Objective To construct a standardized nursing process for insomnia patients treated with stellate ganglion block (SGB) based on the Plan-Do-Check-Act (PDCA) theory, aiming to improve nursing consistency, ensure patient safety, and optimize treatment outcomes. Methods Guided by the PDCA cycle theory, a standardized nursing process was systematically developed and revised through literature review, evidence synthesis, semi-structured interviews, and two rounds of Delphi expert consultations (involving 16 experts in round 1 and 15 in round 2). Results The final standardized nursing process comprised 7 primary items, 20 secondary items. The two rounds of expert consultations showed high expert positivity (effective questionnaire response rates: 100% and 93.75%, respectively), a high expert authority coefficient (0.97 for both rounds), and good consensus (Kendall’s W: 0.122 and 0.204, respectively; P < 0.05). Conclusion The PDCA theory-based standardized nursing process for SGB in insomnia patients is scientifically sound, systematic, and clinically feasible. The protocol shows potential to standardize nursing practices, improve care quality and patient safety, and provides a preliminary reference for clinical implementation. Future validation in real‑world settings is warranted.

The increasing demand for gastrointestinal endoscopic procedures, coupled with a global shortage of anesthesiologists, underscores the need for intelligent automation in anesthesia care. Reinforcement learning (RL) offers a promising strategy for autonomous anesthesia control, yet prospective clinical validation remains limited. We developed an RL-based automated anesthesia system for gastrointestinal endoscopy (AAS-GE) for automated ciprofol delivery and conducted a prospective, multicenter, randomized controlled trial across four centers in China between January 8 and August 27, 2025. Adults aged 18-65 years with American Society of Anesthesiologists physical status I-II undergoing gastrointestinal endoscopy were randomized 1:1 to receive either AAS-GE-controlled anesthesia or clinician-managed manual anesthesia. The primary outcome was the incidence of hypoxemia, defined as oxygen saturation below 92%, with secondary outcomes assessing hypoxemia severity, induction time, drug use, recovery, and adverse events. A total of 509 participants were included in algorithm development, and 418 were enrolled for clinical validation. The incidence of hypoxemia was comparable between groups (14.42 vs. 14.29%; odds ratio 1.01, 95% CI 0.59-1.75; P = 0.968), with no significant differences in secondary safety outcomes. AAS-GE achieved a shorter induction time (median 1.55 vs. 1.90 min; P < 0.001) without increasing total drug dose or recovery time. However, intraoperative body movement was more frequent in the AAS-GE group, consistent with lighter anesthesia depth. These results demonstrate the non-inferior safety and efficacy of AAS-GE compared with clinician management, supporting its potential to improve efficiency and standardize sedation care. Clinical registration: ClinicalTrials.gov on Feb. 26, 2025 (NCT06857344).

Objective:To compare the effects of intravenous sedation‑analgesia (IVSA) versus local anesthesia (LA) on patient‑reported intraoperative comfort and pain control during elective interventional procedures. Methods:This single‑center retrospective cohort study included 1068 adults undergoing interventional procedures between January and March 2024. Patients self‑selected LA or IVSA (midazolam, sufentanil, ketorolac). Propensity score matching (PSM) was applied to balance baseline characteristics. Primary outcomes were patient‑reported comfort and maximum pain scores (0-10 NRS). Operative time was also compared. After PSM, generalized estimating equation (GEE) models were used to compare outcomes. Sensitivity analyses included ordinal logistic regression and inverse probability weighting. Results:After PSM, 336 patients were included in each group. The mean comfort score was 7.2 ± 1.2 in the IVSA group and 3.5 ± 1.2 in the LA group; the mean pain score was 3.4 ± 1.3 and 7.3 ± 1.2, respectively. Median operative time was 39.5 minutes in the IVSA group and 42.5 minutes in the LA group. GEE analysis showed that IVSA was independently associated with higher comfort scores (β = 3.69, 95% CI: 3.50-3.88; P < 0.001) and lower pain scores (β = -3.87, 95% CI: -4.04 to -3.70; P < 0.001), with no significant difference in operative time (geometric mean ratio = 0.965, 95% CI: 0.912-1.020; P = 0.211). Sensitivity analyses yielded consistent results. Conclusion:IVSA was associated with significantly higher intraoperative patient comfort and lower pain scores compared to LA alone, without a significant difference in procedure time, though it was associated with a higher incidence of transient adverse effects.

