Kangaroo Care (Skin-to-Skin) for Clustered Pain Procedures: Case Study

Background: Pain management for term newborns undergoing clustered painful procedures has not been tested. Kangaroo Care (chest-to-chest, skin-to-skin position of infant on mother) effectively reduces pain of single procedures, but its effect on pain from clustered procedures is not known. Aim: The aim was to test Kangaroo Care’s effect on pain in one term infant who received clustered painful procedures while determining feasibility of the Kangaroo Care intervention. Design, Setting, and Participant: A case study design was used with one healthy term newborn who received two heel sticks and one injection in one session in the mother’s postpartum room. Method: Heart rate and oxygen saturation (recorded from Massimo Pulse Oximeter every 30 seconds), crying time (total seconds of crying on videotape) and behavioral state (using Anderson Behavioral State Scoring system every 30 seconds) were measured before (5 minutes), during (10.5 minutes) and after (30 minutes) the three clustered painful procedures in a newborn who was in Kangaroo Care during all observations. One staff nurse administered the clustered procedures. Results: Heart rate increased sequentially with each heelstick, oxygen saturation remained unchanged, sleep predominated, and crying was minimal throughout the procedures. Conclusion: Kangaroo Care appeared to reduce pain from clustered painful procedures and can be further tested.

Stress and deformation analysis of gob-side pre-backfill driving procedure of longwall mining:a case study

At present,non-pillar entry protection in longwall mining is mainly achieved through either the gob-side entry retaining(GER)procedure or the gob-side entry driving(GED)procedure.The GER procedure leads to difficulties in maintaining the roadway in mining both the previous and current panels.A narrow coal pillar about 5-7 m must be left in the GED procedure;therefore,it causes permanent loss of some coal.The gob-side pre-backfill driving(GPD)procedure effectively removes the wasting of coal resources that exists in the GED procedure and finds an alternative way to handle the roadway maintenance problem that exists in the GER procedure.The FLAC^(3D) software was used to numerically investigate the stress and deformation distributions and failure of the rock mass surrounding the previous and current panel roadways during each stage of the GPD procedure which requires"twice excavation and mining".The results show that the stress distribution is slightly asymmetric around the previous panel roadway after the"primary excavation".The stronger and stiffer backfill compared to the coal turned out to be the main bearing body of the previous panel roadway during the"primary mining".The highest vertical stresses of 32.6 and 23.1 MPa,compared to the in-situ stress of 10.5 MPa,appeared in the backfill wall and coal seam,respectively.After the"primary mining",the peak vertical stress under the coal seam at the floor level was slightly higher(18.1 MPa)than that under the backfill(17.8 MPa).After the"secondary excavation",the peak vertical stress under the coal seam at the floor level was slightly lower(18.7 MPa)than that under the backfill(19.8 MPa);the maximum floor heave and maximum roof sag of the current panel roadway were 252.9 and 322.1 mm,respectively.During the"secondary mining",the stress distribution in the rock mass surrounding the current panel roadway was mainly affected by the superposition of the front abutment pressure from the current panel and the side abutment pressure from the previous panel.The floor heave of the current panel roadway reached a maximum of 321.8 mm at 5 m ahead of the working face;the roof sag increased to 828.4 mm at the working face.The peak abutment pressure appeared alternately in the backfill and the coal seam during the whole procedure of"twice excavation and mining"of the GPD procedure.The backfill provided strong bearing capacity during all stages of the GPD procedure and exhibited reliable support for the roadway.The results provide scientific insight for engineering practice of the GPD procedure.

Clustered Pain Procedures in Skin-to-Skin Contact (SSC) Position for Full Term Newborns

As a part of their routine care, full term newborns face many painful procedures immediately after birth and during the first couple days of life. Skin-to-Skin Contact (SSC) has been recommended as a non-pharmacological pain management intervention in newborns. However, the use of SSC in labor and delivery rooms as well as in postnatal units and nurseries is limited due to the discomfort that the nurses and phlebotomists themselves experience during positioning the newborns and themselves to complete these routine procedures. The objective of this paper is to describe a step-by-step procedure that was developed and used in a randomized clinical trial to manage newborns pain during clustered pain procedures. The procedure worked well and no complaints of discomfort were reported by the nurses during the study.

