Acta Anaesthesiologica Taiwanica

An increasing body of evidence shows that the choice of anesthetic can strongly influence more than simply the quality of anesthesia. Regional and general anesthesia have often been compared to ascertain whether one provides benefits through dampening the stress response or harms by accelerating cancer progression. Regional anesthesia offers considerable advantages, by suppressing cortisol and catecholamine levels and reducing muscle breakdown postoperatively. It also has less immunosuppressive effect and potentially reduces the proinflammatory cytokine response. As such, vital organ functions (e.g., brain and kidney) may be better preserved with regional anesthetics, however, further study is needed. Volatile general anesthetics appear to promote cancer malignancy in comparison to regional and intravenous general anesthetics, and reduce the body's ability to act against cancer cells by suppression of natural killer cell activity. There is not sufficient evidence to support an alteration of current clinical practice, however, further research into this area is warranted due to the potential implications elicited by current studies.

Masae Iwasaki

Matthew Edmondson

Atsuhiro Sakamoto

Daqing Ma

Acta anaesthesiologica Taiwanica

Anesthesia, surgical stress, and “long-term” outcomes

麻醉、手术应激与“长期”结局

Vimi Rewari

Senthil Sabapathy

Rashmi Ramachandran

Acta Anaesthesiol Taiwan

Giant maxillary hemangioma in a child–Ketamine to the rescue

儿童巨大上颌血管瘤——氯胺酮解救

Shivinder Singh

Haneesh Thakur

Pneumorrhachis as a result of epidural anesthesia

硬膜外麻醉引起的气脊髓

Transversus abdominis plane (TAP) block is a recently introduced regional anesthesia technique that is used for postoperative pain reduction in some abdominal surgeries. The present study evaluated the efficacy of the TAP block on the post laparoscopic cholecystectomy pain intensity and analgesic consumption.Fifty-four patients were enrolled in three groups: TAP block with normal saline (Group 1, n = 18); TAP block with bupivacaine (Group 2, n = 18); and TAP block with bupivacaine plus sufentanil (Group 3, n = 18). The time to the first fentanyl request, fentanyl consumption in the 24 hours following surgery, and postoperative pain intensity at 30 minutes, 1 hour, 6 hours, 12 hours, and 24 hours following discharge for recovery were measured and recorded.The total amount of 24-hour fentanyl consumption was higher in Group 1 (877.8 ± 338.8 μg) than either Group 2 (566.7 ± 367.8 μg) or Group 3 (555.5 ± 356.8 μg; p = 0.03). Postoperative pain score was higher in Group 1 than intervention groups (p = 0.006); however, there was no significant difference in intervention groups. The time to the first fentanyl request in Group 1 (79.44 ± 42.2) was significantly lower than Group 3 (206.38 ± 112.7; p = 0.001).The present study demonstrated that bilateral TAP block with 0.5% bupivacaine reduces post laparoscopic cholecystectomy pain intensity and fentanyl request and prolongs time to the first analgesic request. Adding sufentanil to the block solution reduced neither pain intensity nor fentanyl further consumption.

Alireza Saliminia

Omid Azimaraghi

Shiva Babayipour

Kamelia Ardavan

Ali Movafegh

Efficacy of transverse abdominis plane block in reduction of postoperation pain in laparoscopic cholecystectomy

横腹肌平面阻滞在腹腔镜胆囊切除术后疼痛减轻中的疗效

This randomized, double-blind study was conducted to evaluate the effect of gabapentin pretreatment on the hemodynamic response to laryngoscopy and endotracheal intubation (LETI) in treated hypertensive patients undergoing surgery. A total of 100 controlled hypertensive patients aged 35–60 years, undergoing elective surgery under general anesthesia with endotracheal intubation, were randomly allocated into three groups. Group 1 patients received placebo at night and 2 hours prior to induction of anesthesia. Group 2 patients received placebo at night and 800 mg gabapentin 2 hours prior to induction of anesthesia. Group 3 patients received 800 mg gabapentin at night and 2 hours prior to induction of anesthesia. Anesthesia was induced with thiopentone, fentanyl, and vecuronium and maintained with isoflurane in oxygen and nitrous oxide. Patients' heart rate (HR), blood pressure (BP), and electrocardiography (ECG) changes were recorded prior to induction, after induction, and at 0 minutes, 1 minute, 3 minutes, 5 minutes, and 10 minutes after intubation. Any episodes of hypotension, bradycardia, tachycardia, hypertension, arrhythmia, and ST-T wave changes were recorded and treated accordingly. The HR was comparable among groups, with a transient rise just after intubation, followed by a gradual fall thereafter at 3 minutes, 5 minutes, and 10 minutes compared with baseline. A significant increase in BP after intubation was reported in Group 1 but not in Group 2 and Group 3. The mean arterial pressure (MAP) was significantly higher in Group 1 at 0 minute, 1 minute and 3 minutes postintubation as compared with Group 2 and Group 3 (p = 0.014). Three patients in Group 1, four patients in Group 2, and 10 patients in Group 3 developed hypotension and were treated with ephedrine, whereas five patients in Group 1 and one patient in Group 2 had hypertension after tracheal intubation. There was no significant difference between the groups with respect to the number of patients who received ephedrine boluses and in whom isoflurane had to be increased due to hypertension. No episode of bradycardia, tachycardia, dysrhythmia, or ST-T wave changes was reported. Gabapentin 800 mg in a single or double dose was equally effective in attenuating the hypertensive response to laryngoscopy and tracheal intubation in treated hypertensive patients.

