Clinical application of ultrasound-guided selective proximal and distal brachial plexus block in rapid rehabilitation surgery for hand trauma

BACKGROUND Anesthesia plays an essential role in the successful surgical procedures for hand trauma.Compared with general anesthesia,brachial plexus block shows lots of benefits for the upper extremity.Specifically,ultrasound-guided selective proximal and distal brachial plexus block may overcome the issues of incomplete block and failure of anesthesia in such circumstances.The present study assessed the efficacy of ultrasound-guided selective proximal and distal brachial plexus block in clinical practice.AIM To explore the efficacy of ultrasound-guided selective proximal and distal brachial plexus block in rapid recovery surgery for hand trauma.METHODS A total of 68 patients with traumatic hand injuries treated at our hospital from January 2018 to June 2019 were selected.They were divided into an observation group and a control group with 34 patients in each group.The observation group underwent selective brachial plexus block guided by ultrasound and the control group underwent conventional brachial plexus block.The analgesic efficacy,intraoperative complications,wound healing time,and length of hospital stay were compared between the two groups under different anesthesia.RESULTS The percentage of cases with analgesia graded as“excellent or very good”was higher in the observation group than in the control group(P<0.05).Moreover,the incidence of intraoperative complications was lower and the wound healing time and length of hospital stay were shorter in the observation group than in the control group(P<0.05).CONCLUSION Ultrasound-guided selective proximal and distal brachial plexus block has remarkable analgesic efficacy in patients with traumatic hand injuries.It can reduce the incidence of intraoperative complications,promote wound healing,and shorten the length of hospital stay.

Application Research of Perioperative Clinical Pathway Based on Accelerated Rehabilitation Surgery Strategy in Patients with ERCP

Objective:To explore the effects of perioperative clinical pathway of accelerated rehabilitation surgery strategy in patients undergoing cholangiopancreatography(ERCP).Methods:Randomly selected 40 patients undergoing ERCP from our hospital which is People's Hospital,Jingjiang City,for research,and divided the patients into two groups.The 20 patients who were given conventional education methods were set as the reference group,and the 20 patients who were given perioperative clinical pathway care with accelerated rehabilitation surgery strategies were the research group,where the clinical nursing effect of the two groups was statistically compared.Results:According to clinical observation and statistics,the study group's postoperative time to eat for the first time,time to get out of bed,hospitalization time,and surgical blood loss were better than those of the reference group,P<0.05;the anxiety and depression scores of the study group were lower than those after nursing in the reference group,P<0.05;the incidence of complications in the study group was lower than that in the reference group,and patient satisfaction was higher than that in the reference group,where both P<0.05.Conclusion:The application of perioperative clinical pathway care based on the strategy of accelerated rehabilitation surgery can achieve significant results in ERCP patients,which can effectively improve the surgical indicators of patients and reduce the risk of complications.

Impact of fast-track surgery on perioperative care in patients undergoing hepatobiliary surgery

BACKGROUND Fast-track surgery(FTS)is a modern nursing approach that has gained popularity in the perioperative phase of surgery.AIM To investigate the impact of FTS on perioperative care for hepatobiliary surgery.METHODS A retrospective analysis was performed on 98 patients who underwent hepato-biliary surgery and were admitted to our hospital from August 2021 to October 2023.They were divided into an observation group and a control group with 49 patients in each group according to different nursing directions.The control group was treated with standard nursing and the observation group was treated with FTS concept nursing.The length of hospital stay,visual analog scale(VAS)score,wound complications,nursing satisfaction,self-rating scale(SAS)score,and SF-36 quality of life(QoL)score were compared between the two groups before and after care.RESULTS The duration of hospitalization,hospitalization cost,operation time,first im-plantation time,exhaust time,and first defecation time were shorter than the observation group(P<0.05).Additionally,the observation group showed a sig-nificant difference between the VAS and SAS scores on days 1,3,and 7(P<0.05).The complication rate in the observation group was 4.05%was significantly lower than the 18.36%in the control group,and the comparison groups were statistically significant(χ2=5.018,P=0.025).The observation group had a significantly higher level of nurse satisfaction(94.92%)than the control group(79.59%;χ2=6.078,P=0.014).Both groups showed higher QoL scores after nursing care,with higher scores in the observation group than in the control group(P=0.032).CONCLUSION FTS in patients undergoing hepatobiliary surgery can effectively improve negative mood,QoL,and nursing sa-tisfaction;reduce wound complications;and accelerate patient rehabilitation.

