Objective To observe the effects of applying incremental positive end expiratory pressure(PEEP)lung recruitment method in lung protective ventilation strategy during anesthesia for laparoscopic colorectal cancer surgery on the respiratory mechanics and postoperative pulmonary complications.Methods The patients who underwent laparoscopic colorectal cancer surgery from June to December 2023 were randomly divided into two groups with 30 cases each group:the incremental PEEP lung recruitment combined with lung protective ventilation method group(RM group)and the lung protective ventilation method group(control group,C group).Both groups underwent lung protective ventilation.The RM group underwent the first lung recruitment immediately after the placement of Trendlenburg position,and then the lung recruitment was performed with the incremental PEEP method hourly thereafter.In the C group,no lung recruitment was performed throughout the procedure.The data of respiratory mechanics and oxygenation were recorded at 5 min before tracheal intubation(T0),immediately after tracheal intubation(T1),after the first pulmonary recruitment(after positioning in the C group)(T2),after the second pulmonary recruitment(60 min after positioning in the C group)(T3),after stopping the pneumoperitoneum(T4),and 30 min after extubation(T5),respectively.Postoperative pulmonary complications(PCC)were compared between the two groups.Results In terms of respiratory mechanics:the differences in peak airway pressure(Ppeak),airway plateau pressure(Pplat),driving pressure(△P),and pulmonary dynamic compliance(Cdyn)at the time point of T1 between the two groups were not significant(P＞0.05);the Ppeak,Pplat,and △P at the time points of T2 and T3 in the RM group were smaller than those in the C group(P＜0.05),and the Cdyn was larger than that in the C group(P＜0.05);the Ppeak at the time point of T4 in the RM group was smaller than that in the C group(P＜0.05),while the Pplat,△P,and Cdyn were not significant(P＞0.05).In terms of oxygenation:the differences in arterial partial pressure of oxygen(PaO2)and partial pressure of CO2(PaCO2)at the time point of T0 in the two groups were not significant(P＞0.05);the PaO2 at the time points of T3,T4,and T5 in the RM group was higher than that in the C group(P＜0.05),and the PaCO2 at the time points of T4 and T5 was lower than that in the C group(P＜0.05).In terms of postoperative pulmonary complications,the incidences of pulmonary atelectasis(5 cases vs.12 cases,P=0.045)and PPC(9 cases vs.18 cases,P=0.020)were lower in the RM group than those in the C group,while the difference of incidence of pulmonary infection and pleural effusion between the two groups was not significant(P＞0.05).There was no occurrence of respiratory failure in both groups.Conclusion Application of incremental PEEP lung recruitment in lung protective ventilation strategy can improve lung respiratory mechanics and reduce incidence of postoperative pulmonary complications in patients undergoing laparoscopic colorectal cancer surgery.

Objective To investigate the effects of preoperative oral electrolyte solution on intraoperative stress response and postoperative nausea and vomiting(PONV)in patients undergoing gynecological laparoscopic surgery.Methods From January to April 2025,200 cases of elective gynecological laparoscopic surgery due to benign diseases were selected and randomly divided into observation group and control group by the envelope method,with 100 cases in each group.The observation group orally took 5 ml/kg electrolyte solution(with a maximum dose of 300 ml)at 2 h before surgery,while the control group was fasted and prohibited from drinking at 2 h before the operation according to the traditional protocol.The mean arterial pressure(MAP),heart rate(HR),end-tidal CO2 partial pressure(PETCO2),Cerebral State Index(CSI),and pneumoperitoneum pressure were recorded at 6 time points:entering the room(T1),entering the laparoscope(T2),30 min after the start of the operation(T3),60 min after the start of the operation(T4),the end of the operation(T5),and 30 min after the operation(T6).The blood samples were taken at T3 and T6 to detect catecholamines(adrenaline,norepinephrine,dopamine),cortisol,and blood glucose levels.The recovery time of bowel sounds,anal exhaust time,and incidence of PONV within 2,6,and 12 h after surgery were recorded.Results There were no statistically significant differences in MAP,HR,PETCO2,CSI,and pneumoperitoneum pressure between the two groups(P＞0.05).The average levels of norepinephrine at T3 and T6 and blood glucose at T3 in the observation group were lower than those in the control group(P＜0.05).The incidence of PONV at 2,6,and 12 h after surgery,recovery time of bowel sounds,and anal exhaust time were all better in the observation group than those in the control group(P＜0.05).Conclusion Preoperative oral electrolyte solution can effectively alleviate the intraoperative stress response of gynecological laparoscopic surgery patients,reduce the incidence of PONV,promote the recovery of gastrointestinal function,and conform to the concept of Enhanced Recovery After Surgery(ERAS).

