Objective To study dexmedetomidine on the adverse impact of ketamine based anesthesia and sedative effects in indirect inguinal hemia.Methods Eighty children underwent indirect inguinal hemia surgery were randomily divided into two groups after injected muscle with midazolam and ketamine,Group B was injectded with 0.5 μg/kg DEX,but Group A with normal saline,analgesia was with caudal block (lidocaine).The with hemodynamic,level of sedation,recovery time and CHW score were observed.The adverse reactions were recorded.Results Two groups of children have hemodynamically stable,and recovery time had no statistical significance.The two groups of CHW score in Group A (1.6 ± 0.5) points higher than in group B (0.9 ± 0.3) points (P ＜ 0.05).The restlessness rated group (1.52 ± 0.54) points was higher than in group B (0.51 ± 0.48) points (P ＜ 0.05).Compared with Group B,Group A had 12 cases of psychiatric symptoms,10 cases of involuntary movement of limbs,6 cases of severe postoperative agitation nausea,and 8 cases of vomiting (P ＜ 0.05).Conclusion 0.5μg/kg DEX can be safely and effectively used in the pediatric anesthesia,and reduce the adverse reactions caused by ketamine.

Objective:To study the analgesic effect of dezocine combined with sufentanil in hip arthroplasty. Methods:Totally 60 patients with hip arthroplasty were randomly divided into the observation group and the control group. The 30 patients in the observation group were treated with dezocine combined with sufentanil, and those in the control group were treated with sufentanil. The analgesic efficacy and adverse reactions in the two groups were investigated and analyzed. Results:The visual analog scale ( VAS) in the obser-vation group in 3h, 6h, 12h, 24h and 48h after the surgery was significantly lower than that in the control group (P<0. 05). MMSE score in the observation group in 1h, 3h and 5h after the surgery was higher than that in the control group (P<0. 05). The total effec-tive rate of the observation group was 100. 00%, which was much higher than that of the control group (70. 00%, P<0. 05). There was significant difference in the adverse reactions between the two groups(P<0. 05). Conclusion:The efficacy of dezocine combined with sufentanil used in hip arthroplasty is significant with lower incidence of adverse reactions, which is worthy of popularized applica-tion in clinical practice.

Objective To investigate the effect of propofol or sevoflurane on the quality of neuromuscular blockade with cisatracurium during comparable depth of anesthesia in elderly patients.Methods A total of 60 patients aged over 60 years [classified as American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅱ] were selected.Patients were randomized into 2 groups:propofol group (induction of anesthesia with propofol) and sevoflurane group (induction of anesthesia with sevoflurane) (n=35,each).Neuromuscular blocking effect was monitored by muscle response to ulnar nerve stimulation.The rates of cisatracurium injection at different time points,time of loss of consciousness and the onset time of cisatracurium neuromuscular block were compared between the two groups.Results The rate of cisatracurium injection was significantly decreased at 60 minutes,90 min,120 min in sevoflurane group(29.82％,42.28％,37.15％),and the onset time of cisatracurium neuromuscular block was significantly shorter in sevoflurane group than in propofol group [(148.62±28.54)s vs (96.53±23.69)s,P＜0.05].Conclusions Compared with propofol,sevoflurane can greatly shorten the onset time of cisatracurium and enhance the effect of cisatracurium neuromuscular block with stable hemodynamics.

Silicosis is a diffuse pulmonary fibrosis disease caused by occupational exposure to silica, which is one of the occupational diseases with high incidence in developing countries. Up to now, there is no definite drug to relieve or reverse the lung injury caused by silicosis, so it is very important to prevent, diagnose and treat pulmonary fibrosis as soon as possible. Studies have shown that a chronic inflammatory environment contributes to pulmonary fibrosis to a certain extent. Interleukin-1β is a cytokine that increases the number of inflammatory factors in the microenvironment in the immune response and plays a key role in inflammatory reaction. Therefore, the release of interleukin-1β is of great significance in the pathogenesis of silicosis. This paper aims to systematically expound the development course of silicosis, the signal pathway of interleukin-1β production, and the relationship between them.

