Objective To evaluate the efficacy of stellate ganglion block(SGB)on postoperative sleep quality in the patients undergoing general anesthesia operation.Methods The randomized controlled trials(RCT)of the effect of SGB on postoperative sleep quality in the patients undergoing general anesthesia were searched from PubMed,Cochrane Library,Embase,CNKI,CBM,VIP and Wang Fang Data.The retrieval limi-tation was from the database establishment to July 21,2023.The screened literatures were evaluated by using the Cochrane 5.1.0 bias risk assessment tool,and then the meta analysis was performed by using Rev Man 5.4 software.Results A total of eight literatures were screened and included.The results of meta analysis showed that the incidence rate of sleep disorders in the first night after surgery in the SGB group was lower than that in the control group(OR=0.26,95％CI:0.15-0.45,P＜0.001),and the postoperative total sleep duration in the SGB group was higher than that in the control group(MD=69.06,95％CI:53.69-84.44,P＜0.001),the sleep efficiency of the SGB group was higher than that of the control group(MD=13.59,95％CI:10.70-16.49,P＜0.001);the postoperative Assens Insomnia Scale(AIS)scores(MD=-1.73,95％CI:-2.43 to-1.03,P＜0.001)and Pittsburgh Sleep Quality Index Scale(PSQI)scores(MD=-3.26,95％CI:-5.40 to-1.12,P＜0.003)in the SGB group were lower than those in the control group.Conclusion SGB could reduce the incidence rate of sleep disturbances at the postoperative first night,extend the postoperative total sleep time,increase the postoperative sleep efficiency,reduce the postoperative sleep quality score,and improve the postoperative sleep quality,which is a non-pharmacological method with good effect and high safety,has good clinical application prospect and is worth promoting.

Perioperative hypothermia,defined as a core body temperature below 36℃,occurs more fre-quently in pediatric patients.This higher incidence in children is primarily attributed to their smaller body size and larger surface area-to-weight ratio.Although infants can adapt to higher heat loss by increasing metabolic rate and heat production capacity,their limited thermoregulatory capacity leads to rapid depletion of metabolic reserves,thereby increasing the risk of hypothermia.Hypothermia may elevate the rates of perioperative com-plications and mortality in pediatric surgical patients.Based on relevant studies,the author summarizes the eti-ology,mechanisms,risk factors,and complications of perioperative hypothermia in pediatric populations,while providing management recommendations for its prevention.

Erector spinae plane block(ESPB)is a fascia plane block technique that involves injecting local anesthetics between the erector spinae muscle and the transverse processes of the spine.It blocks the posterior branches of the spinal nerves to provide perioperative analgesia for spinal surgeries.In recent years,ESPB has been increasingly widely used in spinal surgery analgesia due to its relatively simple operation,high safety and significant clinical benefits.However,its mechanism of action and the best application strategy still need to be further explored.This article systematically reviews the anatomical basis,mechanism of action,op-eration methods,drug selection,analgesic effect in various spinal surgeries,comparative advantages with other commonly used analgesic methods,and potential complications of ESPB,aiming to provide a reference for the clinical application of ESPB.

Analgesia is an important link in the treatment of severe patients after neurosurgery and plays a vital role in improving the prognosis of the patients.Understanding the status quo and influencing fac-tors of pain in severe patients after neurosurgery helps to predict the occurrence of pain,which is crucial for determining the new pain assessment methods and auxiliary analgesic methods and developing novel analgesic drugs.This paper reviews the pain status,pain evaluation and analgesic methods of severe patients after neuro-surgery in recent years so as to understand the pain management current status of the patients with severe neurological conditions and provide reference for the medical staff to implement the analgesic programs.

The goal of gastrointestinal endoscopy anesthesia management is to effectively calm and re-lieve pain while minimizing related adverse reactions and ensuring patient safety.Hypoxemia is the most com-mon adverse event during painless gastrointestinalendoscopy,and severe hypoxemia can cause cardiac and brain accidents.Therefore,how to prevent and reduce the occurrence of hypoxemia isa hot topic in clinical re-search.This article reviews the methods of preventing and reducing hypoxemia in general painless gastrointes-tinal endoscopy,and provides a reference for the selection of appropriate sedation and ventilation strategies for general painless gastrointestinal endoscopy anesthesia.

