Objective To explore the analgesic effect of ropivacaine and flurbiprofen for patients with secondary upper extremity lymphedema after lymphatic venous anastomosis . Methods A total of 45 cases of lymphatic venous anastomosis under general anesthesia between October 2014 and March 2016 were randomly allocated to 3 groups: ropivacaine group ( group R ) , flurbiprofen preprocessing group (group F1), and flurbiprofen postprocessing group (group F2), with 15 cases in each group.Local infiltration anesthesia was made with 0.2% ropivacaine 10 ml at the incision before the end of operation in the group R .The flurbiprofen 100 mg was intravenously injected at 5 minutes before the induction of anaesthesia in the group F 1 and 5 minutes before the end of operation in the group F 2 .The visual analogue scale ( VAS) scores and the number of patients using analgesics after operation at 1, 2, 6, 12, 24 and 48 h were recorded. Results The rest pain and movement pain VAS scores at postoperative 2 h were lower in the group R than those in the group F1 and F2[rest pain:(3.4 ±0.7) points vs.(4.2 ±0.9) points vs.(4.1 ±1.0) points, F=3.741, P=0.032;movement pain:(3.7 ±0.6) points vs.(4.6 ±0.9) points vs.(4.4 ±1.0) points, F=4.305, P=0.020]. The rest pain VAS scores at postoperative 6 h were lower in the group R than those in the group F 1 and F2 [(2.7 ±0.5) points vs. (3.4 ±0.5) points vs.(3.1 ±0.6) points, F=5.783, P=0.006].The number of patients requiring analgetics was lower in the group R than that in the group F1 and F2 at postoperative 2 h (1 case vs.7 cases vs.5 cases,χ2 =6.058, P=0.048). Conclusion Local anesthesia with ropivacaine in patients after lymphatic venous anastomosis can achieve good postoperative analgesia .

Objective To investigate analgesic effects of flurbiprofen in lower extremity liposuction for patients with primary lymphedema. Methods A total of 60 patients receiving lower extremity liposuction under general anesthesia were allocated to 3 groups:the control group (group A) received no analgesic drug 10-20 min before the end of operation, the parecoxib group (group B) received intravenous parecoxib 40 mg, and the flurbiprofen group (group C) received intravenous flurbiprofen 100 mg.The VAS was recorded at 1, 2, 6, 12, and 24 h after operation.Adverse reactions were also recorded . Results The VAS of rest pain and motion pain at 1, 2, 6, and 12 h were significantly lower in the group B than those in the group A (P<0.05);the VAS of rest pain and motion pain at 1, 2, and 12 h were significantly lower in the group C than those in the group A (P<0.05).The VAS at 1 and 2 h did not differ between the group B and C (P>0.05), but had significant difference at 6 and 12 h (P<0.05).No significant differences in the VAS at 24 h were observed among the three groups (P>0.05).Adverse reactions were not different among the three groups (P>0.05). Conclusion Both flurbiprofen and parecoxib sodium can achieve good postoperative analgesic effects in patients with lymphedema receiving lower extremity liposuction .

Objective To evaluate the analgesic efficiency and safety of patient-controlled intravenous analgesia ( PCIA) with both flurbiprofen and sufentanil after Han-uvulopalatopharyngoplasty ( H-UPPP) surgery. Methods Patients undergoing H-UPPP surgery ( n=60 ) were randomly divided into four groups with 15 cases in each group .They received PCIA after operation with a loading dose of 2 ml, lockout time of 15 minutes, background infusion rate of 2 ml/h and liquid volume of 100 ml.The PCIA formulation in each group was as follows:sufentanil 3.0 μg/h in group A;sufentanil 3.0 μg/h+flurbiprofen 4.0 mg/h in group B;sufentanil 2.0μg/h+flurbiprofen 4.0 mg/h in group C;sufentanil 1.0μg/h+flurbiprofen 4.0 mg/h in group D.The visual analogue scale (VAS) and Ramsay sedation scale were recorded at 2, 6, 12, 24, and 48 h after surgery (T1 -T5 time points).Patient pressing times and the adverse effects within 48 h after surgery were counted . Results The VAS scores of the group D were higher than those in the other three groups at T1 and T2 time points (P<0.05).The Ramsay scores of the group D were lower than those in the other three groups at T1 and T2 time points (P<0.05).The numbers of pressing times in the group D were more than those in the other three groups (P<0.05). Conclusion PCIA with both flurbiprofen 4.0 mg/h and sufentanil 2.0 μg/h is effective for postoperative analgesia after H-UPPP.

