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Purpose: Postoperative cognitive dysfunction (POCD) is a common postoperative complication. Studies have reported that lymphocyte-to-monocyte ratio (LMR) was a predictor of many diseases associated with inflammation. However, further examination of the relationship between preoperative LMR and POCD is needed. We aimed to investigate the association between POCD and preoperative LMR levels to examine the potential of LMR to predict POCD. Patients and Methods: This was a prospective cohort study that included patients who underwent elective major abdominal surgery at our hospital between January 2019 and January 2022. Multivariate logistic regression analysis was used to analyze the effects of preoperative LMR on POCD development. The optimal threshold of preoperative LMR for predicting POCD was determined by receiver operating characteristic (ROC) approach. A subgroup analysis was performed according to age, sex, type of surgery and hypertension. Results: Of 964 patients, 362 (37.6%) developed POCD. The preoperative LMR level in the Non-POCD group was higher than that in the POCD group. According to the ROC curve, a cutoff value of 3.758 of the preoperative LMR level could be used to predict POCD occurrence and the area under the curve (AUC) was 0.747 (95% CI: 0.715– 0.779, P < 0.001). The results of the subgroup analyses were consistent with the primary ones, and no heterogeneity was observed in the subgroup analyses (P for interaction > 0.05). Conclusion: LMR was significantly associated with the occurrence of POCD after major abdominal surgery. Preoperative low LMR levels can be used to identify patients who may be at high risk of POCD. [ABSTRACT FROM AUTHOR]

Background: Radical mastectomy often causes acute and chronic pain. One aimed to explore whether unilateral, ultrasound-guided, single-injection modified intercostal nerve block (MINB) could improve postoperative analgesia compared with no-MINB (Control group) in patients undergoing radical mastectomy., Methods: Sixty-five patients were randomly assigned to receive no-MINB (Control group) or MINB (MINB group) with 0.33 % ropivacaine (30 ml). The primary outcome was Visual Analogue Scale (VAS) scores at rest 6 h postoperatively. Secondary outcomes included VAS scores at rest and during movement at 0 h, 12h, 24h, 48h, and 90 days postoperatively; use of intraoperative opioids; postoperative rescue analgesia; time of first ambulation; complications; and score of China version of the Quality of recovery-15 (QoR-15) questionnaire (0 = extremely poor QoR; 150 = excellent QoR) at 24 h after surgery., Results: The MINB group showed lower resting VAS (resting) pain score at 6 h postoperatively (median [interquartile], 1 (0-2), vs 2 (2-3), 95 % CI difference in medians 1-2; P < 0.001), and significantly lower scores at resting and during movement at 0-24 h postoperatively. The MINB group showed lower intraoperative opioid use, a better quality of recovery on the QoR-15 scale, and more patients needed rescue analgesia in control group compared to those in MINB group. None of the MINB subjects showed MINB-related complications., Conclusion: Preoperative ultrasound-guided MINB markedly improved analgesia and concurrently reduced rescue analgesia demands and better recovery in patients undergoing radical mastectomy., Competing Interests: Declaration of competing interest No potential conflict of interest relevant to this article was reported., (Copyright © 2024 Asian Surgical Association and Taiwan Society of Coloproctology. Published by Elsevier B.V. All rights reserved.)