Zhonghua yi xue za zhi
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Zhonghua yi xue za zhi · Feb 2018
Randomized Controlled Trial[Application of continuous serratus plane block with patient-controlled analgesia on postoperation analgesia after thoracoscopic surgery].
Objective: To investigate the application of ultrasound-guided continuous serratus plane block with patient-controlled analgesia on postoperation analgesia after thoracoscopic surgery, and influence on postoperative rehabilitation. Methods: Sixty patients scheduled for thoracoscopic surgery were randomly divided into two groups. PCNA group (n=30) received ultrasound guided continuous serratus plane block with patient-controlled nerve analgesia, with continuous infusion of 0.2% ropivacaine and 30 ml of 0.3% ropivacaine for the first does. ⋯ And the time of out-of-bed activity, passage of gas by anus of the PCNA group were (20.0± 6.9)h, ( 16.0± 8.0)h, which was advanced more than PCIA group [(23.9± 7.1)h, (34.3± 13.2)h, t=-2.20, -6.47, all P<0.05]. Furthermore, PCNA group had better sleep quality from the 2nd night to the 4th night , and with lower adverse reactions (all P<0.05). Conclusion: The application of ultrasound-guided continuous serratus plane block after thoracoscopic surgery can reduce postoperative pain and enhance recovery after surgery.
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Zhonghua yi xue za zhi · Feb 2018
Randomized Controlled Trial[Effects and safety of quadratus lumborum block in analgesia after hip arthroplasty].
Objective: To evaluate the efficacy of ultrasound guided quadratus lumborum block combined with non-steroidal anti-inflammatory drugs for postoperative analgesia in patients undergoing total hip arthroplasty. Methods: From January to June 2017, sixty American Society of Anesthesiologists (ASA) physical status Ⅰ to Ⅲ patients, aged 55-75 yr, scheduled for total hip arthroplasty, were randomly divided into control group(group N) and quadratus lumborum block (group R). Ultrasound guided quadratus lumborum block was implemented on the affected side at the end of operation. ⋯ The incidences of nausea and vomiting, pruritus in group R were lower than those in group N (χ(2)=5.192, 4.875, all P<0.01). The overall satisfaction scores in group R (3.7 ± 1.0 ) were higher than those (1.9±0.7) in the group N(t=7.841, P<0.01). Conclusion: The quadratus lumborum block combined with parecoxib sodium for multimodal analgesia after total hip arthroplasty is effective and provides satisfactory analgesia.
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Zhonghua yi xue za zhi · Feb 2018
Randomized Controlled Trial Comparative Study[Study of comparing dexmedetomidine and remifentanil for conscious sedation during radiofrequency ablation of hepatocellular carcinoma].
Objective: This study aimed to compare dexmedetomidine with remifentanil for conscious sedation in patients undergoing radiofrequency ablation of hepatocellular carcinoma. Methods: Sixty patients, who were aged 41 to 73 years with American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅱ, and scheduled for elective radiofrequency ablation of hepatocellular carcinoma under conscious sedation in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from January 2014 to June 2016, were allocated randomly to receive dexmedetomidine maintenance regimen(group D, n=30)or remifentanil maintenance regimen(group R, n=30)by random digital table. Subjects in group D received dexmedetomidine at a loading dose of 0.5 μg/kg over 10 min followed by 0.2-1.0 μg·kg(-1)·h(-1) infusion until Ramsay sedation scale reached 3-4. ⋯ Compared with group R, the incidence of intraoperative respiratory depression was significantly lower (23.3% vs 56.7%)and the incidence of inadequate anesthesia(20% vs 0) was significantly higher in group D(χ(2)=5.625, 4.630, both P<0.05). Conclusion: Both dexmedetomidine and remifentanil can be successfully used for conscious sedation in patients undergoing radiofrequency ablation of hepatocellular carcinoma. Remifentanil maintenance regimen provides better intraoperative analgesia and operative condition, while dexmedetomidine is superior to remifentanil in reducing intraoperative respiratory depression and postoperative pain.
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Zhonghua yi xue za zhi · Feb 2018
[Surgical treatment of intractable odontoid fracture with atlantoaxial dislocation in children with spinal cord injury].
Objective: To discuss the surgical treatment and its effectiveness of odontoid fracture complicated with atlantoaxial dislocation in children with spinal cord injury. Methods: From January 2010 to December 2014, 10 cases of children under 14 years old, with intractable odontoid fracture with atlantoaxial dislocation were enrolled. The mean duration between injury and admission was 8.5 d (range 1-30 d). ⋯ At the last follow-up, out of 2 cases with Frankel C improved to D, and the other 8 cases were back to normal. Conclusions: Diagnosis of odontoid fracture complicated with atlantoaxial dislocation is usually delayed in children. One-stage posterior reduction and internal fixation or anterior release combined with posterior fixation is an effective and safe surgical procedure for such cases.
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Zhonghua yi xue za zhi · Feb 2018
[The curative effect analysis of unilateral subfrontal combined with interhemispheric approach on the microsurgery of large anterior skull base meningioma].
Objective: To explore the surgical technique and curative effect of microsurgical resection of large anterior skull base meningioma via unilateral subfrontal and interhemispheric approach. Method: The clinical data of 14 patients with large anterior skull base meningioma who received surgical treatment in the Department of neurosurgery in First Affiliated Hospital of Bengbu Medical College from April 2015 to September 2017 were analysed retrospectively. Of 9 cases were olfactory groove meningioma and 5 cases were tuberculum sellae meningioma. ⋯ Fourteen patients had postoperative complications in 2 cases (14.2%), and all of them were no cerebrospinal fluid leakage and death. Conclusion: Microsurgical removal of large anterior skull base meningioma through unilateral frontal and interhemispheric approach is safe and effective, providing a new way for surgical treatment of large anterior skull base meningioma. It had a positive significance for the prognosis of patients.