Zhonghua yi xue za zhi
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Zhonghua yi xue za zhi · Dec 2017
Randomized Controlled Trial[Dose-response relationship of ropivacaine for epidural block in early herpes zoster guided by CT].
Objective: To determine the dose-response relationship of ropivacaine for epidural block in early herpes zoster by CT guided. Methods: From January 2015 to February 2017, according to the principle of completely random digital table, 80 patients with early herpes zoster who were prepared for epidural block were divided into 4 groups(each group 20 patients): in group A the concentration of ropivacaine was 0.08%, in group B was 0.10%, in group C was 0.12% and in group D was 0.14%. Under CT guidance, epidural puncture was performed in the relevant section, mixing liquid 5.0 ml (with 10% iodohydrin)were injected into epidural gap. ⋯ There was one case in group C and four cases in group D were hypoesthesia, others were no significant adverse reactions occurred. The ED(50) and ED(95) (95%CI) of ropivacaine for epidural block in early herpes zoster guided by CT were 0.078%(0.015%-0.095%)and 0.157%(0.133%-0.271%), respectively. Conclusion: Ropivacaine for epidural block in early herpes zoster guided by CT is effective for neuropathic pain, with no significant adverse reactions.
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Zhonghua yi xue za zhi · Dec 2017
Randomized Controlled Trial[Effect of perioperative multi-day low dose ketamine infusion on prevention of postmastectomy pain syndrome].
Objective: To investigate the effects of multi-day low dose ketamine infusion for postmastectomy pain syndrome (PMPS) after breast cancer surgery. Methods: This study was a prospective randomized controlled trial. From June 2015 to May 2016 in Affiliated Yiwu Hospital of Wenzhou Medical University, 66 patients with breast cancer surgery were randomly divided into control group (group C) and ketamine group (group K). ⋯ There were no significant difference in pain level and site between two groups of PMPS patients (all P>0.05). There were no significant difference of HADS scale preoperative and 5 d after surgery between two groups (all P>0.05); and HADS scale in group K at 3 m and 6 m after surgery was significantly lower than that in group C(all P<0.05). Conclusion: Perioperative continuous multi-day low dose ketamine infusion can effectively reduce the incidence of PMPS after breast cancer surgery.
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Zhonghua yi xue za zhi · Nov 2017
Randomized Controlled Trial[Study of sevoflurane/remifentanil coadministration on improving emergence and recovery characteristics of patients following general anaesthesia with sevoflurane].
Objective: To investigate the effects of remifentanil infusion on emergence and recovery characteristics of patients with thoracoscopic lobectomy following general anaesthesia with sevoflurane. Methods: One hundred patients, who were aged 37 to 65 years with American Society of Anesthesiologists (ASA) physical status 1-2, and scheduled for elective thoracoscopic lobectomy under general anaesthesia in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from February 2016 to August 2016, were allocated to receive sevoflurane maintenance regimen(group S, n=50)or sevoflurane/remifentanil maintenance regimen(group SR, n=50)by random digital table. After routine induction and intubation, anaesthesia was maintained with 2% sevoflurane in group S and 1.5% sevoflurane/remifentanil(continuous intravenous injection at rate of 4 μg·kg(-1)·h(-1))coadministration in group SR respectively, with intermittent intravenous infusion of sulfentanil. ⋯ The difference were statistically significant(χ(2)=20.294, 23.574, all P<0.05). The NRS and incidence of complaining CRBD were similar in both groups(all P>0.05). Conclusion: Compared with sevoflurane maintenence, coadministration of remifentanil and sevoflurane maintenance regimen provides better emergence and recovery which are characterized by faster awakening and extubation with a lower incidence of emergence coughing and agitation.
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Zhonghua yi xue za zhi · Nov 2017
Randomized Controlled Trial[A concentration-response observation of hydromorphone combined with ropivacaine in labor analgesia].
Objective: To investigate the median effective dose (ED(50)) of hydromorphone and the appropriate concentration of ropivacaine combined with hydromorphone in epidural labor analgesia. Methods: One hundred and forty nulliparous women undergoing labor selected for delivery with epidural analgesia were enrolled in our hospital from January to June 2016. The first of top 50 women received 0.12% ropivacaine plus 20 μg/ml hydromorphone complex solution, then sequential women were used the modified sequential method to determine the ED(50) and ED(95) of hydromorphone. ⋯ VAS scores at the fourth, fifth, sixth contractions after analgesia in H1 group were significantly higher than those in H2 and H3 groups (all P<0.05). The incidence of motor nerve block in group H3 was higher than that in group H1 and group H2 (26.67%, 6.66%, 3.33%, respectively), the difference was statistically significant (χ(2)=6.413, 4.320, all P<0.05). Conclusions: 0.10% ropivacaine combined with 15 μg/ml hydromorphone has a good analgesic effect, slight motor block, high safety and worthy clinical application for labor analgesia.
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Zhonghua yi xue za zhi · Aug 2017
Randomized Controlled Trial[Efficacy of patient-controlled intravenous analgesia with hydromorphone hydrochloride plus flurbiprofen axetil after endoscopic sinus surgery].
Objective: To evaluate the efficacy of patient-controlled intravenous analgesia (PCIA)with hydromorphone hydrochloride plusflurbiprofen axetil after endoscopic sinus surgery(ESS). Methods: One hundred patients of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for ESS under total intraveous anesthesia with postoperative PCIA in Beijing Tongren Hospital from October 2015 to April 2016 were randomly divided into 3 groups according to the different formula of PCIA pumpin each group: Group A (hydromorphone hydrochloride 1 μg·kg(-1)·h(-1)+ flurbiprofen axetil 200 mg), Group B(hydromorphone hydrochloride 2 μg·kg(-1)·h(-1)), Group C( hydromorphone hydrochloride 1 μg·kg(-1)·h(-1)). The dosage of PCIA in each group was calculated for 50 h, and was diluted in 100 ml normal saline. ⋯ Ramsay sedation score in group A was similar to that in Group C(P>0.05), but was lower than that in Group B(P<0.05). The total rate of adverse effects in Group A was 8.8%, which was similar to that in Group C (9.1%, χ(2)=0.001, P>0.05), but was significantly lower than that in Group B (42.5%, χ(2)=9.99, P<0.05). Conclusion: 1 μg·kg(-1)·h(-1) hydromorphone hydrochloride plus 200 mg flurbiprofen axetil is effective on PCIA for patients after ESS and can reduce the dosage of hydromorphone hydrochloride and the rate of adverse effects as well.