Association of Preoperative Frailty and Post-Induction Hypotension in Elderly Patients Undergoing Major Non-Cardiac Surgery: A Prospective Observational Cohort Study.

Purpose: Post-induction hypotension (PIH) is one of the most common complications during general anesthesia, especially in elderly patients. Frailty, which describes age-related decrease of physiological capacity with increased susceptibility to stress, may be associated with PIH, when stress is brought by anesthetics. This study aimed to explore the association between preoperative frailty and PIH as well as postoperative complications.

High energy nonlinear pulse compression to sub-50 fs by a hybrid bulk-air multi-pass cell.

We demonstrate a high energy nonlinear pulse compression scheme based on a hybrid bulk-air multi-pass cell (MPC), achieving a high-power ultrafast source with 45 fs pulse duration, 130 W average power at 200 kHz repetition rate, and near-diffraction-limited beam quality. The impact of air nonlinearity accumulation in the MPC on beam quality is investigated to maintain good beam quality at high pulse energy, which suggests the adoption of pre-chirped and circularly-polarized pulses can effectively improve the input pulse energy and suppress the spatial quality degradation. The nonlinear mode-matching is also adopted to minimize the impact of the self-focusing effect of solid-thin-plates on q-preserving propagation.

A randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma.

Background: The effects of inhalation anesthesia as compared with total intravenous anesthesia (TIVA) on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma have not been well studied.

Methods: This randomized clinical trial enrolled patients undergoing transsphenoidal surgery between May 2023 to April 2024. Patients were randomly assigned in a 1:1 ratio to receive inhalation anesthesia or TIVA.

Effects of Total Intravenous Anesthesia and Inhalational Anesthesia on Postoperative Recovery in Patients Undergoing Transsphenoidal Pituitary Surgery:A Systematic Review.

Objective To systematically evaluate the effects of total intravenous anesthesia and inhalational anesthesia on postoperative recovery in patients undergoing transsphenoidal pituitary tumor resection.Methods A comprehensive search was conducted in international biomedical databases including Ovid Medline,Embase,CINAHL(EBSCO),Cochrane Library,and Web of Science,from inception to July 4,2023.Additionally,ClinicalTrials.

Association between sarcopenia and postoperative delirium in elderly surgical patients: a systematic review and meta-analysis.

Background: Sarcopenia, characterized by the progressive loss of muscle mass and strength, is common in the elderly and significantly increases the risk of poor postoperative outcomes. This study aims to examine the impact of sarcopenia on postoperative delirium and a range of perioperative outcomes in elderly patients.

Methods: A systematic search was conducted in MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL.

Efficacy and Safety of Prothrombin complex Concentrate in Patients with Massive Intraoperative Bleeding During non-Cardiac Surgery: A Retrospective Cohort Study.

PurposeThe efficacy and safety of four-factor prothrombin complex concentrate (4F-PCC) in managing bleeding during non-cardiac surgery are unclear. We investigated the associations of 4F-PCC with postoperative RBC transfusion and adverse events in non-cardiac surgery patients with massive intraoperative bleeding.MethodsThis retrospective cohort study consecutively included non-cardiac surgery patients with massive intraoperative bleeding at a tertiary hospital (2014-2020).

Semiquantitative 131 I MIBG Scintigraphy Predicts Intraoperative Blood Pressure Fluctuation in Patients Undergoing Surgery for Pheochromocytoma and Paraganglioma.

Objective: Severe blood pressure (BP) fluctuation happens during surgery for pheochromocytoma and paraganglioma (PPGL) due to the release of catecholamines. 131 I MIBG scintigraphy indicates the capacity of PPGL to retake and reserve catecholamines. This study aims to utilize 131 I MIBG scintigraphy to predict intraoperative BP fluctuation in patients undergoing PPGL surgery, thereby guiding preoperative preparation.

The epidemiology of chronic postsurgical pain after video-assisted thoracic surgery (VATS-CPSP) in China: a multicentre prospective study.

Background: Chronic postsurgical pain (CPSP) after video-assisted thoracic surgery (VATS) has been a focus for research and clinical improvement for decades. However, large-scale epidemiological reports from prospective studies are still lacking. The goal of this study was to present the CPSP profiles after VATS from a nationwide survey.

