The effects of a 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
Background: Perioperative stress response is an important risk factor for perioperative neurocognitive disorder (PND) in elderly patients. This study aimed to evaluate and compare the effects of a modified deep serratus anterior plane block (DSPB) combined with general anesthesia on surgical stress and PND in elderly patients undergoing thoracic surgery. Methods: A total of 66 patients undergoing thoracic surgery were randomly assigned to receive either a single-shot DSPB or local block after tracheal intubation using ropivacaine 0.5% (20 mL). The primary outcomes were the visual analog scale (VAS) scores at each time point. The secondary outcomes included the Montreal Cognitive Assessment (MoCA) score before surgery and after discharge from the hospital (or seventh day postoperatively), malondialdehyde (MDA), superoxide dismutase (SOD), and serum cortisol levels, drug consumption, vital signs, and blood gas analysis. Results: ), and drug use during extubation at each time point (all P>0.05). Conclusions: Compared with the local block, the elderly patients undergoing thoracic surgery who received the DSPB had a superior analgesic effect, a lower VAS score, and shorter length of hospitalization. As a DSPB does not require ultrasound equipment, it is simpler and easier to operate than a local block, and is especially suitable for widespread implementation in small hospitals. Trial Registration: China Clinical Trials Registry ChiCTR2300068717.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".