ABSTRACT
Objective Through a prospective randomized controlled study , comparing the effects of three different anesthetic methods on the patients quality of recovery ( QoR ) score and surgical satisfaction after oblique inguinal hernia repair ( OIHR) .Methods Ninety patients who had underwent OIHR were divided into three groups:nerve block group(NB), spinal anesthesia group(SA) and combination of NB and single low-dose SA group(NB+SA). The first two were treated as control groups .Each group had equally thirty cases .The primary outcome was QoR score and surgical satisfaction , while the secondary outcomes included intraoperatively-adjuvant intravenous admin-istration, mean blood pressure (MBP) and heart rate (HR) during operation.Results The QoR score (median, interquartile range ) in NB+SA group was significantly higher than that of NB group and SA group in the first day af-ter surgery (P<0.05),which was NB group QoR 15(13,18),SA group QoR 16(15,17) and NB+SA group QoR 18(16,19)respectively.The second day after the surgery, the QoR score (median, interquartile range) in NB+SA group was still higher than that of SA group (P<0.05),which was correspondingly NB group QoR 18(15,20), SA group QoR 17(16,19) as well as NB+SA group QoR 20(18,20).As for surgical satisfaction, surgeons are more content with the method of NB+SA than that of SA and NB ( P<0.05 ) .In terms of adjuvant intravenous administra-tion, it was most common in NB group followed by NB +SA group and SA group ( P<0.05 ) .Conclusions Compared to NB and SA , patients with NB+SA have higher QoR and surgical satisfaction after surgery .
ABSTRACT
Objective To observe the clinical effect on cervicogenic headache (CEH) of pulsed radiofrequency stimulation (PRF) applied to the C2 dorsal root ganglion combined with nerve block.Methods A total of 78 cases diagnosed as CEH were randomly divided into a combined treatment group,a PRF treatment group and a nerve block group.The combined treatment group was given both PRF applied to the C2 dorsal root ganglion and blocking therapy.The other two groups were given only one treatment or the other.All the treatments were once weekly for 3 weeks.Before treatment and 1,3 and 6 months after treatment,all of the patients' headaches were evaluated using a visual analogue scale (VAS).Results At 1,3 and 6 months after treatment,the average VAS scores of all three groups had decreased significantly.The VAS ratings dropped the most in the combined treatment group,followed by the PRF group and then the nerve block group.All the intergroup differences were statistically significant.The combined treatment group's cure rate (88％) was significantly better than that of the PRF group (81％),which was significantly better than that of the nerve block group (54％).Conclusion Combining PRF applied to the C2dorsal root ganglion with nerve block therapy has a synergistic effect on CEH.The curative effect of the combined treatment was better than either PRF or blocking alone.
ABSTRACT
Objective To compare the advantages and disadvantages of botulinum toxin A (BTX-A) and phenol block in the treatment of spasticity in children with cerebral palsy. Methods Four hundred and twenty children with spastic cerebral palsy were divided into an experimental group (375 cases) and a control group (45 cases).The children were aged from 1 to 22 years ( average age 6 years).The children in the experimental group were treated with BTX-A block at a dosage of 55 to 350 IU (average 130.5 IU).The children in the control group were treated with a 5％ phenol solution block at a dosage of 0.5 to 4.6 ml ( average 2.2 ml).Children of both groups were given systematic functional rehabilitation training. All the children were evaluated with a physician rating scale (PRS) and the modified Ashworth scale (MAS) before and after the blocking.Effectiveness rates,effectiveness durations and side effects rates were calculated. Results Before treatment there was no significant difference in terms of motor disorder or spasticity between the 2 groups.After treatment,spasticity had been significantly reduced in both groups.The effectiveness rate was 98.4％ in the experimental group and 95.6％ in the control group,a difference which was not significant.The average effectiveness duration was ( 24.9 ± 5.76 ) weeks in the experimental group and ( 69.2 ± 13.76) weeks in the control group,significantly longer.The side effects rate was 5.33 ％ in the experimental group and 15.56％ in the control group,also a significant difference. Conclusion BTX-A could be more widely used because of its safety and credibility.