Objective To investigate the influence of ultrasound-guided bilateral quadratus lumborum-pudendal nerve block combined with general anesthesia on analgesic effect after laparoscopic radical resection of colorectal cancer.Methods A total of 76 patients with laparoscopic radical resection of colorectal cancer from January 2025 to May 2025 were included.By using the single-double number method,they were divided into block general anesthesia group(double number,n=38)and conventional general anesthesia group(single number,n=38).The block general anesthesia group was treated with ultrasound-guided bilateral quadratus lumborum-pudendal nerve block combined with general anesthesia,while the conventional general anesthesia group was given conventional general anesthesia regimen.The anesthesia recovery indexes,hemodynamic indexes[heart rate(HR),mean arterial pressure(MAP),and saturation of peripheral oxygen(SpO2)]before anesthesia,at the time of skin incision,skin suture,and the end of surgery,as well as the Visual Analogue Scale(VAS)score of pain at rest and activity and Riker Sedation-Agitation Scale score at 3,12,24,and 48 h after surgery,and levels of inflammatory factors and pain stress indexes before surgery and at 24 h after surgery were compared between the two groups.The adverse anesthesia reactions in the two groups were observed.Results The remifentanil dosage,sufentanil dosage,agitation rate,general anesthesia recovery time,first exhaust time,and remedial analgesia utilization rate in the block general anesthesia group were significantly lower or shorter than those in the conventional general anesthesia group(P<0.05).The HR and MAP were lower in the block general anesthesia group than those in the conventional general anesthesia group at the time of skin incision,skin suture,and the end of surgery(P<0.05),and there was no significant difference in SpO2(P>0.05).The VAS scores at rest and activity in the block general anesthesia group at 3,12,and 48 h after surgery were lower than those in the conventional general anesthesia group(P<0.05),and the Riker Sedation-Agitation Scale scores at 24 and 48 h after surgery were lower than those in the conventional general anesthesia group(P<0.05).At 24 h after surgery,the levels of interleukin-6,cortisol,and adrenocorticotropic hormone in the block general anesthesia group were lower than those in the conventional general anesthesia group(P<0.05).The total incidence rates of adverse anesthesia reactions in the block general anesthesia group[7.9%(3/38)]was significantly lower than that in the conventional general anesthesia group[26.3%(10/38),P=0.033].Conclusions The application of ultrasound-guided bilateral quadratus lumborum-pudendal nerve block combined with general anesthesia during laparoscopic radical resection of colorectal cancer has good analgesic and sedative effects.It has small influence on hemodynamics,reduces the dosages of opioids,relieves the inflammatory stress response,and reduces the adverse reactions.

Objective:To observe the effectiveness and safety of the application of Wei nasal jet tube(WNJT)in anesthesia induction for patients with extensive facial burns.Methods:A total of 60 patients who underwent multiple systemic scab removal and skin graft-ing surgery in our hospital from July 2021 to July 2023 were enrolled in this study.The patients were 18-60 years of age,with a body mass index of 18-29 kg/m2,ASA II or III,and Mallampati I-III.Using a random number table method,the patients were divided into WNJT ventilation group(W group)and mask ventilation group(M group),with 30 cases in each group.Before anesthesia induction,WNJT was inserted into one side of the nasal cavity for hand controlled normal frequency supraglottic jet ventilation in group W pa-tients,while oxygen ventilation was administered to group M patients through conventional two-hand clasped face masks.After 5 min,tracheal intubation was performed under a visual laryngoscope.The mean amplitude of diaphragm fluctuations,end expiratory carbon dioxide partial pressure(PETCO2),and blood oxygen saturation(SpO2)measured by ultrasound were recorded during spontaneous respi-ration at 5 min of oxygenation and nitrogen removal(T0),as well as at 1 min(T1),2 min(T2),3 min(T3),4 min(T4),and 5 min(T5,im-mediately before intubation)of anesthetic induction.Arterial blood gas(PaO2 and PaCO2)at T0 and T5 were measured.Heart rate(HR)and mean arterial pressure(MAP)were recorded at T0-T5 in both groups of patients.The occurrence of postoperative pharyngeal pain,facial or mandibular angle bleeding,gastrointestinal bloating,and nasal mucosal bleeding were recorded in both groups of pa-tients.Results:At T0,there were no statistically significant differences in mean amplitude of diaphragm fluctuations,HR,MAP,PaO2,PaCO2,PETCO2,and SpO2 between the two groups of patients.At T1-T5,the HR and MAP of patients in the W group were significantly lower than those in the M group(P<0.05).At T5,the PaO2 of patients in the W group was significantly higher than that in the M group,while the PaCO2 and PETCO2 were significantly lower than those in the M group(P<0.05).However,the difference in SpO2 was not sta-tistically significant.The W group had less facial or mandibular angle bleeding and postoperative gastrointestinal bloating than the M group,and the differences were statistically significant(P<0.05).There were no statistically significant differences between the two groups of patients in postoperative pharyngitis and nasal mucosal bleeding(P>0.05).Conclusion:During general anesthesia induction in patients with extensive facial burns,WNJT has the advantages of good ventilation effect,high safety,less complications such as gas-trointestinal bloating and facial or mandibular angle bleeding,and more stable hemodynamics.WNJT has good application prospects in clinical anesthesia.

