Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

OBJECTIVETo observe the effects of anesthetic intervention with small-dose lidocaine and ketamine on early postoperative cognitive function in elderly patients undergoing surgeries for gastrointestinal tumors.

METHODSSixty patients (ASA I-III, aged 63-82 years) scheduled for surgeries for gastrointestinal tumors were randomized into intervention group (n=30) and control group (n=30). After intravenous induction and tracheal intubation, the patients in the interventional group received intravenous infusion of 0.5 mg/kg lidocaine and 0.5 mg/kg ketamine, followed by continuous infusion of lidocaine at the rate of 0.5 mg·kg(-1)·h(-1) till the end of the operation; the patients in the control group received saline infusion only. The cognitive function of the patients was assessed at 3 day before and 2 day after the operation using comprehensive neuro-psychological tests. Peripheral venous blood was extracted before anesthesia induction (T0), at the end of the surgery (T1), and at 1 day (T2) and 2 days (T3) after the operation for measurement of serum S-100β protein, NSE and IL-6 levels using ELISA.

RESULTSThe difference between the test scores before and after the operation (X values) was significantly smaller in the intervention group than in the control group (P<0.05). The intervention group showed a significantly lower incidence rate of postoperative cognitive dysfunction (POCD) than the control group (6.7% vs 33.3%, P<0.05). Compared with the control group, the intervention group exhibited significantly lower serum levels of S-100β protein, NSE and IL-6 at T1 (P<0.05), significantly lower NSE and IL-6 levels at T2 (P<0.05) time point, and significantly lower IL-6 level at T3 (P<0.05).

CONCLUSIONIntravenous injection of small-dose lidocaine and ketamine during the operation can reduce the incidence of POCD in elderly patients undergoing surgeries for gastrointestinal tumors possibly in relation to decreased serum S-100β, NSE and IL-6 levels.

Aged ; Aged, 80 and over ; Anesthetics ; therapeutic use ; Cognition ; drug effects ; Gastrointestinal Neoplasms ; surgery ; Humans ; Interleukin-6 ; blood ; Ketamine ; therapeutic use ; Lidocaine ; therapeutic use ; Postoperative Complications ; Postoperative Period ; S100 Calcium Binding Protein beta Subunit ; blood

Objective To observe the effects of anesthetic intervention with small-dose lidocaine and ketamine on early postoperative cognitive function in elderly patients undergoing surgeries for gastrointestinal tumors. Methods Sixty patients (ASA I-III, aged 63-82 years) scheduled for surgeries for gastrointestinal tumors were randomized into intervention group (n=30) and control group (n=30). After intravenous induction and tracheal intubation, the patients in the interventional group received intravenous infusion of 0.5 mg/kg lidocaine and 0.5 mg/kg ketamine, followed by continuous infusion of lidocaine at the rate of 0.5 mg ·kg-1 ·h-1 till the end of the operation; the patients in the control group received saline infusion only. The cognitive function of the patients was assessed at 3 day before and 2 day after the operation using comprehensive neuro-psychological tests. Peripheral venous blood was extracted before anesthesia induction (T0), at the end of the surgery (T1), and at 1 day (T2) and 2 days (T3) after the operation for measurement of serum S-100βprotein, NSE and IL-6 levels using ELISA. Results The difference between the test scores before and after the operation (X values) was significantly smaller in the intervention group than in the control group (P<0.05). The intervention group showed a significantly lower incidence rate of postoperative cognitive dysfunction (POCD) than the control group (6.7%vs 33.3%, P<0.05). Compared with the control group, the intervention group exhibited significantly lower serum levels of S-100βprotein, NSE and IL-6 at T1 (P<0.05), significantly lower NSE and IL-6 levels at T2 (P<0.05) time point, and significantly lower IL-6 level at T3 (P<0.05). Conclusion Intravenous injection of small-dose lidocaine and ketamine during the operation can reduce the incidence of POCD in elderly patients undergoing surgeries for gastrointestinal tumors possibly in relation to decreased serum S-100β, NSE and IL-6 levels.

