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Objective To compare the quadratus lumborum block and transversus abdominis plane block for postoperative analgesia in elderly patients undergoing abdominal surgery. Methods Seventy?two elderly patients of both sexes, aged 65-72 yr, with body mass index of 18-25 kg∕m2, of American Society of Anesthesiologists physical statusⅡorⅢ, scheduled for elective laparoscopic cholecystectomy, were di?vided into 2 groups(n=36 each)by coin toss: transversus abdominis plane block group(group T)and quadratus lumborum block group(group Q). Anesthesia was induced and maintained routinely. Bilateral subcostal transversus abdominis plane block was performed under ultrasound guidance in group T. Bilateral paravertebral approach to quadratus lumborum block was performed under ultrasound guidance in group Q. The height of sensory block was assessed at 30 min after block. Ramsay sedation scores and Bruggrmann comfort scale scores were recorded at 30 min after block and 1, 6, 12, 24 and 48 h after operation. The requirement for parecoxib and fentanyl as rescue analgesics and complications such as nausea, vomiting, block of lower extremities and local anesthetic intoxication were recorded within 48 h after operation. Re?sults The height of sensory block was kept at T4?L1, and the main blocking area was T6?11in group T. The height of sensory block was kept at T4?L4, and the main blocking area was T6?L1in group Q. Compared with group T, the blocking area was enlarged, the requirement for parecoxib and fentanyl and incidence of nausea and vomiting were significantly decreased(P<0.05), and no significant change was found in Ram?say sedation scores or Bruggrmann comfort scale scores in group Q(P>0.05). Conclusion Quadratus lumborum block provides better efficacy for postoperative analgesia than transversus abdominis plane block in elderly patients undergoing abdominal surgery.
RESUMO
Objective To evaluate the efficacy of domestic electronic vaporizer when used for sevoflurane anesthesia in rabbits.Methods Ninety healthy pathogen-free New Zealand rabbits of both sexes,aged 4-5 months,weighing 2.5-3.5 kg,were divided into 3 groups (n=30 each) using a random number table:mechanical vaporizer group (group M),domestic electronic vaporizer group (group E) and Zeus electronic vaporizer group (group Z).In group M,the mechanical vaporizer was used,the sevoflurane vaporizer dial was adjusted to 2％,with the fresh air flow set at 2 L/min.In E and Z groups,BR850 domestic electronic vaporizer and Zeus electronic vaporizer were used,respectively,and the concentration of sevoflurane inhaled was 2％.Sevoflurane was inhaled for 2 h in each group.The formula method and weighing method were used to calculate the consumption of sevoflurane in group M.The electronic calculation method and weighing method were used to calculate the consumption of sevoflurane in Z and E groups.The stable value of end-tidal sevoflurane concentration (ETCsev) and time for ETCsev reaching the stable value were recorded.ETCsev was recorded every 10 min after reaching the stable value (T1T12).Results Compared with group M,the consumption of sevoflurane (weighing method) was significantly reduced,and the time for ETCsev reaching the stable value was shortened in Z and E groups (P＜ 0.05).Compared with group Z,the consumption of sevoflurane (weighing method) was significantly increased (P＜0.05),and no significant change was found in the time for ETCsev reaching the stable value in group E (P＞0.05).Compared with the consumption of sevoflurane (weighing method),no significant change was found in the consumption of sevoflurane (electronic method) in group Z (P＞0.05),and the consumption of sevoflurane (electronic method) was significantly increased in group E (P＜0.05).There was no significant difference in the stable value of ETCsev between the three groups (P＜0.05).There was no significant difference in ETCsev between and within groups (P＞0.05).Conclusion The domestic electronic vaporizer achieves automatic and precise control of volatile concentrations of inhalation anesthetics and can be effectively used for sevoflurane anesthesia in rabbits.When compared with Zeus electronic vaporizer,the precision of the domestic electronic vaporizer needs further improvement,but the cost is obviously low,the compatibility is strong,and it has clinical application value.