Effect of TEAS combined with general anesthesia on early postoperative cognitive function in elderly patients undergoing single-port thoracoscopic lobectomy

Chen, Xi; Cai, Haoliang; Guo, Jun

doi:10.12669/pjms.38.8.6927

Cited by 5 publications

(5 citation statements)

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“…MMA, defined as combining anaesthetics and analgesics with different mechanisms of action [17], aims to provide additive or synergistic pain relief while minimizing side effects associated with higher opioid doses [18]. Surgeons also support using MMA, combining general anaesthesia with regional or local anaesthesia techniques, to improve outcomes [19][20][21]. They actively contribute to postoperative MMA by employing techniques such as local infiltration or inserting surgical site catheters [2,[22][23][24].…”

Section: Why Multimodal Anaesthesia?mentioning

confidence: 99%

The nuts and bolts of multimodal anaesthesia in the 21st century: a primer for clinicians

Lersch,

Correia,

Hight

et al. 2023

Current Opinion in Anaesthesiology

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Purpose of review This review article explores the application of multimodal anaesthesia in general anaesthesia, particularly in conjunction with locoregional anaesthesia, specifically focusing on the importance of EEG monitoring. We provide an evidence-based guide for implementing multimodal anaesthesia, encompassing drug combinations, dosages, and EEG monitoring techniques, to ensure reliable intraoperative anaesthesia while minimizing adverse effects and improving patient outcomes. Recent findings Opioid-free and multimodal general anaesthesia have significantly reduced opioid addiction and chronic postoperative pain. However, the evidence supporting the effectiveness of these approaches is limited. This review attempts to integrate research from broader neuroscientific fields to generate new clinical hypotheses. It discusses the correlation between high-dose intraoperative opioids and increased postoperative opioid consumption and their impact on pain indices and readmission rates. Additionally, it explores the relationship between multimodal anaesthesia and pain processing models and investigates the potential effects of nonpharmacological interventions on preoperative anxiety and postoperative pain. Summary The integration of EEG monitoring is crucial for guiding adequate multimodal anaesthesia and preventing excessive anaesthesia dosing. Furthermore, the review investigates the impact of combining regional and opioid-sparing general anaesthesia on perioperative EEG readings and anaesthetic depth. The findings have significant implications for clinical practice in optimizing multimodal anaesthesia techniques (Supplementary Digital Content 1: Video Abstract, http://links.lww.com/COAN/A96).

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Section: Why Multimodal Anaesthesia?mentioning

confidence: 99%

The nuts and bolts of multimodal anaesthesia in the 21st century: a primer for clinicians

Lersch,

Correia,

Hight

et al. 2023

Current Opinion in Anaesthesiology

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“…Использование севофлурана, как и других ингаляционных анестетиков, в качестве поддержания анестезии во время операции приводит к значительному увеличению количества па циентов (до 30 %) с жалобами на послеоперационную тошноту, рвоту и озноб [60][61][62]. Кроме того, последние исследования [63][64][65] показывают, что ингаляционная анестезия ухудшает когнитивную функцию в раннем по слеоперационном периоде у лиц старше 65 лет по срав нению с использованием пропофола. В целом, являясь довольно безопасным анестетиком [66], севофлуран на сегодняшний день ограничивается только вводным нар козом у детей или клиническими ситуациями, где ис пользование пропофола противопоказано [67,68].…”

