While cancer treatment has improved dramatically, it has also encountered many critical challenges, such as disease recurrence, metastasis, and drug resistance, making new drugs with novel mechanisms an urgent clinical need. The term “drug repositioning,” also known as old drugs for new uses, has emerged as one practical strategy to develop new anticancer drugs. Anesthetics have been widely used in surgical procedures to reduce the excruciating pain. Lidocaine, one of the most-used local anesthetics in clinical settings, has been found to show multi-activities, including potential in cancer treatment. Growing evidence shows that lidocaine may not only work as a chemosensitizer that sensitizes other conventional chemotherapeutics to certain resistant cancer cells, but also could suppress cancer cells growth by single use at different doses or concentrations. Lidocaine could suppress cancer cell growth in vitro and in vivo via multiple mechanisms, such as regulating epigenetic changes and promoting pro-apoptosis pathways, as well as regulating ABC transporters, metastasis, and angiogenesis, etc., providing valuable information for its further application in cancer treatment and for new drug discovery. In addition, lidocaine is now under clinical trials to treat certain types of cancer. In the current review, we summarize the research and analyze the underlying mechanisms, and address key issues in this area.
Background:Day surgery, a popular medical practice in the United States, started rather late in mainland China since 2001 when day surgery was officially launched. Determining Chinese patients’ specialty and attitudes towards day surgery is important for proactive patient education to promote day surgery in China. At present, Chinese patients’ attitudes towards day surgery are blurred with only few relevent research.The goal of this study was to investigate Chinese patients’ specialty, especiallyperioperative worries,and its relationship with patients’ attitudestowardsday surgery in Zhejiang Province, China. Methods: A total of 412 outpatients in Zhejiang Hospital were evaluated by a cross-sectional questionnaire survey between January 2019 andFebruary 2019.To evaluate outpatients’ specialtyand attitudes towardsday surgery, 420 outpatients were asked to fill out questionnaires including their characteristics, perioperative worry and acceptance of day surgery. Multinomial Logistic regression model was used to assess the relationship between them. Results:Of the 412 outpatients, 83.5% reported perioperative worries about day surgery. Outpatients who were older, less-educated, with comorbidities and lower income were more worried perioperatively and had poorer acceptance of day surgery. Outpatients worriedmost aboutpreoperative examinations not being done timely and being unable to monitor and manage complications and adverse events. Age, educated degree, comorbidities, financial status, surgery type and perioperative worry hadsignificantassociations with patient acceptance of day surgery.Outpatients with worries significantly scored lowerin acceptance of day surgery than those without worries, thus had a higher risk of refusing day surgery. Compared with less-educated patients, perioperative worries played a greater role in decreasing patient reception of day surgery in better-educated patients, reducing the possibility of acceptingday surgery. Conclusions:Perioperative worry was identified as an independent factor in influencing patient acceptance of day surgery among outpatients in ZheJiang Province in China.Results of this study can be used to guide patient education according to patients’ characteristics in day surgery, helping promote day surgery in China.
We report a case of a 24-year-old male patient with blunt brachiocephalic trunk injury, who was given low-dose dexmedetomidine (DEX) for 2 weeks to help smoothly pass the preparation period before the recanalization operation. Because the patient’s vital signs were stable after the injury, the surgeon did not perform emergency surgery. Taking into account the characteristics of blunt brachiocephalic trunk injury, it is necessary to avoid damage to or even rupture of brachiocephalic trunk resulting from irritability and high blood pressure. Patients should be sedated to avoid hemodynamic fluctuations that may be caused by cerebral ischemia and restlessness, and based on the patient’s neurological symptoms, prevention or treatment of perioperative neurocognitive disorders (PNDs) cannot be ignored. Therefore, the choice of drugs for bridging the preoperative preparation stage is crucial. DEX is an α2-adrenergic receptor agonist with antianxiety, analgesic, and sedative effects. It can also stabilize hemodynamics, regulate neuroinflammation, and provide neuroprotection. Instead of using either β-adrenergic receptor antagonists or sedatives, the patient received only low-dose DEX during preoperative preparation. DEX achieved the effects of β-adrenergic receptor blockers, vasodilators, and other sedatives, and it also had certain benefits for the patient’s PND. In short, based on our understanding of the relevant physiological factors, risk factors of brachiocephalic trunk injury, and the effects of DEX, low-dose DEX provides a good option for preoperative management in a patient with blunt brachiocephalic trunk injury.
Background Day surgery practice started rather late in mainland China, as it is not until 2001 when day surgery was officially launched. At present, Chinese patients’ cognition and attitudes towards day surgery are blurred with only few relevent research. The goal of this study was to investigate the situation of outpatients’ perioperative worries and its relationship with outpatients’ acceptance of day surgery in Zhejiang Province, China. Methods A total of 412 outpatients in Zhejiang Hospital were evaluated by a cross-sectional questionnaire survey between January 2019 to February 2019. To evaluate outpatients’ perioperative worries and acceptance of day surgery, 412 valid respondents out of all 420 outpatients were divided by 1. demographic characteristics, 2. been with or without worries. The correlation between worries and patient acceptance of day surgery was analyzed. Multinomial Logistic regression model was used to assess the relationship between them. Results Of the 412 outpatients, 83.5% reported perioperative worries about day surgery. Outpatients with worries were significantly older, with a higher incidence of comorbidities than those without worries. Age, educated degree, comorbidities, financial status, and surgery type were important factors of patient acceptance of day surgery. Outpatients without worries significantly scored higher in acceptance of day surgery than those with worries. The score of acceptance of day surgery was negatively correlated with perioperative worries. Compared with outpatients been worried about day surgery, those without worries had a lower risk of refusing day surgery. Conclusions The prevalence rate of perioperative worries about day surgery among Zhejiang outpatients was relatively high, and outpatients’ acceptance of day surgery was negatively associated with perioperative worries. We suggest developing and utilizing a perioperative care process to address outpatients’ perioperative worries, so as to improve outpatients’ acceptance of day surgery.
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