Objective To investigate the influence of ultrasound-guided bilateral quadratus lumborum-pudendal nerve block combined with general anesthesia on analgesic effect after laparoscopic radical resection of colorectal cancer.Methods A total of 76 patients with laparoscopic radical resection of colorectal cancer from January 2025 to May 2025 were included.By using the single-double number method,they were divided into block general anesthesia group(double number,n=38)and conventional general anesthesia group(single number,n=38).The block general anesthesia group was treated with ultrasound-guided bilateral quadratus lumborum-pudendal nerve block combined with general anesthesia,while the conventional general anesthesia group was given conventional general anesthesia regimen.The anesthesia recovery indexes,hemodynamic indexes[heart rate(HR),mean arterial pressure(MAP),and saturation of peripheral oxygen(SpO2)]before anesthesia,at the time of skin incision,skin suture,and the end of surgery,as well as the Visual Analogue Scale(VAS)score of pain at rest and activity and Riker Sedation-Agitation Scale score at 3,12,24,and 48 h after surgery,and levels of inflammatory factors and pain stress indexes before surgery and at 24 h after surgery were compared between the two groups.The adverse anesthesia reactions in the two groups were observed.Results The remifentanil dosage,sufentanil dosage,agitation rate,general anesthesia recovery time,first exhaust time,and remedial analgesia utilization rate in the block general anesthesia group were significantly lower or shorter than those in the conventional general anesthesia group(P<0.05).The HR and MAP were lower in the block general anesthesia group than those in the conventional general anesthesia group at the time of skin incision,skin suture,and the end of surgery(P<0.05),and there was no significant difference in SpO2(P>0.05).The VAS scores at rest and activity in the block general anesthesia group at 3,12,and 48 h after surgery were lower than those in the conventional general anesthesia group(P<0.05),and the Riker Sedation-Agitation Scale scores at 24 and 48 h after surgery were lower than those in the conventional general anesthesia group(P<0.05).At 24 h after surgery,the levels of interleukin-6,cortisol,and adrenocorticotropic hormone in the block general anesthesia group were lower than those in the conventional general anesthesia group(P<0.05).The total incidence rates of adverse anesthesia reactions in the block general anesthesia group[7.9%(3/38)]was significantly lower than that in the conventional general anesthesia group[26.3%(10/38),P=0.033].Conclusions The application of ultrasound-guided bilateral quadratus lumborum-pudendal nerve block combined with general anesthesia during laparoscopic radical resection of colorectal cancer has good analgesic and sedative effects.It has small influence on hemodynamics,reduces the dosages of opioids,relieves the inflammatory stress response,and reduces the adverse reactions.