Application of ERAS Concept Combined with Psychological Stress Intervention in Laparoscopic Urological Surgery Nursing

Enhanced recovery after surgery (ERAS), a series of evidence-based optimization measures during the perioperative period, to reduce patients’ physical and psychological traumatic stress responses, to reduce complications, to shorten the length of hospital stay, to reduce the risk of readmission and mortality, and ultimately to promote rapid patient resuscitation, is adopted. The negative emotional experience of patients may aggravate the surgical stress response, interfere with the endocrine system and nervous system, cause the imbalance of internal environment, and have a negative impact on the surgical effect. This paper uses the concept of ERAS in combination with psychological stress interventions, perioperative psychological nursing instruction, reduces the laparoscopic surgery in patients with psychological stress reaction on the immune function of cells, improves the body’s immune function, improves the body of bacteria such as vitamin attack resistance, reduces the risk of complications such as infection, and accelerates the process of patient rehabilitation. Here is the report.

Application of ERAS Concept and Psychological Guidance in Nursing of Patients with Laparoscopic Urology

Objective: To explore the application and effect of the enhanced recovery after surgery (ERAS) concept combined with psychological stress intervention in laparoscopic urological surgery nursing. Methods: 100 cases of urological surgical patients according to the nursing way, each 50 cases were divided into observation group and control group, and control group routine nursing, and the observation group implement rapid rehabilitation surgery concept in combination with psychological nursing, the comparison of two groups of patients with stress index, immune function, mental health, postoperative recovery index and the effect of complications. Results: There were statistically significant differences in stress index, immune function, mental health level, postoperative recovery index and complications between the observation group and the control group after psychological nursing (P Conclusion: The concept of rapid rehabilitation surgery combined with psychological nursing can help relieve psychological stress, restore immune function, reduce psychological pressure drop, speed up rehabilitation and reduce the incidence of postoperative complications in patients undergoing laparoscopic urologic surgery. Psychological nursing plays an adjunct role in laparoscopic urological surgery, so it is worth promoting.

ERAS Optimization of Cluster Intervention Strategies in Perioperative Period of Acute Stanford Type A Aortic Dissection

Accelerated rehabilitation surgery (ERAS) can promote postoperative recovery and reduce postoperative complications by minimizing surgically related stress, and its efficacy and safety in acute aortic dissection surgery have been demonstrated. However, due to the particularity of acute aortic dissection, studies on the application of accelerated rehabilitation surgery in acute aortic dissection are relatively rare and there are great differences among different studies. This study adopts the method of evidence-based nursing practice accelerate rehabilitation cluster of surgical nursing strategy developed and applied to the patients with primary acute aortic dissection and adopts “accelerate rehabilitation cluster of surgical nursing strategy” and “accelerated rehabilitation cluster of surgical nursing strategies in patients with acute aortic dissection in clinical intervention”, the new nursing concept and organic combination of traditional nursing measures, using the optimal cluster nursing intervention mode, to explore the safety, effectiveness and feasibility of the intervention mode in the perioperative period of the original acute aortic dissection in patients’ cluster intervention, to accelerate the rehabilitation surgery in acute aortic dissection in the clinical care to provide a scientific basis for the operation.

Effect of acupuncture on short-term pain after standard thoracotomy

Background:To observe the effect of perioperative acupuncture on postoperative pain in patients undergoing standard sternotomy.Methods:57 patients who received standard median sternotomy were randomly divided into acupuncture group(30 cases)and control group(27 cases).The control group was treated with routine operation and nursing,and the acupuncture group was treated with acupuncture for 10 days on the basis of perioperative period.The pain levels of the two groups before and after operation were compared.Results:The pain level of the acupuncture group was significantly lower than that of the control group on the 2nd,10th,and 30th days after operation(P<0.05),and the short-term pain levels in the two groups were statistically significant(P<0.05).Conclusion:The perioperative acupuncture treatment has a significant analgesic effect on short-term pain for patients undergoing anterior midline thoracotomy,and it is helpful for patients to recover quickly after surgery.