BACKGROUND Uterine fibroids are common benign gynecological conditions.Patients who experience excessive menstruation,anemia,and pressure symptoms should be administered medication,and severe cases require a total hys...BACKGROUND Uterine fibroids are common benign gynecological conditions.Patients who experience excessive menstruation,anemia,and pressure symptoms should be administered medication,and severe cases require a total hysterectomy.This procedure is invasive and causes severe postoperative pain,which can affect the patient’s postoperative sleep quality and,thus,the recovery process.AIM To evaluate use of dezocine in patient-controlled epidural analgesia(PCEA)for postoperative pain management in patients undergoing total myomectomy.METHODS We selected 100 patients undergoing total abdominal hysterectomy for uterine fibroids and randomized them into two groups:A control group receiving 0.2%ropivacaine plus 0.06 mg/mL of morphine and an observation group receiving 0.2%ropivacaine plus 0.3 mg/mL of diazoxide in their PCEA.Outcomes assessed included pain levels,sedation,recovery indices,PCEA usage,stress factors,and sleep quality.RESULTS The observation group showed lower visual analog scale scores,shorter postoperative recovery indices,fewer mean PCEA compressions,lower cortisol and blood glucose levels,and better polysomnographic parameters compared to the control group(P<0.05).The cumulative incidence of adverse reactions was lower in the observation group than in the control group(P<0.05).CONCLUSION Dezocine PCEA can effectively control the pain associated with total myomectomy,reduce the negative impact of stress factors,and have less impact on patients’sleep,consequently resulting in fewer adverse effects.展开更多
Objective: To study the effect of hydromorphone hydrochloride combined with ropivacaine for patient-controlled epidural analgesia (PCEA) after transurethral resection of prostate on pain mediators and stress response....Objective: To study the effect of hydromorphone hydrochloride combined with ropivacaine for patient-controlled epidural analgesia (PCEA) after transurethral resection of prostate on pain mediators and stress response. Methods: A total of 138 patients who received transurethral resection of prostate in Ankang Central Hospital between May 2014 and October 2016 were selected and randomly divided into group A and group B, group A received postoperative hydromorphone hydrochloride combined with ropivacaine for PCEA, and group B received postoperative morphine hydrochloride combined with ropivacaine for PCEA. The serum contents of pain mediators, inflammatory response cytokines and stress hormones of the two groups were detected before surgery as well as 12 h, 24 h and 48 h after surgery. Results: 12 h, 24 h and 48 h after surgery, serum SP, BK, HIS, CX3CL1, CCL2, IL-1β, TNF-α, IL-10, ACTH, CORT, TSH, FT3, FT4 and GH levels of both groups of patients were significantly higher than those before surgery, and serum SP, BK, HIS, CX3CL1, CCL2, IL-1β, TNF-α, IL-10, ACTH, CORT, TSH, FT3, FT4 and GH levels of group A were significantly lower than those of group B. Conclusion: Hydromorphone hydrochloride combined with ropivacaine for PCEA can effectively reduce the pain and stress after transurethral resection of prostate.展开更多
OBJECTIVE: To assess the clinical effect and safety of direct current(DC) pulse produced by Han's Acupoint Nerve Stimulator in reduction(HANS) of labor pain.METHODS: Totally 120 participants were enrolled in this ...OBJECTIVE: To assess the clinical effect and safety of direct current(DC) pulse produced by Han's Acupoint Nerve Stimulator in reduction(HANS) of labor pain.METHODS: Totally 120 participants were enrolled in this clinical trial, and were randomly divided into4 groups including: HANS group, patient controlled intravenous analgesia(PCIA) group, patient-controlled epidural analgesia(PCEA) group and control group. The HANS group was treated by stimulating the acupoints of Jia Ji(T10-L3) and Ciliao(BL 32)with DC pulse of 100 Hz and 15-30 m A produced by a portable battery-powered Han's Acupoint Nerve Stimulator for 30 min. The PCIA group was intravenously infused Ondansetron(8 mg) for 5 min,then tramadol injection(1.5 mg/kg) was slowly dripped by using Baxter APⅡ electronic pump with50 m L tramadol(0.70%) + ondansetron(8 mg),background infusion 2 m L/h, PCA dose of 2 m L,lockout interval of 10 min. In PCEA group, women received intrathecal injection ropivacaine(3 mg) in L2-3, and epidural catheter was connected to Baxter APⅡ electronic pump, with 100 m L Ropivacaine(0.1%) and Sufentanil(50 ug), background infusion5 m L, Patient controlled analgesia(PCA) dose of 5m L, lockout interval of 10 min. The control group was not received analgesia. The visual analogue scale(VAS), stage and manner of labor, Apgar score of newborn, neonatal weights, oxytocin dosage,postpartum hemorrhage and side effects were monitored in all groups.RESULTS: The vital signs were all stable in the four analgesic groups. After analgesia, there was statistical difference in VAS score between HANS group and control group, between PCEA group and the control group, between PCIA group and control group. The analgesic effect in the PCEA group was significantly better than that of other two groups.The second stage of labor in the PCEA group was longer than the other three groups, showing significant difference between them. The Apgar score of newborn 1min after birth in the PCIA group was slightly lower than that of the other two groups,showing significant difference between them. The neonatal weights between four groups were not significantly different. The rate of cesarean sectionin the control group was significantly higher than that of the labor analgesia group, there was statistically difference in four groups. The number of PCIA group that used oxytocin was lower than that of other three groups. There was no significant difference in postpartum hemorrhage between four groups. The side effects of the PCEA group were itching, uroschesis and neonatal asphyxia and PCIA group were nausea and vomiting and neonatal asphyxia. However, fewer side effects were observed in the HANS group.CONCLUSION: The DC pulse produced by HANS may be a non-pharmacological alternative to labor pain with fewer side effects.展开更多
基金Natural Science Foundation of Gansu Provincial Science and Technology Department(Basic Research Program),No.23JRRA1385.
