Novel multimodal analgesia regimen improves post-TACE pain in patients with hepatocellular carcinoma

Backgroud: Transarterial chemoembolization(TACE) is the primary palliative treatment for patients with unresectable hepatocellular carcinoma(HCC). However, it is often accompanied by postoperative pain which hinder patient recovery. This study was to examine whether preemptive parecoxib and sufentanilbased patient controlled analgesia(PCA) could improve the pain management in patients receiving TACE for inoperable HCC. Methods: From June to December 2016, 84 HCC patients undergoing TACE procedure were enrolled. Because of the willingness of the individuals, it is difficult to randomize the patients to different groups. We matched the patients’ age, gender and pain scores, and divided the patients into the multimodal group( n = 42) and control group( n = 42). Patients in the multimodal group received 40 mg of parecoxib, 30 min before TACE, followed by 48 h of sufentanil-based PCA. Patients in the control group received a routine analgesic regimen, i.e., 5 mg of dezocine during operation, and 100 mg of tramadol or equivalent intravenous opioid according to patient’s complaints and pain intensity. Postoperative pain intensity, percentage of patients as per the pain category, adverse reaction, duration of hospital stay, cost-effectiveness, and patient’s satisfaction were all taken into consideration when evaluated. Results: Compared to the control group, the visual analogue scale scores for pain intensity was significantly lower at 2, 4, 6, and 12 h(all P < 0.05) in the multimodal group and a noticeably lower prevalence of post-operative nausea and vomiting in the multimodal group(31.0% vs. 59.5%). Patient’s satisfaction in the multimodal group was also significantly higher than that in the control group(95.2% vs. 69.0%). No significant difference was observed in the duration of hospital stay between the two groups. Conclusion: Preemptive parecoxib and sufentanil-based multimodal analgesia regime is a safe, efficient and cost-effective regimen for postoperative pain control in HCC patients undergoing TACE.

One-step synthesis of defected Bi_(2)Al_(4)O_(9)/β-Bi_(2)O_(3) heterojunctions for photocatalytic reduction of CO_(2) to CO

Defect and charge transfer efficiency of nano-photocatalysts are important factors which influence their photocatalytic performance.In this work,oxygen vacancies are successfully introduced in the synthesis process of Bi_(2)Al_(4)O_(9)/β-Bi_(2)O_(3)heterojunctions through one-step in situ selfcombustion method.High-resolution transmission electron microscopy (HRTEM),UV-Vis diffuse reflectance spectra (UV-Vis DRS),and electron spin resonance (ESR) measurements confirm the existence of oxygen vacancies.In addition,by controlling the ratio of reactants of Bi(NO_(3))_(3)to Al(NO_(3))_(3),the ratio of Bi_(2)Al_(4)O_(9)and β-Bi_(2)O_(3)in the heterojunction can be easily adjusted.Photocurrent responses and surface photovoltage spectroscopy (SPV) indicate that the construction of the Bi_(2)Al_(4)O_(9)/β-Bi_(2)O_(3)heterostructure improves the separation efficiency of the photo-generated electrons and holes.CO_(2)-TPD results imply that the amounts and stability of heterojunctions are enhanced compared with their counterparts.The Bi_(2)Al_(4)O_(9)/β-Bi_(2)O_(3)heterojunction with 14 mol%Bi_(2)Al_(4)O_(9)shows the highest photocatalytic ability for reduction of CO_(2)into CO.The enhanced photoreduction of CO_(2)performance can be ascribed to the synergistic effects of the heterojunction for electron separation and oxygen vacancies for CO_(2)activation.