Indu Bala

Neerja Bharti

Nanjangud P Ramesh

Effect of gabapentin pretreatment on the hemodynamic response to laryngoscopy and tracheal intubation in treated hypertensive patients

加巴喷丁预处理对已治疗高血压患者喉镜检查和气管插管血流动力学反应的影响

Chia-Chun Chuang

Jen-Yin Chen

Chien-Ching Lee

Severe acute peripheral edema induced by noninvasive blood pressure cuff in an elderly patient with hypoalbuminemia under general anesthesia

老年低白蛋白血症患者在全身麻醉下因无创血压袖带引起的严重急性外周水肿

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a key part of multimodal perioperative analgesia. This study aimed to evaluate the influence of perioperative NSAIDs application on complications after gastrointestinal surgery by using meta-analysis. A systematic review of published literature was conducted by searching computerized databases including PubMed, CBM, Springer, Chinese Academic Journals, and China Info since the databases were published until June 2015. The articles and retrospective references regarding complications after gastrointestinal surgery were collected to compare postoperative complications associated with NSAIDs or other analgesics. After they were assessed by randomized controlled trials and extracted by the standard of the Jadad systematic review, the homogeneous studies were pooled using RevMan 5.3 software. The meta-analysis was performed on five postoperative complications: postoperative anastomotic leak, cardiovascular events, surgical site infection, nausea and vomiting, and intestinal obstruction. Twelve randomized controlled trials involving 3829 patients met the inclusion criteria. The results of meta-analyses showed the following: (1) postoperative anastomotic leak: NSAIDs (including selective and nonselective NSAIDs) increased the incidence of anastomotic leak [odds ratio (OR) = 3.02, 95% confidence interval (CI): 2.16–4.23, p = 0.00001]. Further results showed that nonselective NSAIDs significantly increased the incidence of anastomotic leak (OR = 2.96, 95% CI: 1.99–4.42, p < 0.00001), and selective NSAIDs had no significant difference as compared with the control group using other analgesics (OR = 2.27, 95% CI: 0.68–7.56, p = 0.18); (2) postoperative cardiovascular events: NSAIDs (selective and nonselective NSAIDs) had no difference when compared with other analgesics (OR = 0.50, 95% CI: 0.23–1.12, p = 0.09); (3) postoperative surgical site infection: NSAIDs (selective and nonselective NSAIDs) and other analgesics had no difference in surgical site infection (OR = 0.77, 95% CI: 0.52–1.15, p = 0.20); (4) postoperative nausea and vomiting: NSAIDs (selective and nonselective NSAIDs) decreased the incidence of nausea and vomiting (OR = 0.53, 95% CI: 0.34–0.81, p = 0.003); (5) postoperative intestinal obstruction: NSAIDs (selective and nonselective NSAIDs) decreased the incidence of intestinal obstruction (OR = 0.35, 95% CI: 0.13–0.89, p = 0.03). The meta-analysis suggests that postoperative NSAIDs, especially nonselective NSAIDs, could increase the incidence of anastomotic leak. NSAIDs could decrease postoperative nausea and vomiting and intestinal obstruction, but showed no difference in cardiovascular events and surgical site infection as compared with other analgesics.

Fang Peng

Shijiang Liu

Youli Hu

Min Yu

Jing Chen

Cunming Liu

Influence of perioperative nonsteroidal anti-inflammatory drugs on complications after gastrointestinal surgery: A meta-analysis

围手术期非甾体抗炎药对胃肠手术后并发症影响的Meta分析

Chuen-Chau Chang

Chih-Shung Wong

Postoperative nausea and vomiting free for all: A solution from propofol?

术后无恶心呕吐：丙泊酚的解决方案？

Takeshi Murouchi

Quadratus lumborum block intramuscular approach for pediatric surgery

儿童手术中腰方肌阻滞的肌肉内入路

Wangping Zhang

Reply to: Respiratory acidosis in obese gynecologic patients undergoing laparoscopic surgery independently of the type of ventilation

回复：肥胖妇科患者在腹腔镜手术中出现呼吸性酸中毒，与通气类型无关

出版信息	出版商: Elsevier Taiwan LLC，出版周期: ，期刊类型: journal，开源期刊: 否
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