Myocardial Infarction (MI) is a severe cardiovascular event, causing not only substantial damage to the heart but also potentially exerting a profound impact on brain function through a complex cardiac-brain interaction mechanism. The pathological process of MI encompasses myocardial cell necrosis, inflammatory cell infiltration, and the release of a substantial amount of inflammatory mediators. Through the bloodstream, these myocardial mediators may traverse the Blood-Brain Barrier (BBB), eliciting a neuroinflammatory response that can lead to cognitive dysfunction. This article proposes a critical research direction: investigating whether MI mediates the effects of myocardial- derived mediators on the permeability of the BBB, as well as the potential consequences of these mediators on cognitive functions. This review is aimed at triggering future research to elucidate the underlying mechanisms governing heart-brain interactions after MI in order to facilitate the development of more effective cognitive protection strategies for patients with MI.

BACKGROUND Postoperative nausea and vomiting (PONV) remains a common and clinically important problem after laparoscopic sleeve gastrectomy (LSG), even with routine multimodal prophylaxis. Existing studies have often relied on retrospective designs or simple binary outcomes, which may not adequately reflect the full burden of postoperative symptoms. AIM To estimate the incidence and severity of PONV after LSG and to identify perioperative factors associated with its development. METHODS This prospective cohort study included consecutive adults undergoing elective LSG between March 2022 and December 2023. PONV was assessed using the validated Chinese version of the Index of Nausea, Vomiting, and Retching at seven time points during the first 3 postoperative days. Demographic, clinical, and perioperative data were collected. Potential predictors were screened using least absolute shrinkage and selection operator regression and then entered into multivariable logistic regression models. RESULTS A total of 1054 patients were included in the final analysis. During the 3-day postoperative period, 804 patients experienced at least one episode of PONV, yielding an overall incidence of 76.3%. Nausea occurred in 73.7% of patients, vomiting in 50.3%, and retching in 35.0%. In multivariable analysis, intraoperative dexmedetomidine use was independently associated with a lower risk of PONV [odds ratio (OR) = 0.50; 95%CI: 0.36-0.70; P < 0.001]. Apfel scores of 3 (OR = 4.27; 95%CI: 1.33-13.55; P = 0.013) and 4 (OR = 4.93; 95%CI: 1.51-15.94; P = 0.007) were associated with an increased risk. CONCLUSION PONV remains highly prevalent after LSG despite guideline-based prophylaxis. Intraoperative dexmedetomidine was associated with a reduced risk of PONV, whereas higher Apfel scores predicted an increased risk. These findings may help refine antiemetic strategies for patients undergoing LSG.

Introduction:Postoperative thirst is a common yet under-investigated issue following metabolic and bariatric surgery (MBS), such as sleeve gastrectomy (SG), despite its significant impact on patient comfort and recovery. While studies in other surgical fields report a high prevalence of this distressing symptom, its incidence and predictors remain unquantified in the MBS population. This study aims to prospectively determine the incidence of postoperative thirst (primary outcome), the incidence of moderate-to-severe thirst, and the factors associated with postoperative thirst (secondary outcomes) in adults undergoing SG. Methods:This prospective, single-center, observational cohort study will enroll adults (age ≥18, ASA class 2‒3) undergoing elective SG. Based on a preliminary incidence of 90% from a 10-patient pilot study, we plan to enroll 180 patients. The primary outcome-incidence of postoperative thirst-will be assessed immediately upon arrival in the post-anesthesia care unit using the Numeric Rating Scale (NRS), with thirst defined as an NRS score ≥ 1. Moderate-to-severe thirst will be defined as an NRS score ≥4. We will collect demographic, perioperative, and intraoperative data to investigate factors potentially associated with postoperative thirst. A two-stage analytical approach will be employed: variable selection using Least Absolute Shrinkage and Selection Operator (LASSO) regression, followed by multivariable binary logistic regression to identify factors associated with postoperative thirst. Discussion:The findings from this protocol will clarify the epidemiology of postoperative thirst in MBS and help identify modifiable perioperative risk factors. This evidence will inform nursing practices and the optimization of postoperative care pathways, supporting better recovery and comfort for individuals undergoing MBS. Results are intended to provide a basis for further interventional studies and contribute to improved perioperative management in MBS. Trial Registration:Registered at the Chinese Clinical Trial Registry on May 9, 2025. Trial Registration Number: ChiCTR2500102147.