Accuracy study of a binocular-stereo-vision-based navigation robot for minimally invasive interventional procedures

BACKGROUND Medical robot is a promising surgical tool,but no specific one has been designed for interventional treatment of chronic pain.We developed a computed tomography-image based navigation robot using a new registration method with binocular vision.This kind of robot is appropriate for minimal invasive interventional procedures and easy to operate.The feasibility,accuracy and stability of this new robot need to be tested.AIM To assess quantitatively the feasibility,accuracy and stability of the binocularstereo-vision-based navigation robot for minimally invasive interventional procedures.METHODS A box model was designed for assessing the accuracy for targets at different distances.Nine(three sets)lead spheres were embedded in the model as puncture goals.The entry-to-target distances were set 50 mm(short-distance),100 mm(medium-distance)and 150 mm(long-distance).Puncture procedure was repeated three times for each goal.The Euclidian error of each puncture was calculated and statistically analyzed.Three head phantoms were used to explore the clinical feasibility and stability.Three independent operators conducted foramen ovale placement on head phantoms(both sides)by freehand or under the guidance of robot(18 punctures with each method).The operation time,adjustment time and one-time success rate were recorded,and the two guidancemethods were compared.RESULTS On the box model,the mean puncture errors of navigation robot were 1.7±0.9 mm for the short-distance target,2.4±1.0 mm for the moderate target and 4.4±1.4 mm for the long-distance target.On the head phantom,no obvious differences in operation time and adjustment time were found among the three performers(P>0.05).The median adjustment time was significantly less under the guidance of the robot than under free hand.The one-time success rate was significantly higher with the robot(P<0.05).There was no obvious difference in operation time between the two methods(P>0.05).CONCLUSION In the laboratory environment,accuracy of binocular-stereo-vision-based navigation robot is acceptable for target at 100 mm depth or less.Compared with freehand,foramen ovale placement accuracy can be improved with robot guidance.

Role of original and modified Frey's procedures in chronic pancreatitis

AIM To retrospectively review patients with chronic pancreatitis(CP) treated with Frey's procedures between January 2009 and January 2014.METHODS A retrospective review was performed of patients with CP treated with Frey's procedures between January 2009 and January 2014 in the Department of Pancreatic Surgery. A cross-sectional study of postoperative pain relief, quality of life(Qo L), and alcohol and nicotine abuse was performed by clinical interview, letters and telephone interview in January 2016. Qo L of patients was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30) version 3.0. The patients were requested to fill in the questionnaires by themselves via correspondence or clinical interview.RESULTS A total of 80 patients were enrolled for analysis, including 44 who underwent the original Frey's procedure and 36 who underwent a modified Frey's procedure. The mean age was 46 years in the original group and 48 years in the modified group. Thirtyfive male patients(80%) were in the original group and 33(92%) in the modified group. There were no differences in the operating time, blood loss, and postoperative morbidity and mortality between the two groups. The mean follow-up was 50.3 mo in the original group and 48.7 mo in the modified group. There were no differences in endocrine and exocrine function preservation between the two groups. The original Frey's procedure resulted in significantly betterpain relief, as shown by 5-year follow-up(P = 0.032), better emotional status(P = 0.047) and fewer fatigue symptoms(P = 0.028). When stratifying these patients by the M-ANNHEIM severity index, no impact was found on pain relief after the two types of surgery.CONCLUSION The original Frey's procedure is as safe as the modified procedure, but the former yields better pain relief. The severity of CP does not affect postoperative pain relief.