Section: выбор типа анестезииunclassified

Anaesthesia for day case surgery. Review

Kuklin

2020

Annals of Critical Care

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Discharging patients from day case surgery (DCS) units at day of procedure makes high demands on staff professionalism. With DCS development, both lists of surgical operations and their complexity are progressively increasing. Selection of patients for surgical treatment in DCS is based on patient’s condition and stability of chronic diseases. Upon admission to DCS of Scandinavian countries, there is no need for blood tests, ECG or X-ray. Questionnaires filled in by patients help anaesthesiolo-gists identify almost all pathology that affect safe anaesthesia, and additional examination methods are used at doctor’s discretion. Multimodal premedication is the basis for postoperative analgesia. Premedication with sedatives is indicated mainly for children. For the safe treatment of patient, the correct and logical DCS organisation is much more important than the type of anaesthesia used in this department. However, the choice of anaesthesia can significantly affect the manifestation of side effects, the time of restoration of the patient's normal functionality and, ultimately, the duration of the patient's stay in DCS. Spinal anaesthesia is safe and easy to perform, but its use in the DCS can lead to delays in the patient's discharge, and sometimes to need for hospitalisation. Inhalation anaesthetics increase significantly the number of patients (up to 30 %) with postoperative nausea, vomiting and chills. That why, total intravenous anaesthesia with Propofol and Remifentanil is the most commonly used in Scandinavian countries. Regional anaesthesia under ultrasound control provides effective postoperative analgesia. For the relief of acute postoperative pain, it is necessary to use low doses of intravenous opioids. Use of Clonidine as an adjuvant in postoperative pain treatment helps enhance the analgesic effect of opioids. Patient discharge from DCS should be based on established criteria.

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“…This may cause significant fluctuations in hemodynamics, and increase the risk of respiratory depression and bradycardia. 5 In recent years, numerous clinical studies have shown that the injury of the affected side of the chest wall is the main source of pain in thoracoscopic lobectomy. Paravertebral nerve block can obtain unilateral banded pain relief by injecting local anesthetics at the required block plane, blocking noxious stimulation conduction, and achieving good analgesic effect.…”

Section: Introductionmentioning

confidence: 99%

Analgesic effect of thoracic paravertebral block on patients undergoing thoracoscopic lobectomy under general anesthesia

Zeng,

Zhang,

Huang

et al. 2023

Pak J Med Sci

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Objective: To investigate the analgesic effect of thoracic paravertebral block (TPVB) in patients undergoing thoracoscopic lobectomy under general anesthesia (GA). Methods: Clinical records of 82 patients who underwent thoracoscopic lobectomy under GA from October 2021 to October 2022 in the General Hospital of Southern Theater Command were retrospectively analyzed. The patients were divided into two groups according to the method of anesthesia used: general anesthesia group (Group-G, n=37), and TPVB plus GA group (Group-T, n=45). The analgesic effect, mean arterial pressure (MAP), heart rate (HR) and the rate of adverse events in both groups were compared. Results: Visual analogue scale (VAS) scores of patients in Group-T at 12h, 24h and 48h after the operation were significantly lower compared to Group-G (P<0.05). MAP and HR the time of tracheal intubation induction (T1), single lung ventilation (T2), skin incision (T3), operation completion (T4), and 20 minutes after the extubation (T5) were lower in both groups compared to T0, and were significantly higher in Group-T compared to Group-G (P<0.05). The rate of adverse events in Group-T was 6.67%, significantly lower compared to Group-G (24.32%) (P<0.05). Conclusions: TPVB combined with GA can improve the analgesic effect, improve MAP and HR during the operation, and reduce the incidence of adverse events in patients undergoing thoracoscopic lobectomy. doi: https://doi.org/10.12669/pjms.39.6.7937 How to cite this: Zeng W, Zhang J, Huang L, Tang Z. Analgesic effect of thoracic paravertebral block on patients undergoing thoracoscopic lobectomy under general anesthesia. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7937 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Effect of TEAS combined with general anesthesia on early postoperative cognitive function in elderly patients undergoing single-port thoracoscopic lobectomy

Cited by 5 publications

References 24 publications

The nuts and bolts of multimodal anaesthesia in the 21st century: a primer for clinicians

The nuts and bolts of multimodal anaesthesia in the 21st century: a primer for clinicians

Anaesthesia for day case surgery. Review

Analgesic effect of thoracic paravertebral block on patients undergoing thoracoscopic lobectomy under general anesthesia

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