ABSTRACT
<p><b>OBJECTIVE</b>To explore the anesthetic effect and safety of ultrasound-guided thoracic paravertebral blockade in video-assisted thoracoscopic sympathectomy for treatment of palmar hyperhidrosis.</p><p><b>METHODS</b>A total of 120 patients undergoing video-assisted thoracoscopic sympathectomy for moderate or severe hyperhidrosis were randomized to receive ultrasound-guided thoracic paravertebral blockade (group A, n=60) or general anesthesia with tracheal intubation (group B, n=60). In both groups routine monitoring and radial artery catheterization were used. The patients in group A were given oxygen inhalation via a nasal tube after thoracic paravertebral blockade, and those in group B had intratracheal intubation. Blood gas analyses were conducted 5 min before and 5 min after the operation and the clinical outcomes and complications were recorded in each group.</p><p><b>RESULTS</b>All the patients completed the operations safely and none of the patients with thoracic paravertebral blockade required conversion to general anesthesia. Significant differences were recorded between groups A and B in anesthetic preparation time (6.26∓2.09 vs 46.32∓15.76 min), awakening time (6.26∓2.09 vs 46.32∓15.76 min), and mean hospitalization expense (6355.54∓426.00 vs 8932.25∓725.98 RMB Yuan). Compared with those in group B, the patients in group A showed a significantly lower rate of postoperative throat discomfort (0% vs 100%), a shorter monitoring time (2 h vs 12 h), and faster recovery time for food intake (2 h vs 6 h). The parameters of artery blood gas analysis both before and after the operation were similar between the two groups, but the postoperative variations differed significantly between the two groups in pH value and PaCObut not in PaO.</p><p><b>CONCLUSION</b>Ultrasound-guided thoracic paravertebral blockade is safe and effective in video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis and is associated with less complications and better postoperative recovery.</p>
ABSTRACT
<p><b>BACKGROUND</b>Thymokidney has been reported as an approach for a vascularized thymus for transplantation to induce donor specific tolerance. A completely thymectomized model which ensures that the obtained thymus is not injured has not been developed yet and it would be useful for evaluating autologous thymokidney function in rats.</p><p><b>METHODS</b>Adult Sprague-Dawley male rats weighing 150 - 300 g (n = 30) underwent non-invasive intubation with the assistance of an improved self-made wedge-shaped cannula made from a 2-ml plastic syringe and transillumination from the anterior tracheal area by an operation spotlight. The rats then received a thoracotomy while their breathing was supported by a small animal ventilator, and both lobes of the thymus were entirely extirpated under a 10× microscope. The postoperative survival rate of the rats was recorded, and changes in the T-cell reservoir from 9 of 30 rats within 21 days after surgery were monitored using flow cytometry. The complete thymectomy rate was confirmed by autopsy and histological examination on 21 days post-operation.</p><p><b>RESULTS</b>The postoperative survival rate of rats was 100%. The exsected thymus was free of injury and the rate of complete thymectomy was 100%.</p><p><b>CONCLUSIONS</b>This model has a stable survival rate and complete thymectomy is able to be achieved. The obtained thymus tissue is free of injury and can be used for transplantation.</p>