Association between perioperative continuous glucose monitoring and clinically relevant postoperative pancreatic fistula (CR-POPF) in pancreatic surgery: a protocol for a prospective cohort study.

Introduction: Surgical resection is the cornerstone therapy for pancreatic neoplasms, particularly in cases of resectable pancreatic carcinoma identified in the early stages. Clinically relevant postoperative pancreatic fistula (CR-POPF) persists as a prevalent and formidable postsurgical complication, substantially elevating patient morbidity and mortality. The current literature reveals a gap in the understanding of the relationship between perioperative glucose levels and the incidence of CR-POPF in patients undergoing pancreatic surgery.

High-power regenerative amplifier based on dual-crystal Yb:CALGO configuration.

We demonstrated a high average power dual-crystal Yb:CALGO regenerative amplifier(RA) operated in TEM mode. The dual-crystal configuration effectively mitigated thermal effects and enabled a continuous output power of 42.5 W at a pump power of 160 W with the central wavelength of 1054 nm.

Global, regional, and national trends and burden of opioid use disorder in individuals aged 15 years and above: 1990 to 2021 and projections to 2040.

Aim: Opioid use disorder (OUD) is a medical condition associated with problematic opioid use, leading to addiction and severe life impairments. This research delivers an in-depth evaluation of OUD burden and trends at global, regional and national levels.

Methods: This study analysed the global burden of OUD from 1990 to 2021 using data from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study.

Current state and future education implication of enhanced recovery after surgery (ERAS) among Chinese anesthesiologists: national repeated cross-sectional surveys from 2019 to 2023.

Background: Enhanced recovery after surgery (ERAS) protocols have been widely adopted to improve surgical outcomes. In this study, we aimed to assess the current state of awareness and specific knowledge of ERAS among Chinese anesthesiologists, examine difficulties in implementation, and identify future priorities for ERAS education and training.

Methods: A self-designed, repeated national survey regarding awareness and practice of the ERAS concept, specific knowledge, learning modalities, and difficulties in ERAS implementation was conducted in 2019, 2021, and 2023.

Perioperative Oral decontamination and ImmunoNuTrition (POINT) to prevent postoperative pulmonary complications in elderly patients scheduled for elective non-cardiac surgeries: protocol for a multicentre, randomised controlled trial.

Introduction: Elderly patients are known to be vulnerable to postoperative pulmonary complications (PPCs), especially pneumonia. Apart from elder age, preoperative pulmonary diseases, anaemia, malnutrition, dysphagia and frailty may all be contributing factors to PPCs. Poor oral hygiene is a risk factor for PPC as well, as oropharyngeal microflora might be introduced to the lower respiratory tract following endotracheal intubation for general anaesthesia during surgery.

Comparative Analysis of Muscle Elasticity and Pathological Characteristics Between Affected and Unaffected Sides in Postherpetic Neuralgia Patients: Protocol for a Pilot Cohort Trail.

Background: Postherpetic neuralgia (PHN) is the most common condition that can develop as a complication after herpes zoster (HZ) infection, characterized by pain that persists for more than 3 months after the initial rash has resolved. In most patients with HZ, the rash appears unilaterally. While the treatment of PHN is primarily focused on neural mechanisms due to HZ's neurotropism nature, recent evidence suggests that muscle tissues within the affected regions may also experience pathological changes that contribute to the pain.

Wnt5a in keratinocytes contributes to complex regional pain syndrome through the activation of NR2B and MMP9 in rats.

Background: Complex regional pain syndrome (CRPS) is a chronic pain condition characterized by inflammatory features, though the underlying mechanisms remain partly understood. Our study examined whether Wnt5a in skin keratinocytes contributes to CRPS-related pain hypersensitivity by activating downstream N-methyl-D-aspartate receptor subunit 2B (NR2B) and matrix metalloproteinase-9 (MMP9) signaling in rats.

Methods: We developed a cell-culture model to mimic the local inflammation of CRPS and a rat model to mimic the chronic post-ischemia pain experienced by CRPS patients.

Dexmedetomidine Reduces Presynaptic γ-Aminobutyric Acid Release and Prolongs Postsynaptic Responses in Layer 5 Pyramidal Neurons in the Primary Somatosensory Cortex of .