Objective To observe the effects of anesthetic intervention with small-dose lidocaine and ketamine on early postoperative cognitive function in elderly patients undergoing surgeries for gastrointestinal tumors. Methods Sixty patients (ASA I-III, aged 63-82 years) scheduled for surgeries for gastrointestinal tumors were randomized into intervention group (n=30) and control group (n=30). After intravenous induction and tracheal intubation, the patients in the interventional group received intravenous infusion of 0.5 mg/kg lidocaine and 0.5 mg/kg ketamine, followed by continuous infusion of lidocaine at the rate of 0.5 mg ·kg-1 ·h-1 till the end of the operation; the patients in the control group received saline infusion only. The cognitive function of the patients was assessed at 3 day before and 2 day after the operation using comprehensive neuro-psychological tests. Peripheral venous blood was extracted before anesthesia induction (T0), at the end of the surgery (T1), and at 1 day (T2) and 2 days (T3) after the operation for measurement of serum S-100βprotein, NSE and IL-6 levels using ELISA. Results The difference between the test scores before and after the operation (X values) was significantly smaller in the intervention group than in the control group (P<0.05). The intervention group showed a significantly lower incidence rate of postoperative cognitive dysfunction (POCD) than the control group (6.7%vs 33.3%, P<0.05). Compared with the control group, the intervention group exhibited significantly lower serum levels of S-100βprotein, NSE and IL-6 at T1 (P<0.05), significantly lower NSE and IL-6 levels at T2 (P<0.05) time point, and significantly lower IL-6 level at T3 (P<0.05). Conclusion Intravenous injection of small-dose lidocaine and ketamine during the operation can reduce the incidence of POCD in elderly patients undergoing surgeries for gastrointestinal tumors possibly in relation to decreased serum S-100β, NSE and IL-6 levels.

Objective To investigate whether rosuvastatin has the effects of anti-oxidative stress and attenuates vascular endothelial adhesiveness on the vessel wall in apolipoprotein E(apoE)knockedout mice. Methods Eighty 8-week-old apolipoprotein E-deficient mice and twenty 8-week-old C57BL/6 mice,were fed a normal chow diet for 12 weeks,and were divided into 2 weeks treatment group and 6 weeks treatment group.apoE knocked-out mice were subcutaneously injected with rosuvastatin at a dose of 1, 5, or 20 mg/kg daily for 2 or 6 weeks prior to sacrifice.Blood sample was taken by cardiopuncture and the aorta was obtained at the end of the 2th or 6th weeks. Results Total cholesterol level was significantly decreased after 2 or 6 weeks of 5,or 20 mg/kg rosuvastatin treatment[2 weeks:(480.7±35.3)mmol/L,(371.5±27.1)mmol/L;6 weeks:(400.1±37.6)mmol/L,(305.0±19.3)mmol/L],compared with 0 mg/kg group(20 weeks:(675.0±42.0)mmol/L;6weeks:(660.0±44.3)mmol/L](P＜0.05 or 0.01).But the changes of triglyceride and high-density lipoprotein were not like the above.The endothelial adhesiveness for monocytes was significantly attenuated after 2 weeks in 20 mg/kg group versus 0 mg/kg group[(2.24±0.72)%vs.(3.76 ±2.53)%](P＜0.05),and even more significantly after 6 weeks in 5,20 mg/kg groups[(1.94±0.40)%,(3.95±2.61)%](P＜0.01).In addition,rosuvastatin inhibited vascular expression of p22phox and superoxide production[0 mg/kg for 6 weeks group:(3.22±1.53)%,(4.75±2.62)μg/L;20 mg/kg for 6 weeks group:(1.41±0.72)%,(2.72±0.88)μg/L](all P＜0.05). Conclusions Rosuvastatin has a role of anti-oxidative stress and attenuates vascular endothelial adhesiveness on the vessel wall.