ABSTRACT
Objective:To investigate the effects of intraoperative irrigation with hypothermic 3% sodium chloride solution on surgery effect and post-tonsillectomy pain in adults.Methods:A total of 120 adult patients with the plasma tonsillectomy from January to December 2020 in the First Affiliated Hospital of Soochow University were divided into observation group A, observation group B, observation group C and control group according to random number table method, with 30 cases in each group. During operation, observation group A used hypothermia 3% sodium chloride, observation group B used room temperature 3% sodium chloride, observation group C used hypothermia 0.9% sodium chloride, control group used room temperature 0.9% sodium chloride. The quality of surgical field quality, operation time, blood loss in operation, duration of catheter, the postoperative wound pain at 24, 48, 72 h after operation were compared among four groups.Results:The surgical field quality scores were (2.07 ± 0.87) points in the observation group A, significantly lower than in the observation group B (2.57 ± 0.73) points, observation group C (2.60 ± 0.56) points and control group (3.10 ± 0.66) points, the differences were statistically significant ( t=2.71, 2.89, 5.61, all P<0.01). Amounts of blood loss in operation were (9.13 ± 1.74), (10.03 ± 2.81), (10.50 ± 2.09) ml in the observation group A, observation group B and observation group C, significantly lower than in the control group (15.23 ± 3.64) ml, the differences were statistically significant ( t=8.85, 7.54, 6.87, all P<0.01). At 24 h after operation, the scores of Numerical Rating Scale(NRS) were (3.23 ± 0.77), (3.53 ± 0.63), (3.80 ± 0.89) points in the observation group A, observation group B and observation group C, significantly lower than in the control group (4.43 ± 1.17) points. At 48 h after operation, the scores of NRS were (2.37 ± 0.72) points in the observation group A, significantly lower than in the control group (2.93 ± 0.83) points, the differences were statistically significant ( t values were 2.77-5.25, all P<0.01).There was no significant difference in operation time, duration of catheter and wound pain 72 hours after operation among the four groups ( P>0.05). Conclusions:Intraoperative use of hypothermic 3% sodium chloride solution can reduce the amount of blood loss in operation in adult patients with plasma tonsillectomy, increase the clarity of visual field, and effectively reduce postoperative pain.
ABSTRACT
Objective:To construct a Soochow University model of comfortable medical procedures during peri-anesthesia period for patients undergoing radical resection of lung cancer through thoracoscope.Methods:In this prospective study, eight hundreds and sixty patients undergoing radical resection of lung cancer through thoracoscope were enrolled in our hospital in 2018.During peri-anesthesia period, the 860 patients were randomly(by the random number table method)divided into the control group(the group C receiving routine medical procedures, n=430)and the comfort group(the group S receiving the comfortable medical procedures of Soochow University model, n=430). The scores of Visual Analogue Scale(VAS), Richmond Agitation-Sedation Scale(RASS), and Thirsty Analogue Scale(TAS)were recorded at 5 min after extubation(T1), at out of the post-anesthesia care unit(T2), at 1 h(T3), 6 h(T4), 12 h(T5), 24 h(T6), 2 d(T7)and 3 d after surgery(T8)in two groups.The incidences of postoperative sore throat(POST), nausea and vomiting(PONV), catheter-related bladder discomfort(CRBD), thirst and hypothermia were recorded at T2, T6 and T8, respectively.Meanwhile, the peri-anesthesia comfort questionnaire(PCQ)and peri-anesthesia satisfaction questionnaire(PSO)were completed at T6 and T8.Results:The incidences of POST(48.6% vs.16.2%), PONV(24.9% vs.13.0%), CRBD(78.8% vs.20.9%)and thirst(74.9% vs.20.0%)were higher in the group C than in the group S at T2( P<0.05). The comfort score and satisfaction score were lower in the group C than in the group S at T6(3.14±1.04 vs.4.92±1.42, 2.67±0.89 vs.3.30±1.01)and at T8(3.84±1.83 vs.5.05±1.77, 2.74±0.84 vs.3.26±1.06)( P<0.05). Conclusions:The Soochow University model of comfortable medical procedures during peri-anesthesia period for patients undergoing radical resection of lung cancer through thoracoscope has been successfully constructed, and this model can reduce the incidence of complications, and improve the comfort and satisfaction during peri-anesthesia period.