ObjectiveTo explore the effect of transcutaneous electrical acupoint stimulation （TEAS） on stress response in patients undergoing unilateral biportal endoscopy （UBE） and to identify optimal TEAS parameters. MethodsA total of 96 patients undergoing UBE were randomly grouped into total intravenous anesthesia （TIVA） group， acupuncture-assisted anesthesia with continuous waves （AACW） group， and acupuncture-assisted anesthesia with sparse-dense waves （AASDW） group， with 32 patients per group. All groups were given a standardized TIVA protocol. In the AACW group （100 Hz continuous wave stimulation） and the AASDW group （2/100 Hz sparse-dense wave stimulation）， TEAS intervention was applied to both bilateral Zusanli （ST36） and Sanyinjiao （SP6） 30 minutes before TIVA induction and continued until the end of the surgery. In the TIVA group， electrodes were only connected without electrical stimulation. The stress response indicators including cortisol （Cor） and adrenocorticotropic hormone （ACTH）， heart rate （HR）， mean arterial pressure （MAP）， and bispectral index （BIS） at before anesthesia induction （T0）， after tracheal intubation （T1）， during laminectomy （T2）， and 1 hour after surgery （T3） were compared across groups. The operation duration， anesthesia duration， extubation and recovery duration were recorded， as well as pain intensity including visual analogue scale （VAS）， and sedation level （by Ramsay sedation score） at 2， 6， 12 hours after surgery， and postoperative complications. ResultsThe AACW group and AASDW group had lower ACTH and COR levels at T1， T2 and T3， as well as lower HR and MAP levels at T1 and T2 than TIVA group， with AASDW group being lower than AACW group （P＜0.05）. At T3， the AASDW group had higher BIS than TIVA group and AACW group （P＜0.05）. No significant difference in operation duration was observed （P＞0.05）. The AACW group and AASDW group had shorter anesthesia， extubation and recovery duration than TIVA group， with AASDW group being the shortest （P＜0.05）. The VAS scores at 2 h， 6 h， and 12 h after surgery in the AACW and AASDW groups were lower than those in the TIVA group， with the AASDW group showing significantly lower scores than the AACW group （P＜0.05）. The Ramsay sedation scores in the AASDW group were lower than those in the AACW group at 2 h and 6 h after surgery （P＜0.05）. The total incidence of complications in the AASDW group was 6.25% （2/32）， significantly lower than 28.13% （9/32） in the TIVA group （P＜0.05）. ConclusionTEAS can effectively suppresses stress response in patients undergoing UBE， with the 2/100 Hz sparse-dense wave parameter being most effective， which can stabilize hemodynamics， accelerate recovery， improve postoperative sedation and analgesia quality， and reduces complications.

Objective:To observe the effect of betamethasone combined with ropivacaine on postoperative analgesia and sleep depth in patients undergoing laparoscopic cholecystectomy.Methods:A total of 150 patients undergoing laparoscopic cholecystectomy treated in the Hangzhou Traditional Chinese Medicine Hospital from October 2021 to December 2022 were selected as the study objects and divided into group A, group B and group C, with 50 cases in each group. Groups A and B were treated with ropivacaine and betamethasone at different doses (5 mg, 2.5 mg), while group C was treated with ropivacaine only. The perioperative period indexes of the three groups were compared. Pain degree at 4, 8, 12, 24 and 48 h after surgery and Pittsburgh Sleep index (PSQI) scores at 1 day before surgery, 1 day and 2 days after surgery were compared among the three groups.Results:There were no significant differences in operation time, anesthesia time, postoperative exhaust time and hospital stay, and the dosage of fentanyl and propofol among the three groups (all P>0.05). The Visual Analogue Scale (VAS) scores of group A and group B at 4, 8, 12, 24 and 48 h after surgery were significantly lower than those of the group C (all P<0.05), and the VAS scores of group A at 12, 24 and 48 h after surgery were significantly lower than those of the group B (all P<0.05). There was no significant difference in PSQI scores 1 day before surgery among the three groups (all P>0.05). The PSQI scores of the group A and the group B 1 and 2 days after surgery were significantly lower than those of the group C (all P<0.05), and the PSQI scores of the group A 2 days after surgery were significantly lower than those of the group B, with statistical significance ( P<0.05). There was no significant difference in the incidence of adverse reactions between the group A and the group B and the group C (all P>0.05). Conclusions:Betamethasone combined with ropivacaine can improve postoperative analgesia and sleep quality in patients undergoing laparoscopic cholecystectomy.