A novel access method for endovascular procedures in the porcine model

Objective To evaluate the use of the saphenous artery as an alternative access for endovascular procedures in the porcine model. Methods Fourteen adult pigs (25-35 kg) were used in this study, 3 pigs from an acute study and 11 from chronic studies. A 2-3 cm incision was made and a saphenous artery cutdown was performed in 24 sides. Micropuncture sets (Boston Scientific) or 18 G puncture needles were used to access the artery. Different sizes of introducers (4-7 F) were used to establish endovascular access. Angiographic catheters were then used to confirm if the access was usable. Four saphenous arteries were explanted in the pigs from a chronic study 4 to 28 days after surgical procedure. Results The saphenous artery was very easy to expose and 4-5 F introducer sheaths were able to be inserted to establish access for endovascular procedures in the pigs. The saphenous artery was unable to accomodate an introducer with a size larger than 6 F. Four saphenous arteries were injured when 5 and 6 F introducers were used, but angiographic procedures could still be performed. Morphologic evaluation of the explanted arteries demonstrated occlusion of the saphenous arteries without injury or disruption of the adjacent femoral arteries. Conclusion The saphenous artery can be used as an access site in pigs for angiographic and interventional procedures if the catheter size is less than 6 F. This vessel is easier to access and can preserve the femoral artery for repeat procedures in the future.

Resolving Specific Psychological Stressors Can Instantly Reduce or Relieve Chronic Neck Pain and Upper Back Pain: Case Reports

Introduction: The goal of this study was to use a novel approach to pain relief which includes a participant using their mind to reduce or relieve their neck pain in a matter of minutes and taking continuous thermal medical imaging scans during the process to capture any concurrent temperature changes at the location of the self-reported pain. Previous studies using multidisciplinary approaches have shown that it is possible for a person to achieve a moderate reduction in pain over a period of time (typically two or more months). However, in this innovative study, the goal was to demonstrate rapid pain relief (in a matter of minutes) using only the mind. Case report: For this study, six subjects were selected, all of whom were experiencing long-term chronic neck pain. The subjects consisted of five adult females and one adult male. Several of the subjects also had pain that radiated into their upper back region. Each subject participated in one talk therapy session during which the subject’s neck was actively scanned by a thermal imaging (TI) camera that was programmed to take a new thermal image every thirty (30) seconds. The goal of the talk therapy session was to create a strong emotional shift by encouraging the subject to let go of negative emotions and replace buried painful feelings with feelings of positive expectation and optimism. Then, as the subject created this emotional shift, the goal was to observe if this change affected the subject’s self-reported physical pain, as well as noting any visible effects in thermal images. Results: All six subjects reported that they were able to relieve some or all of their pain by the end of the talk therapy session. As they did, there was simultaneously a significant decrease in temperature recorded on the TI images in the corresponding location in their neck and upper back region. This suggested that the pain relief the subjects reported was not merely “mind over matter”, since there were marked physiological changes taking place. Discussion and Conclusion: It’s worth noting that three of the subjects had moments during their talk therapy session where they thought about a specific painful memory that increased their negative emotions. At that moment, their self-reported pain also increased, and simultaneously, the infrared camera detected an increase in temperature in the corresponding location where the subjects reported increased pain. Subsequently, when the subjects were able to change the painful memory and once again move towards feelings of optimism, they reported pain relief, and simultaneously, the TI camera reported a decrease in temperature. Neither this potential outcome nor any other potential outcome was discussed with the subjects before or during the session. This research shows that talk therapy may be used as a new therapeutic option for people not only with neck pain, but possibly other types of pain, and that under certain circumstances, the results can be rapid.

