ABSTRACT
BACKGROUND:Traditional analgesia method can relieve the pain after total knee arthroplasty, but the prognosis is poor and drug dependence is strong. Therefore, it is of great significance to study the analgesic drugs in perioperative period of total knee arthroplasty. OBJECTIVE:To explore the analgesic effect of gabapentin combined with continuous femoral nerve block on total knee arthroplasty. METHODS: A total of 48 patients with knee osteoarthritis receiving total knee arthroplasty in the Department of Orthopedics, Affiliated Hospital of Inner Mongolia Medical University from October 2013 to October 2014 were enroled in this study. Using general anesthesia, femoral nerve block was conducted before anesthesia. Analgesia pump was connected after arthroplasty. Patients were randomized to two groups. The control group received multimodal analgesia, and the experimental group received gabapentin combined with continuous femoral nerve block analgesia. Patient’s pain was scored by using resting, activity visual analog scale. Postoperative quality of life, range of motion of knee joint and complications were observed. RESULTS AND CONCLUSION:No significant difference in preoperative resting pain and activity pain was detected between the two groups (P > 0.05). Visual analog scale scores were decreased with time prolonged after arthroplasty in both groups. Visual analog scale scores of resting pain and activity pain were significantly lower in the experimental group than in the control group at 1, 3 and 7 days and 1 month (P < 0.05). Range of motion was significantly larger in the experimental group than in the control group at 3-7 days after arthroplasty (P< 0.05). Activity of daily living score, physical function score, mental function score and social function score were significantly higher in the experimental group than in the control group (P < 0.05). The complication rate was significantly lower in the experimental group than in the control group (17%, 46%,P < 0.05). These data indicate that during perioperative period of total knee arthroplasty, analgesic effect of gabapentin combined with continuous femoral nerve block is ideal. In particular, in patients with acute pain within 48 hours, their combination can promote early rehabilitation of the patient’s knee, and few side effects are found.
ABSTRACT
Objective To explore serum levels of visfatin and high-sensitivity C-reactive protein (Hs-CRP) in patients with polycystic ovary syndrome (PCOS), as well as their clinical significance. Methods Ninety patients with PCOS and 30 ovulating healthy women with body mass index (BMI) less than 25 as controls were recruited. PCOS patients were divided to two groups, 48 in obese group with BMI≥ 25 and 42 in non-obese group with BMI<25. Serum level of visfatin was measured by enzyme-linked immunosorbent assay (ELISA) and that of Hs-CRP was assayed by immunoturbidimetry in all participants. Oral glucose tolerance test (OGTT) and insulin sensitivity were assessed in PCOS patients only. Results ①Obese and non-obese patients with PCOS beth presented markedly higher serum levels of visfatin and Hs-CRP than those in controls (t=11.35, 8.46, 10.43 and 8.25, respectively, P<0.05), and levels of visfatin and Hs-CRP were higher in obese group than those in non-obese group (t=7.74 and 6.38, respectively, P< 0.05 ). ②Univariate analysis revealed that serum levels of visfatin and Hs-CRP positively correlated with BMI and homeostasis model assessment insulin resistance, respectively (P<0.05) and serum level of visfatin positively correlated with that of Hs-CRP (P<0.05). Conclusions Chronic inflammation possibly exists in patients with PCOS, which may cause their serum visfatin and Hs-CRP levels increased.