Meralgia paresthetica (MP) is a recognized complication following bariatric surgery, yet its risk factors remain poorly defined. This study aimed to investigate the incidence of MP after laparoscopic sleeve gastrectomy (LSG) in patients with obesity and to identify its independent risk factors. We conducted a retrospective cohort study of patients who underwent LSG under general anesthesia at our institution between May 2020 and August 2024. Patients were divided into MP and non-MP groups based on postoperative occurrence. Propensity score matching (PSM) with a 1:4 ratio was used to balance baseline characteristics. Univariate and multivariate logistic regression analyses were performed to assess the association between potential risk factors (including preoperative body mass index [BMI] and common comorbidities) and postoperative MP. A total of 2,635 patients were included. The incidence of postoperative MP was 9.86‰ (26/2635). After PSM, 26 MP patients and 104 non-MP patients were analyzed. Univariate analysis showed the MP group had a significantly higher preoperative BMI than the non-MP group (48.78 ± 7.36 kg/m² vs. 43.07 ± 12.17 kg/m², P < 0.05). Comorbidities such as diabetes and hypertension were not significantly different between groups. Multivariate logistic regression confirmed that a higher preoperative BMI was an independent risk factor for postoperative MP (OR = 1.036, 95

Maternal immune activation (MIA) during early to mid-pregnancy may be associated with offspring psychological issues, while the association between MIA in late pregnancy and offspring brain inflammation remains controversial. This study investigated the effects of maternal exposure to IL-6 during late pregnancy on brain inflammation in offspring born via different delivery methods. On gestation day 20 ± 1, pregnant rats were randomly assigned to an IL-6 intramuscular injection group and a saline control group. Rectal temperature was monitored every half hour for 8 h postinjection. Based on spontaneous delivery within 8 h, each group was further subdivided into cesarean section and spontaneous delivery subgroups. Pregnant rats that did not deliver spontaneously underwent cesarean section to retrieve fetuses for brain inflammation assessment, while newborns from spontaneous deliveries were nursed by their mothers for 4 days. Immunohistochemistry and western blotting were used to detect Iba1, GFAP, and COX2 expression to assess brain inflammation levels in fetuses and newborns. The mode of delivery did not affect rectal temperature in pregnant rats between the IL-6 group and the saline group. In the brain tissue of pups delivered by cesarean section, the IL-6 group exhibited significantly higher expression levels of Iba1, GFAP, and COX2 compared with the control group, while no significant difference was observed between the two groups in pups delivered vaginally. In both groups of newborn rats delivered vaginally, GFAP and COX2 expression increased on Day 2, peaked on Day 3, and decreased on Day 4, while Iba1 expression peaked on Day 4. Maternal inflammation and the stimuli of natural birth can both induce brain inflammation in fetal or newborn rats. Maternal inflammation during late pregnancy has a moderate effect on fetuses, comparable to the effects observed after natural birth.

The rising global prevalence of obesity has established bariatric surgery as a key therapeutic option; however, postoperative pain management remains a challenge. This study investigated the influence of body mass index (BMI) stratification on acute postoperative pain in patients undergoing bariatric surgery. Fifty-five patients aged 18–65 years with BMI ≥ 30 kg/m2 scheduled for laparoscopic sleeve gastrectomy were categorized into the obesity group (O group; 30 kg/m2 ≤ BMI < 40 kg/m2) and the severe obesity group (SO group; BMI ≥ 40 kg/m2). Preoperative pain threshold and pain tolerance threshold, perioperative inflammatory cytokines, Brief Pain Inventory (BPI) scores, Quality of Recovery-15 (QoR-15) scores, postoperative resting and movement numeric rating scale (NRS) scores, patient-controlled analgesia (PCA) pump usage, cumulative analgesic consumption, and analgesic satisfaction were assessed. Compared with the O group, the SO group demonstrated a significantly higher pain tolerance threshold (4.1 ± 0.8 vs. 3.5 ± 1.0, P < 0.01), along with lower demand for PCA and reduced consumption of cumulative morphine milligram equivalents and flurbiprofen (P < 0.05). Notably, the primary outcome, the 24-h BPI score, showed no significant difference between the two groups. On postoperative days 1 and 3, tumor necrosis factor-α (TNF-α) levels were significantly lower in the O group, whereas no significant intergroup differences were observed in other inflammatory cytokines. No significant differences were observed in NRS or QoR-15 scores between the two groups. BMI may be considered as a factor for stratifying postoperative analgesia, favoring multimodal, opioid-sparing strategies in patients with severe obesity who demonstrate higher pain tolerance and lower analgesic requirements. Chinese Clinical Trial Registry, ChiCTR2400095080.