Objective To observe the effects of applying incremental positive end expiratory pressure(PEEP)lung recruitment method in lung protective ventilation strategy during anesthesia for laparoscopic colorectal cancer surgery on the respiratory mechanics and postoperative pulmonary complications.Methods The patients who underwent laparoscopic colorectal cancer surgery from June to December 2023 were randomly divided into two groups with 30 cases each group:the incremental PEEP lung recruitment combined with lung protective ventilation method group(RM group)and the lung protective ventilation method group(control group,C group).Both groups underwent lung protective ventilation.The RM group underwent the first lung recruitment immediately after the placement of Trendlenburg position,and then the lung recruitment was performed with the incremental PEEP method hourly thereafter.In the C group,no lung recruitment was performed throughout the procedure.The data of respiratory mechanics and oxygenation were recorded at 5 min before tracheal intubation(T0),immediately after tracheal intubation(T1),after the first pulmonary recruitment(after positioning in the C group)(T2),after the second pulmonary recruitment(60 min after positioning in the C group)(T3),after stopping the pneumoperitoneum(T4),and 30 min after extubation(T5),respectively.Postoperative pulmonary complications(PCC)were compared between the two groups.Results In terms of respiratory mechanics:the differences in peak airway pressure(Ppeak),airway plateau pressure(Pplat),driving pressure(△P),and pulmonary dynamic compliance(Cdyn)at the time point of T1 between the two groups were not significant(P＞0.05);the Ppeak,Pplat,and △P at the time points of T2 and T3 in the RM group were smaller than those in the C group(P＜0.05),and the Cdyn was larger than that in the C group(P＜0.05);the Ppeak at the time point of T4 in the RM group was smaller than that in the C group(P＜0.05),while the Pplat,△P,and Cdyn were not significant(P＞0.05).In terms of oxygenation:the differences in arterial partial pressure of oxygen(PaO2)and partial pressure of CO2(PaCO2)at the time point of T0 in the two groups were not significant(P＞0.05);the PaO2 at the time points of T3,T4,and T5 in the RM group was higher than that in the C group(P＜0.05),and the PaCO2 at the time points of T4 and T5 was lower than that in the C group(P＜0.05).In terms of postoperative pulmonary complications,the incidences of pulmonary atelectasis(5 cases vs.12 cases,P=0.045)and PPC(9 cases vs.18 cases,P=0.020)were lower in the RM group than those in the C group,while the difference of incidence of pulmonary infection and pleural effusion between the two groups was not significant(P＞0.05).There was no occurrence of respiratory failure in both groups.Conclusion Application of incremental PEEP lung recruitment in lung protective ventilation strategy can improve lung respiratory mechanics and reduce incidence of postoperative pulmonary complications in patients undergoing laparoscopic colorectal cancer surgery.

Objective To investigate the effects of preoperative oral electrolyte solution on intraoperative stress response and postoperative nausea and vomiting(PONV)in patients undergoing gynecological laparoscopic surgery.Methods From January to April 2025,200 cases of elective gynecological laparoscopic surgery due to benign diseases were selected and randomly divided into observation group and control group by the envelope method,with 100 cases in each group.The observation group orally took 5 ml/kg electrolyte solution(with a maximum dose of 300 ml)at 2 h before surgery,while the control group was fasted and prohibited from drinking at 2 h before the operation according to the traditional protocol.The mean arterial pressure(MAP),heart rate(HR),end-tidal CO2 partial pressure(PETCO2),Cerebral State Index(CSI),and pneumoperitoneum pressure were recorded at 6 time points:entering the room(T1),entering the laparoscope(T2),30 min after the start of the operation(T3),60 min after the start of the operation(T4),the end of the operation(T5),and 30 min after the operation(T6).The blood samples were taken at T3 and T6 to detect catecholamines(adrenaline,norepinephrine,dopamine),cortisol,and blood glucose levels.The recovery time of bowel sounds,anal exhaust time,and incidence of PONV within 2,6,and 12 h after surgery were recorded.Results There were no statistically significant differences in MAP,HR,PETCO2,CSI,and pneumoperitoneum pressure between the two groups(P＞0.05).The average levels of norepinephrine at T3 and T6 and blood glucose at T3 in the observation group were lower than those in the control group(P＜0.05).The incidence of PONV at 2,6,and 12 h after surgery,recovery time of bowel sounds,and anal exhaust time were all better in the observation group than those in the control group(P＜0.05).Conclusion Preoperative oral electrolyte solution can effectively alleviate the intraoperative stress response of gynecological laparoscopic surgery patients,reduce the incidence of PONV,promote the recovery of gastrointestinal function,and conform to the concept of Enhanced Recovery After Surgery(ERAS).

Objective To compare the application effects of different anesthesia methods under preoper-ative optimization measures in elderly patients with hip fracture surgery.Methods A total of 120 elderly pa-tients (≥75 years old) with hip fracture surgery in this hospital from May 2022 to December 2023 were se-lected as the study subjects and divided into group A and group B,60 cases in each group.The two groups a-dopted the preoperative optimization measures.The group A performed "two single three low" (unilateral,once,low position,low concentration and low dose) lumbar anesthesia,while group B conducted the laryngeal mask artificial airway anesthesia.The hemodynamic changes at skin incision in operation beginning (T1),at 30 min after operation (T2),suture at operation end (T3),at the end of operation (T4) and at 30 min after opera-tion end (T5),postoperative recovery time and occurrence situation of complications such as nausea and vomi-ting,agitation,postoperative delirium (POD) were compared between the two groups.Results The systolic blood pressure and the heart rate at T1 in group B were lower than those in group A,and the differences were statistically significant (P<0.05).The systolic blood pressure and heart rate at T4 in group B were higher than those in group A,and the difference was statistically significant (P<0.05).The recovery time,agitation,nausea and vomiting and incidence rate of adverse reactions such as POD had no statistical difference between the two groups (P<0.05).Conclusion On the basis of preoperative optimization measures,selecting the "two single three low" lumbar anesthesia method in elderly patients with hip fracture surgery anesthesia has more stable hemodynamics,less complications and faster postoperative recovery.

