ABSTRACT
OBJECTIVE: To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on pulmonary function, superoxide dismutase (SOD) activity, and malondialdehyde (MDA) content in patients using tourniquet after lower extremity surgery. METHODS: A total of 40 patients who underwent lower extremity surgery were equally randomized into control group and TEAS group by using a random number table. All patients underwent lumbar epidural anesthesia combined with block anesthesia. The patients in the TEAS group were given TEAS at Zusanli (ST36) and Sanyinjiao (SP6) beginning from 30 min before surgery to the end of surgery, and those in the control group received TEAS at the same acupoints with minimum current intensity. Mean arterial pressure (MAP) and heart rate (HR) were recorded at each time point (T0: pre-surgery /TEAS, T1: 5 min after anesthesia, T2: 1 min before tourniquet-loosening, T3: 1 min after tourniquet-loosening, T4: 5 min after tourniquet-loosening, and T5: 6 h after tourniquet-loosening). Blood samples (4 mL) was collected from the radial artery before TEAS and 6 h after loosening tourniquet for analyzing blood gas parameters as partial pressure of caron dioxide(PCO2), arterial partial pressure of oxygen (PaO2), alveolar partial pressure of oxygen (PAO2), alveolar-arterial oxygen pressure difference (PA-aDO2) and respiratory index (RI) by using a blood gas analyzer, and plasma SOD activity and MDA content were assayed by using xanthine oxidase method and thiobarbituric acid colorimetry method, respectively. RESULTS: Intra-group comparison showed that compared with T0, a significant increase was found in PA-aDO2 and RI at T5 and a significant reduction in PaO2 and PaO2/ PAO2 (a/A) ratio in the control group (P<0.05), and the same changes in the TEAS group (P<0.05) except a/A ratio. Comparison between two groups showed that at T5, both PaO2 and a/A levels were significantly higher in the TEAS group than in the control group (P<0.05), and both PA-aDO2 and RI levels were obviously lower in the TEAS group than in the control group (P<0.05), suggesting an improvement of the pulmonary function after TEAS. At T5, plasma SOD activity was significantly decreased and plasma MDA content was remarkably increased in the control group relevant to T0 (P<0.05), SOD activity was significantly higher in the TEAS group than in the control group (P<0.05), and MDA content was evidently lower in the TEAS group than in the control group (P<0.05), suggesting a reduction of oxidative stress response after TEAS. CONCLUSION: TEAS at ST36 and SP6 can improve pulmonary function and attenuate oxidative stress response in patients using tourniquet after lower extremity surgery.
ABSTRACT
Há poucos estudos sobre a reabilitação de pacientes com a doençade Charcot Marie. Estes pacientes apresentam sintomas da doença precocemente e têm sobrevida longa o que determina alterações biomecânicas que afetam a qualidade de vida dos mesmos e por esta razão o estudo de possíveis tratamentos para estes pacientes são de grande importância. A intervenção cirúrgica das extremidades inferiores é uma destas possibilidades. Apesar de não haver conclusões ainda sobre qual a técnica cirúrgica e se a mesma é omelhor tratamento, a mesma é realizada para melhorar a qualidade de marcha e qualidade de vida destes pacientes. O estudo tem então o objetivo de avaliar o impacto do procedimento cirúrgico na qualidade de vida dos pacientes com doença de Charcot MarieTooth. Foram avaliados 9 pacientes antes e após procedimento cirúrgico através de análise do laboratório de marcha, questionário MFM e SF 36. Houve diferença significativa nas avaliações pré e pós operatórias no MFM e SF36. Neste estudo, a cirurgia corretiva de membros inferiores mostrou ter um impacto positivo na qualidade de vida dos pacientes com a doença de CMT, principalmente através da melhora do desempenho motor e da dor.
Background: There are few studies regarding the rehabilitation of a CMT patient. Because patients present symptoms at an early age,have a long life expectancy, and have serious biomechanical complications that generate a great impact on a patients life, a careful study of possible treatments for this population seems to be important. Surgical interventions on the lower extremities are among these possible treatments. Although there are no conclusions about the most effective surgical techniques, this surgical treatment would be done to give the patient a better quality of life since it improves the gait quality.The aim of this study was to analyze the impact of lower limb surgical procedures on the quality of life of CMT patients. Nine patients with CMT disease were analyzed before and after surgery, and the participants underwent gait analysis, Motor Function Measure (MFM) andthe SF-36 questionnaires. There was a significant difference in the MFM and SF-36 evaluations. This study showed an improvement in the quality of life of Charcot-Marie-Tooth patients, especially related to motor performance and pain.
Subject(s)
Humans , Male , Female , Child , Adolescent , Middle Aged , Young Adult , Motor Skills , Charcot-Marie-Tooth Disease/surgery , Charcot-Marie-Tooth Disease/rehabilitation , Lower Extremity/surgery , Pain Measurement , Gait Disorders, Neurologic/surgery , Cohort Studies , Preoperative Period , Postoperative Period , Quality of LifeABSTRACT
[Purpose]To study the changes of hemodynamic response and the states of myocardial ischemia with peripheral nerve block in patients with coronary heart disease after introcoronary stent(ICS)undergoing lower-extremity surgery in order to guide the clinical application.[Methods]Peripheral nerve block was performed on 32 patients with coronary heart disease after ICS undergoing lower-extremity surgery,the SP,DP and HR were measured before anesthesia,at the beginning of incision,30 min after the incision of surgery and after completion of operation;the states of myocardial ischemia reflected by DCG were monitored before 24h of surgery,2～5h after the incision and 48h after completion of operation.[Results]The SP,DP and HR were decreased more significantly at the beginning of incision,30 min after the incision of surgery and after completion of operation than before anesthesia(P0.05).The frequency of occurences of myocardial ischemia during and after the surgery was increased significantly(P
ABSTRACT
PURPOSE: To evaluate the safety and efficacy of postoperative patient controlled epidural analgesia via the lumbar approach in children undergoing lower extremity surgery. MATERIALS AND METHODS: 40 patients between the ages of 5 and 12 years were randomly allocated into two groups; one group received conventional pain medications (intramuscular injection of ketorolac 1 mg/kg t.i.d. and meperidine 0.5 mg/kg p.r.n.) and the other group received patient controlled epidural analgesia. The composition of the analgesics in the experimental group was 0.1% bupivacaine +fentanyl 2 g/mL in 100 mL of normal saline. Pain scores were measured 3 times using a standardized pain scale containing questions regarding side effects - upon arrival at the ward, 6 hours thereafter and 24 hours after the first measurement. RESULTS: Pain scores were significantly lower in the epidural group with minimal side effects requiring no further treatment (p<0.01). A significant correlation was found between the number of boluses and the incidence of nausea/vomiting in epidural group (p<0.01). CONCLUSION: This study demonstrates the safety and efficacy of patient controlled epidural analgesia using low concentrations of bupi-vacaine and fentanyl, in pediatric patients undergoing lower extremity surgery.