ABSTRACT
Objective To evaluate the efficiency of multimodal analgesia for the patients who had the posterior lumbar spine surgery.Methods Sixty-four cases of patients who were scheduled to the posterior lumbar spine surgery were randomly divided into two groups, multimodal analgesia group (n =32) and control group(n=32).Multimodal analgesia group patients were given oxycodone acetaminophen 1 day before and the next day after operation, during the operation the patients received injiection of multimodal drugs (consisting of ropivacaine 150 mg, flurbiprofen 50 mg, phenylephrine 0.4 ml, normal saline 50 ml) around the incisions by infiltrated injection before the skin incision closed, then had controlled intravenous analgesia.In the control group, the incisions were sutured without the local infiltration analgesia.Then only had patient controlled intravenous analgesia after operati on.Visual analogue scale(VAS) ,Japanese Orthopedic Association(JOA) and Prolo lumbar function score was recorded respectively perioperatively.Results (1) VAS: the patients of multimodal analgesia group had significantly lower rest pain scores and activity pain scores at 6, 12,24 hours, first moving than the control group((3.1±1.6) ,(2.8±1.1),(2.4±0.9) ,(2.3±1.1) vs.(3.5±1.8) ,(3.4± 1.3), (3.4±0.8), (3.0± 1.5), P＜0.05).There was no significant difference at the discharge between the two groups (P＞0.05).(2)JOA:JOA scores of the patients of multimodal analgesia group were obviously higher than that of the control group at 1,3,7 days after operation (P＜0.05).There was no significant difference at the discharge between the two groups (P＞0.05).(3) Prolo lumbar function score : Prolo scores of the patients of the multimodal analgesia group were obviously higher than that of control group at 1,3,7 days after operation (P ＜0.05).There was no significant difference at the discharge between the two groups(P＞0.05).Conclusion Multimodal Analgesia is shown to safely provide excellent pain control and functional recovery.It can reduce visual analogue pain score and improve lumbar function after surgery.
ABSTRACT
ObjectiveTo study the effect and mechanism of NGF gene modified SCs on DRG (dorsal root ganglion) neurons repair after compressed injury.MethodsSCs were obtained by one enzyme digestion method.SCs were transfected with NGF gene by adenovirus.Thirty-two female SD rats with compression injury of dorsal root ganglia on right lumbar nerve roots.were divided randomly into following groups:Normal saline(NS) group,Pure SCs group,Ad-NGF group,and SCs+NGF group.Nerve root tissues were harvested 2 weeks after treatment.Western blot were used to detect the proNGF volume in nerve root tissue lysis; Double-labeling fluorescent Immunohistochemistry(IHC) was used to count the number of β-Tubulin Ⅲ positive cells and activating transcription factor 3 positive cells.The ratio of injured neurons to survived neurons was calculated.ResultsWestern bolt showed the proNGF volume in nerve root tissue lysis of SCs+NGF group increased dramatically.Double-labeling fluorescent IHC showed SCs+NGF group vs any group,the density of survived DRG neurons(β-Tubulin Ⅲ positive cells) increased significantly,meanwhile the percentage of injured neurons (ATF3 positive cells) in survived neurons decreased dramatically.Conclusion NGF gene Modified SCs could promote the survival of DRG neurons after compression injury and decrease the ratio of injured neurons.We conclude that this study provides a new treatment strategy for the patients who suffer from chronic compression injury on nerve roots and DRG neurons.