Volume 2, Issue 3

Heatstroke is a life-threatening acute condition characterized by dysregulated temperature control, resulting in high core temperature and multi-organ dysfunction. Despite extensive research, the molecular mechanisms underlying heatstroke-induced organ damage have not been fully elucidated. This review aims to summarize recent advancements in the field of heatstroke, focusing on etiological factors, organ damage, and molecular mechanisms. By exploring the intricate interplay between heat-related cytotoxicity, inflammatory response, and tissue dysfunction, this review offers insights for future research and clinical practice in managing heatstroke patients. Further investigations are warranted to elucidate the specific mechanisms of organ damage and improve treatment strategies for heatstroke.

Objective: In light of the advancement of modern medicine, anesthesiologists and surgeons are increasingly prioritizing patient comfort in diagnostic and therapeutic procedures. A growing body of research revolves around the utilization of ultrasound-guided forearm selective nerve blocks for surgeries involving the distal upper limb. This review aims to provide an overview of regional anesthesia techniques in forearm, hand, and wrist surgeries, laying a theoretical foundation for the prospects of ultrasound-guided forearm selective nerve blocks in optimizing comfort during diagnostic and therapeutic procedures. Methods: A retrospective review of literature sourced from the PubMed database was conducted to comprehensively evaluate and elucidate the advantages and drawbacks of ultrasound-guided forearm selective nerve blocks, brachial plexus blocks, Bier blocks, and wrist blocks. Additionally, a summary was provided regarding the selection of local anesthetics for ultrasound-guided forearm selective nerve blocks. Results: Overall, ultrasound-guided forearm selective nerve block techniques exhibit several advantages over Bier's block, brachial plexus block, and wrist block for the majority of forearm, wrist, and hand surgeries. These advantages include reduced anesthesia-related time, prolonged duration of analgesia, and minimal impairment of upper extremity motor function. Consequently, these techniques enhance surgical safety and facilitate postoperative recovery. Furthermore, the addition of dexmedetomidine or dexamethasone to ultrasound-guided selective nerve blocks of the forearm could extend the duration of analgesia. Conclusion: Ultrasound-guided forearm selective nerve block is a straightforward and conducive anesthesia method for distal upper limb surgeries, aligning with the principles of fast surgical recovery and enhanced patient comfort during diagnostic and therapeutic procedures. Given its manifold benefits, widespread promotion and adoption of this technique in clinical practice are warranted.

Artificial intelligence (AI) leverages its swift, precise, and fatigue-resistant problem-solving abilities to significantly influence anesthetic practices, ranging from monitoring the depth of anesthesia to controlling its delivery and predicting events. Within the domain of anesthesia, pain management plays a pivotal role. This review examines the promises and challenges of integrating AI into perioperative pain management, offering an in-depth analysis of  their converging interfaces. Given the breadth of research in perioperative pain management, the review centers on the quality of training datasets, the integrity of experimental outcomes, and the diversity of algorithmic approaches. We conducted a thorough examination of studies from electronic databases, grouping them into three core themes: pain assessment, therapeutic interventions, and the forecasting of pain management-related adverse effects. Subsequently, we addressed the limitations of AI application, such as the need for enhanced predictive accuracy, privacy concerns, and the development of a robust database. Building upon these considerations, we propose avenues for future research that harness the potential of AI to effectively contribute to perioperative pain management, aiming to refine the clinical utility of this technology.

Objective: To evaluate the safety of a novel modified retracting arm for endoscopic thyroidectomy by gasless unilateral axillary approach (ETGUA) and its effectiveness in minimizing complications. Methods: A novel retracting arm, which comprises a suspension part, a retracting arm, and a suction tube, was designed for ETGUA. The thyroid pull hook used in this study is an approved medical device: Su Xu, 20210063 (https://scjgj.xz.gov.cn/).The cohort of this randomized controlled study included 84 patients with unilateral thyroid cancer who underwent ETGUA at  Xuzhou Central Hospital from February 2021 to March 2023. The patients (n=42/group) were randomly assigned to a control group (conventional endoscopic retracting arm) or an experimental group (modified endoscopic thyroid retracting arm). Clinical indicators, complication rates, neck pain scores, and cosmetic scores were compared between the two groups. Results: There were no significant differences in hospitalization time, surgical duration, intraoperative blood loss, postoperative drainage volume, hypoparathyroidism, or postoperative hematoma between the groups. However, there were significant differences in the incidences of transient recurrent laryngeal nerve injury (x2=6.65, p=0.02) and transient superior laryngeal nerve injury (x2=4.49, p=0.03), as well as visual analog scale scores on postoperative day (POD) 1 and 7 (tPOD1=12.66; tPOD7=10.54; both, p<0.001), and cosmetic scores (t=-15.27, p<0.05). Conclusion: The modified retracting arm was safe and effective for ETGUA.