Composting and Vermicomposting Techniques (13)
Pluripotent Stem Cells Research (12)
CRISPR and Genetic Engineering (11)
Immune cells in cancer (9)
Chronic Kidney Disease and Diabetes (8)
The study aimed to explore the impact of transversus abdominis plane block (TAPB) combined with intravenous lidocaine on rapid recovery after bariatric surgery. A total of 80 patients who underwent elective bariatric surgery from October 2022 to October 2023 were selected as study participants and divided into a control group (CG) and a study group (SG). The CG received ultrasound-guided TAPB with ropivacaine, while the SG received ultrasound-guided TAPB with ropivacaine plus intravenous lidocaine. The two groups were compared in terms of total doses of propofol, remifentanil, and sufentanil used; pain intensity; intraoperative conditions; levels of inflammatory factors; additional use of postoperative analgesics; incidence of adverse reactions; and postoperative recovery time. Compared to the CG, the SG showed significant reductions in the total intraoperative doses of propofol, remifentanil, and sufentanil ( < 0.05). In addition, the SG had lower visual analog scale (VAS) scores at rest and during coughing at 12, 24, and 48 h postoperatively ( < 0.05), as well as lower heart rate (HR) and mean arterial pressure (MAP) values at time points T1-T3 ( < 0.05). On the first day after surgery, the levels of tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) in the SG were significantly lower than those in the CG ( < 0.05), and the SG also required less additional use of postoperative analgesics ( < 0.05). Furthermore, the SG exhibited a shorter time to first flatus, first defecation, and first ambulation, as well as a shorter length of hospital stay compared to the CG (all < 0.05). TAPB combined with intravenous lidocaine may provide effective postoperative analgesia for patients after bariatric surgery and may accelerate their rapid recovery.
Anesthesia techniques and drug selection may influence tumor recurrence and metastasis. Neutrophil extracellular trapping (NETosis), an immunological process, has been linked to an increased susceptibility to metastasis in individuals with tumors. Furthermore, recurrence may be associated with vascular endothelial growth factor A (VEGF-A), a mediator of angiogenesis. This study investigates the impact of lidocaine (combined with sevoflurane or propofol anesthesia ) during breast cancer surgery inhibits the expression of biomarkers associated with metastasis and recurrence (specifically H3Cit, NE, MPO, MMP-9 and VEGF-A). We randomly assigned 120 women undergoing primary or invasive breast tumor resection to receive one of four anesthetics: sevoflurane (S), sevoflurane plus i.v. lidocaine (SL), propofol (P), and propofol plus i.v. lidocaine (PL). Blood samples were collected before induction and 3 h after the operation. Biomarkers associated with NETosis (citrullinated histone H3 [H3Cit], myeloperoxidase [MPO], and neutrophil elastase [NE]) and angiogenesis were quantified using enzyme-linked immunosorbent assays. Patient and breast tumor characteristics, along with perioperative management, did not differ between study groups. In intra-group comparisons, S and P groups demonstrated a statistically significant increase in post-operative MPO (S group: 10.39[6.89-17.22] vs. 14.31[8.55-20.87] ng ml-1, P = 0.032; P group: 9.45[6.73-17.37] vs. 14.34[9.87-19.75] ng ml-1, P = 0.035)and NE(S group: 182.70[85.66-285.85] vs. 226.20[91.85-391.65] ng ml-1, P = 0.045; P group: 154.22[97.31-325.30] vs. 308.66[132.36-483.57] ng ml-1, P = 0.037) concentrations compared to pre-operative measurements, whereas SL and PL groups did not display a similar increase. H3Cit, MMP-9, and VEGF-A concentrations were not significantly influenced by the anesthesia techniques and drugs. Regardless of the specific technique employed for general anesthesia, there was no increase in the postoperative serum concentrations of MPO and NE after perioperative lidocaine infusion compared to preoperative serum concentrations. This supports the hypothesis that intravenous lidocaine during cancer surgery aimed at achieving a cure may potentially decrease the likelihood of recurrence. Further interpretation and discussion of clinical implications are warranted, emphasizing the significance of these findings in the context of cancer surgery and recurrence prevention. ChiCTR2300068563.