Study of the factors that affect the quality of life in postoperative patients

1)非卧床手术后恢复时间延长的主要原因是术后的不适症状(疼痛、术后恶心呕吐(PONV)、嗜睡/头晕/疲劳)，其次是社会/系统问题。延迟的患者更频繁地抱怨术后疼痛，并报告较低的自我评估的正常活动(RNA)恢复水平和对门诊手术的接受度。满意度较低的患者报告的术后不适症状更频繁，RNA水平和可接受性较低。20%的患者在门诊手术后有中度到重度的疼痛。在短期乳腺癌手术中，七氟醚复合芬太尼麻醉较七氟醚麻醉有更高的PONV发生率和术后恢复时间；全静脉麻醉术中血流动力学变化和心率变异性抑制程度较低，PONV发生率较低，术后恢复较快；七氟醚麻醉…术中低血压、心动过缓发生率较高，恢复较慢，不影响术后疼痛和PONV的严重程度；七氟醚“轻”麻醉苏醒快，不影响PONV频率和心率变异性抑制。2)建立了以脑电双频指数(BIS)为控制变量的丙泊酚输注自动闭环控制系统。在TIVA中，它比人工控制更精确地保持BIS值。3)在体外培养的大鼠气管上皮细胞上，硫喷妥钠、咪达唑仑和右美托咪啶对纤毛运动无明显影响，但高剂量的氯胺酮和芬太尼使纤毛运动增强，而戊巴比妥对纤毛运动有强烈的抑制作用。氟烷和异氟醚的降幅较大，而七氟醚的降幅最小。异氟醚抑制异丙肾上腺素诱导的纤毛刺激，但不抑制细胞内cAMP水平的升高。异氟醚不影响细胞内三磷酸腺苷水平。较少

1)Prolonged recovery after ambulatory surgery is mainly due to postoperative unpleasant symptoms (pain, postoperative nausea and vomiting (PONV), drowsiness/dizziness/fatigue) and secondly due to social/system problems. Delayed patients complained postoperative pain more frequently, and reported lower self-rated resumption of normal activity (RNA) levels and acceptability for ambulatory surgery. Patients in lower satisfaction levels reported postoperative unpleasant symptoms more frequently, and lower RNA level and acceptability. Twenty percent of patients had moderate to severe pain after ambulatory surgery. In short-stay breast cancer surgery, sevoflurane anesthesia combined with fentanyl revealed higher PONV rate and delayed postoperative recovery ; total intravenous anesthesia (TIVA) revealed lower intraoperative hemodynamic changes and inhibition in heart rate variability (HRV), lower PONV rate, and faster postoperative recovery than sevoflurane anesthesia; sevoflurane anesthesia … More combined with dexmedetomidine revealed intraoperative hypotension and bradycardia episodes more frequently, and delayed recovery without affecting severity in postoperative pain and PONV ; sevoflurane "light" anesthesia revealed faster emergence without affecting PONV frequency and HRV inhibition.2)The automated closed-loop control system for propofol infusion using bispectral index (BIS) value as a controlled variable was developed. In TIVA, it maintained the BIS value more precisely than manual control. However, in monitored anesthesia care, control was difficult.3)In cultured rat tracheal epithelial cells, thiopental, midazolam and dexmedetomidine did not affect ciliary motility, but high doses of ketamine and fentanyl augmented it and pentbarbital depressed it strongly. Halothane and isoflurane decreased it vigorously, but seveflurane did minimally. Isoflurane inhibited isoproterenol-induced cilio-stimulation, but did not depress increased intracellular cAMP levels. Isoflurane did not affect intracellular ATP levels. Less