Opioid-sparing effect of modified intercostal nerve block during single-port thoracoscopic lobectomy: Retraction: A randomised controlled trial.

BACKGROUND: Peripheral local anaesthetic blockade has an important role in multimodal postoperative analgesia after video-assisted thoracic surgery. Intercostal nerve block has an opioid-sparing effect after thoracoscopic surgery, but there is little information about an intra-operative opioid-sparing effect. OBJECTIVE: This prospective randomised trial was designed to evaluate the feasibility of a modified intercostal nerve block and its potential opioid-sparing effect during single-port thoracoscopic lobectomy. DESIGN: This was a randomised controlled study. SETTING: The First Affiliated Hospital of Anhui Medical University, Hefei, China, from January 2020 to April 2020. PATIENTS: Fifty patients scheduled for single-port thoracoscopic lobectomy were enrolled. INTERVENTION: Patients were randomised to receive the intercostal nerve block using 10 ml 0.35% ropivacaine (group MINB) or conventional general anaesthesia (group CGA). Following a bolus of 0.5 to 1.0 µg kg-1 remifentanil, it was then infused at 0.2 to 0.5 µg kg-1 min-1 during surgery to keep mean arterial pressure or heart rate values around 20% below baseline values. MAIN OUTCOME MEASURES: The primary outcome was intra-operative remifentanil consumption. RESULTS: Median [IQR] remifentanil consumption was reduced in the MINB group [0 µg (0 to 0 µg)] compared with the CGA group [1650.0 µg (870.0 to 1892.5 µg)]. The median difference was 1650.0 µg (95%CI 1200.0 to 1770.0 µg; P = 0.00). The total number of analgesic demands during the first 24 and 48 h in the MINB group was significantly less than in the CGA group (difference = 1; 95% CI 1 to 3; P = 0.00 and difference = 4; 95% CI 3 to 5; P = 0.00; respectively). The difference in time to first demand for analgesia was significant [difference = 728 min (95% CI 344 to 1381 min), P = 0.00] and also in the number of patients requiring additional tramadol (P = 0.03). CONCLUSION: We have shown intra-operative opioid-sparing with a modified intercostal nerve block during single-port thoracoscopic lobectomy, with opioid-sparing extending 48 h after surgery. However, the opioid-sparing effect was not associated with a reduction in opioid side effects. TRIAL REGISTRATION: http://www.chictr.org.cn, ChiCTR2000029337.

[Psychological anxiety evaluation and analysis of graduates at a medical university under employment pressure].

OBJECTIVE: To evaluate the psychological anxiety of graduates at a medical university under the ever-increasing employment pressure, so as to provide ground work for psychological intervention on college students. METHODS: Subjects were randomly drawn from the students who majored in clinical medicine, biomedical engineering, nursing and integrated Chinese and western medicine and graduated in the year of 2008 and 2009, with 25 subjects from each major each year, totaling up to 200. In March of their graduation year, they were evaluated by Hamilton Anxiety Scale (HAMA). A general analysis into their anxiety was first made and then the comparative analysis of anxiety on the basis of gender, year group and major of the subjects. RESULTS: Female students showed a significantly higher anxiety than male students. Graduates in 2009 showed a significantly higher anxiety than those in 2008. In terms of the major difference, the anxiety was in a falling curve from integrated Chinese and western medicine, clinical medicine, biomedical engineering and nursing. There was no major difference in the students majoring integrated Chinese and western medicine, clinical medicine and biomedical engineering, but nursing students showed significantly low anxiety. CONCLUSIONS: The increasing employment pressure has caused the significant increase in the anxiety of college students. The employment rate in different majors may play a positive role in anxiety. Generally, female students showed a higher degree of anxiety than male students.

[Psychological health status of students taking part in medical support for military training on the sea].

OBJECTIVE: To investigate the adaptability and psychological health status of the students from the military medical universities enrolled in the medical support service for military training on the sea, so as to provide more pertinent and specific psychological advice for students in military medical universities. METHODS: The psychological health status of 139 students were assessed by issuing a self-rating symptom scale (SCL-90) before the training and later before the maneuvers commenced, respectively. RESULTS: Except for obsessive-compulsive and interpersonal sensitivity factors, significant increases were recorded in the scores for other factors immediately before the maneuvers as compared with those recorded before the training (P<0.01, P<0.05). The positive symptom rates of various factors measured before the maneuvers were also higher. CONCLUSIONS: It is the essential task for daily psychological health education to help the students foster psychological self-regulation ability and cope with stresses to strengthen their psychological well-being. Building self-confidence, improving the adaptability and conquering fears should be the primary concern of the psychological advisors before military actions.