomical and physiological considerations,such as a difficult airway with potential hypoxia,full stomach precautions,and a reduced functional residual capacity.Achondroplasia increases the risks of maternal and fetal complications.Although neuraxial techniques are generally preferred for cesarean sections,there is no consensus among patients with achondroplasia.We aimed to discuss the anesthetic challenges in an achondroplastic patient and report our regional anesthesia approach for an elective cesarean section.
文摘In the present paper, the authors make a review on the progresses of acupuncture anesthesia (AA) from ① historical development, ② research on acupuncture combined with local anesthesia; ③ research on acupuncture combined with epidural anesthesia; and ④ research on acupuncture combined with general anesthesia. Compound acupuncture anesthesia provides a new anesthetic measure for surgical operations and has a definite analgesic effect and many advantages, and should be investigated further.
文摘Objective: To find out whether high resection rate and low incidence of disability can be obtained from operations for tumors on cerebral functional areas by applying “combined acupuncture-drug anesthesia”Methods: According to the route of entry of operations, two different groups of acupoints for body acupuncture combined with ear acupuncture therapy were applied.Results: Among the 80 patients operated on, 20 were suffering from tumors in the speech center, 60 in the sensorimotor center. Good result was obtained from all the operations. Grade 1 effective rate of acupuncture anesthesia reached 100%. None of the patients experienced aggravation of dysphasia or dysfunction. Five patients showed aggravation of myasthenia and dysesthesia, but all of them recovered within 2-4 weeks.Conclusions: High resection rate and low incidence of disability may result from operations performed with “combined acupuncture-drug anesthesia;” so this kind of anesthesia can be used as a routine anesthetic method for operations.
基金Supported by the National Key Basic Research Program (973 Program): 2007 CB 512503
文摘Objective To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy. Methods Eighty cases of supratentorial tumor resection were randomly divided into a group A and a group S, 40 cases in each group. All the patients were anesthetized with 2% Sevoflurane. The patients in group A received eleetroacupuneture at Hegu （合谷 LI 4） and Waiguan （外关 TE 5）, Jinmen （金门 BL 63） and Taichong （太冲 LR 3）, Zusanli （足三里 ST 36） and Qiuxtu（丘墟 GB 40） from anesthesia beginning to the end of operation, and in group S without electroacupuncture. tidal Sevoflurane concentration, minimum alveolar concentration （MAC）, bispectral index （BIS） and the information during anesthesia recovery stage were recorded, respectively. Results The end-tidal concentration and MAC of Sevoflurane in group A at all times were significant lower than those in group S （P〈0.05, P〈0.01） with a Sevoflurane saving of 9.62% on average. The BIS in group A during a few phases were higher than that in group S （all P〈0.05）. During anesthesia recovery stage, the time of each phase in group A was significantly shorter than that in group S （all P〈0.01）. No dysphoria and one case with nausea and vomiting were shown in group A, but in group S, 2 patients had dysphoria and 3 patients had nausea and vomiting. Conclusion Electroacupuncture combined with Sevoflurane anesthesia can decrease the dosage of Sevoflurane, shorten the recovery time of anesthesia and improve the quality of anesthesia recovery of the patients undergoing resection of supratentorial tumor.
基金Supported by National Natural Scientif ic Foundation: 30772832
文摘Objective To compare effects of combined acupuncture and general anesthesia （CAGA） and general anesthesia （GA） on immune function in patients of laparoscopic cholecystectomy （LC） in peri-operative period. Methods Thirty-nine cases undergoing LC were randomly divided into a CAGA group and a GA group. The CAGA group was treated with electroacupuncture at Hegu （合谷- LI 4）, Neiguan （内关PC 6）, Zusanli （足三里ST 36） and Yanglingquan （阳陵泉 GB 34） for 15-30 minutes followed by the general anesthesia, and the continuous electroacupuncture stimulation was given till the operation finished. The GA group was treated with simple general anesthesia. Changes of T cell subsets, tumor necrosis factor-alpha （TNF-α） and interleukin-6 （IL-6） were observed before anesthesia induction, and 2 hours, 1st and 3 rd day after operation, and the adverse reaction after operation was recorded. Results At 2 hours after operation, the percentages of CD3 and CDs in both groups were significantly lower than those before anesthesia induction （all P〈0.05）, and the percentage of CD4 in the GA group decreased significantly （P〈0.05）, while the percentage of CD： did not significantly change and CD4/CD8 increased significantly in the CAGA group （P〈0.05）. At 3 days after operation, the level of TNF-α in the ACGA group decreased significantly as compared with that before anesthesia induction （P〈0.05）. The cases with nausea after operation in the CAGA group were significantly less than those in the GA group （P〈0.05）. Conclusion Acupuncture combined with general anesthesia has a little effect on immune function in patients of LC with less adverse reactions.
