RESUMO
Objective To investigate the efficacy of the single-injection technique of PECS Ⅰ and Ⅱ blocks for postoperative analgesia in patients undergoing modified radical mastectomy. Methods Sixty female patients who would undergo elective unilateral modified radical mastectomy, aged 30-65 years, falling into ASA physical status Ⅰ or Ⅱ, were selected and randomly divided into PECS group (group P) or control group (group C), 30 cases in each. After induction, patients in group P underwent ultrasound-guided combined PECS Ⅰ and Ⅱ blocks in a single-injection technique before surgery, 30 ml of 0.5％ ropivacaine was given to these patients. Patients in group C received general anesthesia alone. Anesthesia maintenance was performed by total intravenous anesthesia. The dosage of intraoperative propofol and remifentanil, postoperative recovery time, the requirement of sufentanil at 48 h after operation and the first time pressing the analgesic pump button, rescue analgesic requirements at 48 h after operation and the pressing frequency of analgesic pump were recorded in the two groups. Results The usage of propofol and remifentanil in group P were significantly less than those in group C (P ＜ 0.05). The recovery time after operation was significantly shorter than that in group C (P ＜ 0.05). The total consumption of sufentanil after 48 h was significantly less than that in group C (P ＜ 0.05). The first pressing time of the analgesic pump in group P was significantly later than that in group C (P ＜ 0.05).The rescue analgesic requirements in group P at 48 h were lower than those in group C (P ＜ 0.05).The pressing frequencies of analgesic pump in group P at 24 h were less than those in group C (P ＜ 0.05). Conclusion For patients undergoing modified radical mastectomy, ultrasound-guided combined PECS Ⅰ and Ⅱ blocks in a single-injection technique can reduce the dosage of opioid drugs in the perioperative period, and can provide better analgesic effect after operation.
RESUMO
Objective The article is prepared to evaluate the efficacy of Chinese acupressure and ventral massage on prevention and treatment of constipation.Methods Electronic databases such as CNKI,VIP,CBM,Wanfang,EBSCO,PubMed and the Cochrane Library were searched from their establishment to December 2013 to meet the inclusion criteria of randomized and quasi-randomized controlled trials.Meta-analysis was conducted using RevMan 5.2 and Stata 12.0 software.Results A total of 29 RCTs involving 3 084 participants were included.The Meta analysis showed that compared with the control group,the new option for prevention and treatment tended to be more effective for constipation.Compared with the control group,first defecation time,defecation difficulty rate,defecation time,dry stool rate and defecating unfinished feeling rate of the experimental group were lower.Laxative provided for the experimental group was less than that of the control group.Conclusions On the basis of available evidence,the traditional Chinese acupressure and ventral massage treatment are effective and safe in prevention and treatment of constipation.