General anesthesia alters time perception by phase shifting the circadian clock

Following general anesthesia, people are often confused about the time of day and experience sleep disruption and fatigue. It has been hypothesized that these symptoms may be caused by general anesthesia affecting the circadian clock. The circadian clock is fundamental to our well-being because it regulates almost all aspects of our daily biochemistry, physiology, and behavior. Here, we investigated the effects of the most common general anesthetic, isoflurane, on time perception and the circadian clock using the honeybee (Apis mellifera) as a model. A 6-h daytime anesthetic systematically altered the time-compensated sun compass orientation of the bees, with a mean anticlockwise shift in vanishing bearing of 87° in the Southern Hemisphere and a clockwise shift in flight direction of 58° in the Northern Hemisphere. Using the same 6-h anesthetic treatment, time-trained bees showed a delay in the start of foraging of 3.3 h, and whole-hive locomotor-activity rhythms were delayed by an average of 4.3 h. We show that these effects are all attributable to a phase delay in the core molecular clockwork. mRNA oscillations of the central clock genes cryptochrome-m and period were delayed by 4.9 and 4.3 h, respectively. However, this effect is dependent on the time of day of administration, as is common for clock effects, and nighttime anesthesia did not shift the clock. Taken together, our results suggest that general anesthesia during the day causes a persistent and marked shift of the clock effectively inducing "jet lag" and causing impaired time perception. Managing this effect in humans is likely to help expedite postoperative recovery.     

辽宁省麻醉学领域经食管超声心动图应用情况调查研究

目的调查并分析辽宁省麻醉学领域经食管超声心动图(TEE)的应用情况,为促进TEE技术在该地区麻醉学领域的发展提供依据。方法制定《辽宁省三级医院麻醉学领域重点可视化技术调查问卷》,以纸质问卷形式对辽宁省14个地市的98家三级医院麻醉科主要负责人进行问卷调查。结果收回的92份有效问卷显示,仅有13家三级甲等公立医院开展TEE,部分医院开展经胸超声心动图(TTE),69.2%的医院在非心脏手术术中应用过TEE/TTE,86.4%的医院3年间术中TEE总例数≤200。在开展TEE技术的医院中,麻醉医生具有TEE资质的人数平均≤3人,麻醉医生掌握TEE/TTE人数>5的医院仅1家。在科研方面,开展TEE的13家医院3年内相关科研产出均少于2项。结论近3年来,辽宁省三级医院麻醉学领域TEE技术开展医院数量少,发展不平衡,应用与研究不理想,有很大的提升空间。     

麻醉学专业“三段式”准入人才培养探索与实践

目的：研究麻醉学专业“三段式”准入人才培养的实施效果.方法：分别对麻醉学专业本科2008级、2009级、2010级学生进行MCQ和OSCE方式的“三段式”准入考试,评价考试成绩.结果：2009级和2010级本科学生全部达到准入要求.2008级本科学生全部具有领取毕业证资格.结论：麻醉学专业“三段式”准入考试对教育教学质量有积极的推动作用.     

以临床麻醉学为中心的课程整合改革研究与实践

介绍了在麻醉学专业课程教学中将以“学科为主”的教学模式转化为以“临床麻醉”为主线的课程整合模式做法,并对整合后的教学体系在实践中暴露出的问题进行分析,提出了应对举措。     

从麻醉学走向围手术期医学：我们准备好了吗

随着舒适化医疗新理念的提出,以加速康复外科（ERAS）为导向的围手术期管理新模式越来越被关注,这就要求麻醉学向围手术期医学转变,从而实现精准麻醉。如何实现这一转变,改变传统的麻醉学管理实践方法,对于麻醉医生而言是巨大的挑战。麻醉学科的发展对医学事业的进步及患者的远期预后具有重要作用。     

麻醉学本科生临床技能考核体系的构建

为提高麻醉学专业学生的临床能力,我系在教学实践中,结合麻醉学专业特色和执业医师考试的实际,逐步探索建立了麻醉学专业临床操作考评体系。麻醉学专业技能考核的重点学科包括临床相关学科(内科、外科、妇产科及儿科)和麻醉学专业学科(临床麻醉学、危重病医学、疼痛诊疗学)。该体系包括考核方法、考核内容和考核标准三个部分。能客观和公正地反映学生临床能力,为就业及执业医师的考试打下坚实的基础。