BMC anesthesiology
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Blood nerve barrier (BNB) participates in the development of neuropathic pain. AQP1 is involved in peripheral pain perception and is negatively correlated with HIF-1α phenotype, which regulates endothelial permeability. However, the role of HIF-1α-AQP1-mediated BNB dysfunction in Chronic Postsurgical Pain (CPSP) has not been reported. ⋯ Early dysfunction of BNB mediated by HIF-1α/AQP1 activated by SMIR may be an important mechanism to promote acute postoperative painful transformation of CPSP. Preadaptive protection of endothelial cells around nerve substructures may be an important countermeasure to inhibit CPSP transformation. Early impairment of BNB function mediated by HIF-1α/AQP1 activated by SMIR may be an important mechanism for promoting acute postoperative pain transformation of CPSP.
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This study aimed to investigate the effects of perioperative dexmedetomidine (DEX) infusion rates on the postoperative short-term cognitive function. ⋯ Compared to a high dose (0.5-0.9 µg/kg/h) of DEX infusion, a low-dose (0.1-0.5 µg/kg/h) infusion started after induction of anesthesia and continued until 1 h before extubation improved postoperative cognitive function scores on postoperative Day 2 in patients aged 60 years and older.
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Randomized Controlled Trial
Pressure-controlled ventilation-volume guaranteed mode improves bronchial mucus transport velocity in patients during laparoscopic surgery for gynecological oncology: a randomized controlled study.
Mechanical ventilation during general anesthesia may impair airway mucosal function. This study aimed to investigate the effect of pressure-controlled ventilation-volume guaranteed (PCV-VG) on bronchial mucus transport velocity (BTV) in patients during laparoscopic surgery for gynecological oncology compared with volume controlled ventilation (VCV). ⋯ PCV-VG is more suitable for patients undergoing laparoscopic surgery for gynecological oncology than VCV since it can protect mucociliary clearance function.
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Observational Study
Effect of preoperative sleep disorders on delirium in proximal femoral surgery patients aged 60 or older.
To examine the effect of preoperative sleep disorders on delirium in patients older than 60 years of age who underwent surgery for proximal femoral fracture. ⋯ Preoperative sleeping disorders may be an independent risk factor leading to PD and an independent predictive factor for the development of delirium in proximal femoral surgery patients aged 60 or older.
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The world faces a significant global health threat - climate change, which makes creating more environmentally sustainable healthcare systems necessary. As a resource-intensive specialty, anesthesiology contributes to a substantial fraction of healthcare's environmental impact. This alarming situation invites us to reconsider the ecological health determinants and calls us to action. ⋯ Sustainable anesthesia initiatives have the potential to both encourage engagement among anesthesia providers and raise awareness of this global issue. These findings inspire opportunities for action in sustainable anesthesia and broaden the capacity to decrease the climate impact of health care.