International journal of clinical and experimental medicine
-
This work aims to compare the curative effect of transumbilical single-port laparoscopic cholecystectomy (TUSPLC) and four-port laparoscopic cholecystectomy (FPLC). 200 patients with cholecystolithiasis were enrolled in this study. They were randomly divided into TUSPLC group and FPLC group, 100 cases in each group, and the TUSPLC and FPLC was performed, respectively. The surgical time, intraoperative complication, conversions rate, postoperative pain, postoperative analgesic drug use, incision infection, postoperative hospitalization time and postoperative cosmetic results in two groups were compared. ⋯ TUSPLC has obvious advantage in treatment of Nassar grade I patients with cholecystolithiasis. It can be used as a supplement for standard laparoscopic gallbladder surgery. It is safe and feasible, without abdominal scar, thus achieving to excellent cosmetic result and high satisfaction in patients.
-
Brachial plexus perineural blocks provide specific analgesia for upper limb surgery. We present our experience with ultrasound-guided supraclavicular brachial plexus perineural blocks for distal upper limb surgery. Although single-injection ultrasound-guided supraclavicular blocks have been reported, little is known about the advantages using this approach compared with nerve stimulator guided. ⋯ Supraclavicular brachial plexus perineural insertion using ultrasound guidance is feasible and almost have no complications, deserves further study with a randomized controlled trial comparing this relatively new technique with only using nerve stimulator.
-
Vasospasm is one of the most common complications after aneurysmal subarachnoid hemorrhage. Statins have been proven to be effective to reduce the incidence of vasospasm both in experimental subarachnoid hemorrhage and several clinical trials before. This meta-analysis aimed to investigate the efficacy of statins for patients with aneurysmal subarachnoid hemorrhage. ⋯ There were in total 1031 patients in six RCTs with 504 patients received statins and 527 patients in placebo group. 561 patients with statins compared with 1579 patients in no statin-use group were finally included in 8 observational studies. Outcomes included in this meta-analysis (cerebral vasospasm, DIC and poor outcome) all indicated no statistical significance between two groups both in RCTs and observational studies. No benefits of statins-use for patients with aneurysmal subarachnoid hemorrhage were observed in both RCTs and observational studies, which was quite different from the results of several previous meta-analysis.
-
Postoperative cognitive dysfunction (POCD) is a subtle impairment of cognitive abilities and can manifest on different neuropsychological features in the early postoperative period. It has been proved that the use of mechanical ventilation (MV) increased the development of delirium and POCD. However, the impact of variable and conventional lung protective mechanical ventilation on the incidence of POCD still remains unknown, which was the aim of this study. ⋯ Variable vs conventional lung protective MV decreased the incidence of postoperative delirium and POCD by reducing the systemic proinflammatory response.
-
Ginkgolide B, a diterpene, is an herbal constituent isolated from the leaves of Ginkgo biloba tree. The present study demonstrates the effect of ginkgolide B in osmotherapy on brain metabolism and tissue oxygenation. Multimodality monitoring including intracranial pressure (ICP), cerebral perfusion pressure (CPP), partial pressure of brain tissue oxygen (PbtO2), lactate/pyruvate ratio (LPR) and microdialysis were employed to study the effect of ginkgolide B osmotherapy. ⋯ However there was no significant effect on MAP but PbtO2 was maintained in the range of 22-26. The peak lactate/pyruvate ratio was recorded at the time of initiation of osmotherapy (44 ± 20) with an 18% decrease over 2 h following gingkolide B therapy. Also the brain glucose remained unaffected.