Stress Recovery Procedure for the Bonded Particle Model

In the simulation of discontinuous block systems,the discrete element method(DEM)has better computational efficiency and convergence than the finite element method(FEM).When several DEM particles are bonded together with parallel bonds(the bonded particle model,BPM),various shapes and block fractures can be simulated.The main aim of the BPM is to simulate a continuous material in which the stress distribution is continuous.Since the existing stress result for a single particle is an average value over the particle’s area,stress results do not exist in the area between particles.In this paper,the stress value for a single two-dimensional DEM particle is deduced.A stress recovery procedure with a linear stress function for a triangular element generated by the centroids of three bonded particles is proposed.In this way,the recovered stress field for the whole mesh composed of all triangular elements is continuous.A stress gradient exists in the whole mesh.This can also provide more accurate stress values for judging a fracture inside a block.Symmetrical and asymmetrical models are simulated by the BPM and FEM.Similar to the FEM results,the recovered stress results for the BPM can describe the stress distribution in the simulated continuous blocks.For the model with the theoretical stress solution,the recovered result and the theoretical solution coincide well.

Evaluation of Procedural Pain in Neonates in Cameroon

Introduction: Acute pain associated with caregiving is a major cause of pain among neonates. Left untreated, it can lead to long-term neurosensory and psychoaffective consequences. In Cameroon, this subject has been scarcely explored, thus constituting an impediment to the management of care-induced pain. Objective: Assess procedural pain in neonates in Yaoundé. Material and Methods: We conducted a cross sectional study with prospective data collection over a period of eight months (October 2022 to May 2023) in three hospitals. We included neonates who were being cared for and were not crying prior to the onset of healthcare, whose parents consented to the study. Assessments were done using the DAN scale, which is specific to care-induced pain. Data was entered and analyzed using SPSS 23.0 software. Results: A total of 161 newborns were included. The hospital prevalence of care-induced pain in neonates was 85%. Neonatal sepsis was the main cause for admission (96.6%). The most common procedures were venous blood sampling (94.4%) and insertion of peripheral venous lines (93.8%). The pain intensity for these procedures was severe (83.9%). The most painful procedure was lumbar tap, followed by venous access procedures. Conclusion: Neonates in hospitals are subjected to many painful procedures. The pain experienced during these procedures is severe. The most nociceptive procedure is a lumbar puncture.

The correlation of matrix metalloproteinase expression and oxidative stress in ectopic endometrial tissue with pelvic adhesion and pelvic pain

Objective:To study the correlation of matrix metalloproteinase expression and oxidative stress in ectopic endometrial tissue with pelvic adhesion and pelvic pain in patients with endometriosis (EMs).Methods:A total of 67 patients with EMs who accepted oophorocystectomy in our hospital between May 2014 and April 2016 were selected to collect ectopic endometrial tissue and eutopic endometrial tissue, 45 patients who accepted tubal sterilization in our hospital during the same period were selected to collect normal endometrial tissue, and the expression levels of matrix metalloproteinases and their inhibitors as well as the levels of oxidative stress-related molecules were detected.Results:MMP2, MMP3, MMP7, 8-iso-PGF2α, AOPP and 8-OHdG levels in ectopic endometrial tissue were significantly higher than those in eutopic endometrial tissue and normal endometrial tissue while TIMP1, TIMP2, CAT, PON-1 and SOD levels were significantly lower than those in eutopic endometrial tissue and normal endometrial tissue;MMP2, MMP3, MMP7, 8-iso-PGF2α, AOPP and 8-OHdG levels in ectopic endometrial tissue of EMs patients with severe pain and moderate pain were significantly higher than those of EMs patients with mild pain while TIMP1, TIMP2, CAT, PON-1 and SOD levels were significantly lower than those of EMs patients with mild pain;MMP2, MMP3, MMP7, 8-iso-PGF2α, AOPP and 8-OHdG levels in ectopic endometrial tissue of EMs patients with severe pain were significantly higher than those of EMs patients with moderate pain while TIMP1, TIMP2, CAT, PON-1 and SOD levels were significantly lower than those of EMs patients with moderate pain.Conclusion:The abnormally high expression of matrix metalloproteinases and the abnormal activation of oxidative stress response in ectopic endometrial tissue are closely related to the degree of pelvic pain.

