ABSTRACT
Objective To investigate the effectiveness and safety of wound infiltration with rop-ivacaine for postoperative analgesia as a fast-track approach in patients undergoing open hepatectomy. Methods Fifty-two patients with hepatocellular carcinoma,32 males,20 females,aged 18-70 years, scheduled for selective open hepatectomy were enrolled in this trible-blind,randomized,controlled study.Patients were randomized to receive 0.75% ropivacaine (group ROP)or 0.9% normal saline (group NS)wound infiltration before incision closures at a total volume of 10 ml.Numerical rating score (NRS)at 6,12,24 and 48 hours after surgery,length of hospital stay,time to bowel recovery,ambulation and drainage tube extraction were recorded.Side effects, including post-operative liver and renal function,allergic reaction,nausea and vomiting,and wound infection,were also assessed.Results NRS was significantly decreased at 6 [(3.85±1.29)scores vs.(5.30±1.76) scores],12 [(3.38±0.85)scores vs.(5.69 ±1.38)scores]and 24 hours [(3.69 ±0.74)scores vs. (4.42±1.13)scores]after surgery in group ROP compared to group NS (P <0.05).Group ROP al-so showed shorter postoperative hospital stays [(1 7.92±1.97)d vs.(1 9.53±2.42)d],earlier anal exsufflation [(48.07±7.49)h vs.(53.42±10.38)h]and ambulation [(2.34±0.62)d vs.(2.80± 0.84)d](P <0.05).However,there were no significant differences between the two groups in re-garding post-operative liver and renal function.The incidence of nausea and vomiting was 1 5% (4 ca-ses)and 1 9%(5 cases)in group NS and group ROP,respectively.No allergic reactions occurred in either group.Conclusion The present study shows that ropivacaine wound infiltration could effectively release post-operative pain,and could be a safe and effective fast-track approach for patients undergoing open hepatectomy.
ABSTRACT
Objective To investigate the effects of two different dosages of dexmedetomidine on short-latency somatosensory evoked potentials (SLSEP)in intracranial surgery.Methods Forty pa-tients,ASA Ⅰor Ⅱ,aged 20-65 years old,selected for intracranial surgery were randomly divided in-to two groups,20 patients in each group.Bolus dose of 0.5 μg/kg dexmedetomidine was infused within first 10 min and followed by continuous infusion of 0.5 μg·kg-1·h-1 for 10 min in group A;Bolus dose of 1.0 μg/kg dexmedetomidine was infused within first 10 mins and followed by continu-ous infusion of 1.0 μg·kg-1·h-1 for 10 min in group B.SLSEP indications include N20-P25 amplitute and N20 latent period were observed.MAP,HR,N20-P25 amplitute and N20 latent period were re-corded respectively before dexmedetomidine adminstraition (T0 )and 20 mins after dexmedetomidine adminstraition (T1 ).Results Compared with T0 ,MAP and HR at T1 significantly decreased in both groups(P <0.05).N20-P25 amplitude had no statistically significant difference in both groups,while N20 latent period significantly prolonged (P <0.05).Conclusion Both doses of 0.5 μg/kg and 1.0μg/kg dexmedetomidine can significantly prolong the latent period of N20.
ABSTRACT
Objective To investigate the effects of limb ischemia-reperfusion injury(I-RI) on blood coagulation.Methods Eighteen patients scheduled for unilateral knee arthroscopy surgery under epidural anesthesia were treated with an inflatable tourniquet to ptoduce ischemia for (42 ± 6) min.Venous blood was taken before tourniquet inflation,at 30 min during ischemia,3 min and 30 min during reperfusion for measuring blood coagulation by thrombelastography(TEG).Results TEG showed the decreases in reaction time(R value) and coagulation time(K value),and the increases in alpha angle(α) and maximal amplitude(MA),which were all within the normal limits and had no significant differences among four time points of testing.Conclusion I-RI of the limbs has no significant effects on blood coagulation.