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Objective:To investigate the application value of intravenous anesthesia combined with ultrasound-guided nerve block in patients with intestinal cancer.Methods:A total of 200 patients who prepared to undergo laparoscopic radical resection of intestinal cancer under general anesthesia in Beijing Yanhua Hospital between January 2017 and January 2022 were selected as the study subjects.They were divide into study group and control group according to inter-group matching principle,with 100 cases in each group.Control group adopted single intravenous anesthesia,and study group adopted intravenous anesthesia combined with ultrasound-guided nerve block.The heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SpO2)before anesthesia(T0),after anesthesia(T1),when skin incision(T2)and when completed surgery(T3),and the visual analogue scale(VAS)values,the time of the first exhausting,the time of postoperative hospital stay,the occurrence of adverse reaction at the 6th h(T4)and 12th h(T5)after surgery between two groups were compared.The drive pressure(DP)values at five time points included 5min(t1)after endotracheal intubation,5min(t2)after establishing pneumoperitoneum,5min(t3)and 60min(t4)after implementing the position with lower head and higher foot,and 5min(t5)after restoring horizontal position of pneumoperitoneum exhaust were recorded.And then,the concentrations of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),angiotensin(AngⅡ)and cortisol(Cor)before and 24h after surgery were respectively measured.Results:The results of one-way ANOVA indicated that there were no statistically significant differences in HR,MAP and SpO2 between the two groups at T0,T1,T2 and T3(P>0.05),respectively.The dosage of Propofol within unit time of study group was significantly lower than that of control group(t=8.305,P<0.05),and the time of the first exhausting and the time of hospital stay of study group were significantly shorter than those of control group(t=7.978,t=9.141,P<0.05),respectively.The VAS scores of study group were significantly lower than that of control group at T4 and T5(t=10.033,t=9.071,P<0.05),and the incidence of adverse reaction of study group was significantly lower than that of control group(x2=13.78,P<0.05),respectively.The results of one-way ANOVA showed that there were statistically significant differences in DP values between the two groups at different times(F=595.765,F=448.108,P<0.05),and the DP values of two groups at t2,t3,t4 and t5 were significantly higher than that at t1(10.59±1.52)(F=595.765,P<0.05).The DP values at t2,t3 and t4 of study group were significantly higher than those of control group(t2=17.69±2.12,t3=20.16±2.06,t4=20.06±2.0)(t=9.650,t=14.339,t=0.738,P<0.05),respectively.The differences of the serum AngⅡ,Cor,TNF-α and IL-6 levels between two groups were not statistically significant before surgery(P>0.05).The serum AngⅡ,Cor,TNF-α and IL-6 levels of the two groups of patients after surgery were significantly higher than them before surgery.At 24 hours after surgery,the serum AngⅡ,Cor and TNF-α and IL-6 levels of study group of patients were significantly lower than them of control group(t=2.601,t=3.790,t=5.779,t=6.154,P<0.05),respectively.Conclusion:The application of intravenous anesthesia combined with ultrasound-guided nerve block in patients who undergo laparoscopic radical resection of intestinal cancer can effectively maintain intraoperative hemodynamic stability,and reduce the amount of anesthetic,and shorten the times of the first exhausting and hospital stay,and reduce postoperative pain,stress and inflammation reaction,and improve respiratory function.
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@#BACKGROUND: Ultrasound guided regional anesthesia is widely taught using task trainer models. Commercially available models are often used; however, they can be cost prohibitive. Therefore, alternative "homemade" models with similar fidelity are often used. We hypothesize that professional task trainers will be preferred over homemade models. The purpose of this study is to determine realism, durability and cleanliness of three different task trainers for ultrasound guided nerve blocks. METHODS: This was a prospective observational study using a convenience sample of medical student participants in an ultrasound guided nerve block training session on January 24th, 2015. Participants were asked to perform simulated nerve blocks on three different task trainers including, 1 commercial and 2 homemade. A questionnaire was then given to all participants to rate their experiences both with and without the knowledge on the cost of the simulator device. RESULTS: Data was collected from 25 participants. The Blue Phantom model was found to have the highest fidelity. Initially, 10 (40%) of the participants preferred the Blue Phantom model, while 10 (40%) preferred the homemade gelatin model and 5 (20%) preferred the homemade tofu model. After cost awareness, the majority, 18 (72%) preferred the gelatin model. CONCLUSION: The Blue Phantom model was thought to have the highest fidelity, but after cost consideration the homemade gelatin model was preferred.
