Continuous erector spinae plane block for analgesia and better pulmonary functions in patients with multiple rib fractures: a prospective descriptive study

Abstract Background: The present study explored the role of continuous erector spinae plane (ESP) block for analgesia as well as its impact on pulmonary functions in patients with multiple rib fractures. Methods: Ten patients with multiple rib fractures were enrolled after getting informed and written consent. Ultrasound-guided ESP block was performed at the level midway between the fractured ribs followed by the insertion of the catheter. Pre- and post-block VAS score, hemodynamics, respiratory rate (RR), peripheral oxygen saturation (SpO2), inspiratory capacity (IC), blood gases (PaO2 and PCO2), and complications were compared. Results: Pain scores at rest as well as on movement showed a significant reduction from 5.9 and 7.5 pre block to 1.6 and 2.5 respectively at 96 hours (p < 0.0001). Similarly, RR, SpO2, IC, and PaO2 were significantly better after the block placement (p < 0.001). Conclusion: Continuous ESP block provide adequate analgesia with better respiratory functions in patients with multiple rib fractures.

Analgesia posoperatoria con opioide de acción rápida en la colecistectomía video laparoscópica / Postoperative analgesia with fast-acting opioid during videolaparoscopic cholecystectomy

Introducción: La cirugía video laparoscópica posee beneficios para los pacientes. Las intervenciones con tiempos reducidos implican técnicas anestésicas ajustadas a ellos, lo que determina no pocas dificultades cuando el dolor aparece en la práctica asistencial. El hallazgo de pacientes con dolor posoperatorio inmediato motivó la realización del estudio. Objetivo: Evaluar la efectividad de un opioide de acción rápida como analgésico posoperatorio inmediato administrado vía intranasal. Método: Se desarrolló un estudio causiexpereimental, con dos grupos de enfermos (100 cada uno) a los que se les realizó colecistectomía por vía laparoscópica en el Hospital Militar Central Dr. Luis Díaz Soto, a los 100 pacientes en estudio se les administró FENTANYL 50 mcg intranasal en gotas al llegar a la sala de cuidados posoperatorios. Las variables de estudio incluyeron el dolor según la Escala Visual Análoga (EVA), el tiempo de inicio de acción del opioide y la analgesia lograda, así como los efectos derivados de su empleo. Resultados: la edad promedio fue 51 ± 2, predominó el sexo masculino con 55 por ciento de los casos, se evidenció una EVA promedio de todos los casos iniciales en 3. Al alta, 100 por ciento de los pacientes del grupo estudio poseían analgesia excelente (EVA 2), mientras que los controles poseían una EVA promedio en 5. El prurito fue el evento adverso más frecuente tras la administración de FENTANYL intranasal. Conclusiones: El empleo de un opioide de acción rápida (FENTANYL) es una medida de control del dolor posoperatorio excelente y segura(AU)

Introduction: Videolaparoscopic surgery has benefits for patients. Interventions with reduced times involve anesthetic techniques adjusted to them, which determines many difficulties when pain manifests in the care practice. The finding of patients with immediate postoperative pain motivated the study. Objective: To evaluate the effectiveness of a fast-acting opioid as an immediate postoperative analgesic administered by intranasal way. Method: A quasiexperimental study was developed, with two groups of patients (100 each) who underwent laparoscopic cholecystectomy at Dr. Luis Díaz Soto Central Military Hospital. The hundred patients under study were administered fentanyl 50 mcg as intranasal drops upon arriving at the postoperative care room. The study variables included pain according to the Visual Analogue Scale (VAS), the onset time of opioid action, and the analgesia achieved, as well as the effects derived from its use. Results: The average age was 51 ± 2, the male sex predominated with 55 percent of the cases, an average VAS of all the initial cases was evidenced in three. At discharge, 100 percent of the patients in the study group had excellent analgesia (VAS 2), whereas the controls had an average VAS in 5. Pruritus was the most frequent adverse event after the administration of intranasal fentanyl. Conclusions: The use of a fast-acting opioid (fentanyl) is an excellent and safe postoperative pain control measure(AU)

Efficacy comparision of lumbar disc herniation treated with acupuncture at different time intervals / 中国针灸

OBJECTIVE@#To observe the effect of lumbar disc herniation treated with acupuncture at different time intervals.@*METHODS@#A total of 180 patients of lumbar disc herniation were randomized into an observation group 1, an observation group 2 and an observation group 3, 60 cases in each one. All patients were treated with acupuncture at Jiaji L-L (EX-B 2), Huantiao (GB 30), Weizhong (BL 40), etc. And then KWD-808 electroacupuncture instrument was connected, time intervals of acupuncture were once every day, once every 2 days and once every 3 days, 3 weeks were provided. At 1-week, 2-week and 3-week treatment, the visual analogous scale (VAS) and Japanese Orthopedics Association (JOA) scale were observated, and the effects were evaluated.@*RESULTS@#The effective rates in the observation group 1 and the observation group 2 were 96.7% (58/60) and 95.0% (57/60), there was no significant different between the two groups (>0.05), which were superior to 88.3% (53/60) in the observation group 3 (both 0.05) at 1-week, 2-week and 3-week treatment, however, they were significantly reduced compared with the observation group 3 (all 0.05) at 1-week, 2-week and 3-week treatment, however, they were significantly increased compared with the observation group 3 at 3-week treatment (both <0.05).@*CONCLUSION@#Acupuncture once every day and once every 2 days in the treatment of lumbar disc herniation is equally effective, better than once every 3 days.

Effects of Bed Rest on Acute Nonspecific Low Back Pain / 中国康复理论与实践

@#Objective To investigate the effect of bed rest on acute nonspecific low back pain(ANLBP).Methods87 cases were randomly divided into bed rest group (42 cases) and free activity group (45 cases).The bed rest group would be proper activity indoor and step up activity outdoor after absolute in bed for a week.The free activity group would be prescribed free activity.At the same time,all of them received physiotherapy and non-steroidal anti-inflammatory drugs (NSAIDs).The visual analogous scale (VAS) were measured before and 2 weeks after treatment.The Roland-Morris disability questionnaire (RMDQ) were measured before and 2,6 weeks after treatment.ResultsThe difference of VAS and RMDQ scores between these 2 groups were not significant before treatment (P>0.05),but were significant 2 weeks after treatment(P<0.05).Further more,the difference of RMDQ scores between these 2 groups were not significant 6 weeks after treatment (P>0.05).ConclusionThe bed rest about patients could not promote,but delay the improvement of the pain and disability in the early period or later period recovery of ANLBP.

Effects of Bed Rest on Acute Nonspecific Low Back Pain / 中国康复理论与实践

@#Objective To investigate the effect of bed rest on acute nonspecific low back pain(ANLBP).Methods87 cases were randomly divided into bed rest group (42 cases) and free activity group (45 cases).The bed rest group would be proper activity indoor and step up activity outdoor after absolute in bed for a week.The free activity group would be prescribed free activity.At the same time,all of them received physiotherapy and non-steroidal anti-inflammatory drugs (NSAIDs).The visual analogous scale (VAS) were measured before and 2 weeks after treatment.The Roland-Morris disability questionnaire (RMDQ) were measured before and 2,6 weeks after treatment.ResultsThe difference of VAS and RMDQ scores between these 2 groups were not significant before treatment (P>0.05),but were significant 2 weeks after treatment(P<0.05).Further more,the difference of RMDQ scores between these 2 groups were not significant 6 weeks after treatment (P>0.05).ConclusionThe bed rest about patients could not promote,but delay the improvement of the pain and disability in the early period or later period recovery of ANLBP.