Combined use of transversus abdominis plane block and laryngeal mask airway during implementing ERAS programs for patients with primary liver cancer: a randomized controlled trial.

The incidence and mortality of primary liver cancer are very high and resection of tumor is the most crucial treatment for it. We aimed to assess the efficacy and safety of combined use of transversus abdominis plane (TAP) block and laryngeal mask airway (LMA) during implementing Enhanced Recovery After Surgery (ERAS) programs for patients with primary liver cancer. This was a prospective, evaluator-blinded, randomized, controlled parallel-arm trial. A total of 96 patients were enrolled (48 in each group). Patients in the control group received general anesthesia with endotracheal intubation, while patients in the TAP + LMA group received general anesthesia with LMA and an ultrasound-guided subcostal TAP block. The primary end-point was postoperative time of readiness for discharge. The secondary end-points were postoperative pain intensity, time to first flatus, quality of recovery (QoR), complications and overall medical cost. Postoperative time of readiness for discharge in the TAP + LMA group [7 (5-11) days] was shorter than that of the control group [8 (5-13) days, P = 0.004]. The postoperative apioid requirement and time to first flatus was lower in the TAP + LMA group [(102.8 ± 12.4) µg, (32.7 ± 5.8) h, respectively] than the control group [(135.7 ± 20.1) µg, P = 0.000; (47.2 ± 7.6) h, P = 0.000; respectively]. The QoR scores were significantly higher in the TAP + LMA group than the control group. The total cost for treatment in the TAP + LMA group [(66,608.4 ± 6,268.4) CNY] was lower than that of the control group [(84,434.0 ± 9,436.2) CNY, P = 0.000]. There was no difference in complications between these two groups. The combined usage of a TAP block and LMA is a simple, safe anesthesia method during implementing ERAS programs for patients with primary liver cancer. It can alleviate surgical stress, accelerate recovery and reduce medical cost.

[Effect of single low level laser therapy on initial pain during fixed orthodontic treatment].

PURPOSE: To investigate the effect of single low level laser therapy on initial pain during fixed orthodontic treatment. METHODS: Sixty patients who underwent fixed orthodontic treatment in our hospital from January 2015 to December 2017 were enrolled.Patients were divided into 2 groups by random number table method, 30 in each group. Patients in the experimental group were treated with a single low level laser therapy ,while patients in the control group were treated with a placebo.The results of the 2 groups were compared in regard to spontaneous pain and chewing pain during the day and night using SPSS 22.0 software package. RESULTS: Spontaneous pain during day and night with 0.012, 0.014 inch superelastic nickel-titanium (NiTi) line was significantly lower in the experimental group than in the control group(P<0.05), and there was no significant difference with 0.016 and 0.018 inch NiTi (P>0.05).Chewing pain with 0.012, 0.014, 0.016, and 0.018 inch NiTi lines in the experimental group was significantly lower than that in the control group(P<0.05). CONCLUSIONS: Single low level laser therapy significantly reduced postoperative pain while placing a superelastic NiTi wire for initial alignment and correction.