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The aim of this study was to evaluate of analgesic effect of ultrasound guided transversus abdomines plane block in children undergoing open appendectomy surgery and compare to children were used GA alone.Twenty children aged 5-15 years with ASA I-II classification were randomly enrolled in this study.Each group had 10 children and all children were received GA with same techniques. Study group(transversus abdomines plane block group) were assigned to receive ultrasound guided block using 0.3 ml/kg of Bupivacaine 0.25%. Intraoperative hemodynamic changes, postoperative maximum pain score, the time the first analgesic requirement, correllation between inflammatory process, surgical disease complication and pain intensity were studied. Statistic analysis was made in Excel usingdescriptive analysis, correlation and regressive analysis. A p-value<0.05 was considered significant.There was no differencies between the two studied groups regarding demographic and clinicalcharacteristics. Intraoperative systolic blood pressure changes was higher in control group than studygroup (17%), and HR and BP were more stable in the study group. Level of WBC had direct positive relationship with appendix inflammation (r=0.71 (p-утга <0.001) and weak positive correlation (r=0.44 p-утга <0.05) with pain intensity. Postoperative pain score was higher in control group and the first analgesic requirement time was 2h. In the study group had mild to moderate pain and the the firstanalgesic requirement time was 4h.Transversus abdomines plane block under ultrasound guidance was easy, safe, reliable and effective analgesic in children undergoing open appendectomy surgery.
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Skin grafting is often required for diabetic ulcerative foot lesions. In skin grafting, effective regional or local anesthesia into the donor and recipient areas plays a significant role in continuous control of pain. We report on a technique of ultrasound-guided nerve block on the femoral, sciatic, and lateral femoral cutaneous nerves in large split-thickness skin grafting for ulcer of the foot and leg.
Subject(s)
Humans , Anesthesia, Local , Femoral Nerve , Foot , Leg , Nerve Block , Sciatic Nerve , Skin Transplantation , Tissue Donors , UlcerABSTRACT
We report a case in which feelings of abdominal distension and discomfort of the abdominal wall caused by malignant ascites were relieved by ultrasound-guided rectus sheath block. <b>Case report</b>: A 59-year-old man developed gastric cancer with malignant ascites and experienced feelings of abdominal distension, but no nausea, dyspnea, poor mobility, or limb edema. Symptom control was inadequate with diuretic therapy and abdominal paracentesis. Feelings of distension improved temporarily with ultrasound-guided rectus sheath block. A percutaneous catheter was then used to administer an infusion of 0.25% ropivacaine triweekly until his death 20 days later. <b>Conclusion</b>: Feelings of abdominal distension is one of various symptoms of severe ascites and is difficult to manage. Ultrasound-guided rectus sheath block can be used to relieve this symptom on a case-by-case basis.
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We report a case whose left lower limb neuropathic pain accompanied by pelvic tumor invasion was remarkably eliminated by ultrasound-guided sciatic nerve block. <b>Case report</b>: The subject was a sixty year old male. Pharmacological therapy was given according to the WHO analgesic ladder, but his left lower limb pain failed to respond to drugs. His intractable lower limb neuropathic pain was alleviated by ultrasound-guided sciatic nerve block. Drug delivery can be achieved with a percutaneous catheter and a disposable infusion pump. Infusions were run at 5mlh<SUP>-1</SUP> with 0.1% ropivacaine. <b>Conclusion</b>: Neuropahic pain is sometimes hard to be controlled only by opioids or adjuvant analgesics, but there is a possibility of providing pain relief by combination use with nerve blocks. Interventional techniques can be highly effective but also have the potentiality to produce significant adverse effects. Many patients have factors which would be considered a near absolute contra-indication to the use of nerve blocks such as immuno-compromise or impairment of coagulation. Skillful application of peripheral neural blockade with ultrasound imaging broadens the options for providing optimal pain management. Palliat Care Res 2011; 6(1): 313-315