Objective To investigate the effects of dexmedetomidine injection at the Neiguan acupoint before general anaesthesia on neurocognitive disorder and sleep quality after non-cardiac major surgery in eld-erly people.Methods Elderly patients undergoing elective thoracic and laparoscopic surgery in this hospital from February 2023 to March 2024 were selected and divided into the dexmedetomidine Neiguan acupoint in-jection group(A),saline Neiguan acupoint injection group(B)and dexmedetomidine intravenous injection group(C)by the randomised numerical table method,40 cases in each group.The postoperative neurocognitive function and sleep-related condition in the three groups were observed.Results The incidence rate of postop-erative delirium(POD)on postoperative 1 d in the group A and C was significantly decreased compared with the group B,and the difference was statistically significant(P＜0.05);the incidence rate of POD on postoper-ative 2 d in the group A was significantly decreased compared with the group B(P＜0.05);the incidence rate of postoperative cognitive dysfunction(POCD)on postoperative 1 d in the group A and C was significantly de-creased compared with the group B,moreover which in the group A was lower than that in the group C,and the differences were statistically significant(P＜0.05);the incidence rate of POCD on postoperative 3,5 d in the group A was lower than that in the group B(P＜0.05).The MMSE score on postoperative 1,3,5 d in the group B and C was significantly decreased compared with preoperative 1 d(P＜0.05).The MMSE score on postoperative 1,3,5 d in the group A and C was higher than that in the group B.and the difference was statis-tically significant(P＜0.05).The PSQI score on postoperative 1,3,5 d in the group A and C was increased compared with preoperative 1 d(P＜0.05);compared with the group B,the PSQI score on postoperative 1,3,5 d in the group A and C was decreased,moreover the group A was lower the group C,and the differences were statistically significant(P＜0.05).The incidence rate of bradycardia in the group A and C was signifi-cantly higher than that in the group B(P＜0.05).The incidence rate of postoperative nausea and vomiting(PONV)in the group A was significantly lower than that in the group B and C(P＜0.05),and the difference between the group B and C had no statistical significance(P＞0.05).Conclusion Dexmedetomidine injection at the Neiguan acupoint before anaesthesia for minimally invasive surgery can significantly reduce periopera-tive neurocognitive dysfunction(PND)and improve the quality of sleep in elderly patients,moreover simulta-neously has the effect for preventing PONV.

Objective To observe the sedative and analgesic effect of remazolam combined with sufentanil during ultrasound-guided nerve block in patients undergoing orthopedic surgery.Methods A total of 80 patients who underwent orthopedic surgery in our hospital from January to June 2023 were selected.They were randomly assigned to two groups with 40 cases in each group.In anesthesia preparation room,one group was injected intravenously 10 ml remazolam(0.15 mg/kg)+ sufentanil 0.1 μg/kg(R group)and the other group was injected intravenously 10 ml normal saline +sufentanil 0.1 μg/kg(S group).Ultrasound-guided nerve block was performed 2 min later.The Visual Analogue Scale(VAS)of the two groups were observed during the process of postural position,nerve block puncture and drug injection.Whether there was any discomfort or body movement during the nerve block process were recorded.The mean arterial pressure(MAP),heart rate,and pulse oxygen saturation were measured at baseline,5 min after intravenous injection,nerve block injection,and 10 min after nerve block.Adverse reactions were noted.Results The VAS scores of the R group were 0 point at the time of postural position,nerve block puncture and drug injection,which were significantly lower than those of the S group(all P =0.000).The incidence of sore swelling,electrical sensation,and pain at the time of nerve block of the R group were lower than those of the S group(P<0.05).The incidence of transient glossoptosis of the R group was higher than that of the S group(6 cases vs.0 case,P =0.026).The MAP before and after nerve block in the S group remained at a high level(>95 mm Hg),and the highest MAP appeared at the time point of nerve block;while the MAP of the R group decreased and remained at 80-90 mm Hg after sedation.Conclusion Remazolam combined with sufentanil can provide safe,painless,fear free"comfort medical service"for nerve block sedation and analgesia in anesthesia preparation room,and does not increase the risk of nerve injury and local anesthetic poisoning.