Relaxation technique training to alleviate emotional stress in patients with chronic pain: A report of two cases

Aim: Chronic pain can leads to uncomfortable sensory and emotional experiences and remarkably decrease one’s quality of life. The purpose of this report is to describe our experience of treatment with relaxation techniques for two outpatients with chronic pain-related emotional stress. Methods: We offer outpatient relaxation treatment as a specialized out-patient nursing service. Two patients were motivated to self-manage their pain, and thus sought outpatient instruction in relaxation techniques to provide methods of pain self-management. We examined the usefulness of relaxation techniques as pain self-management methods based on subjective information and the Mental Health Pattern questionnaire. Results: Two patients were able to incorporate the relaxation techniques into their daily schedules and control their symptoms. Ultimately, their attitudes toward their pain changed, which lessened their stress levels and improved their quality of life. Conclusions: Our results suggest that nursing care using continuous relaxation techniques improves pain self-management in patients with chronic pain.

Chronic pain, posttraumatic stress disorder, and opioid intake: A systematic review

BACKGROUND The literature suggests that there is a high degree of co-occurrence between chronic pain and posttraumatic stress disorder(PTSD). An association has been found between PTSD and substance abuse. PTSD is a severe disorder that should be taken into account when opioids are prescribed. It has been found that the prevalence of opioid use disorder(OUD) in chronic pain patients is higher among those with PTSD than those without this disorder.AIM To perform a systematic review on the association between PTSD, chronic noncancer pain(CNCP), and opioid intake(i.e., prescription, misuse, and abuse).METHODS We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Patient, Intervention,Comparator, and Outcomes(PICOS) criteria were formulated a priori in the protocol of the systematic review. A search was conducted of the PROSPERO database. In March 2019, searches were also conducted of 5 other databases:Pub Med, MEDLINE, Psyc INFO, Web of Science, and PILOTS. The Scottish Intercollegiate Guidelines Network checklist for cohort studies was used to assess the selected studies for their methodological quality and risk of bias. Each study was evaluated according to its internal validity, participant sampling,confounding variables, and the statistical analysis.RESULTS A total of 151 potentially eligible studies were identified of which 17 were retained for analysis. Only 10 met the selection criteria. All the studies were published between 2008 and 2018 and were conducted in the United States. The eligible studies included a total of 1622785 unique participants. Of these, 196516 had comorbid CNCP and PTSD and were consuming opiates. The participants had a cross-study mean age of 35.2 years. The majority of participants were men(81.6%). The most common chronic pain condition was musculoskeletal pain:back pain(47.14% across studies;range: 16%-60.6%), arthritis and joint pain(31.1%;range: 18%-67.5%), and neck pain(28.7%;range: 3.6%-63%). In total,42.4% of the participants across studies had a diagnosis of PTSD(range: 4.7%-95%). In relation to opioid intake, we identified 2 different outcomes: opioid prescription and OUD. All the studies reported evidence of a greater prevalence of PTSD in CNCP patients who were receiving prescribed opioids and that PTSD was associated with OUD in CNCP patients.CONCLUSION Opioid analgesic prescription as the treatment of choice for CNCP patients should include screening for baseline PTSD to ensure that these drugs are safely consumed.

Study on the value of parecoxib sodium preemptive analgesia for laparoscopic surgery based on postoperative pain and stress mediator secretion

