ABSTRACT
Objective· To compare the clinical effect of ultrasound-guided perineural space expansion by normal saline combined with perivascular technique (PSE-PV) with traditional perivascular technique in axillary brachial plexus block (PV).Methods· A randomized,controlled,and double blind study was performed.Sixty patients arranged for emergency hand surgery were allocated to 2 groups,i.e.PSE-PV group and PV group,with 30 cases in each group receiving ultrasound-guided axillary brachial plexus block.For PSE-PV group,injection was carried out at the 12 o'clock position using 5 mL of normal saline firstly to expand the perineural space followed by 15 mL of 0.5％ ropivacaine at the same position.The patients of PV group got their injections of 20 mL of 0.5％ ropivacaine at the direction of 12 o'clock of axillary artery.The sensory and motor blockade assessment 30 min after drug injection,performance time,success rate,and adverse events were recorded.Results· The sensory and motor blockade scores were 1.7±0.3 and 1.6±0.3 in PSE-PV group,and 1.8±0.4 and 1.6±0.3,respectively in PV group without significant differences (P＞0.05).The performance time of PSE-PV group was (4.0± 1.3) min,a little longer than that of PV group,but the difference was not statistically significant (P＞0.05).The success rates of nerve block reached 100％ in both groups.Only l case in PV group reacted to the local anesthetics.Conclusion · Ultrasound-guided perineural space expansion by normal saline reduces dosage of local anesthetics in axillary brachial plexus block,which has similar anesthetic effect,performance time and adverse effect with traditional perivascular method.
ABSTRACT
Objective To evaluate the expression of ? opioid receptor of the knee joint synovium tissue in patients with chronic inflammation. Methods The patients were divided into inflammatory group and control group(n=25 for both). Those who were allocated to the inflammatory group were diagnosed as osteoarthritis by arthroscopy, and in the control group, the patients were having dislocation of patella and took internal fixation with arthroscopy. The synovium tissues were harvested from suprapateller bursa, articulation vestibule, intercondylar fossa and articulation metacele. The synovium were taken to measure ? opioid receptor by immunohistochemistry and RT-PCR in both groups. Results Immunohistochemical and RT-PCR results revealed that the expression of mRNA and the optical density (OD) of immunoreaction of ?-opioid receptor in the knee synovium tissue in the chronic inflammation group were significantly higher than those in the control group (P0.05). Conclusion The expression of ? opioid receptor of the knee joint synovium tissue in chronic inflammation was significantly up-regulated. It may play a partial role in the peripheral mechanism of morphine.