ABSTRACT
Objective:To systematically evaluate the efficacy of dorsal penile nerve block (DPNB) and caudal block (CB) for analgesia after penile surgery under general anesthesia in the pediatric patients.Methods:Databases including PubMed, EMbase, Web of Science, the Cochrane Library, Wanfang, VIP, CNKI and CBM were searched to collect the randomized controlled trials involving DPNB and CB for penile surgery under general anesthesia in children from inception to September 2021.Meta-analysis was performed using RevMan 5.4 software.Results:Sixteen randomized controlled trials involving 1 271 pediatric patients were enrolled.The results of meta-analysis showed that the requirement for analgesic drugs during recovery was significantly lower in CB group than in DPNB group ( RR=2.54, 95% CI 1.19-5.40, P=0.020); the time of first postoperative activity was significantly shortened ( SMD=-0.68, 95% CI -1.23--0.13, P=0.020), and the incidence of postoperative motor block was decreased ( RR=0.05, 95% CI 0.01-0.16, P<0.001) in DPNB group as compared with CB group.There were no significant differences in the incidence of intraoperative block failure ( RR=1.25, 95% CI 0.62-2.51, P=0.530) between two groups.There were no significant differences in objective pain scores at awakening ( SMD=-0.29, 95% CI -0.01-0.59, P=0.050), at 1 h after surgery ( SMD=1.02, 95% CI -1.37-3.41, P=0.400), or at 2 h after surgery ( SMD=0.05, 95% CI -0.59-0.68, P=0.880) between two groups.There were no significant differences in the incidence of agitation during recovery ( RR=0.71, 95% CI 0.44-1.14, P=0.150) between two groups.There were no significant differences in the time of first urination ( MD=-84.52, 95% CI -195.72-26.69, P=0.140) between two groups.There were no significant differences in the incidence of postoperative nausea and vomiting ( RR=0.56, 95% CI 0.29-1.07, P=0.080) between two groups. Conclusions:DPNB and CB provide similar postoperative analgesic efficacy, but DPNB can prevent the occurrence of postoperative motor block, which is helpful for the postoperative rehabilitation in the pediatric patients undergoing penile surgery with general anesthesia.
ABSTRACT
The present paper was aimed to study the security of burning during the continuous monitoring of transesophageal arterial oxygen saturation. 20 rabbits were randomly divided into two groups: control group and high-frequency electrotome group. All rabbits were implanted with the oxygen saturation detection probes into the lower esophageal after anesthesia. The probes were made up with two light-emitting diode (LED) and then connected with oxygen saturation sensor to monitoring for 2h and 6h, respectively. We then intercepted two luminous points as esophageal specimens and dist the esophageal tissue detection device headend 1cm gastric side esophageal specimens (self-contr01) after monitoring, and carried out pathological examination. The pathological results of the LED-1, LED-2 esophageal biopsy and self-control section were mucous integrity, submucosal mildedema, hyperemia, a small number of lymphocytes and mononuclear cell infiltration. All the score of the esophageal tissue histologic was 2. The results showed that montioring the SteO2 not more than 6h was safe with montiored using a matching of oxygen saturation sensor and monitoring esophageal arterial oxygen saturation.