Ultrasound-Guided Continuous Thoracic Paravertebral Block Improves Patientʼs Quality of Recovery After Open Hepatectomy: A Randomized, Double-Blind, Placebo-Controlled Trial

Background Ultrasound-guided continuous thoracic paravertebral block can provide pain-relieving and opioid-sparing effects in patients receiving open hepatectomy.We hypothesize that these effects may improve the quality of recovery(QoR)after open hepatectomy.Methods Seventy-six patients undergoing open hepatectomy were randomized to receive a continuous thoracic paravertebral block with ropivacaine(CTPVB group)or normal saline(control group).All patients received patient-controlled intravenous analgesia with morphine postoperatively for 48 hours.The primary outcome was the global Chinese 15-item Quality of Recovery score on postoperative day 7,which was statistically analyzed using Student’s t-test.Results Thirty-six patients in the CTPVB group and 37 in the control group completed the study.Compared to the control group,the CTPVB group had significantly increased global Chinese 15-item Quality of Recovery scores(133.14±12.97 vs.122.62±14.89,P=0.002)on postoperative day 7.Postoperative pain scores and cumulative morphine consumption were significantly lower for up to 8 and 48 hours(P<0.05;P=0.002),respectively,in the CTPVB group.Conclusion Perioperative CTPVB markably promotes patient’s QoR after open hepatectomy with a profound analgesic effect in the early postoperative period.

A Multi-Objective Optimization Approach for Heat Exchanger Network in Process Industries

To simultaneously improve the quantity and quality of heat recovery in a heat exchanger network(HEN),this study conducts a theory analysis based on the first and second laws of thermodynamics.Under the premise of maximizing the heat recovery quantity of HEN,Ġdiss is used as an evaluation index to optimize the quality of heat recovery.Meanwhile,the total annual cost(TAC)is considered as another optimization objective to ensure the economic feasibility of the HEN.A superstructure-based multi-objective mixed integer non-linear programming approach is put forward to solve the trade-off between minimizingĠdiss and minimizing TAC.This allows for the optimum HEN structure to be obtained.A well-studied example is solved to highlight the benefits of the proposed method.

Vividly Colored Accessories and Mood Changes in Patients Undergoing Breast Surgery

Few studies have examined the impacts of color stimuli on perioperative mood and quality of recovery;thus, this randomized controlled trial aimed to assess impacts of vividly colored accessories on mood and quality of recovery after breast surgery. This single-center, single-blind randomized controlled trial included 36 participants (all aged ≥ 20 years) who were randomized into intervention (n = 19) and control groups (n = 17). The intervention group received vividly colored accessories. The primary and secondary study outcomes were patient mood, evaluated using a two-dimensional mood scale, and postoperative recovery, evaluated using Quality of Recovery-15, which were assessed on postoperative day 3. There were no statistical intergroup differences in the scores of the Two-Dimensional Mood Scale (11.2 [intervention group] vs. 10.4 [control group], P = 0.75) and Quality of Recovery-15 (126.8 [intervention group] vs. 129.3 [control group], P = 0.73). Thus, the use of vividly colored accessories by patients undergoing breast surgery was not found to affect patients’ mood and quality of recovery.