文摘Objective To observe postoperative effect of electroacupuncture（EA） of different frequencies in acupuncture anesthesia combined with drugs on patients undergoing thyroid surgery.Methods One hundred and twenty patients undergoing thyroid surgery were randomly divided into a 2Hz electroacupuncture anesthesia group（group A）,a 100 Hz electroacupuncture anesthesia group（group B）,a 2Hz/100 Hz electroacupuncture anesthesia group（group C） and a cervical plexus block group（group D） in accordance with the random number table method,with 30 patients in each group.In group A,group B and group C,electroacupuncture was applied at bilateral Futu（扶突 LI 18）,Hegu（合谷 LI 4） and Neiguan（内关 PC 6） at frequencies of 2 Hz,100 Hz and 2 Hz/100 Hz respectively for 30 min.The needles were retained till the end of the surgery.Dolantin and atropine were intramuscularly injected In group D,bilateral cervical plexus block was produced with a mixture of1%lidocaine and 0.375%bupivicaine.Before surgery,pain threshold and threshold of pain tolerance were determined;during surgery,the duration of surgery was recorded;and after surgery,QOLS（Quality Of Life Score） and PHS（Prince-Henry Score） were assessed.Results PHS in group A,group B and group C were lower than that in group D,respectively（0.20±0.41,0.17±0.38,0.10±0.31 vs 0.40±0.50,P〈0.01）,and PHS in group C was lower than those in group A and group B,respectively（both P〈0.01）.QOLS in group A,group B and group C were higher than that in group D,respectively（9.97±1.07,9.97±2.27,10.40±1.45 vs 9.73±1.41,P〈0.05,P〈0.01）,and QOLS in group C was higher than those in group A and group B,respectively（both P〈0.05）.Conclusion Acupuncture anesthesia combined with drugs has better postoperative effect than drug anesthesia.Electroacupuncture of different frequencies can significantly improve general quality of life of patients,so patients recover well after thyroid surgery.As patients in group C suffered from the slightest pain with the highest quality of life,they recovered best within the shortest time.Electroacupuncture at frequency of 2 Hz/100 Hz can better play postoperative analgesic effect.
文摘Objective： To investigate tumor necrosis factor （TNF） of lung the regulation of acupuncture on γ-interteron （LNF-γ） and cancer-operative cases. Methods： to determine the INF-γ and TNF contents in the blood serum of lung cancer patients by double antibody sandwich immunoenzymatic method （ELISA）; to measure the INF-γ and TNF contents of 30 lung cancer patients in the acupuncture anesthesia group and 30 lung cancer patients in general anesthesia group before the operation and at the 8th days, the 12th day after the operation respectively and make comparison between the two groups. Results. The pre-operation INF-γ contents of the two groups showed no significant difference （P〉 0.05）; the post operation INF-γ contents of the two groups showed significant difference at 8th day and 12th day after the operation （P〈 0.05）; the acupuncture anesthesia group was superior to the general anesthesia group; the self-comparison of the anesthesia group showed significant difference at the 12th day and 8th day after the operation （P〈 0.05）; the pre-operation TNF contents of the two groups showed no significant difference （P〉 0.05） and the post-operation TNF contents of the two groups showed significant difference at the 8th day and 12th day after the operation （P〈 0.05）. Conclusion：Acupuncture can increase the serum INF-γ and TNF contents of lung cancer patients and therefore regulate the immunity of the patients.
