The purpose of our study was to investigate the effect of gender on postoperative pain, sleep quality, and recovery outcomes in patients undergoing VATS surgery under general anesthesia. Perioperative peripheral blood inflammatory markers system inflammation Index (SII) was recorded for perioperative inflammatory response. The visual analog scale (VAS) was used to evaluate pain level. And the Athens Insomnia Scale (AIS) was evaluated on the night before surgery (sleep preop 1), the first night after surgery (sleep POD 1), and the third night after surgery (sleep POD 3) for postoperative sleep. In this prospective cohort study, 79 males and 79 females were consecutively included. Females had significantly higher pain score (both rest and cough pain) compared to the males at 3 h after the surgery (3.85 ± 1.2 vs. 3.16 ± 1.1) (rest) (p < 0.001) and 5.10 ± 1.3 vs. 4.46 ± 1.6 (coughing) (p = 0.006)). Patients in the male group had significantly lower AIS scores than those in the female group at Sleep POD 1 and Sleep POD 3 (p = 0.024 and p = 0.045). And in both groups, postoperative SII was increased and statistically significant compared to preoperative SII (p < 0.001, respectively). Women presented higher levels of SII on the first day after surgery, and the increase of postoperative SII in females groups was significantly higher than that in male group when compared to preoperative SII (1806.33 ± 1314.8 vs 1430.55 ± 958.4) (p = 0.042). These findings highlight the complex multidimensional nature of postoperative pain, nausea and vomiting, sleep quality and the potential contributory role of sex in shaping these outcomes. Women had worse sleep quality, higher postoperative inflammatory response level and pain level than men.

Chronic pain often leads to cognitive impairment. Resveratrol (Res), a natural polyphenol existing in Polygonum cuspidatum, has been widely investigated for its antinociceptive, anti‐inflammatory, and neuroprotective properties. Our aim was to explore the ameliorating effects of resveratrol on pain‐related behaviors and learning and memory deficits induced by cobra venom‐induced trigeminal neuralgia (TN). The TN model of rats was established by injecting cobra venom solution beneath the epineurium of the infraorbital nerve. Resveratrol was intragastrically administered at a dose of 40 mg/kg twice daily beginning on postoperative day 15. CREB inhibitor 666‐15 was intraperitoneally administered at a dose of 10 mg/kg from POD 35‐42 after morning resveratrol treatment. Mechanical allodynia was measured via von Frey filaments. Rat free movement was videotaped and analyzed. Spatial learning and memory were evaluated via the Morris water maze test. Ultrastructures of the hippocampal DG region and infraorbital nerve were observed by transmission electron microscopy. We found that resveratrol alleviated TN‐induced allodynia, ameliorated learning and memory deficits, restored the ultrastructure of hippocampal neurons and synapses, repaired the damaged myelin sheath of the infraorbital nerve, and activated the CREB/BDNF pathway in the hippocampus of TN rats. CREB inhibitor administration suppressed the resveratrol‐rescued abnormal hippocampal ultrastructural changes and aggravated spatial learning and memory impairment by inhibiting CREB/BDNF pathway activation in the hippocampus. Our findings indicated that resveratrol alleviated pain and improved cognitive deficits, probably by regulating neural ultrastructure remodelling and the CREB/BDNF pathway.