Objective:To investigate the effect of parecoxib sodium preemptive analgesia on postoperative pain and stress response in patients with laparoscopic surgery.Methods:118 patients with asymptomatic gallbladder polyps who underwent elective laparoscopic surgery in our hospital between January 2018 and January 2019 were divided into the control group(n=59)and the preemptive analgesia group(n=59)by random number table.Control group received routine total intravenous anesthesia,and preemptive analgesia group received intravenous injection of parecoxib sodium 0.7mg/kg during anesthesia induction.The differences in serum levels of pain mediators[prostaglandin E2(PGE2),substance P(SP)and neuropeptide Y(NPY)],inflammatory factors[interleukin-1β(IL-1β),interleukin-6(IL-6)and interleukin-12(IL-12)]as well as stress mediators[cortisol(Cor),norepinephrine(NE)and epinephrine(E)]at before surgery(T0),30min after extubation(T1),6h after surgery(T2)and 24h after surgery(T3)were compared between the two groups of patients.Results:At T0,there was no significant difference in VAS score as well as inflammatory factor or stress mediator levels between the two groups(P>0.05).At T1,T2 and T3,VAS scores of the preemptive analgesia group were lower than those of the control group;serum IL-1β,IL-6,IL-12 and TNF-αlevels were lower than those of the control group;serum Cor,NE and E levels were lower than those of the control group(P<0.05).Conclusion:Parecoxib sodium preemptive analgesia has a positive effect on reducing postoperative pain and systemic stress in patients with laparoscopic cholecystectomy.

Association between Depression, Pressure Pain Sensitivity, Stress and Autonomous Nervous System Function in Stable Ischemic Heart Disease: Impact of Beta-Adrenergic Receptor Blockade

Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternum, and the latter by the PPS and systolic blood pressure (SBP) response to a tilt table test (TTT). Beta-blocker treatment reduces the efferent beta-adrenergic ANS function, and thus, the physiological stress response. Objective: To test the effect of beta-blockers on changes in depression score in patients with IHD, as well as the influence on persistent stress and ANS dysfunction. Methods: Three months of non-pharmacological intervention aiming at reducing PPS and depression score in patients with stable IHD. Beta-blocker users (N = 102) were compared with non-users (N = 75), with respect to signs of depression measured by the Major Depressive Inventory questionnaire (MDI), resting PPS, and PPS and SBP response to TTT. Results: MDI score decreased 30% in non-users (p = 0.005) compared to 4% (p > 0.1) among users (between-group p = 0.003;effect size = 0.4). Resting PPS decreased in both the groups. Among most vulnerable patients with MDI ≥ 15, reductions in MDI score and resting PPS score correlated in non-users, only (r = 0.69, p = 0.007). Reduction in resting PPS correlated with an increase in PPS and SBP response to TTT. Conclusions: Stress intervention in patients with IHD was anti-depressive in non-users, only. Similarly, the association between the reduction in depression, reduction in persistent stress, and restoration of ANS dysfunction was only seen in non-users, suggesting a central role of beta-adrenergic receptors in the association between these factors.

Role of α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor regulation in stress-induced pain chronification

Persistent postsurgical pain is a serious issue in public health, which has received increased interest in recent years. Previous studies have reported that psychological factors promote the development of chronic postsurgical pain. However, it is unclear how chronification of postsurgical pain occurs. The α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor(AMPA) phosphorylation in the central nervous system plays a critical role in synaptic plasticity and contributes to central sensitization and chronic pain development. Here, we discuss the role of AMPA receptor regulation in stress-induced pain chronification after surgery.

Effect of nerve stimulator-guided nerve block on the pain mediator secretion and stress degree after lower extremity operation

Objective: To study the effect of nerve stimulator-guided nerve block on the pain mediator secretion and stress degree after lower extremity operation. Methods: Patients who received lower extremity operation in Mianyang Orthopaedic Hospital between March 2015 and August 2017 were selected, and the analgesia methods within the medical records were reviewed and used to divide the patients into nerve block group, spinal analgesia group and intravenous analgesia group. The secretion of pain mediators, stress hormones, stress products and inflammatory factors in serum was measured 24 h after surgery. Results: CGRP, β-EP, 5-HT, HA, ACTH, Cor, PRL, GH, TSH, sTNFR-1, IL-2, IL-10 and TGF-β1 secretion as well as CRP, MPO, MDA and ROS generation in serum of nerve block group were significantly lower than those of spinal analgesia group and intravenous analgesia group, and the differences in serum pain mediators, stress hormones, stress products and inflammatory factors were statistically significant between nerve block group and spinal analgesia group as well as between nerve block group and intravenous analgesia group. Conclusion: The nerve stimulator-guided nerve block can be more effective than spinal analgesia and intravenous analgesia to reduce the secretion of pain mediators and relieve the degree of stress after lower extremity operation.