FactsOxygen is essential for most living organisms on the Earth, but excessive oxygen can cause oxygen toxicity.For individuals with mitochondrial dysfunction, even normal oxygen concentration in the air may be relatively excessive.Consensus regarding oxygen supply for critically ill patients in the intensive care unit has yet to be reached.Open QuestionsHow to strike a balance between insufficient and excessive oxygen supply during oxygen inhalation?Is it necessary to integrate monitoring of oxygen supply to form a closed-loop oxygen supply system with autonomous regulation for patients/individuals who need oxygen therapy?How to better achieve individualized oxygen supply? Oxygen inhaled through respiration is consumed in the mitochondria, mainly for oxidative phosphorylation to produce energy. Too little or too much oxygen can be extremely harmful to humans. Insufficient oxygen supply to tissues and organs can result in either dysfunctions or necrosis. However, when the oxygen supply is over supplied, the body is unable to consume the excessive oxygen, which puts the cells in a state of hyperoxia, leading to the production of a large number of reactive oxygen species, which can further cause oxidative damage to the cell membranes and organelles, leading to oxygen toxicity. Although the body has several oxygen-sensing mechanisms to prevent organs and cells from being exposed to hypoxia- or hyperoxia-induced oxidative stress, the relevant capacity and duration of action are relatively limited. Thus, continuous and real-time individualized monitoring and guidance is particularly important in oxygen therapy, especially in the elderly, in order to correct hypoxemia and tissue hypoxia while avoiding or reducing oxygen toxicity caused by hyperoxia. This review aims to briefly summarize the physiology of oxygen and to update the latest progress regarding the mechanism of oxygen toxicity, providing theoretical insights on oxygen therapy practice.

Myocardial Ischaemia-Reperfusion Injury (MIRI) is increasingly recognized as a contributor to cognitive dysfunction, with High-Mobility Group Box 1 (HMGB1) serving as a pivotal mediator in this heart-brain axis. Released from damaged cardiomyocytes, HMGB1 acts as a Damage-Associated Molecular Pattern (DAMP), activating Toll-Like Receptor 2/4 (TLR2/4) and the Receptor for Advanced Glycation End Products (RAGE), thereby triggering systemic inflamma-tion and neuroinflammation that disrupts Blood-Brain Barrier (BBB) integrity, promotes microglial activation, and induces synaptic dysfunction, ultimately leading to cognitive impairment. This article reviews recent studies on the role of HMGB1 in MIRI and cognitive dysfunction and aims to elucidate its potential interplay with the recently identified adipokine, Meteorin-like (Metrnl), which has also been shown to be critically involved in both MIRI and cognition; subsequently, the HMGB1/Metrnl functional antagonism may be a potential therapeutic mechanism for MIRI-induced cognitive impairment. Addressing the HMGB1/Metrnl interplay offers a pathway to mitigate the long-term disability and loss of independence associated with MIRI-induced cognitive impairment, potentially alleviating the substantial socioeconomic burden and caregiver strain that follows major cardiac events.

BACKGROUND:Sevoflurane is one of the most widely used anesthetics in pediatric medicine; however, accumulating evidence raises critical concerns regarding its potential to induce long-term neurodevelopmental deficits. Despite extensive research, the underlying systemic molecular mechanisms driving these outcomes remain elusive. METHODS:Pregnant C57BL/6J mice were exposed to 2.5% sevoflurane for 2 h at embryonic day 14 (E14). Offspring were assessed for spatial learning and anxiety-related behaviors. To reconstruct the molecular landscape of toxicity, we employed an integrative multi-omics approach combining transcriptomics, proteomics, and paired brain-serum metabolomics, complemented by ELISA validation and histopathology. RESULTS:Sevoflurane-exposed offspring exhibited persistent spatial learning deficits and anxiety-like behaviors. These functional impairments were mirrored by histopathological damage, characterized by disordered neuronal arrangement and reduced Nissl-positive cells in the hippocampus. Consistently, ELISA analysis revealed a pronounced systemic inflammatory response (elevated IL-1β, IL-6, TNF-α). Integrated multi-omics profiling uncovered the molecular basis of these phenotypes, revealing a landscape of neurodevelopmental gene suppression alongside the activation of oxidative stress and inflammatory signaling. Underpinning these multidimensional pathologies, we identified a convergent reprogramming of amino acid metabolism, defined by glutamate depletion and lysine accumulation-metabolic shifts previously implicated in neuroinflammation and cognitive decline. Finally, ectoine and 5-OPPA were consistently depleted in both brain and serum, identifying them as novel concordant biomarkers of anesthetic neurotoxicity. CONCLUSIONS:These findings demonstrate that gestational sevoflurane exposure induces persistent neurocognitive dysfunction in offspring driven by amino acid metabolic reprogramming. The concordant depletion of ectoine and 5-OPPA highlights their potential as minimally invasive biomarkers for anesthetic induced neurodevelopmental injury.

