ABSTRACT
Objective@#To compare the analgesic effect of ultrasound-guided femoral nerve block and iliofascial lacuna block after total knee arthroplasty.@*Methods@#From June 2016 to June 2018, 96 patients with total knee replacement in Orthopaedic Hospital of Yongkang were selected in this research and divided into two groups by random number table method, with 48 cases in each group.The control group was treated with ultrasound-guided femoral nerve block, and the observation group was treated with ultrasound-guided iliofascial lacuna block.Visual analogue (VAS) pain score, puncture injection time, cumulative fentanyl dosage, recovery time, effective analgesia time, active joint flexion angle and adverse reactions of the affected limb were compared between the two groups at 4 h, 8 h, 12 h, 24 h and 48 h after surgery.@*Results@#There were no statistically significant differences in VAS score at each postoperative time point between the two groups (all P>0.05). At 4 h, 8 h, 12 h and 24 h after surgery, the VAS scores in the observation group [(2.16±0.58) points, (2.03±0.52) points, (1.94±0.47) points, (1.86±0.51) points] were significantly lower than those in the control group [(2.55±0.63) points, (2.46±0.61) points, (2.31±0.55) points, (2.17±0.58) points] (all P<0.05). The time of puncture injection and the cumulative dose of fentanyl were compared between the two groups.The time of puncture injection in the observation group [(2.61±0.41) min] was shorter than that in the control group [(4.20±0.61) min], and the difference was statistically significant (P<0.05). The cumulative dosage of fentanyl in the observation group [(0.51±0.02) mg] was less than that in the control group [(0.68±0.04) mg], and the difference between the two groups was statistically significant (P<0.05). There was no statistically significant difference in anesthesia recovery time between the two groups(P>0.05). The effective analgesic time, limb active joint flexion angle at 24 h, 48 h after operation in the observation group[(39.17±3.52)h, (47.99±4.78)°, (68.97±4.13)°] were significantly higher than those in the control group[(27.34±1.23)h, (30.12±4.68)°, (45.52±3.87)°], the differences were statistically significant (all P<0.05). After treatment, all patients had complications such as nausea and vomiting, pruritus, and hematoma at the puncture point.The total incidence of the observation group(4.17%) was lower than that of the control group (16.67%), the difference was statistically significant (χ2=4.019, P<0.05).@*Conclusion@#Ultrasound-guided iliac fascial space block analgesia is significantly better than femoral nerve block in total knee replacement patients, which can effectively reduce pain and adverse reactions.
ABSTRACT
Objective:To compare the analgesic effect of ultrasound-guided femoral nerve block and iliofascial lacuna block after total knee arthroplasty.Methods:From June 2016 to June 2018, 96 patients with total knee replacement in Orthopaedic Hospital of Yongkang were selected in this research and divided into two groups by random number table method, with 48 cases in each group.The control group was treated with ultrasound-guided femoral nerve block, and the observation group was treated with ultrasound-guided iliofascial lacuna block.Visual analogue (VAS) pain score, puncture injection time, cumulative fentanyl dosage, recovery time, effective analgesia time, active joint flexion angle and adverse reactions of the affected limb were compared between the two groups at 4 h, 8 h, 12 h, 24 h and 48 h after surgery.Results:There were no statistically significant differences in VAS score at each postoperative time point between the two groups (all P>0.05). At 4 h, 8 h, 12 h and 24 h after surgery, the VAS scores in the observation group [(2.16±0.58) points, (2.03±0.52) points, (1.94±0.47) points, (1.86±0.51) points] were significantly lower than those in the control group [(2.55±0.63) points, (2.46±0.61) points, (2.31±0.55) points, (2.17±0.58) points] (all P<0.05). The time of puncture injection and the cumulative dose of fentanyl were compared between the two groups.The time of puncture injection in the observation group [(2.61±0.41) min] was shorter than that in the control group [(4.20±0.61) min], and the difference was statistically significant ( P<0.05). The cumulative dosage of fentanyl in the observation group [(0.51±0.02) mg] was less than that in the control group [(0.68±0.04) mg], and the difference between the two groups was statistically significant ( P<0.05). There was no statistically significant difference in anesthesia recovery time between the two groups( P>0.05). The effective analgesic time, limb active joint flexion angle at 24 h, 48 h after operation in the observation group[(39.17±3.52)h, (47.99±4.78)°, (68.97±4.13)°] were significantly higher than those in the control group[(27.34±1.23)h, (30.12±4.68)°, (45.52±3.87)°], the differences were statistically significant (all P<0.05). After treatment, all patients had complications such as nausea and vomiting, pruritus, and hematoma at the puncture point.The total incidence of the observation group(4.17%) was lower than that of the control group (16.67%), the difference was statistically significant (χ 2=4.019, P<0.05). Conclusion:Ultrasound-guided iliac fascial space block analgesia is significantly better than femoral nerve block in total knee replacement patients, which can effectively reduce pain and adverse reactions.
ABSTRACT
OBJECTIVE:To study the protective effects of autophagy inhibitor 3-Methyladenine (3-MA) against lipopolysac-charide(LPS)-induced acute lung injury in mice and its mechanism. METHODS:Mice were randomly divided into normal control group,model group (LPS 15 mg/kg),drug control group (3-MA 20 mg/kg),low-dose and high-dose groups (LPS 15 mg/kg+3-MA 20,40 mg/kg),with 10 mice in each group. Except for normal control group and drug control group,other groups were giv-en LPS intraperitoneally to induce acute lung injury model,and drug control group and low-dose and high-dose groups were given equivalent dose of 3-MA intraperitoneally 1 h before modeling. 6 h after modeling,lung wet/drug mass ratio (W/D) was deter-mined respectively,and pathology change of lung tissue was observed by HE staining. TNF-α,NF-κB p65,LC3BⅡ/Ⅰ and Cleaved-caspase-3 protein expression were detected by Western blot. RESULTS:Compared with normal control group,W/D, TNF-α,NF-κB p65,LC3BⅡ/Ⅰ and Cleaved-caspase-3 protein expression increased in model group (P<0.01). Compared with model group,W/D,the expression of TNF-α,NF-κB p65,LC3BⅡ/Ⅰ and Cleaved-caspase-3 protein decreased in low-dose group (P<0.05),white just only LC3BⅡ/Ⅰ protein decreased high-dose group(P<0.01). CONCLUSIONS:In LPS-induced acute lung injury model in mice,the excessive autophagy could activate the NF-κB pathway and involve the inflammatory responses and induce lung cells apoptosis. The moderate autophagy inhibition by 3-MA can ameliorate inflammatory response and protect lung tissue.