目的:探讨超声引导下收肌管阻滞联合膝关节后方浸润在膝关节镜下前交叉韧带重建术术后的镇痛作用和早期的康复作用。方法:行膝关节镜下前交叉韧带重建术患者60例,随机均分为收肌管阻滞联合膝关节后方浸润组(A组,0.375%罗哌卡因30 m L进...目的:探讨超声引导下收肌管阻滞联合膝关节后方浸润在膝关节镜下前交叉韧带重建术术后的镇痛作用和早期的康复作用。方法:行膝关节镜下前交叉韧带重建术患者60例,随机均分为收肌管阻滞联合膝关节后方浸润组(A组,0.375%罗哌卡因30 m L进行收肌管阻滞、0.2%罗哌卡因50 m L进行膝关节后方浸润)和对照组(B组,0.9%生理盐水30 m L进行收肌管阻滞、0.9%生理盐水50 m L膝关节后方浸润),观察2组患者术后2、4、8、24及48 h膝关节的静息时和活动时视觉模拟疼痛评分(VAS),比较2组患者术后24 h和48 h的膝关节活动度及患肢首次行主动直腿抬高时间及术后使用镇痛药物的不良反应。结果:术后2、4、8、24及48 h,A组患者的静息痛、活动痛VAS评分低于B组、主动膝关节活动度优于B组(P<0.05或P<0.01);2组患者均在术后早期能够进行直腿抬高锻炼,但首次直腿抬高时间比较,差异无统计学意义(P=0.077)。结论:超声引导下收肌管阻滞联合膝关节后方浸润可以为膝关节镜前交叉韧带手术患者提供良好的术后镇痛效果及术后康复。展开更多
Although empirically well understood in their clinical administration, volatile anesthetics are not yet well comprehended in their mechanism studies. A major conundrum emerging from these studies is that there is no v...Although empirically well understood in their clinical administration, volatile anesthetics are not yet well comprehended in their mechanism studies. A major conundrum emerging from these studies is that there is no validated model to assess the presumed candidate sites of the anesthetics. We undertook this study to test the hypothesis that the single-celled Paramecium could be anesthetized and served as a model organism in the study of anesthetics. We assessed the motion of Paramecium cells with Expert Vision system and the chemoresponse of Paramecium cells with T-maze assays in the presence of four different volatile anesthetics, including isoflurane, sevoflurane, enflurane and ether. Each of those volatiles was dissolved in buffers to give drug concentrations equal to 0.8, 1.0, and 1.2 EC50, respectively, in clinical practice. We could see that after application of volatile anesthetics, the swimming of the Paramecium cells was accelerated and then suppressed, or even stopped eventually, and the index of the chemoresponse of the Paramecium cells （denoted as Iche） was decreased. All of the above impacts were found in a concentration-dependent fashion. The biphasic effects of the clinical concentrations of volatile anesthetics on Paramecium simulated the situation of high species in anesthesia, and the inhibition of the chemoresponse also indicated anesthetized. In conclusion, the findings in our studies suggested that the single-celled Paramecium could be anesthetized with clinical concentrations of volatile anesthetics and therefore be utilized as a model organism to study the mechanisms of volatile anesthetics.展开更多
文摘目的:探讨超声引导下收肌管阻滞联合膝关节后方浸润在膝关节镜下前交叉韧带重建术术后的镇痛作用和早期的康复作用。方法:行膝关节镜下前交叉韧带重建术患者60例,随机均分为收肌管阻滞联合膝关节后方浸润组(A组,0.375%罗哌卡因30 m L进行收肌管阻滞、0.2%罗哌卡因50 m L进行膝关节后方浸润)和对照组(B组,0.9%生理盐水30 m L进行收肌管阻滞、0.9%生理盐水50 m L膝关节后方浸润),观察2组患者术后2、4、8、24及48 h膝关节的静息时和活动时视觉模拟疼痛评分(VAS),比较2组患者术后24 h和48 h的膝关节活动度及患肢首次行主动直腿抬高时间及术后使用镇痛药物的不良反应。结果:术后2、4、8、24及48 h,A组患者的静息痛、活动痛VAS评分低于B组、主动膝关节活动度优于B组(P<0.05或P<0.01);2组患者均在术后早期能够进行直腿抬高锻炼,但首次直腿抬高时间比较,差异无统计学意义(P=0.077)。结论:超声引导下收肌管阻滞联合膝关节后方浸润可以为膝关节镜前交叉韧带手术患者提供良好的术后镇痛效果及术后康复。
基金supported by a grant from the National Natural Science Foundation of China(No.30972837)
文摘Although empirically well understood in their clinical administration, volatile anesthetics are not yet well comprehended in their mechanism studies. A major conundrum emerging from these studies is that there is no validated model to assess the presumed candidate sites of the anesthetics. We undertook this study to test the hypothesis that the single-celled Paramecium could be anesthetized and served as a model organism in the study of anesthetics. We assessed the motion of Paramecium cells with Expert Vision system and the chemoresponse of Paramecium cells with T-maze assays in the presence of four different volatile anesthetics, including isoflurane, sevoflurane, enflurane and ether. Each of those volatiles was dissolved in buffers to give drug concentrations equal to 0.8, 1.0, and 1.2 EC50, respectively, in clinical practice. We could see that after application of volatile anesthetics, the swimming of the Paramecium cells was accelerated and then suppressed, or even stopped eventually, and the index of the chemoresponse of the Paramecium cells （denoted as Iche） was decreased. All of the above impacts were found in a concentration-dependent fashion. The biphasic effects of the clinical concentrations of volatile anesthetics on Paramecium simulated the situation of high species in anesthesia, and the inhibition of the chemoresponse also indicated anesthetized. In conclusion, the findings in our studies suggested that the single-celled Paramecium could be anesthetized with clinical concentrations of volatile anesthetics and therefore be utilized as a model organism to study the mechanisms of volatile anesthetics.
