Ultrasound-Guided Transmuscular Quadratus Lumbar Block Reduces Opioid Consumption after Laparoscopic Partial Nephrectomy / 中国医学科学杂志(英文版)

Objectives Transmuscular quadratus lumborum block (TQLB) may provide postoperative analgesia in patients undergoing intraperitoneal surgeries. The purpose of this study was to examine the potential efficacy of TQLB among patients undergoing retroperitoneal procedures, such as the laparoscopic partial nephrectomy (LPN). Methods This prospective, randomized, controlled study was conducted from August 2017 to November 2018 at Peking Union Medical College Hospital (Beijing, China). Patients who were scheduled for a LPN, aged 18-70 years old with an ASA physical status score of I - II were randomly assigned to receive either TQLB with 0.6 ml/kg of 0.5% ropivacaine plus general anesthesia (TQLB group) or general anesthesia alone (control group). Patient-controlled intravenous analgesia with morphine was initiated immediately upon surgery completion. The primary outcome was the cumulative consumption of morphine within 8 h after surgery. The secondary outcome included postoperative consumptions of morphine at other time points, pain score at rest and during activity, postoperative nausea and vomitting (PONV), and recovery related parameters. Results Totally 30 patients per group were recruited in the study. The 8 h consumption of morphine was lower in the TQLB group than in the control group (median, 0.023 mg/kg

A Survey of Surgical Patient's Perception about Anesthesiologist in a Large Scale Comprehensive Hospital in China / 中国医学科学杂志(英文版)

Objectives This study aim to evaluate patient's perception about anesthesiologists' job roles and investigate their expectations for anesthesia care.Methods We designed a self-administered questionnaire for this cross-sectional survey study and delivered questionnaire forms to adult in-patients who were scheduled for elective surgery before pre-operative anesthetic visit the day before surgery. We collected information of respondents' demographic data, education background, health literacy and previous experience of anesthesia, perception of anesthesiologist's job, the expectation on anesthesia care. Descriptive analyses, test and multiple linear regression analysis were used for data analysis. Results Of 550 participants, 521（94.7%）completed the questionnaire. In these respondents, 335 (64.3%) considered anesthesiology as an independent medical discipline, 225 (43.2%) believed that anesthesiology department was an independent clinical department, and 243 (46.6%) recognized anesthesiologists as qualified doctors. Only 21.5% of them knew that anesthesiologists also work in the intensive care unit and 26.9% of them knew that anesthesiologists also work in pain clinic as well. Younger patients (=-0.044<0.001) those with higher education (=1.200<0.001), or with better health literacy (=0.781=0.005) had significant more knowledge about the job roles of anesthesiologists. Most patients demanded pre-anesthetic visit (80.5%), expected availability of preoperative anesthetic clinic (74.1%), wished to receive more information about anesthesia (91.3%) and anesthesiologist (77.4%).Conclusions Patients' perception about anesthesiologists might be limited. Efforts should be made on education about anesthesia, especially for elderly patients and those under-educated patients. Preoperative anesthetic clinic is expected by most in-patients.

Assessment and analysis of influencing factors of patients' satisfaction with perioperative anesthetic care / 基础医学与临床

Objective To introduce and revise the patient satisfaction with perioperative anesthetic care question-naire (PSPACq). To assess the patient satisfaction with perioperative anesthetic care and to analyse the influencing factors. Methods Translation and culture adaptation were used for PSPACq, then the questionnaire was applied to three hundred and eighty patients after selective operation. The reliability and validity of the simplified Chinese version was evaluated. To evaluate the patient satisfaction with perioperative anesthetic care and to analyse the influencing factors. Results The Cronbach's a coefficient was employed to evaluate the internal reliability, which was 0.935. The content validity index(CVI) was 0.933. The total score of patient satisfaction with perioperative anesthetic care was (4.28±0.45). The factor " discomfort and needs" had gotten the highest score(4.68±0.67), and the factor "fear" had gotten the lowest score (3.56±0.79). Patients with different characteristics had different satisfaction. Multiple regression analysis showed that marriage, previous anesthetics and anesthesia methods are the main influencing factors(P＜0.05). Conclusions Simplified Chinese version PSPACq may be used to evaluate and analyse patient's satisfaction with perioperative anesthetic care. It is possible to improve patient's satisfaction by taking effective measures depending on the influencing factors.

Ultrasound-guided Selective Cervical Nerve Root Block Plus Superficial Cervical Plexus Block for Minimally Invasive Parathyroidectomy / 中国医学科学院学报

Objective To explore the efficacy and safety of ultrasound-guided cervical root block (CRB) in patients undergoing minimally invasive parathyroidectomy (MIP).Methods We enrolled 35 patients with hyperparathyroidism undergoing MIP in Peking Union Medical College Hospital.C4-7 nerve roots were identified in ultrasound imaging by the shape of the transverse process.A 50 mm insulated needle was gently introduced by an in-plane approach toward the posterior edge of the nerve root located at the inside of the posterior tubercle.After careful aspiration,a total of 3-4 ml of a mixture of 0.5% ropivacaine and 1% lidocaine was slowly injected.The superficial block was administered at the midpoint of the posterior border of the sternocleidomastoid by injecting 5-6 ml of the same mixture.The patients were administrated with dexmedetomidine during the surgery.All patients were assessed for sensory following the procedure and for pain after the surgery.Results Totally 35 patients successfully received MIP under ultrasound-guided CRB plus superficial block.There was no conversion to general anesthesia,no toxic reaction of local anesthetics,and no intravertebral injection.Hoarseness occurred in 6 patients (17.1%) and Horner syndrome occurred in 3 patients (8.6%).The median cold sensory visual analogue scale score was 1.2 [0,5] points at 10 minutes after the procedure.Patient's satisfaction score was 9.5 points.Conclusion Ultrasound-guided CRB plus superficial block can achieve accurate and safe anesthesia,and it provides lasting analgesic effect during and after MIP.

Influence of Anesthetic Brochure on Patient's Information Gain, Preoperative Anxiety, Trust, and Satisfaction / 中国医学科学院学报

Objective To assess the impacts of anesthetic brochure on anesthetic information gain, preoperative anxiety, trust to anesthesiologists, and satisfaction to the preanesthesia visit for patients undergoing general anesthesia. Methods Totally 134 patients scheduled for elective thyroid surgery under general anesthesia in Peking Union Medical College Hospital were assigned to two groups using the random number table method, among whom 68 patients received brochure before preoperative visit (brochure group) and 66 patients did not (control group). Questionnaires with items for evaluating patient's information gain, preoperative anxiety and trust were completed after preanesthetic visit. Patient's satisfaction with preanesthetic visit was evaluated on the second postoperative day. Results Compared with the control group, patients in the brochure group had significantly higher information gain scores (7.2±1.8 vs. 5.2±2.1, P<0.001) and satisfaction scores (25.0±3.4 vs. 22.7±3.1, P<0.001). There was no significant difference in anxiety scores and trust scores between these two groups. Conclusion Preoperative anesthetic brochure-assisted education can improve information gain and satisfaction among patients undergoing general anesthesia; however, it can not remarkably alter patient's preoperative anxiety and trust.