Analgesic effect of intercostal nerve block given preventively or at the end of operation in video-assisted thoracic surgery: a randomized clinical trial

Abstract Objective To compare the analgesic effect of intercostal nerve block (INB) with ropivacaine when given preventively or at the end of the operation in patients undergoing video-assisted thoracic surgery (VATS). Methods A total of 50 patients undergoing VATS were randomly divided into two groups. The patients in the preventive analgesia group (PR group) were given INB with ropivacaine before the intrathoracic manipulation combined with patient-controlled analgesia (PCA). The patients in the post-procedural block group (PO group) were administered INB with ropivacaine at the end of the operation combined with PCA. To evaluate the analgesic effect, postoperative pain was assessed with the visual analogue scale (VAS) at rest and Prince Henry Pain Scale (PHPS) scale at 6, 12, 24, 48, and 72 hours after surgery. Results At 6 h and 12 h post-surgery, the VAS at rest and PHPS scores in the PR group were significantly lower than those in the PO group. There were no significant differences in pain scores between two groups at 24, 48, and 72 hours post-surgery. Conclusion In patients undergoing VATS, preventive INB with ropivacaine provided a significantly better analgesic effect in the early postoperative period (at least through 12 h post-surgery) than did INB given at the end of surgery.

Clinical and Histopathological Review of 229 Cases of Ranula / 华中科技大学学报（医学）（英德文版）

The purpose of this paper was to evaluate the relationship between the thrombosis and secretory duct dilation,lesion size,clinical types,nature (primary or recurrent) and duration of illness in the development of ranula.A total of 229 cases of sublingual gland cysts were treated with surgical resection from Jan.1990 to Feb.2010.The patients' data were investigated on histopathological findings,size of ranula,the clinical types,nature of ranula (primary or recurrent) and duration of illness.Sections from the paraffin-embeded blocks were HE-stained.CK expression was immunohistochemically detected.Among 229 cases the incidence of venous thrombosis was 58.52％.The incidence of venous thrombosis with or without duct dilation was 73.25％ and 26.39％ respectively,with a significant difference between the two groups (P＜0.005).The incidence of venous thrombosis of ranulas with diameter larger or less than 3 cm was 72.22％ and 46.28％ (P＜0.005).The incidence of venous thrombosis of oral ranula,plunging ranula and mixed ranula was 49.37％,77.19％ and 85.71％ respectively,with a significant difference found between oral and plunging or mixed ranula (P＜0.01).The incidence of venous thrombosis in ranula patients with duration of illness longer or less than 3 months was 69.77％ and 51.75％ (P＜0.01).The incidence of venous thrombosis with recurrent and primary ranulas was 51.85％ and 64.85％,without a significant difference noted between them (P＞0.05).It is concluded that the formation of venous thrombosis was related to the dilation of secretory duct,lesion size,clinical types,duration of lesion but formation of venous thrombosis was not related to the nature (primary or recurrent) of ranulas.