The effects of modified deep serratus anterior plane block on surgical stress and perioperative neurocognitive disorders in elderly patients undergoing thoracic surgery: a randomized clinical study
Bibliographic record
Abstract
Abstract Background To evaluate and compare the effects of a modified deep serratus anterior plane block (DSPB) combined with general anesthesia on surgical stress and perioperative neurocognitive disorder (PND) in elderly patients undergoing thoracic surgery, providing a new way to reduce the occurrence of PND in elderly patients undergoing thoracic surgery. Methods Sixty-six patients undergoing thoracic surgery were randomly assigned to receive either single-shot DSPB or local block after tracheal intubation using ropivacaine 0.5% 20 mL. The primary outcomes were the visual analog scale (VAS) score at each time point and the Montreal cognitive assessment (MoCA) score before surgery and after discharge from the hospital (or seventh day postoperative). Secondary outcomes included drug consumption, vital signs, blood gas analysis, malondialdehyde, superoxide dismutase, and serum cortisol levels. Results Sixty patients were eventually enrolled in this study. The VAS scores were significantly lower in the DSPB group than in the local block group (all P < 0.05). The difference in blood gas analysis index TCO2 (27.71 ± 3.49 vs 29.31 ± 2.26) in the two groups was statistically significant (P < 0.05). The length of hospitalization in the DSPB group was shorter than that in the local block group (6.03 ± 1.35 vs 7.20 ± 1.49), and the difference was statistically significant (P < 0.05). There were no statistically significant differences in MoCA scores before surgery and after hospitalization (or the seventh day postoperative), stress indices, vital signs, bispectral index value, blood gas analysis (except TCO2), and drug addiction during extubation at each time point (all P > 0.05). Conclusion Compared with local block, DSPB provided a superior analgesic effect with a lower VAS score and shorter length of hospitalization in elderly ptalatients undergoing thoracic surgery. It does not require ultrasound equipment, making it simpler and easier to operate, and is especially suitable for widespread implementation in grassroots hospitals.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".