International journal of clinical and experimental medicine
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The increasing use of the transversus abdominis plane (TAP) block, as a form of pain relief after laparoscopic surgery, warrants evaluation of its effectiveness, when compared with other analgesic techniques. ⋯ TAP block would result in less analgesic consumption, less requirement of analgesic, and less pain at 2 h and slightly at 6 h but at 24 h after laparoscopic surgery in comparison with usual care alone or placebo block. In addition TAP block can increase the incidence of postoperative nausea and vomiting.
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We aimed to determine the sympatholytic and clinical effects of low dose high frequency ultrasound (US) applied on stellate ganglion in Complex Regional Pain Syndrome (CRPS) type I patients. ⋯ Low dose high frequency US applied on stellate ganglion did not make a sympathetic blockade and was not of further benefit for pain, range of motion, grip strength and upper extremity disability in CRPS type I patients.
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Panda is regarded as Chinese national treasure. Most people always thought they were cute and just ate bamboo and had never imagined a panda could be vicious. Giant panda attacks on human are rare. There, we present three cases of giant panda attacks on humans at the Panda House at Beijing Zoo from September 2006 to June 2009 to warn people of the giant panda's potentially dangerous behavior.
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To compare the effects of hydroxyethyl starch (HES) 130/0.4 and HES 200/0.5, which have different molecular weights and degrees of substitution, on microcirculation perfusion and tissue oxygenation in patients undergoing liver surgery. Thirty patients with an American Society of Anesthesiologists status I/II who were scheduled for liver surgery were randomly divided into two groups: one received an intraoperative HES 130/0.4 infusion equal to the amount of blood loss (HES 130/0.4 group, n=15), and the other received HES 200/0.5 equal to the amount of blood loss (HES 200/0.5 group, n=15). Gastric mucosal perfusion and tissue oxygenation were monitored by measuring the gastric mucosal pH (pHi), which was determined using a carbon dioxide tonometer inserted through a nasogastric tube. ⋯ A multivariate analysis showed that the type of colloid used intraoperatively was the only variant that affected pHi (F=0.626, P<0.05). Moreover, there were good correlation between pHi at the end of surgery and the length of postoperative hospital stay (r=-0.536, P<0.05) and the time intervals from surgery to the passage of flatus (r=-0.547, P<0.05). Compared with HES 200/0.5, the use of HES 130/0.4 (with a relatively lower molecular weight and lower degree of substitution) could significantly improve internal organ perfusion and tissue oxygenation in patients undergoing liver surgery with a relatively large amount of blood loss.
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The aim of this study is to compare the operative parameters and outcomes of conventional CO2-pneumoperitoneum (PP) versus gasless abdominal wall-lifting (AWL) for laparoscopic surgery. The literature databases of PubMed, Google Scholar and Cochrane Library were searched for randomized controlled trials (RCTs) that had compared the CO2-PP approach with that of gasless AWL for laparoscopic surgery and which had been published between 1995 and 2012. Data for the operative parameters (i.e. surgery duration, intraoperative heart rate (HR), perioperative complications, and postoperative duration of hospital stay and time to activity) and outcomes (postoperative shoulder pain, nausea/vomiting (PONV), partial pressure of CO2 in the blood (PaCO2), blood pH, and serum levels of the inflammatory cytokine interleukin (IL)-6) were extracted from the identified RCTs. ⋯ However, the CO2-PP method was associated with a significantly shorter surgery duration than the gasless AWL method (WMD = 8.61, 95% CI: 3.19 to 14.03; P = 0.002). There were no significant advantages detected for either approach with respect to the intraoperative HR, the perioperative complication rate, or the postoperative parameters of duration of hospital stay, shoulder pain, blood pH, or serum IL-6 level. We concluded form present study that the gasless AWL method has the features of shorter time, lower postoperative PaCO2, and lower PONV incidence while the CO2-PP method for laparoscopy requires shorter surgical time.