ABSTRACT
Objective To investigate the efficacy ofpoly (lactic acid co castor oil) microspheres containing ropivacaine for sciatic nerve block of mice.Methods A total of 150 Kunming male mice were randomly assigned into 3 groups,namely placebo microspheres (lactic acid co castor oil) group (group A,n=50),ropivacaine injection group (group B,n=50) and ropivacaine microspheres group (group C,n=50).After sevoflurane anesthesia,the mouse was fixed on the operating table and the bilateral sciatic nerve was exposed.The corresponding preparations were implanted or injected near the sciatic nerve.Five mice were randomly selected from each group for the next experiments.Paw withdrawal thermal latency,the ability to splay and flex of the hind paw and plasma ropivacaine concentration were measured 10min,30min,1h,3h,5h,7h,10h,15h,30h and 48h after drug administration.Results The anesthetic effect of group C began to work at 3h.Compared with group B,the duration of sciatic nerve sensory block of group C was significantly longer and the effect of motor block was weaker.No anesthetic effect was observed in group A.The sensory and motor block of group B reached the peak at 1h,and the pharmacodynamics subsided at 7h.Compared with group B,the concentration of ropivacaine in group C increased slowly,and the peak value at 10h after administration was gradually decreased.Conclusions Ropivacaine loading poly (lactic acid co castor oil) microspheres can significantly extend the effect of ropivacaine on sciatic nerve sensory block.Compared with ropivacaine injection,motor block effect of ropivacaine loading poly (lactic acid co castor oil) microspheres is reduced and its plasma ropivacaine concentration fluctuation range is small.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the medium- and long-term effect of pneumatic ballistic extracorporeal shock wave versus ultrasound-guided hormone injection in the treatment of plantar fasciitis.</p><p><b>METHODS</b>The clinical data were collected from patients with plantar fasciitis admitted to PLA General Hospital pain department from September, 2015 to February, 2017. The patients were randomly divided into ultrasound-guided drug injection group and shock wave group. The therapeutic parameters including the numerical rating scale (NRS) scores in the first step pain in the morning, American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale, and thickness of the plantar fascia were monitored before and at 1 week, 1 month, 3 months, and 6 months after the treatment. The recurrence rate, effectiveness, and patient satisfaction were compared between the two groups at 6 months after the treatment.</p><p><b>RESULTS</b>Thirty-nine patients were enrolled in shock wave group and 38 patients in ultrasound group. The NRS scores in the first step pain in the morning were lowered after treatment in both groups (P<0.05), and the scores were significantly lower in ultrasound group than in shock wave group at 1 week and 1 month (P<0.01), but significantly higher in ultrasound group than in shock wave group at 3 and 6 months after treatment (P<0.05). The AOFAS functional scores were increased in both groups (P<0.05) at 6 months after treatment, was significantly lower in ultrasound group than in shock wave group than group B (90.44∓13.27 vs 75.76∓21.40; P<0.05). The effective rates in shock wave group and ultrasound group were 92.31% and 76.32%, respectively (P<0.05). Recurrence was found in 1 patient (2.56%) in shock wave group and in 8 (21.05%) in ultrasound group (P<0.05). The patient satisfaction scores were significantly higher in shock wave group than in ultrasound group (8.13∓2.67 vs 6.63∓3.75, P=0.048).</p><p><b>CONCLUSION</b>Pneumatic ballistic extracorporeal shock achieves better medium- and long-term outcomes than ultrasound-guided hormone injection in the treatment of plantar fasciitis.</p>