Effects of ketamine combined with lidocaine for preemptive analgesia on postoperative pain, inflammatory response and stress response in patients with cervical cancer

Objective:To investigate the effects of ketamine combined with lidocaine for preemptive analgesia on postoperative pain, inflammatory response and stress response in patients with cervical cancer.Methods: A total of 68 patients with cervical cancer who received radical operation in the hospital between July 2016 and May 2017 were divided into routine analgesia group (n=37) and ketamine group (n=31) according to the postoperative analgesic solution. Routine analgesia group received lidocaine for preemptive analgesia and ketamine group received ketamine combined with lidocaine for preemptive analgesia. The differences in serum levels of pain mediators, inflammatory factors and stress hormones were compared between the two groups before surgery (T0), immediately after postoperative recovery (T1) and 24h after surgery (T2).Results: At T0, there was no statistically significant difference in serum levels of pain mediators, inflammatory factors and stress hormones between the two groups. At T1 and T2, serum pain mediators SP and NPY levels of ketamine group were lower than those of routine analgesia group;inflammatory factors IL-1β, IL-6 and IL-8 levels were lower than those of routine analgesia group;stress hormones AngⅠ, AngⅡ and NE levels were lower than those of routine analgesia group.Conclusion: Ketamine combined with lidocaine for preemptive analgesia can effectively suppress the early postoperative pain mediator secretion and relieve the systemic inflammatory response and stress response in patients with cervical cancer.

Effect of sufentanil analgesia for hip replacement on pain mediator, stress hormone and inflammatory cytokine secretion

Objective:To study the effect of sufentanil analgesia for hip replacement on pain mediator, stress hormone and inflammatory cytokine secretion.Methods: Patients who underwent hip replacement in People's Hospital of Dongxihu District Wuhan between August 2015 and October 2017 were selected as the research subjects and randomly divided into the sufentanil group who accepted postoperative sufentanil analgesia and the fentanyl group who accepted postoperative fentanyl analgesia. The expression levels of pain mediators and inflammatory cytokines in peripheral blood as well as the levels of pain mediators, stress hormones and inflammatory cytokines in serum were measured 1 day and 3 days after surgery.Results:Serum PGE2, SP,β-EP, GH, COR, ACTH, INS, AT-II, TNF-α and ICAM-1 levels as well as peripheral blood MKP1, p38MAPK, Caspase-1, IL-1β and IL-18 expression intensity of sufentanil group 1 day and 3 days after surgery were significantly lower than those of fentanyl group.Conclusion: Sufentanil analgesia for hip replacement can be more effective than fentanyl to reduce the secretion of pain mediators, stress hormones and inflammatory cytokines.

Effect of laparoscopic radical resection of rectal cancer on gastrointestinal hormones, visceral protein and pain stress in patients