Perioperative anxiety is a common psychophysiological stress response experienced by patients before and after surgery, with a global prevalence of approximately 48%. Its occurrence is influenced by multiple factors including age, sex, type of surgery, and psychosocial determinants. The underlying pathophysiological mechanisms are complex, involving multi-system interactions such as autonomic nervous system imbalance, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, dysfunction of limbic system neural circuits, and neuroinflammation. Current assessment strategies are evolving from sole reliance on psychological scales toward multimodal approaches incorporating objective biomarkers including heart rate variability, cortisol, and electroencephalography. Management paradigms have shifted from traditional pharmacological premedication to integrated systems encompassing structured patient education, digital health tools, neuromodulation techniques, and cognitive behavioral therapy. However, significant gaps persist regarding standardized screening protocols, biomarker validation, and targeted intervention pathways for high-risk populations. Future management is likely to require more individualized risk assessment and intervention selection. Biomarker-based risk prediction, artificial intelligence-assisted intervention decision-making, and the deep integration of digital therapeutics such as virtual reality with existing enhanced recovery pathways will be key directions for improving patient outcomes and recovery quality. This structured narrative review summarizes current evidence on perioperative anxiety in adults, focusing on epidemiology, pathophysiological mechanisms, assessment tools, biomarkers, and multimodal management strategies.

Introduction:The optimal timing of paravertebral block (PVB) for metabolic and bariatric surgery (MBS) remains uncertain. Drawing on the concept of preemptive analgesia-which suggests that blocking nociceptive signals before surgical stimulus may limit central sensitization-we designed this study to test whether a preoperative PVB reduces 24-hour opioid consumption more effectively than a postoperative PVB in patients undergoing laparoscopic sleeve gastrectomy (LSG). Methods:This single-center retrospective cohort study enrolled patients aged ≥18 years undergoing LSG with bilateral T8 PVB between January and October 2025. Patients were categorized into Pre (PVB before anesthesia induction) and Post (PVB after surgery) groups. The primary outcome was 24-hour postoperative opioid consumption (morphine milligram equivalents, MME). Secondary outcomes included time to first rescue analgesia, rescue analgesia requirement, postoperative nausea and vomiting (PONV), time to first ambulation, and length of hospital stay. Propensity score matching (PSM, 1:3 nearest-neighbor matching with a caliper width of 0.2) was performed to control for confounders. Results:After PSM, 233 patients were analyzed (Pre, n=168; Post, n=65). Median 24-hour MME consumption was 104.1 (IQR 64.8-147.3) in the Pre group and 91.2 (IQR 50.4-158.4) in the Post group (P=0.425). No significant differences were observed in any secondary outcomes, including time to first rescue analgesia (3h vs 4h, P=0.182), PONV incidence (70.2% vs 73.8%, P=0.585), time to first ambulation (2.5h vs 2.5h, P=0.681), or length of hospital stay (3 vs 4 days, P=0.865). Conclusion:In patients undergoing LSG within a multimodal analgesic protocol, preoperative PVB was not associated with reduced 24-hour opioid consumption or improved early recovery outcomes compared to postoperative PVB in this retrospective cohort. These findings suggest that PVB timing may be guided by logistical considerations without compromising analgesic efficacy, but prospective studies are needed to confirm this observation.

