ABSTRACT
OBJECTIVE: To compare and analyze the analgesic effect of iliac fascial block with vertical and horizontal inguinal approach after total hip arthroplasty. METHODS: 78 patients who admitted to our hospital and underwent unilateral total hip replacement from January 2019 to June 2020 were enrolled and randomly divided into Group A (n=40) and Group B (n=38). 30 min before surgery, the group A received ultrasound-guided iliac fascial block by vertical inguinal approach, and group B underwent ultrasound-guided iliac fascial block with horizontal inguinal approach. Both groups received patient-controlled intravenous analgesia (PCA) postoperatively. Subsequently, the postoperative VAS scores, the cumulative postoperative PCA dosage of Sufentanil, the occurrence of postoperative adverse reactions, and the overall satisfaction scores of patients with anesthesia 24 h after surgery were compared accordingly. RESULTS: The VAS score of Group A at 4 h, 8 h, 12 h, 24 h after surgery was remarkably lower than that of Group-B (P<0.05). The cumulative Sufentanil dosage of PCA in Group A was substantially less than that in Group B (P<0.05). The incidence of adverse reactions between the two groups of patients was statistically insignificant (P>0.05). The satisfaction degree with anesthesia 24 h after surgery in Group A was notably higher than that in Group B (P<0.05). CONCLUSION: Compared with the horizontal inguinal approach, patients received iliac fascial block by vertical inguinal approach can achieve better postoperative analgesic effect for hip replacement. It helps to reduce Sufentanil dosage and improve the patient's satisfaction with analgesia, and thus safe for clinical application.
ABSTRACT
OBJECTIVE: This research investigated the combined analgesic effects of intercostal nerve block and intravenous patient-controlled analgesia (IV-PCA) on patients after lung cancer surgery. METHODS: 95 patients with thoracoscopic radical resection of lung cancer from April 2017 to July 2020 were enrolled as the research objects, and randomly divided into observation-group (n=50) and control-group (n=45) by random number table. The control-group received intravenous patient-controlled analgesia (IV-PCA), and the observation group received combinative treatment of intercostal nerve block and IV-PCA. The changes of VAS scores and Ramsay sedation scores postoperatively, the satisfaction with analgesia of patients, the number of IV-PCA pump compressions and the incidence of postoperative anaesthetic-related adverse reactions were compared between the two groups. RESULTS: The VAS score of the observation-group was markedly lower than that of the control-group 2 h, 4 h, 8 h, 12 h and 24 h after surgery (P<0.05). There was no statistically significant difference in Ramsay sedation scores between the two groups 2 h, 4 h, 8 h, 12 h and 24 h after surgery (P>0.05). The satisfaction score of analgesia and the times of IV-PCA pump compressions of the observation group were obviously less than those of the control group (P<0.05). The incidences of nausea and emesia, bradycardia and somnolence between the two groups of objects were statistically insignificant (P>0.05). CONCLUSION: The combinative treatment of intercostal nerve block and IV-PCA is safe and have obviously postoperative analgesic effect on patients undergoing thoracoscopic resection of lung cancer.
ABSTRACT
OBJECTIVE: To explore the effect and complications of esketamine combined with ultrasound-guided nerve block in children with lower extremity fractures. METHODS: 120 children with fractures of lower extremities were included into the observation group (OG) and control group (CG) according to the specific anesthesia method. The OG was given esketamine combined with ultrasound-guided nerve block, and the CG was given ultrasound-guided nerve block combined with general anesthesia. Serum norepinephrine (NE), epinephrine (E), renin (R), mean arterial pressure (MAP), heart rate (HR), oxyhemoglobin saturation (SpO2) and respiration rate (RR) were measured before, at 10, 20, and 30 min after anesthesia. The incidence of clinical complications and the anesthetic effects were compared between the two groups. The mini-mental state examination (MMES) scale was performed to evaluate the cognitive function of children in the two groups before and after surgery. RESULTS: At 10 min and 20 min after anesthesia, the CG showed higher MAP and HR than the OG (P<0.05); however, RR and SpO2 showed no difference between the two groups (P>0.05). At 30 min after anesthesia, HR and MAP were not significantly different between the two groups (P>0.05); NE, E, and R showed no significant difference before surgery (P>0.05), which were higher in CG than those in the OG after surgery (P<0.05). The success rate of nerve block and anesthesia were 91.67% and 85.00%, respectively in the OG, which were higher than 88.33% and 83.33% in the CG (P>0.05). The OG had a complication rate of 8.33%, significantly lower than that of 20.00% in the CG (P<0.05). CONCLUSION: Esketamine combined with ultrasound-guided nerve block anesthesia was superior to ultrasound-guided nerve block combined with general anesthesia in children with lower extremity fractures, with fewer compilations.
