AIM:To investigate the effect of pain relief after infu-sion of ropivacaine at port sites at the end of surgery.METHODS:From October 2006 to September 2007,72 patients undergoing laparoscopic cholecystectomy(LC) were ...AIM:To investigate the effect of pain relief after infu-sion of ropivacaine at port sites at the end of surgery.METHODS:From October 2006 to September 2007,72 patients undergoing laparoscopic cholecystectomy(LC) were randomized into two groups of 36 patients.One group received ropivacaine infusion at the port sites at the end of LC and the other received normal saline.A visual analog scale was used to assess postoperative pain when the patient awakened in the operating room,6 and 24 h after surgery,and before discharge.The amount of analgesics use was also recorded.The demographics,laboratory data,hospital stay,and perioperative complications were compared between the two groups.RESULTS:There was no difference between the two groups preoperatively in terms of demographic and lab-oratory data.After surgery,similar operation time,blood loss,and no postoperative morbidity and mortality were observed in the two groups.However,a significantly lower pain score was observed in the patients undergo-ing LC with local anesthesia infusion at 1 h after LC and at discharge.Regarding analgesic use,the amount of meperidine used 1 h after LC and the total used during admission were lower in patients undergoing LC with local anesthesia infusion.This group also had a shorter hospital stay.CONCLUSION:Local anesthesia with ropivacaine at the port site in LC patients signif icantly decreased post-operative pain immediately.This explains the lower meperidine use and earlier discharge for these patients.展开更多
Objective To compare effects of combined acupuncture and general anesthesia (CAGA) and general anesthesia (GA) on immune function in patients of laparoscopic cholecystectomy (LC) in peri-operative period. Method...Objective To compare effects of combined acupuncture and general anesthesia (CAGA) and general anesthesia (GA) on immune function in patients of laparoscopic cholecystectomy (LC) in peri-operative period. Methods Thirty-nine cases undergoing LC were randomly divided into a CAGA group and a GA group. The CAGA group was treated with electroacupuncture at Hegu (合谷- LI 4), Neiguan (内关PC 6), Zusanli (足三里ST 36) and Yanglingquan (阳陵泉 GB 34) for 15-30 minutes followed by the general anesthesia, and the continuous electroacupuncture stimulation was given till the operation finished. The GA group was treated with simple general anesthesia. Changes of T cell subsets, tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were observed before anesthesia induction, and 2 hours, 1st and 3 rd day after operation, and the adverse reaction after operation was recorded. Results At 2 hours after operation, the percentages of CD3 and CDs in both groups were significantly lower than those before anesthesia induction (all P〈0.05), and the percentage of CD4 in the GA group decreased significantly (P〈0.05), while the percentage of CD: did not significantly change and CD4/CD8 increased significantly in the CAGA group (P〈0.05). At 3 days after operation, the level of TNF-α in the ACGA group decreased significantly as compared with that before anesthesia induction (P〈0.05). The cases with nausea after operation in the CAGA group were significantly less than those in the GA group (P〈0.05). Conclusion Acupuncture combined with general anesthesia has a little effect on immune function in patients of LC with less adverse reactions.展开更多
文摘AIM:To investigate the effect of pain relief after infu-sion of ropivacaine at port sites at the end of surgery.METHODS:From October 2006 to September 2007,72 patients undergoing laparoscopic cholecystectomy(LC) were randomized into two groups of 36 patients.One group received ropivacaine infusion at the port sites at the end of LC and the other received normal saline.A visual analog scale was used to assess postoperative pain when the patient awakened in the operating room,6 and 24 h after surgery,and before discharge.The amount of analgesics use was also recorded.The demographics,laboratory data,hospital stay,and perioperative complications were compared between the two groups.RESULTS:There was no difference between the two groups preoperatively in terms of demographic and lab-oratory data.After surgery,similar operation time,blood loss,and no postoperative morbidity and mortality were observed in the two groups.However,a significantly lower pain score was observed in the patients undergo-ing LC with local anesthesia infusion at 1 h after LC and at discharge.Regarding analgesic use,the amount of meperidine used 1 h after LC and the total used during admission were lower in patients undergoing LC with local anesthesia infusion.This group also had a shorter hospital stay.CONCLUSION:Local anesthesia with ropivacaine at the port site in LC patients signif icantly decreased post-operative pain immediately.This explains the lower meperidine use and earlier discharge for these patients.
基金Supported by National Natural Scientif ic Foundation: 30772832
文摘Objective To compare effects of combined acupuncture and general anesthesia (CAGA) and general anesthesia (GA) on immune function in patients of laparoscopic cholecystectomy (LC) in peri-operative period. Methods Thirty-nine cases undergoing LC were randomly divided into a CAGA group and a GA group. The CAGA group was treated with electroacupuncture at Hegu (合谷- LI 4), Neiguan (内关PC 6), Zusanli (足三里ST 36) and Yanglingquan (阳陵泉 GB 34) for 15-30 minutes followed by the general anesthesia, and the continuous electroacupuncture stimulation was given till the operation finished. The GA group was treated with simple general anesthesia. Changes of T cell subsets, tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were observed before anesthesia induction, and 2 hours, 1st and 3 rd day after operation, and the adverse reaction after operation was recorded. Results At 2 hours after operation, the percentages of CD3 and CDs in both groups were significantly lower than those before anesthesia induction (all P〈0.05), and the percentage of CD4 in the GA group decreased significantly (P〈0.05), while the percentage of CD: did not significantly change and CD4/CD8 increased significantly in the CAGA group (P〈0.05). At 3 days after operation, the level of TNF-α in the ACGA group decreased significantly as compared with that before anesthesia induction (P〈0.05). The cases with nausea after operation in the CAGA group were significantly less than those in the GA group (P〈0.05). Conclusion Acupuncture combined with general anesthesia has a little effect on immune function in patients of LC with less adverse reactions.