Clinical trials

The goal of this clinical trial is to learn if the "Visual-Auditory-Tactile-Numerical" (VANT) four-dimensional integrated teaching model improves clinical thinking and decision-making skills in second-year anesthesia residents. The main questions it aims to answer are: * Does the VANT teaching model improve structured clinical thinking scores (measured by the Anesthesia Clinical Thinking Process Scale) compared to traditional teaching methods? * Does the VANT teaching model enhance crisis management performance, including accuracy of primary management and critical decision time, in high-fidelity simulation scenarios? * Does the VANT teaching model lead to better long-term knowledge retention (at 1 month) and ability to apply learned skills to new clinical situations (at 3 months)? Researchers will compare the VANT four-dimensional integrated teaching group to a traditional structured teaching group to see if the VANT model produces greater improvements in clinical reasoning, crisis response, and knowledge transfer. Participants will: * Complete a 4-week training program (16 credit hours total) in either the VANT group or the traditional teaching group * In the VANT group, engage in multisensory immersive learning involving visual displays (physiological curves and brain network animations), auditory case narratives, tactile manikin manipulation with real-time feedback, and numerical modeling using PK/PD simulation software * In the control group, participate in traditional structured teaching including theoretical lectures, case discussions, and simulation practice with basic feedback * Complete clinical thinking assessments before training, immediately after, and at 1 month and 3 months post-training * Participate in a high-fidelity crisis simulation scenario to evaluate real-time decision-making ability * Complete questionnaires about their learning experience and cognitive load

Objective: To investigate the temporal dynamics of dexmedetomidine's analgesic effects in the brain using EEG. Methods: Eligible patients scheduled for total hip arthroplasty under intrathecal anesthesia received a continuous infusion of DEX at 1.5 μg/(kg·h) for 15 minutes before neuraxial puncture, followed by an additional 15-minute infusion. The study was divided into three phases: Phase 1: Non-dosing phase (Baseline). Phase 2: DEX preemptive analgesia phase (DEX infusion). Phase 3: DEX cessation phase (Post-infusion). Outcomes: Primary safety outcome: EEG spectral analysis at different phases. Secondary outcomes: NRS scores, postoperative nausea and vomiting (PONV), dizziness, agitation, and time to intestinal exhaust within 48 hours. Intraoperative hemodynamics were also monitored.

Background:Preemptive analgesia is the initiation of analgesic regimen before the onset of nociceptive stimulation, preventing the amplification of pain due to peripheral and central sensitization and thereby reducing subsequent pain. Preemptive analgesia of dexmedetomidine (DEX) in the epidural and subarachnoid space can effectively prevent the central sensitization, and significantly reduce the phantom limb pain, residual pain after one year of lower limb amputation. Objective: To investigate the per-operative effects of DEX preemptive analgesia. Method:The patients scheduled noncardiac surgery undergoing general anesthesia were selected and divided into DEX group and Placebo group randmized. The DEX group was continuously pumped at 1.5 μg /(kg·h) for 15 minutes before induction, and 15min after induction. The Placebo group was infused with equal amounts of normal saline.The Coprimary efficacy outcome was a composite of analgesia effect, one is the Compliance Rate of IOC2 target in intra-operation, another is the the rate of none-to-slight post-operative pain assessed with the p-NRS≦3 at 12 hours after surgery \[Pain numeric rating scale was assessed with the (Numeric Rating Scale, p-NRS)\].

1. Sufentanil as an strong analgesic is used widespreadly during laparoscopic cholecystectomy. 2. Lower dosages of sufentanil facilitated with dexmedetomidine can offer enough analgesia effect. 3. The investigator are planning use the most classical method for determining the ED50 or half effective concentration of sufentanil facilitated with dexmedetomidine using sequential method, which is also called" up and down method" and" ladder method".