Objective: To investigate the effects of laparoscopic radical resection of rectal cancer on gastrointestinal hormones, visceral protein and pain stress. Methods: A total of 96 patients with rectal cancer radical resection from January 2017 to December 2017 in our hospital, were selected as the research objects, the patients were randomly divided into the observation group (48 cases) and the control group (48 cases). The observation group received laparoscopic radical resection of rectal cancer, while the control group underwent open radical resection of rectal cancer. The levels of gastrin (GAS), motilin (MTL), vasoactive intestinal peptide (VIP), transferrin (TRF), retinol binding protein (RbP), albumin (ALB), prealbumin (PRE), P substance (SP), bradykinin (BK), and prostaglandin-E2 (PGE2) were measured and compared in the two groups. Results: Before operation, there was no significant difference in GAS, MTL and VIP between the two groups. 1, 3, and 5 d after operation, the GAS, MTL and VIP of the two groups were significantly lower than those before operation, and the differences were statistically significant. 1, 3, and 5 d after operation, GAS of the observation group were (66.60±5.79) μmol/L, (71.95±6.16) μmol/L and (77.68±6.38) μmol/L respectively, MTL were (225.68±19.83) pg/mL, (253.76±21.42) pg/mL and (289.98±24.74) pg/mL, VIP were (1.99±0.42) μmol/L, (2.43±0.46) μmol/L, (2.80±0.51) μmol/L, respectively, which were higher than that of the control group at the same time, and the difference was statistically significant. Before operation, there was no significant difference in TRF, RbP, ALB and PRE levels in the two groups. 1, 3 and 5 d after operation, the TRF, RbP, ALB and PRE levels in the two groups were significantly lower than those before operation, and the differences were statistically significant. 1, 3 and 5 d after operation, TRF of the observation group were (1.64±0.33) ng/L, (1.44±0.30) ng/L, (1.46 ±0.32) ng/L, RbP were (19.05±3.85) mg/L, (21.83±4.26) mg/L and (24.54±4.45) mg/L respectively, and ALB were (31.49±2.54) ng/L, (28.21±2.05) ng/L and (28.43±1.99) ng/L, PRE were (0.20±0.06) ng/L, (0.16±0.05) ng/L, (0.15±0.05) ng/L, which were all higher than those in the control group at the same time, and the differences were statistically significant. Before operation, there was no significant difference in SP, BK and PGE2 between the two groups. 1, 3 and 5 d after operation, the SP, BK and PGE2 of the two groups were significantly higher than those before operation and the differences were statistically significant. 1, 3 and 5 d after operation, SP of the observation group was (7.31±0.87) μg/mL, (5.43±0.51) μg/mL and (3.10±0.24) μg/mL, BK was (9.53±0.80) μg/L, (7.81±0.79) μg/L and 6.30±0.53) pg/mL, and PGE2 were (152.42±14.80) pg/mL, (131.22±13.35) pg/mL, (117.86±11.95) pg/mL, which were all lower than those in the control group at the same time, and the differences were statistically significant. Conclusion: Laparoscopic radical resection of rectal cancer can help patients recover gastrointestinal function faster and cause less pain stress.

Effect of flurbiprofen axetil intervention before induction on incision pain and inflammatory stress response after orthopedic surgery

Objective:To study the effect of flurbiprofen axetil intervention before induction on incision pain and inflammatory stress response after orthopedic surgery.Methods: A total of 86 cases of elderly patients who underwent operative treatment of femoral neck fracture in Guangyuan Hospital of Traditional Chinese Medicine between March 2014 and December 2017 were selected as the research subjects. All patients were randomly divided into the experimental group who accepted flurbiprofen axetil intervention before induction + routine anesthesia induction and maintenance, and the control group who accepted routine anesthesia induction and maintenance, and each group included 43 cases. The pain levels of the two groups were assessed 24 h after surgery;the levels of pain mediators and inflammatory stress molecules in serum as well as the expression intensity of inflammatory stress molecules in peripheral blood were determined before surgery and 24 h after surgery.Results:24 h after surgery, serum SP, NPY, PGE2, TNF-α, IL-1β, IL-18, ACTH, COR and NE levels as well as peripheral blood NF-κB, NLRP3, Caspase-1, GLUT4 and FOXP3 expression intensity of both groups were significantly higher than those before surgery, and NRS pain score, serum SP, NPY, PGE2, TNF- , IL-1β, IL-18, ACTH, COR and NE levels as well as peripheral blood NF-κB, NLRP3, Caspase-1, GLUT4 and FOXP3 expression intensity of experimental group 24 h after surgery were significantly lower than those of control group.Conclusions:Flurbiprofen axetil intervention before induction can improve and inhibit the incision pain and inflammatory stress response after orthopedic surgery.