文摘BACKGROUND Uterine fibroids are common benign gynecological conditions.Patients who experience excessive menstruation,anemia,and pressure symptoms should be administered medication,and severe cases require a total hysterectomy.This procedure is invasive and causes severe postoperative pain,which can affect the patient’s postoperative sleep quality and,thus,the recovery process.AIM To evaluate use of dezocine in patient-controlled epidural analgesia(PCEA)for postoperative pain management in patients undergoing total myomectomy.METHODS We selected 100 patients undergoing total abdominal hysterectomy for uterine fibroids and randomized them into two groups:A control group receiving 0.2%ropivacaine plus 0.06 mg/mL of morphine and an observation group receiving 0.2%ropivacaine plus 0.3 mg/mL of diazoxide in their PCEA.Outcomes assessed included pain levels,sedation,recovery indices,PCEA usage,stress factors,and sleep quality.RESULTS The observation group showed lower visual analog scale scores,shorter postoperative recovery indices,fewer mean PCEA compressions,lower cortisol and blood glucose levels,and better polysomnographic parameters compared to the control group(P<0.05).The cumulative incidence of adverse reactions was lower in the observation group than in the control group(P<0.05).CONCLUSION Dezocine PCEA can effectively control the pain associated with total myomectomy,reduce the negative impact of stress factors,and have less impact on patients’sleep,consequently resulting in fewer adverse effects.
文摘Objective: To study the effect of hydromorphone hydrochloride combined with ropivacaine for patient-controlled epidural analgesia (PCEA) after transurethral resection of prostate on pain mediators and stress response. Methods: A total of 138 patients who received transurethral resection of prostate in Ankang Central Hospital between May 2014 and October 2016 were selected and randomly divided into group A and group B, group A received postoperative hydromorphone hydrochloride combined with ropivacaine for PCEA, and group B received postoperative morphine hydrochloride combined with ropivacaine for PCEA. The serum contents of pain mediators, inflammatory response cytokines and stress hormones of the two groups were detected before surgery as well as 12 h, 24 h and 48 h after surgery. Results: 12 h, 24 h and 48 h after surgery, serum SP, BK, HIS, CX3CL1, CCL2, IL-1β, TNF-α, IL-10, ACTH, CORT, TSH, FT3, FT4 and GH levels of both groups of patients were significantly higher than those before surgery, and serum SP, BK, HIS, CX3CL1, CCL2, IL-1β, TNF-α, IL-10, ACTH, CORT, TSH, FT3, FT4 and GH levels of group A were significantly lower than those of group B. Conclusion: Hydromorphone hydrochloride combined with ropivacaine for PCEA can effectively reduce the pain and stress after transurethral resection of prostate.
基金Supported by The Scientific Achievement and Appropriate Technology Extension Project of Beijing Municipal Commission of Health and Family Planning(TG-2014-12)
文摘OBJECTIVE: To assess the clinical effect and safety of direct current(DC) pulse produced by Han's Acupoint Nerve Stimulator in reduction(HANS) of labor pain.METHODS: Totally 120 participants were enrolled in this clinical trial, and were randomly divided into4 groups including: HANS group, patient controlled intravenous analgesia(PCIA) group, patient-controlled epidural analgesia(PCEA) group and control group. The HANS group was treated by stimulating the acupoints of Jia Ji(T10-L3) and Ciliao(BL 32)with DC pulse of 100 Hz and 15-30 m A produced by a portable battery-powered Han's Acupoint Nerve Stimulator for 30 min. The PCIA group was intravenously infused Ondansetron(8 mg) for 5 min,then tramadol injection(1.5 mg/kg) was slowly dripped by using Baxter APⅡ electronic pump with50 m L tramadol(0.70%) + ondansetron(8 mg),background infusion 2 m L/h, PCA dose of 2 m L,lockout interval of 10 min. In PCEA group, women received intrathecal injection ropivacaine(3 mg) in L2-3, and epidural catheter was connected to Baxter APⅡ electronic pump, with 100 m L Ropivacaine(0.1%) and Sufentanil(50 ug), background infusion5 m L, Patient controlled analgesia(PCA) dose of 5m L, lockout interval of 10 min. The control group was not received analgesia. The visual analogue scale(VAS), stage and manner of labor, Apgar score of newborn, neonatal weights, oxytocin dosage,postpartum hemorrhage and side effects were monitored in all groups.RESULTS: The vital signs were all stable in the four analgesic groups. After analgesia, there was statistical difference in VAS score between HANS group and control group, between PCEA group and the control group, between PCIA group and control group. The analgesic effect in the PCEA group was significantly better than that of other two groups.The second stage of labor in the PCEA group was longer than the other three groups, showing significant difference between them. The Apgar score of newborn 1min after birth in the PCIA group was slightly lower than that of the other two groups,showing significant difference between them. The neonatal weights between four groups were not significantly different. The rate of cesarean sectionin the control group was significantly higher than that of the labor analgesia group, there was statistically difference in four groups. The number of PCIA group that used oxytocin was lower than that of other three groups. There was no significant difference in postpartum hemorrhage between four groups. The side effects of the PCEA group were itching, uroschesis and neonatal asphyxia and PCIA group were nausea and vomiting and neonatal asphyxia. However, fewer side effects were observed in the HANS group.CONCLUSION: The DC pulse produced by HANS may be a non-pharmacological alternative to labor pain with fewer side effects.