Objective To investigate the application of anesthesia management plan based on the concept of enhanced recovery after surgery(ERAS)in thoracoscopic surgery.Methods From December 2021 to December 2022,100 patients underwent thoracoscopic surgery were randomly divided into control group and observation group with 50 patients in each.The control group received routine anesthesia management,and the observation group received anesthesia management based on ERAS concept.The two groups were compared in terms of clinical indicators,the degree of incision pain on day 1,3,5 and 7 after surgery,the levels of inflammatory factors on day 1 and 3 after surgery.The incidence rates of pulmonary complications,nausea and vomiting,and respiratory depression in the two groups were calculated.Results Awakening and extubation time and hospital stay of observation group were shorter than those of control group,the treatment costs of observation group was less than that of control group,the visual analogue scale(VAS)of observation group at each time point after surgery were lower than those of control group,the levels of C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)of observation group on day 1 and 3 after surgery were lower than those of control group,the differences were statistically significant(P<0.05).The total incidence of pulmonary complications of observation group was lower than that of control group(6.00%vs 22.22%),the difference was statistically significant(P<0.05).The incidence rates of respiratory depression and nausea and vomiting in the observation group were 0.00%and 2.00%,respectively,while the incidence rates of respiratory depression and nausea and vomiting in the control group were 4.00%and 6.00%,respectively.There was no statistically significant difference in the total incidence rates of other complications between the two groups of patients(P>0.05).Conclusion Applying the anesthesia management plan based on ERAS concept in thoracoscopic surgery can promote postoperative recovery,reduce pain and pulmonary complications,and save treatment costs.It is worthy of clinical application.

Objective:To investigate the anesthetic and analgesic effects of ultrasound-guided high-position fascia iliaca compartment block (FICB) in older adult patients undergoing hip fracture surgery.Methods:A total of 120 older adult patients who underwent hip fracture surgery at the Department of Orthopedics, Dongyang People's Hospital, between January 2022 and October 2023, were enrolled in this study. This is a prospective controlled study. The patients were randomly assigned to either a conventional group or a high-position group, with 60 patients in each group, using a random number table method. The patients in the conventional group received ultrasound-guided routine FICB 30 minutes before entering the operating room, whereas the patients in the high-position group underwent ultrasound-guided high-position FICB 30 minutes prior to entering the operating room. The onset time of nerve block in both groups was observed, specifically targeting the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve. Changes in hemodynamic indicators, including heart rate and mean arterial pressure, were monitored at various time points: before nerve block (T0), upon entering the operating room (T1), during anesthesia positioning (T2), and after anesthesia completion (T3). The pain level was assessed using the Visual Analogue Scale score at the same time points. Changes in pain neurotransmitters prostaglandin E 2 and 5-hydroxytryptamine were analyzed at T0 and T3. Results:The onset time of the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve in the high-position group [(4.02 ± 1.16) minutes, (4.55 ± 1.29) minutes, (7.71 ± 2.02) minutes] were significantly shorter than those in the conventional group [(5.15 ± 1.42) minutes, (6.62 ± 1.78) minutes, (12.24 ± 3.68) minutes, t = 4.77, 7.29, 8.35, all P < 0.001]. At T1 and T2, the heart rates in the high-position group [(77.55 ± 9.19) beats/minute, (75.54 ± 9.37) beats/minute] and mean arterial pressures [(95.62 ± 10.51) mmHg (1 mmHg = 0.133 kPa), (92.72 ± 11.44) mmHg] were significantly higher than those in the conventional group [(74.62 ± 9.68) beats/minute, (72.41 ± 9.36) beats/minute, (92.36 ± 10.04) mmHg, (88.24 ± 11.35) mmHg, t = 1.70, 1.82, 1.73, 2.15, P = 0.046, 0.035, 0.042, 0.017]. At T1 and T2, the VAS scores of the high-position group [(3.05 ± 0.61) points, (3.44 ± 0.89) points] were significantly lower than those in the conventional group [(3.72 ± 0.67) points, (4.29 ± 1.06) points, t = 5.73, 4.76, both P < 0.001]. At T3, the levels of prostaglandin E2 and 5-hydroxytryptamine in the high-position group [(35.38 ± 6.12) mg/L, (0.59 ± 0.09) μmol/L] were significantly lower than those in the conventional group [(44.91 ± 6.72) mg/L, (0.63 ± 0.13) μmol/L, t = 8.12, 1.96, P < 0.001, P = 0.026]. Conclusion:Ultrasound-guided high-position FICB exhibits a favorable application effect in anesthetizing older adult patients undergoing hip fracture surgery. It effectively shortens the onset time of nerve block, stabilizes hemodynamic indicators, and alleviates pain.