Dexmedetomidine (DEX) exhibits notable sedative, analgesic, and anesthetic-sparing properties. While growing evidence suggests these effects are linked to the modulation of γ-aminobutyric acid (GABA) system, the precise pre- and postsynaptic mechanisms of DEX action on cortical GABAergic signaling remain unclear. In this study, we applied whole-cell patch-clamp recording to investigate the impact of DEX on GABAergic transmission in layer 5 pyramidal neurons of the primary somatosensory cortex.

Trends and Hotspots in Nanomedicine Applications for Pain: A Bibliometric Analysis from 1999 to 2024.

Pain, especially chronic pain, is a leading cause of individuals seeking medical attention and presents a significant public health challenge due to its widespread prevalence and associated healthcare costs. Nanomedicine has shown considerable potential in pain management research. However, there is a lack of comprehensive bibliometric and trend analyses that explore the current status, research hotspots, and future directions of nanomedicine applications in pain.

Prediction of postoperative myocardial injury in patients undergoing laparoscopic pheochromocytoma/paraganglioma resection: protocol for an ambispective cohort study.

Introduction: Pheochromocytoma/paraganglioma (PPGL) resection remains a high-risk surgical procedure owing to severe haemodynamic instability, which can lead to myocardial injury after non-cardiac surgery (MINS). MINS is the most common and easily overlooked cardiovascular complication and results in increased postoperative mortality and prolonged inpatient hospitalisation. We aimed to develop and validate a predictive model for MINS in patients undergoing laparoscopic PPGL resection.

Striatal neurones expressing D1 dopamine receptors modulate consciousness in sevoflurane but not propofol anaesthesia in mice.

Background: Sevoflurane and propofol are the most widely used inhaled and i.v. general anaesthetics, respectively.

The Efficacy of Liposomal Bupivacaine in Thoracic Surgery: A Systematic Review and Meta-Analysis.

Purpose: Patients undergoing thoracic surgery suffer from severe postoperative pain, and a series of complications will occur if there is no effective analgesic treatment. Liposomal bupivacaine (LB) is a novel multivesicular formulation with up to 72 hours of analgesia, which can be used in thoracic surgery. This meta-analysis aimed to evaluate the efficacy of LB in improving recovery in patients undergoing thoracic surgery compared with non-liposomal local anesthetics.

Differences in anaesthesiologist-surgeon seniority and patient safety: a single-centre mixed-methods study.

Background: Junior anaesthesiologists often find it difficult to gain the trust of surgeons, possibly because of their limited experience and unfamiliarity with surgeons. Therefore, they can face pressure when navigating disagreements with senior surgeons. We investigated whether and how differences in anaesthesiologist-surgeon seniority might impact patient safety.

Hippocampal cannabinoid type 2 receptor alleviates chronic neuropathic pain-induced cognitive impairment via microglial DUSP6 pathway in rats.

Approximately 50% of patients with chronic neuropathic pain experience cognitive impairment, which negatively impacts their quality of life. The cannabinoid type 2 receptor (CB2R) may be involved in hippocampal cognitive processes. However, its role in chronic neuropathic pain-induced cognitive impairment remains elusive.

Chinese Anesthesiology Milestones in Resident Evaluation: Reliability, Validity, and Correlation with Objective Examination Scores: A Cross-sectional Study.

Background: Evaluating competency acquisition during residency training is crucial. The Anesthesiology Milestones have been implemented in the United States. The China Consortium of Elite Teaching Hospitals for Residency Education has also developed the Chinese Resident Core Competency Milestone Evaluation System.

Acustimulation combined with pharmacological prophylaxis versus pharmacological prophylaxis alone in postoperative nausea and vomiting (PONV) prophylaxis among patients undergoing laparoscopy abdominal surgery: a research protocol for a randomised controlled trial.

Introduction: This study evaluates the efficacy of integrating percutaneous electrical nerve stimulation at the pericardium 6 (PC6) acupuncture point through a wearable acustimulation device with standard pharmacological prophylaxis to prevent postoperative nausea and vomiting (PONV) compared with pharmacological prophylaxis alone in patients undergoing laparoscopic abdominal surgery.

Method And Analysis: This prospective study will enrol 302 patients scheduled for elective laparoscopic surgery. Participants will be randomly allocated to one of two groups: acustimulation combined with pharmacological prophylaxis or sham stimulation combined with pharmacological prophylaxis.