Objective:To observe the effect of betamethasone combined with ropivacaine on postoperative analgesia and sleep depth in patients undergoing laparoscopic cholecystectomy.Methods:A total of 150 patients undergoing laparoscopic cholecystectomy treated in the Hangzhou Traditional Chinese Medicine Hospital from October 2021 to December 2022 were selected as the study objects and divided into group A, group B and group C, with 50 cases in each group. Groups A and B were treated with ropivacaine and betamethasone at different doses (5 mg, 2.5 mg), while group C was treated with ropivacaine only. The perioperative period indexes of the three groups were compared. Pain degree at 4, 8, 12, 24 and 48 h after surgery and Pittsburgh Sleep index (PSQI) scores at 1 day before surgery, 1 day and 2 days after surgery were compared among the three groups.Results:There were no significant differences in operation time, anesthesia time, postoperative exhaust time and hospital stay, and the dosage of fentanyl and propofol among the three groups (all P>0.05). The Visual Analogue Scale (VAS) scores of group A and group B at 4, 8, 12, 24 and 48 h after surgery were significantly lower than those of the group C (all P<0.05), and the VAS scores of group A at 12, 24 and 48 h after surgery were significantly lower than those of the group B (all P<0.05). There was no significant difference in PSQI scores 1 day before surgery among the three groups (all P>0.05). The PSQI scores of the group A and the group B 1 and 2 days after surgery were significantly lower than those of the group C (all P<0.05), and the PSQI scores of the group A 2 days after surgery were significantly lower than those of the group B, with statistical significance ( P<0.05). There was no significant difference in the incidence of adverse reactions between the group A and the group B and the group C (all P>0.05). Conclusions:Betamethasone combined with ropivacaine can improve postoperative analgesia and sleep quality in patients undergoing laparoscopic cholecystectomy.

Objective To compare the efficacy and safety in patients received paravertebral block and epi-dural block for postoperative rehabilitation pain after unilateral ureterolithotomy.Methods 120 ASA Ⅰor Ⅱ patients were randomly allocated into research group (n =60)and control group (n =60).After operation,the research group received paravertebral block performed with peripheral nerve stimulator,the control group received epidural block.All patients received patient -controlled intravenous analgesia (PCIA)in the same time.The operation time,amount of bleeding,postoperative hospitalization time,operation completion,number of press PCIA,occurrence rate of postopera-tive adverse reaction in 48 h,and visual analog scores (VAS)at 4,8,16 and 24 h after surgery were recorded. Results The patients of the two groups were completed the stone surgery,there was no cases of conversion to open surgery.There was no significant difference in operation time,bleeding volume,postoperative hospital stay between the two groups (all P >0.05).But the PCIA times of the research group was (2.14 ±0.45)times,which of the control group was (4.20 ±0.68)times,the difference was statistically significant (t =4.27,P =0.029).The postoperative VAS scores of the research group[4 h (2.68 ±0.480)points,8 h (2.68 ±0.48)points,16 h (2.81 ±0.43) points,24 h (2.88 ±0.49)points]were significantly lower than those of the control group[(3.12 ±0.53)points, (3.37 ±0.58)points,(3.42 ±0.52)points,(3.39 ±0.55)points],the differences were statistically significant (t =2.68,3.13,306,311,all P <0.05).Of the research group,the nausea and vomiting occurred rate (23.33%), hypotension rate (0.00%),skin itching (5.00%),the incidence of decreased muscle strength (0.00%)were significantly lower than the control group(43.3%,31.6%,28.33% and 8.33%),the differences were statistically significant(χ2 =5.40,22.57,11.76,522,all P <0.05 ).Conclusion Nerve stimulator guidance for thoracic paravertebral nerve block for upper ureter incision to take stone surgery patients can significantly reduce postoperative pain and the PCIA analgesia drug dosage and the incidence of adverse reactions.

Objective To investigate the safety and effectiveness of thoracic paravertebral nerve block on radiofrequency ablation of liver tumors. Methods A total of 40 patients underwent radiofrequency ablation of liver tumor, were ran-domly divided into target-controlled infusion group(group G,n=20)and paravertebral nerve block group (group P,n=20). The intraoperative vital signs, anesthesia effects,anesthesia work time, total operation time,postanesthesia care unit stay time, major adverse clinical events and postoperative VAS scores of two groups were recorded and compared. Results The anesthesia satisfactory rate of G group was 95% and P group was 100%. After anesthesia induction MAP,HR,SPO2 and R declined significantly in group G. Compared with group G,intraoperative vital signs were more stable in group P. Major adverse clinical events in group P were less than group G (P<0.05). The effecting time in group P was longer than group G. The postanesthesia care unit stay time was longer in group G than group P(P<0.05). The post-operative VAS scores in group P declined much more than those in group G before 24 hours postoperatively(P<0.05). Conclusion Thoracic paravertebral nerve block for anesthesia in liver tumors underwent radiofrequency ablation is safe and effective.

Objective To investigate the effects of continuous wound infusion of ropivacaine for postoperative analgesia on local inflammation.Methods Forty ASA Ⅰ or Ⅱ patients,aged 45-64 yr,weighing 45-80 kg,undergoing simple nephrectomy,were randomized into either continusous wound infusion of local anesthetic group ( group CWI ) or control group ( group C),with 20 cases each.Group CWI were treated with continuous wound infusion of 0.25％ ropivacaine for postoperative analgesia,while group C were infused with the same volume of normal saline.All patients received patient-controlled analgesia with intravenous morphine.At 6,12,24 and 48 h after operation,the accumulated consumption of morphine was documented,and the concentration of prostaglandinE2 (PGE2) of drainage was determined using ELISA.Results Compared with group C,the accumulated consumption of morphine was decreased,and the PGE2 concentration was decreased in group CWI at each time points.Conclusion The mechanism of postoperative analgesic effect of continuous wound infusion of ropivacaine is related to the suppression of local inflammation in wound sites.