Background Opioids are commonly used in general anesthesia for pain management. However, they are related to obvious side effects. Patients with obesity undergoing laparoscopic sleeve gastrectomy are at higher risk of experiencing adverse effects associated with opioids. However, there is great heterogeneity in how to select and combine antinociceptive drugs to replace opioids. This randomized controlled double-blind study was conducted to evaluate the use effect of opioid-free anesthesia (OFA) in obese patients undergoing laparoscopic sleeve gastrectomy on the quality of postoperative recovery. Methods This prospective, parallel-group, double-blind, randomized controlled study included seventy-six patients undergoing laparoscopic sleeve gastrectomy in Beijing Friendship Hospital, Capital Medical University. Patients were randomly assigned to OFA group or opioid-based anesthesia (OBA) group. The primary outcome included the 15-item recovery quality scale (QOR-15). Secondary measures included intraoperative hemodynamic stability, intraoperative operation information, duration of until postoperative PACU Aldrete score > 9 points, anesthesia-related complication, and number of analgesic pump presses. Results The scores of QOR-15 in OFA group were higher than that in OBA group at 24 h and 48 h after surgery. The total dose of propofol required in OFA group was statistically less than that in OBA group. Patients in the OBA group had significantly lower bispectral index (BIS) values and lower levels of MAP at T2 (after intubation) than those in the OFA group patients in the OBA group. Patients in the OFA group showed significantly lower levels of heart rate (HR) at T3 (after abdominal closure) when compared to the OBA group. The changing trend of visual analog scale (VAS) and OBAS scores recorded after surgery were similar between both groups and the VAS and Overall Benefit of Analgesia Scale (OBAS) scores in OBA group were obviously higher than those in OFA group in each time point. The Rhodes Index of Nausea and Vomiting in OBA group were obviously higher than those in OFA group in each time point. Conclusions OFA significantly improved postoperative recovery quality as evidenced by higher QOR-15 scores, reduced postoperative nausea and vomiting (PONV), lower pain scores and decreased opioid requirements compared to OBA. Although duration of awakening from anesthesia was prolonged, OFA demonstrated superior recovery outcomes and fewer complications supporting its clinical utility in obese patients undergoing laparoscopic sleeve gastrectomy.

Objective: Our study aimed to demonstrate that the combination of sevoflurane inhalation with continuous intravenous anesthesia can effectively reduce the dosage of muscle relaxants, shorten extubation time under anesthesia while meeting the requirements of laparoscopic deep neuromuscular block (dNMB) in obese patients. Additionally, we sought to assess the potential reduction in postoperative residual muscle relaxants. Methods: Fifty-nine patients were randomly assigned. Anesthesia-related variables, such as anesthetics dosages, muscle relaxant effective time, clinical muscle relaxant time, muscle relaxant in vivo action time, muscle relaxant recovery time, body movement times, and extubation duration were recorded. Surgery-related variables (the Leiden-Surgical Rating Scale (L-SRS), duration of the procedure) were recorded. Pain was measured using the visual analog scale (VAS) score before leaving the PACU. The duration of the PACU stay and patients’ satisfaction levels in the PACU were also recorded. Results: Patients who inhaled sevoflurane during the operation required a lower dosage of muscle relaxant to achieve the same deep neuromuscular block (dNMB) effect. The time from stopping the rocuronium pump to T1 recovery of 90% was shorter, and the time for T1 to recover from 25% to 75% was faster among patients who inhaled sevoflurane during the operation. Furthermore, the sevoflurane combined with continuous intravenous anesthesia group exhibited a shorter extubation time for obese patients undergoing laparoscopic bariatric surgery, along with a reduced risk of experiencing hypoxemia and a shorter observation time in the PACU. Conclusion: Inhaling sevoflurane combined with continuous intravenous anesthesia during the operation effectively reduces the dosage of muscle relaxant required to achieve the same deep neuromuscular block (dNMB) effect. Additionally, this approach significantly shortens the extubation time for obese patients undergoing laparoscopic bariatric surgery and reduces the risk of experiencing hypoxemia, along with reducing the observation time in the PACU.

Introduction: Postoperative nausea and vomiting (PONV) remains a prevalent complication following laparoscopic cholecystectomy, often linked to perioperative opioid use. This randomized controlled trial aims to evaluate the efficacy of opioid-free anesthesia (OFA) in reducing PONV incidence and improving postoperative recovery quality compared to conventional opioid-based anesthesia (OBA). Methods/Analysis: This study is a prospective randomized, controlled clinical trial with a concealed allocation of patients scheduled to undergo elective laparoscopic cholecystectomy 1:1 to receive either a standard anesthesia protocol or an OFA. A total of 96 patients were recruited in the study. Primary outcomes include the Rhodes Index of Nausea and Vomiting and the incidence of nausea and vomiting at 6 and 24 hours postoperatively. Ethics and Dissemination: This trial has been approved by the Institutional Review Board of Beijing Friendship Hospital of China Capital University. The trial study protocol was approved on April 16, 2025, with an anticipated patient recruitment period of 12 months. The ethical approval number was BFHHZS20250091. The trial started recruiting patients after registered on the Chinese Clinical Trial Registry. Trial Registration Number: CTR2500102278; Pre-results.