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Objective To compare the postoperative analgesic effect between serratus plane block and thoracic paravertebral block in patients undergoing thoracoscopic surgery.Methods Sixty patients undergoing thoracoscopic surgery, 38 males and 22 females, aged 18-65, BMI 18-25 kg/m2, falling into ASA physical status I or II.They were divided into groups S and T by random number table, 30 cases in each group.Two groups of patients were treated with general anesthesia with endobronchial intubation and PCIA after operation.Group S performed Ultrasound-guided serratus plane block and group T performed thoracic paravertebral block, 0.4％ropivacaine 30 ml were used in the two groups.The two groups of patients were observed 30 min after block, and the sensory block plane was measured with acupuncture and recorded.Recording operation time, onset time and duration of the block.Resting and cough VAS score were recorded at 2, 4, 8, 12, 24, and 48 hafter surgery.The first pressing time of the analgesic pump and times of press analgesic pump, the amount of sufentanil used and times the number of cases of useing piperidine were recorded within 48 hafter operation.Block related complications and analgesic related adverse reactions were recorded.Results Compared with group T, the operation time of the block obviously shortening but the duration obviously lengthening (P<0.01).Resting and cough VAS score at 12 hafter surgery significantly was lower (P<0.01).The first pressing time of the analgesic pump obviously lengthening, the number of press analgesic pump and the amount of sufentanil used significantly were reduced (P<0.01) in group S.Conclusion Ultrasound guided SP block and TPVB block can provide good postoperative analgesia for patients undergoing thoracoscopic surgery, but SP block is more durable, with less operation time and complications than TPVB block, and can effectively reduce the opioid demand and incidence of nausea and vomiting after operation.
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Objective:To assess the effect of patient-controlled intravenous analgesia (PCIA) with different postoperative analgesics on prognosis after colorectal surgery. Methods:A total of 460 colorectal cancer patients (TNMⅠ-Ⅱ) who underwent elective surgery within January 2010 to December 2012 in Chongqing Cancer Hospital were randomly divided into five groups for PCIA with sufentanil, dezocine, butorphanol, morphine, and tramadol. We evaluated the analgesic efficacy, detected NK cell activity and Th1/Th2 ratio from peripheral blood, and observed short-term complications and long-term cancer recurrence and metastasis. Healthy volunteers served as the control group. Results:The morphine group displayed a VAS score of less than 3 in the rest state and showed the longest hospital stay and the highest incidence of pruritus (P0.05), whereas those in the morphine group remained low (Pbutorphnol>dezocine>sufentanil>tramadol. Conclusion:Tramadol and sufentanil used in PCIA after colorectal surgery could facilitate the recovery of immune function and reduced the incidence of recurrence and metastasis.
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Objective To compare the effects of oxycodone hydrochloride injection versus sufentanil for postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC) operation. Methods Sixty patients of both sexes , aged 18-65 yr , weighing 46-85 kg , scheduled for LC operation , were randomly divided into 2 groups (n = 30). Patient-controlled intravenous analgesia (PCIA) pump (oxycodone hydrochloride injection 20 mg or sufentanil 100 μg with physiological saline to 100 ml ) was used for postoperative analgesia five minutes before the end of operation. The first dose and bolus dose were both 5 ml , background infusion was 2 ml/h,lockout interval was 5 minute. The NRS score of rest and during movement at 1 ,6 and 24 h after operation,total oxycodone or sufentanil consumption in 24 h, requirement for rescue analgesic, the level of patient′s satisfaction , the adverse events were recorded. Results There was no significant difference in the NRS scores at rest and during movement , total oxycodone or sufentanil consumption in 24 h and postoperative nausea and vomiting (PONV) between the two groups. The patient’s satisfaction were significantly higher (P < 0.05), and the incidence of dizziness were significantly lower (P = 0.026) in group Q than in group S. Both groups were no requirement for rescue analgesic , no sleepiness , no itch , no retention of urine and other adverse reaction. Conclusion PCIA with oxycodone hydrochloride injection is safe and effective in reducing pain after LC operation, however the incidence of dizziness is lower and the level of patient’s satisfaction is higher with oxycodone hydrochloride than with sufentanil.
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OBJECTIVE: To assess the prescribing practice of parecoxib in surgical inpatients, especially for its efficacy and safety. METHODS: This was a retrospective, multi-center survey. Based on medical records, patient's characteristics, perioperative analgesics, postoperative pain intensity scale and drug adverse events were recorded in case report form (CRF). RESULTS: Forty-one comprehensive tertiary hospitals were enrolled in this study, 3 542 inpatients were eligible, 44.7% of whom were male. The most dominant dosing regimen of parecoxib was single dose shot (62%), 27% of the enrolled patients were given more than two shots, and 4.7% of the patients were given two shots. Besides parecoxib, the analgesics used postoperatively included tramodal (17.8%), flurbiprofen axetil (14.4%), celecoxib (11.3%), fentanyl (10.2%), butorphanol (7.3%), morphine (5.1%) and pethidine (4.6%). visual analogue scale was used for pain evaluation in 24.6% of the enrolled patients. The percentage of patients who had severe pain on the operation day, postoperative day 1, postoperative day 2, and postoperative day 3 were 19.7%, 17.8%, 6.8% and 5.2%, respectively. The incidence of drug adverse events of parecoxib was 0.2% (6/3 542), most of which were hypotension, nausea, vomiting, pruritus and rash. CONCLUSION: This retrospective, multi-center survey reveals that parecoxib had a good safety profile; there is no serious adverse event in 3542 inpatient who received parecoxib postoperatively. Parecoxib is mainly used for short term, which is consistent with the current medical evidences.