Risk factors for massive blood loss in pediatric patients with congenital scoliosis undergoing posterior hemivertebra resection / 中华麻醉学杂志

Objective:To identify the risk factors for massive blood loss in pediatric patients with congenital scoliosis undergoing posterior hemivertebra resection.Methods:The clinical data of pediatric patients with congenital scoliosis who underwent posterior hemivertebra resection in our hospital from May 2017 to July 2019 were collected.The children were divided into group A (massive blood loss, blood loss/blood volume ≥30%) and group B (non-massive blood loss, blood loss/blood volume <30%) according to intraoperative blood loss.Logistic regression analysis was used to stratify the risk factors.Results:A total of 108 pediatric patients were enrolled in the study including 29 cases in group A and 79 cases in group B, respectively.There were significant differences in the preoperative Cobb angle, body mass index, the number of fused levels, the number of screws and operative time between the two groups ( P<0.05). Logistic regression analysis showed that the preoperative Cobb angle, operative time, the number of fused levels and body mass index were the risk factors for intraoperative massive blood loss ( P<0.05). Conclusion:Lower BMI, larger Cobb angle, increased operative time and more fused levels are the risk factors for massive blood loss in pediatric patients with congenital scoliosis undergoing posterior hemivertebra resection.

Efficacy of nalbuphine combined with propofol for esophageal dilation with gastroscope in pediatric patients / 中华麻醉学杂志

Objective:To evaluate the effect of nalbuphine combined with propofol for esophageal dilation with gastroscope in the pediatric patients.Methods:A total of 150 pediatric patients with esophageal stenosis, aged 6 months-2 yr, weighing 6-15 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective painless balloon dilation with gastroscope under general anesthesia, were randomized into 3 groups ( n=50 each) according to the random number table method: nalbuphine 0.1 mg/kg plus propofol group (N 1P group), nalbuphine 0.2 mg/kg plus propofol group (N 2P group), and fentanyl plus propofol group (FP group). Nalbuphine 0.1 and 0.2 mg/kg and fentanyl 1 μg/kg were intravenously injected in N 1P, N 2P and FP groups, respectively, and 2 min later propofol 1.5-2.0 mg/kg was intravenously injected for sedation until the eyelash reflex disappeared in the three groups.Propofol 1.0 mg/kg was added when body movement occurred during surgery.The amount of propofol consumed during surgery, occurrence of body movement and respiratory depression, occurrence of adverse reactions such as postoperative nausea and vomiting, and laryngospasm, emergence time, Face Legs Activity Cry Consolability (FLACC) pain scale score and surgeons′ satisfaction were recorded. Results:Compared with group N 1P, the consumption of propofol, body movement classification ratio and FLACC score were significantly decreased, and the emergence time was shortened in group N 2P ( P<0.05), and no significant change was found in the parameters mentioned above in group FP ( P>0.05). There was no significant difference in the incidence of perioperative adverse reactions and degree of surgeons′ satisfaction among the three groups ( P>0.05). Conclusion:Nalbuphine combined with propofol can provide satisfactory anesthetic efficacy with fewer adverse reactions when used for esophageal dilation with gastroscope in the pediatric patients.

Radial shock wave therapy in the treatment of chronic constriction injury model in rats: a preliminary study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pain physicians pay close attention to neuropathic pain (NP), since there is currently no ideal treatment. Radial shock wave therapy (RSWT) is a noninvasive treatment to chronic pain of soft tissue disorders. So far, there is no information on the use of RSWT for the treatment of NP. Therefore we observe the effects of RSWT on a NP model induced by chronic constriction injury (CCI) in rats.</p><p><b>METHODS</b>Four different energy densities (1.0, 1.5, 2.0 and 2.5 bar) RSWT administered as a single session or repeated sessions in rats with NP induced by CCI of the sciatic nerve. The analgesic effect was assessed by measuring mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL). The safety was assessed through calculating sciatic functional index (SFI).</p><p><b>RESULTS</b>MWT and TWL increased after a single session of RSWT from day 1 to day 5 but returned to baseline levels by day 10. Following repeated sessions of RSWT, both the MWT and TWL were significantly higher than NP group (P < 0.01) for at least 4 weeks. In addition, no significant changes of SFI were observed in any groups after repeated sessions of RSWT and no increased pain or other side effects in any animals.</p><p><b>CONCLUSIONS</b>A single session of RSWT is rapidly effective in the treatment of CCI, but the efficacy maintained in a short period. However, repeated sessions of RSWT have prolonged efficacy.</p>

External Experimental Researches of Pulsed Radiofrequency for Chronic Pain (review) / 中国康复理论与实践

@#Pulsed radiofrequency is a novel therapy for pain. This article reviewed the recent experimental researches for pulsed radiofrequency.