Objective:To evaluate the effect of ultrasound-guided internal branch block of superior laryngeal nerve on stress response during endotracheal catheter indwelling in patients undergoing uvulopalatopharyngoplasty (UPPP).Methods:A total of 80 patients with severe obstructive sleep apnea syndrome requiring elective UPPP from the Hunan Provincial People′s Hospital from January 2020 to December 2021 were retrospectively selected and divided into nerve block group (group B) and dexmedetomidine group (group D). Patients in group B and D received general anesthesia. Patients in the group B received bilateral internal branch block of superior laryngeal nerve under ultrasound guidance before postoperative recovery. Patients in the group D received dexmedetomidine intravenously before the end of surgery. The cough scores and mean arterial pressure (MAP), heart rate (HR), plasma epinephrine (E) and norepinephrine (NE) levels of patients before anesthesia (T 1), immediately after recovery (T 2), 2 h after recovery (T 3), 6 h (T 4), and 12 h (T 5) during endotracheal catheterization were recorded in both groups. The Visual Analogue Scale (VAS) scores of T 2, T 3, T 4, T 5 and 24 h after surgery (T 6) were also obtained. Results:Compared with group D, the cough scores of the group B patients were significantly lower, and the number of cases requiring remedial analgesia was significantly less (all P<0.01). Compared with T 1, MAP and HR at T 2-T 5 time points in the group B and HR and MAP at T 2-T 5 time points in the group D were significantly increased (all P<0.05). Compared with the group D, MAP and HR were significantly higher than those at each time point of T 2-T 5 in the group B (all P<0.05). Compared with T 1, the serum NE and E levels in the group D at T 2-T 5 time points, and the serum NE and T 2 E levels in the group B at T 2-T 5 time points were increased, and the differences were statistically significant (all P<0.05). Compared with the group D, serum E and serum NE levels at T 2-T 5 and T 2-T 4 in the group B were significantly lower (all P<0.05). Compared with T 2, T 5-T 6 VAS scores in the group B and T 3-T 6 VAS scores in the group D were significantly decreased (all P<0.05). Compared with the group D, the VAS scores at T 2-T 5 time points in the group B were significantly lower (all P<0.05). Conclusions:Compared with intravenous use of dexmedetomidine, ultrasound-guided internal branch block of superior laryngeal nerve can significantly reduce the discomfort and stress response during catheterization after UPPP, increase the comfort level of patients, reduce the incidence of postoperative complications, and promote rapid recovery of patients.

Objective:To evaluate the effect of ultrasound-guided internal branch block of superior laryngeal nerve on stress response during endotracheal catheter indwelling in patients undergoing uvulopalatopharyngoplasty (UPPP).Methods:A total of 80 patients with severe obstructive sleep apnea syndrome requiring elective UPPP from the Hunan Provincial People′s Hospital from January 2020 to December 2021 were retrospectively selected and divided into nerve block group (group B) and dexmedetomidine group (group D). Patients in group B and D received general anesthesia. Patients in the group B received bilateral internal branch block of superior laryngeal nerve under ultrasound guidance before postoperative recovery. Patients in the group D received dexmedetomidine intravenously before the end of surgery. The cough scores and mean arterial pressure (MAP), heart rate (HR), plasma epinephrine (E) and norepinephrine (NE) levels of patients before anesthesia (T 1), immediately after recovery (T 2), 2 h after recovery (T 3), 6 h (T 4), and 12 h (T 5) during endotracheal catheterization were recorded in both groups. The Visual Analogue Scale (VAS) scores of T 2, T 3, T 4, T 5 and 24 h after surgery (T 6) were also obtained. Results:Compared with group D, the cough scores of the group B patients were significantly lower, and the number of cases requiring remedial analgesia was significantly less (all P<0.01). Compared with T 1, MAP and HR at T 2-T 5 time points in the group B and HR and MAP at T 2-T 5 time points in the group D were significantly increased (all P<0.05). Compared with the group D, MAP and HR were significantly higher than those at each time point of T 2-T 5 in the group B (all P<0.05). Compared with T 1, the serum NE and E levels in the group D at T 2-T 5 time points, and the serum NE and T 2 E levels in the group B at T 2-T 5 time points were increased, and the differences were statistically significant (all P<0.05). Compared with the group D, serum E and serum NE levels at T 2-T 5 and T 2-T 4 in the group B were significantly lower (all P<0.05). Compared with T 2, T 5-T 6 VAS scores in the group B and T 3-T 6 VAS scores in the group D were significantly decreased (all P<0.05). Compared with the group D, the VAS scores at T 2-T 5 time points in the group B were significantly lower (all P<0.05). Conclusions:Compared with intravenous use of dexmedetomidine, ultrasound-guided internal branch block of superior laryngeal nerve can significantly reduce the discomfort and stress response during catheterization after UPPP, increase the comfort level of patients, reduce the incidence of postoperative complications, and promote rapid recovery of patients.

To investigate the alteration of c-Jun N-terminal kinase (JNK) activity after myocardial ischemia reperfusion injury (MIRI) and further explore the effect of naloxone postconditioning on MIRI. Forty male Sprague Dawley rats were randomly divided into five groups: sham operation (sham, n=8); ischemia reperfusion (IR, n=8); IR+naloxone 0.5 mg/kg (Nal L, n=8); IR+naloxone 1.0 mg/kg (Nal M, n=8); IR+naloxone 2.0 mg/kg (Nal H, n=8). Pathological changes of myocardial tissue were visualized by HE staining. The expression of p-JNK, and the apoptosis of cardiomyocytes were investigated with Western blotting and the TUNEL assay, respectively. Irregular arrangement and aberrant structure of myocardial fibers, cardiomyocytes with granular or vacuolar degeneration, and inflammatory cells infiltrating the myocardial interstitial regions characterized MIRI in the IR group. Signs of myocardial injury and inflammatory infiltration were less prominent in the Nal-treated groups. The expression of p-JNK in the sham group and in all Nal-treated groups was significantly lower than that in the IR group (p<0.01). The apoptosis index of cardiomyocytes in the IR group was significantly higher than in the sham group (p< 0.01). The apoptosis indices of cardiomyocytes in all Nal-treated groups were significantly reduced to 55.4%, 26.2%, and 27.6%, respectively, of the IR group (p< 0.01). This study revealed that Naloxone postconditioning before reperfusion inhibits p-JNK expression and decreases cell apoptosis, thus alleviating MIRI.
Animals ; Apoptosis ; Blotting, Western ; Humans ; In Situ Nick-End Labeling ; Ischemia ; JNK Mitogen-Activated Protein Kinases ; Male ; Myocardial Ischemia* ; Myocytes, Cardiac ; Naloxone* ; Rats* ; Rats, Sprague-Dawley ; Reperfusion Injury* ; Reperfusion*