Objective To evaluate the analgesic efficiency of patients controlled intravenous analgesia ( PCIA) with sufentanil and dexmedetomidine after hyperthermic intraperitoneal chemotherapy ( HIPC) . Methods A total of 45 patients undergoing HIPC were randomly divided into 3 groups with 15 in each group .They received PCIA after operation with a background infusion rate of 2 ml/h, a loading dose of 2 ml, a lockout time of 15 min, and a liquid volume of 100 ml.The PCIA formulation in each group was as follows:group A (sufentanil 3.0 μg/h), group B (sufentanil 2.0 μg/h), and group C (sufentanil 2.0 μg/h +dexmedetomidine 4.0 μg/h).The VAS, Ramsay sedation scale, patient pressing times, and the adverse effects were recorded at 1 h (T1), 2 h (T2), 6 h (T3), 12 h (T4), 24 h (T5), and 48 h (T6) after surgery.Results The VAS scores of the group B were higher than those in the other two groups at T3-T6 time points [T3:(2.9 ±0.5) points vs.(3.5 ±0.8) points, q=3.600, P<0.05, (2.8 ±0.6) points vs.(3.5 ±0.8) points, q=4.200, P<0.05;T4:(2.4 ±0.6) points vs.(2.9 ±0.7) points, q=3.049, P<0.05;(2.3 ± 0.6) points vs.(2.9 ±0.7) points, q=3.659, P<0.05;T5:(1.9 ±0.6) points vs.(2.5 ±0.5) points, q=3.838, P<0.05;(1.8 ±0.7) points vs.(2.5 ±0.5) points, q=4.477, P<0.05;T6:(1.6 ±0.5) points vs.(2.0 ±0.4) points, q=3.303, P<0.05;(1.5 ±0.5) points vs.(2.0 ±0.4) points, q=4.129, P<0.05].The Ramsay scores of the group A were statistically higher than those of the group B at T5 and T6 [T5:(2.5 ±0.5) points vs.(2.1 ±0.5) points, q=2.893, P<0.05;T6: (2.3 ±0.5) points vs.(1.9 ±0.3) points, q=3.493, P<0.05].The Ramsay scores of the group B were statistically lower than those of the group C at T3-T6 [T3:(2.4 ±0.5) points vs.(3.1 ±0.7) points, q=4.477, P<0.05; T4: (2.2 ±0.4) points vs.(2.8 ± 0.7) points, q=4.243, P<0.05;T5:(2.1 ±0.5) points vs.(2.6 ±0.6) points, q=3.617, P<0.05;T6:(1.9 ±0.3) points vs.(2.4 ±0.5) points, q=4.367, P<0.05].The incidence of nausea and vomiting in the group A was higher than that in the group C [7 cases (46.7%) vs.1 case (6.7%),χ2 =4.261, P=0.039], while there were no differences between group B and C and between group A and B (P>0.05).The number of pressing times in the group B was more than that in the other two groups [(5.3 ±2.6) times vs.(8.4 ±4.2) times, q=3.662, P<0.05; (4.5 ±2.8) times vs.(8.4 ±4.2) times, q=4.608, P<0.05 ] . Conclusion Dexmedetomidine can reduce postoperative consumption of sufentanil in patients undergoing HIPC and decrease the incidence of nausea and vomiting .

Objective To observe the efficiency and safety of dexmedetomidine and tramadol to prevent postoperative shivering after liposuction. Methods A total of 80 patients undergoing liposuction were randomly divided into 4 groups with 20 cases in each group:dexmedetomidine 0.4 μg/kg(D1 group),dexmedetomidine 0.6 μg/kg(D2 group),tramadol 1 mg/kg(T group),and saline control group(N group).These patients received an intravenous injection of dexmedetomidine, tramadol, or saline at the time of surgical suture.The respiratory recovery time,awakening time, extubation time, orientation recovery time, the case of shivering and adverse reactions after surgery were recorded. Results The respiratory recovery time,awakening time, and extubation time in the group D2 were longer than those in the other 3 groups[respiratory recovery time:(5.5 ±1.3)min vs.(6.2 ±1.2)min vs.(5.1 ± 1.8)min vs.(5.0 ±0.9)min,F=3.330,P=0.024;awakening time:(10.2 ±1.3)min vs.(11.5 ±1.5)min vs.(9.7 ±2.7) min vs.(9.5 ±1.8)min,F=4.429,P=0.006;extubation time:(12.9 ±1.5)min vs.(14.2 ±1.6)min vs.(12.8 ±2.4)min vs.(12.7 ±1.9)min,F=2.845,P=0.043].Postoperative shivering incidence in the group N was higher than those in the other 3 groups(3 cases vs.2 cases vs.3 cases vs.9 cases,χ2=9.188,P=0.027).The incidence of nausea and vomiting in the group T was higher than those in the other 3 groups(2 cases vs.1 case vs.8 cases vs.4 cases,χ2=9.436,P=0.024).The incidence of tachycardia in the group D2 was higher than those in the other 3 groups(3 cases vs.7 cases vs.1 case vs.1 case,χ2=9.412, P=0.024). Conclusion Dexmedetomidine 0.4 μg/kg by intravenous injection can treat postoperative shivering after liposuction effectively and reduce the adverse reactions.