Background: Patient-controlled analgesia (PCA) is an effective method for managing postoperative pain, yet a significant number of eligible patients in China decline its use. The reasons for this refusal are not fully understood, limiting the development of patient-centered pain management strategies. This study aims to investigate the incidence, influencing factors, and underlying reasons for PCA refusal among surgical patients. Methods: A prospective, mixed-methods cohort study will be conducted at a tertiary hospital in China. A total of 4,000 adult patients scheduled for surgery and eligible for PCA will be enrolled. Before the standard preoperative anesthesiology consultation, participants will complete a baseline assessment of sociodemographic, clinical, and cognitive factors related to PCA. After a standardized PCA recommendation, patients' acceptance or refusal will be recorded. Quantitative data will first be analyzed using least absolute shrinkage and selection operator (LASSO) regression to select predictors; subsequently, multivariable logistic regression will be used to identify factors associated with refusal. Patients who refuse PCA will be invited to participate in semi-structured interviews to explore their decision-making motivations. Interviews will be documented through detailed written notes and analyzed using qualitative content analysis to identify the primary reasons for refusal; data collection will continue until saturation is reached. Postoperative pain scores and decision regret among refusers will also be assessed. Discussion: This study will provide insights into PCA refusal from both quantitative and qualitative perspectives. The findings are expected to inform the development of targeted patient education programs and improve shared decision-making processes, ultimately enhancing postoperative pain management and recovery outcomes. Trial Registration: Chinese Clinical Trial Registry (ChiCTR2600116056). Registered on January 5, 2026.

Background This study aimed to investigate the therapeutic potential of a combined low-dose propofol (PPF) and salvianolic acid A (SAA) regimen in mitigating lipopolysaccharide (LPS)-induced cardiac dysfunction and ferroptosis in diabetic contexts, and to explore the role of the sirtuin 1 (SIRT1)/forkhead box O1 (FoxO1) signaling pathway.Methods Type 2 diabetes (DM) was induced in mice, followed by LPS administration to induce cardiac injury. The mice were randomly assigned to six groups: control, DM, control + LPS, DM + LPS, DM + LPS + high-dose PPF, and DM + LPS + low-dose PPF + SAA. Cardiac function was assessed via echocardiography, while ferroptosis was evaluated with BODIPY staining and transmission electron microscopy. In vitro, H9c2 cardiomyocytes were treated with high glucose and LPS. Ferroptosis was assessed with FerroOrange and JC-1 staining. Oxidative stress and inflammatory cytokines were measured using ELISA or flow cytometry, and protein expression of key markers was analyzed.Results Diabetes aggravated LPS-induced cardiac injury in mice evidenced as impaired myocardial function, which was concomitant with decreased cardiac expression of SIRT1, FoxO1, and GPX4 proteins; increased production of oxidative stress, pro-inflammatory cytokines, oxidized lipids, and damaged mitochondrial cristae as compared to NC + LPS group. The combined use of PPF and SAA enhanced cardiac SIRT1 and FoxO1 and ameliorated LPS-mediated cardiac dysfunction in diabetic mice, but these beneficial effects were abolished by inhibition of SIRT1 or FoxO1. In vitro, hyperglycemia and LPS-induced cellular injuries were ameliorated by PPF and SAA, respectively. Low dose of PPF in combination with SAA reduced the production of ROS and ferroptosis that were concomitant with increased SIRT1 and FoxO1 expression, effects that were either comparable or superior to those achieved with high-dose PPF alone, but these protective effects were reversed by silencing SIRT1 or FoxO1.Conclusion The combination of low-dose PPF and SAA effectively protects against LPS-induced cardiac dysfunction and ferroptosis in diabetic conditions by activating the SIRT1/FoxO1 pathway.

Acute pain differs in many aspects from chronic pain states and can arise from various etiologies. Recent years have seen advancements in postoperative acute pain management, which is a critical component of perioperative care. These strategies play a key role in enhancing recovery after surgery (ERAS) with goals of reducing postoperative opioid consumption and shortening hospital stay durations. To further standardize postoperative pain management for adult patients in China，the Guidelines Working Group has developed the Clinical Practice Guideline for Postoperative Pain Management in Adults (2024 Edition). These guidelines were formulated in accordance with World Health Organization handbook for guideline development and the Guidance Principles for Developing/Revising Clinical Guidelines in China (2022 Edition). These guidelines consist of 33 evidence-based recommendations for 17 clinical questions on postoperative pain management. We provide recommendations pertaining to preoperative education, risk assessment, selection of analgesic modalities, and management of adverse effects. We also provide some principles of analgesia strategy including: using preemptive or multimodal analgesia; foundation; regional blocks; patient-controlled intravenous analgesia; and opioid sparing. By enhancing the scientific rigor of postoperative pain management， the guidelines aim to provide healthcare professionals with a clear decision-making framework, ultimately improving patient outcomes.