ABSTRACT
Objective To investigate the effect of patient-controlled intravenous analgesia (PCIA) with dexmedetomidine mixed with sufentanil on the sleep quality after spinal surgery.Methods Eighty patients of both sexes, aged 21-72 yr, weighing 48-100 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective spinal surgery, were randomly assigned into sufentanil group (group S) and dexmedetomidine mixed with sufentanil group (group DS) with 40 cases in each group.In group S, PCIA solution contained sufentanil 2 μg/kg and tropisetron 6 mg in 100 ml of normal saline.In group DS, PCIA solution contained sufentanil 2 μg/kg, dexmedetomidine 3 μg/kg and tropisetron 6 mg in 100 ml of normal saline.The PCA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml/h.Sufentanil 5 μg injected intravenously and celecoxib 200 mg given orally were used as rescue analgesics, and numeric rating scale (NRS) score at rest was maintained ≤4 within 48 h after surgery.Ramsay sedation scores were recorded at 1, 2, 6, 12, 24 and 48 h after surgery.Sleep quality was evaluated using the Medical Outcomes Study Sleep Scale (MOS-SS), and the average time of daily sleep and Sleep Problems Index (SPI) were recorded at week 1 before and after surgery.Patient's satisfaction with sleep was assessed on the night of surgery and 1st day after surgery.The requirement for rescue analgesics was recorded.Results There was no significant difference in the requirement for rescue analgesics between group S and group DS (P＞0.05).Compared with the value before surgery, the average time of daily sleep was significantly shortened, and SPI was increased at week 1 after surgery in group S (P＜0.05 or 0.01), and no significant change was found in group DS (P＞0.05).Compared with group S, the Ramsay sedation scores were significantly increased at 1, 2, and 6 h after surgery, the average time of daily sleep was prolonged at week 1 after surgery, the SPI was decreased at week 1 after surgery, and the degree of satisfaction with sleep was increased on 1st day after surgery in group DS (P＜0.05 or 0.01).Conclusion PCIA with dexmedetomidine mixed with sufentanil is helpful in improving the sleep quality after spinal surgery in the patients.
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ObjectiveTo observe the effectiveness of collagen sponge for reducing volume of drainage after surgery for lumbar spinal stenosis. MethodsOne hundred and eighty-six patients who suffered from lumbar spinal stenosis were divided into two groups by random digits table method. The test group(96 cases) used collagen sponge to cover dura mater before placing drainage tube,the control group (90 cases) was treated without collagen sponge. The volume of drainage at 1,12,24 h after surgery were observed, the blood routine test was carried out at before and 48 h after surgery and the volume and ratio of blood transfusion after surgery was also measured and compared between the two groups. ResultsThe volume of drainage were significantly decreased in the test group compared with the control group at 1,12,24h after surgery [( 106.11 ± 20.02 ) ml vs. ( 127.02 ± 25.09) ml, (236.12 ± 34.06) ml vs. (327.31 ± 51.21 )ml, (355.16 ± 49.03 ) ml vs.( 506.36 ± 85.29 ) ml](P ＜ 0.05 ). The volume and the ratio of blood transfusion in the test group were ( 176.27 ± 21.37) ml and 10.42％(10/96) ,which were greatly lower than those in the control group[(445.94 ±24.56) ml and 32.22％ (29/90)](P ＜0.05). The number of RBC and the concentration of Hb were (2.96 ± 0.45 ) × 1012/L and ( 106.75 ± 7.30) g/L, differently in the test group at 48 h after surgery,which were increased significantly compared with the control group[(2.35 + 0.57) × 1012/Land (90.45 ± 5.10) g/L](P ＜ 0.05 ). ConclusionsCollagen sponge provides rapid ,effective and durable hemostasis and decreases the leak of cerebrospinal fluid after surgery for lumbar spinal stenosis. It can be used as an effective and economic method to reduce the volume of drainage after surgery.
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Objective To observe the effect of the injection of myoblast carrying human insulin-like growth factor-1(hIGF-1) on the expression of endogenous IGF-1 mRNA and IGF-1 level in mice skeletal muscle following injury.Methods Seventy two male C3H mice(20~30g,7~11w)were randomly divided into three groups(24 mice in each group) with four mice normal controls.Applied a falling hit from certain height at the medial calf of right lower limbs in three groups,the injured skeletal muscle model was successfully simulated.Three days following injury,the mice in group A and B were injected with 1?106 myoblasts either carried with or without hIGF-1 gene respectively and the mice in group C were injected with 100?l saline at the injured muscle.Three mice in each group were sacrificed randomly at day 2,5,10,15,20,30 after contusion.The expression level of mIGF-1 was assessed by immunohistochemical staining and real time PCR.Results mIGF-1 mRNA expression and mIGF-1 factor secretion were observed in all three groups;the amount of mIGF-1 mRNA expression and mIGF-1 secretion in group A were significant higher than that in group B and C.Conclusion Myoblast carrying hIGF-1 transplantation could promote endogenous IGF-1 secretion in injured skeletal muscle.
ABSTRACT
Objective To observe the survival of myoblasts carrying hIGF-1 gene transplanted into the mice, and the expression of hIGF-1 in the transplanted mice. Methods Eighty four male C3H mice(20～30g,7～11w)were divided into four groups: group A, B, C and D (20 mice each group), and the remaining four mice were used as normal control. At the middle of the right gastrocnemius muscle, the mice in group A and B were injected with 1?10~6 myoblasts either carried with or without hIGF-1 gene. Muscle contusion at the middle of the right gastrocnemius muscle of the mice in group C and D was produced. At day 3 following injury, they were injected with 1?10~6 myoblasts either carried with hIGF-1 gene (group C) or without hIGF-1 gene (group D). At the day 2, 5, 10, 20, 30 after injection, four mice of each group were sacrificed randomly. BrdU staining in all mice were performed to evaluate cells surviving, and the expression level of hIGF-1 in group A and C was assessed by immunohistochemical staining and real-time-PCR. Results The BrdU staining in both normal and injured mice transplanted with myoblast carried with or without hIGF-1 were positive. hIGF-1 was expressed and secreted in both group A and C. Conclusion The myoblast carrying hIGF-1 gene transplanted into normal or injured mice can survive for a certain period of time, and can secrete hIGF-1.