Objective To investigate the application value of local anesthesia with lidocaine carbonate and tetracaine in the prevention of tracheal intubation and extubation response in nasal endoscopy. Methods From January 2016 to March 2017, 90 patients scheduled for endoscopic sinus surgery were randomly divided into 3 groups,with 30 cases in each group.Before endotracheal intubation,1%tetracaine was used for endotracheal surface anesthesia,and air was filled into tracheal intubation airbag(group T). The intratracheal surface was sprayed with physiological saline and 1.73%lidocaine carbonate was filled into tracheal intubation airbag (group C).The 1%tetracaine was used for endotracheal surface anesthesia,and 1.73%lidocaine carbonate was filled into tracheal intubation airbag(group TC).The mean artery pressure(MAP)and heart race(HR)were recorded before induction(T1), immediately after intubation(T2),immediately after extubation(T3),and 5 min after extubation(T4).The scoring of cough during extubation was recorded.Sore throat scores were recorded by using Visual Analogue Scale(VAS)at 30 min,1 h,2 h,6 h and 24 h after extubation,respectively. Results The MAP and HR were less in the group T and TC than those in the group C at T 2(F=8.384,P=0.000;F=6.154,P=0.003), less in the group C and TC than in the group T at T 3(F=14.112, P=0.000; F=3.514,P=0.034).The cough scores were the lowest in the group TC(0.9 ±0.7), median in the group C(1.3 ±0.7), and the highest in the group T(1.7 ±0.5)(F=10.307, P=0.000).The VAS scores of pharyngalgia were the lowest in the group TC (2.1 ±0.8),median in the group C(3.0 ±1.2),and the highest in the group T(3.8 ±1.3)(F=17.961,P=0.000)at 30 min after surgery,and lower in the group TC(1.8 ±0.7)than in the group T(2.5 ±1.0)(F=5.058,P=0.008)at 1 h after surgery.Conclusion Local anesthesia combined with lidocaine carbonate and tetracaine can effectively reduce the cardiovascular response of endotracheal intubation and extubation and relieve the incidence of postoperative cough and sore throat.

Objective:To establish a predictive model for post-induction hypotension (PIH) in the patients undergoing colorectal cancer resection using machine learning algorithms based on muscle CT parameters.Methods:This was a single-center, retrospective study. Electronic medical records from 318 patients who underwent colorectal cancer resection from September 1, 2018 to September 30, 2021 at our hospital were collected. Predictive variables included age, gender, body mass index, hemoglobin, American Society of Anesthesiologists Physical Status classification, TNM staging, age-adjusted Charlson comorbidity index, prognostic nutritional index, L 3 level skeletal muscle index, and muscle quality assessed by Hounsfield unit average calculation. The outcome variable was PIH. The training and testing sets were divided based on the timeline (patients before September 1, 2020 were included in the training set, and those after that date were included in the testing set). The filtering method was used to screen the feature variables. Eight models, including logistic regression, Bayesian models, K-nearest neighbors, support vector machines, neural networks, decision trees, extreme gradient boosting trees, and random forests, were established in the training set using over-sampling technique, repeated cross-validation and hyperparameter optimization. After selecting the best model, a sorting chart of the feature variables, a univariate partial dependency profile, and a breakdown profile were drawn. In the testing set, the confusion matrix and parameters were calculated, and the receiver operating characteristic curve, precision recall curve, calibration curve, and decision curve were drawn to evaluate the performance of the predictive model. Results:The screened feature variables were Hounsfield unit average calculation value, age, L 3 level skeletal muscle index, prognostic nutritional index, hemoglobin and body mass index. The random forest was the optimal model, with an accuracy of 0.985 9, a MCC of 0.970 8, the area under the receiver operating characteristic curve was 1.0, and the area under the precision recall curve was 1.0. The Brier score of the calibration curve was 0.076 6; the decision curve showed the highest clinical net benefit of 0.6. Conclusions:In this study, machine learning algorithm is used to identify the important characteristic variables and establish a high-performance PIH prediction model based on muscle CT parameters.