RESUMEN
Sedative−hypnotic misuse is associated with psychiatric diseases and overdose deaths. It remains uncertain whether types of anesthesia affect the occurrence of new postoperative uses of sedative−hypnotics (NPUSH). We used reimbursement claims data of Taiwan's National Health Insurance and conducted propensity score matching to compare the risk of NPUSH between general and neuraxial anesthesia among surgical patients who had no prescription of oral sedative−hypnotics or diagnosis of sleep disorders within the 12 months before surgery. The primary outcome was NPUSH within 180 days after surgery. Multivariable logistic regression models were used to calculate the adjusted odds ratio (aOR) and 95% confidence interval (CI). A total of 92,222 patients were evaluated after matching. Among them, 15,016 (16.3%) had NPUSH, and 2183 (4.7%) were made a concomitant diagnosis of sleep disorders. General anesthesia was significantly associated both with NPUSH (aOR: 1.17, 95% CI: 1.13−1.22, p < 0.0001) and NPUSH with sleep disorders (aOR: 1.11, 95% CI: 1.02−1.21, p = 0.0212) compared with neuraxial anesthesia. General anesthesia was also linked to NPUSH that occurred 90−180 days after surgery (aOR: 1.12, 95% CI: 1.06−1.19, p = 0.0002). Other risk factors for NPUSH were older age, female, lower insurance premium, orthopedic surgery, specific coexisting diseases (e.g., anxiety disorder), concurrent medications (e.g., systemic steroids), postoperative complications, perioperative blood transfusions, and admission to an intensive care unit. Patients undergoing general anesthesia had an increased risk of NPUSH compared with neuraxial anesthesia. This finding may provide an implication in risk stratification and prevention for sedative−hypnotic dependence after surgery.
RESUMEN
A silica-nanoparticle-and-azo-dye-doped liquid crystal (LC) phase grating with multistable and dynamic modes based on photo- and nanoparticle-induced alignments was demonstrated. The photoalignment suppressed the electrophoretic movement of the silica nanoparticles in the hybrid aligned nematic (HAN) LC cell to maintain the vertical orientation of LCs during the electrical operation process by means of the azo dyes adsorbed on the silica networks in the homogeneously aligned side of the sample, and contributed two LC structures to form a grating. Through the excitation of a DC pulse with proper polarity and an AC voltage, the multistable and dynamic diffraction efficiencies of the grating were achieved, respectively, by electrophoretically controlled silica nanoparticles and the electrically controlled birefringence effect of LCs.