Remote ischemic conditioning (RIC) is a means of playing the systemic organ protective effect by transient ischemia/reperfusion of the limb,thus reduces the damage caused by more severe ischemic events.RIC can be applied before,during and after ischemic events;among them,the application before ische-mia is relatively more,which is called the remote ischemic preconditioning (RIPC).Researches have shown that RIC has considerable clinical translation value characterizing by non-invasion,economy,safety and effect. Although the specific mechanism needs to continue to be explored,but its protective targets are quite exten-sive.Especially for the heart,RIC seems to have favorable protective effects on the heart under almost all pathological conditions.Moreover,RIC has a certain degree of protective effect on the nervous system,lungs,livers and kidneys.Based on this,this article reviews the protective effects of RIC in different organs and its possible mechanisms.

In clinical surgery,various anesthetic drugs produce different effects on the blood circulation of patients.For example,propofol and inhaled anesthetics may lead to dose-related cardiovascular depression,meanwhile which is accompanied by sympathetic nerve tensile decline,vascular resistance decrease and is easy to induce postoperative hypotension.Ketamine can activate the sympathetic nervous system leading to release catecholamines and inhibit the vagus nerve,thus which is clinically manifested as increased blood pressure,in-creased heart rate and other cardiovascular excitation characteristics.As the dextroisomer-isomer of ketamine,esketamine(S-ketamine)not only retains the properties of ketamine,but also has relatively few side effects.Currently,it has been used in clinical anesthesia induction and maintenance,analgesia and treatment of refrac-tory depression.This paper provides a comprehensive overview of the effects of ketamine and S-ketamine on the hemodynamics of general anesthesia.

OBJECTIVETo compare the differences of postoperative patient-controlled intravenous analgesia for laparoscopic cholecystectomy and gynecological laparoscopy in female patients.

METHODSThis retrospective study included 645 female patients received laparoscopic cholecystectomy or gynecological laparoscopy (laparoscopic oophorocystectomy/myomectomy) between January 2011 and July 2012 in Tongji Hospital. Among them, 207 cases of sufentanil-tramadol patient-controlled intravenous analgesia (PCIA) were enrolled and divided into 2 groups:77 cases in laparoscopic cholecystectomy group, and 130 cases in gynecological laparoscopy group. The pressing frequency and consumption of PCIA, localization and quality of postoperative pain, visual analogue scale (VAS) at 4-6 h, 8-12 h, 18-24 h after surgery, and adverse effect were compared by t-test,χ(2) test, Fisher exact test or Mann-Whitney test.

RESULTSThere was no statistical difference of age, body mass index, and operation time between the two groups (all P > 0.05). As compared with the gynecological laparoscopy group (3 (4)), PCIA pressing frequency was higher in the laparoscopic cholecystectomy group (5 (7)), but there was no statistical difference (Z = -1.747, P = 0.081). PCIA consumption in the laparoscopic cholecystectomy group (79 (33) ml) was higher than that in the gynecological laparoscopy group (48 (30) ml) (Z = -6.267, P = 0.000). The postoperative pain localization and quality were different in the two groups, the patients in the laparoscopic cholecystectomy group experienced dull pain in lower abdomen, but the ones in the gynecological laparoscopy group had distending pain in upper abdomen and piercing pain around scapula. The differences of 4-6 h, 8-12 h, 18-24 h VAS scores in the two groups had no statistical significance (all P > 0.05). The total incidence of postoperative adverse effect between the two groups had no statistical significant difference (laparoscopic cholecystectomy group:11.7%, gynecological laparoscopy group:16.2%) (χ(2) = 0.778, P = 0.378). The incidence of dizziness was higher in the gynecological laparoscopy group (6.2%) than that in the laparoscopic cholecystectomy group (0) (Fisher exact test:P < 0.05).

CONCLUSIONIn the case of sufentanil-tramadol PCIA, laparoscopic cholecystectomy needs more postoperative analgesia, while gynecological laparoscopy has higher incidence of dizziness.

Analgesia, Patient-Controlled ; Cholecystectomy, Laparoscopic ; Female ; Gynecologic Surgical Procedures ; Humans ; Laparoscopy ; Pain Measurement ; Pain, Postoperative ; Retrospective Studies ; Sufentanil ; Tramadol