Anesthesia Effect of Remifentanil Combined with Propofol in Laparoscopic Cholecystectomy and Its Impact on Postoperative Cognitive Recovery.

Objective: To investigate the anesthesia effect of remifentanil combined with propofol for laparoscopic cholecystectomy and its impact on postoperative cognitive recovery. Methods: A total of 120 patients who underwent laparoscopic cholecystectomy in our hospital from February 2019 to June 2021 were recruited and assigned into either control group or experimental group at a ratio of 1 : 1 via the random number table method. The patients in the control group were anesthetized with fentanyl combined with propofol, and the patients in the experimental group were anesthetized with remifentanil combined with propofol. The clinical basic indicators (extubation time, recovery time, breathing recovery time, and orientation recovery time), and observer's assessment of awareness/sedation (OAA/S) scores and complications were compared between the two groups. Results: There was no significant difference in extubation time between the two groups (P > 0.05). The postoperative wake-up time, respiratory recovery time, and orientation recovery time of the experimental group were significantly better than those of the control group (P < 0.05). The OAA/S scores of the patients in the experimental group were significantly higher than those in the control group immediately after surgery, 1 h after surgery, and 3 h after surgery (P < 0.05). There was no significant difference in the OAA/S scores between the two groups on the 1st day after operation (P > 0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (P < 0.05). Conclusion: Remifentanil + propofol for laparoscopic cholecystectomy patients has a significant anesthesia effect. This strategy effectively shortens the extubation, awakening, respiratory recovery, orientation recovery time of patients, and OAA/S score, suggest a minor impact on the postoperative cognitive function and state of consciousness. It has a high safety profile and thus is worthy of clinical application.

Effects of ultrasound-guided erector spinae plane block on postoperative analgesia and plasma cytokine levels after uniportal VATS: a prospective randomized controlled trial.

PURPOSE: Although uniportal video-assisted thoracoscopic surgery (VATS) has been widely used, the associated postoperative pain is still severe. Currently, a variety of regional anesthesia methods have been used to relieve postoperative pain. In our study, we wanted to evaluate the effectiveness of ultrasound-guided erector spinae plane block (ESPB) as a postoperative analgesia after uniportal VATS. METHODS: Eighty patients scheduled to undergo uniportal VATS were randomly divided into Group ESP and Group C. In Group ESP, the patients underwent ultrasound-guided ESPB under general anesthesia before surgery, while Group C was set as blank control group without ESPB. The primary outcome was the sufentanil dose within 24 h after surgery. The secondary outcomes mainly included postoperative pain scores at 2, 4, 8, and 24 h evaluated using a numeric rating scale (NRS), intraoperative opioid dosage, levels of inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) in the plasma, side effect profile, and length of postoperative hospital stay. RESULTS: Postoperative sufentanil consumption (32.5 ± 6.3 µg vs. 42.8 ± 7.6 µg, P < 0.001) was significantly lower in Group ESP than in Group C. Intraoperative sufentanil consumption was significantly lower in Group ESP than in Group C (P < 0.001). The postoperative NRS score and levels of inflammatory cytokines were significantly lower in Group ESP than in Group C (P < 0.05). CONCLUSIONS: Ultrasound-guided ESPB decreased the consumption of sufentanil both postoperatively and intraoperatively for patients undergoing uniportal VATS and appeared to be an effective treatment option.

[Effects of exogenous spermidine on mitochondrial function of tomato seedling roots under salinity-alkalinity stress].

Two cultivars of tomato (Solanum lycopersicum, cvs. 'Jinpengchaoguan' and 'Zhongza No. 9', with the former being more tolerant to saline-alkaline stress) seedlings grown hydroponically were subjected to salinity-alkalinity stress condition (NaCl: Na2SO4:NaHCO3:Na2CO3 = 1:9:9:1) without or with foliar application of 0.25 mmol . L-1 spermidine (Spd), and the root morphology and physiological characteristics of mitochondrial membrane were analyzed 8 days after treatment, to explore the protective effects of exogenous Spd on mitochondrial function in tomato roots under salinity-alkalinity stress. The results showed that the salinity-alkalinity stress increased the concentrations of both mitochondrial H2O2 and MDA as well as the mitochondrial membrane permeability in the roots of the two cultivars, while it decreased the mitochondrial membrane fluidity, membrane potential, Cyt c/a and H+-ATPase activity, which impaired the mitochondria and therefore inhibited the root growth; and these effects were more obvious in 'Zhongza No. 9' than in 'Jinpengechaoguan'. Under the salinity-alkalinity stress, foliar application Spd could effectively decrease the concentrations of mitochondrial H2O2 and MDA and mitochondrial membrane permeability, while increased the mitochondrial membrane fluidity, membrane potential, Cyt c/a and H+-ATPase activity. These results suggested that exogenous Spd could effectively mitigate the damage on mitochondria induced by salinity-alkalinity stress, and the alleviation effect was more obvious in 'Zhongza No. 9' than in 'Jinpengchaoguan'.