Dezocine Research Articles

Dezocine as preemptive analgesia alleviates ultrapulse CO2 fractional laser treatment induced pain in patients with acne scars.

Ultrapluse CO2 fractional laser technology has emerged as an effective treatment for scar management. However, one drawback of this modality is the pain caused during the procedure. This study aims to explore the efficacy and safety of dezocine (DZC) as preemptive analgesia for reduction of pain induced by ultrapulse CO2 fractional laser treatment for acne scars. The study cohort included 78 outpatients with acne scars between February and April 2023. Patients were randomly assigned into three groups with intravenous injection (iv) of DZC prior to laser treatment: (1) control, iv of saline; (2) DZC group 1 (DZC_1), iv of DZC at 0.15 mg/kg; and (3) DZC_2, iv of DZC at 0.20 mg/kg. After 30 min, one session of ultrapulse CO2 fractional laser treatment on acne scars was performed. Hemodynamics, visual analogue scale (VAS), and anxiety visual analog test (AVAT) were monitored prior to, during, and after the procedure. Operative success rates for patients in the control, DZC_1, and DZC_2 groups were 34.6%, 84.6%, and 100%, respectively. DZC administered with either dosage significantly reduced the VAS and AVAT scores of patients in treatment groups as compared with the subjects in the control group during the course of ultrapulse CO2 fractional laser treatment. Patients in DZC_1 and DZC_2 groups did not show any significant difference in hemodynamic parameters, VAS, and AVAT scores. Temporary adverse effects such as nausea and dizziness were observed in some subjects after treatment; the symptoms were quickly dissolved after a rest in supine position. DZC as preemptive analgesia could effectively reduce pain and anxiety induced by ultrapulse CO2 fractional laser treatment in patients. This study provided an option of preemptive anesthesia to minimize the pain and discomforts associated with laser treatments in clinical practices.

Efficacy of dezocine on preventing opioid-induced cough during general anaesthesia induction: a PRISMA-compliant systematic review and meta-analysis

ObjectivesTo systematically review the effects of dezocine (DZC) on the occurrence rate and severity of opioid-induced cough (OIC).DesignSystematic review and meta-analysisData sourcesPubMed, Embase, Cochrane Library, Ovid, Web of Science as...

The protective effects of dezocine on interleukin-1β-induced inflammation, oxidative stress and apoptosis of human nucleus pulposus cells and the possible mechanisms

ABSTRACT Intervertebral disc degeneration (IDD) is a natural problem linked to the inflammation. We aimed to investigate the role of dezocine (DEZ) in the development of IDD. Human nucleus pulposus cells (HNPCs) induced by interleukin (IL)-1β was used as a cellular model of IDD. After treatment with DEZ, HNPCs viability was evaluated with a CCK-8 assay. Then, the levels of inflammatory factors, including IL-6 and tumor necrosis factor-α (TNF-α), and oxidative stress-related markers, including reactive oxygen species (ROS), malondialdehyde (MDA) and reduced glutathione (GSH), were tested by RT-qPCR or kits. TUNEL staining was employed to detect cell apoptosis and Western blot was used to determine the expression of proteins related to inflammation, oxidative stress, apoptosis, endoplasmic reticulum stress (ERS) and MAPK signaling. Afterward, PMA, a MAPK signaling pathway agonist, was adopted for exploring the regulatory effects of DEZ on MAPK pathway. Results indicated that DEZ enhanced cell viability of HNPCs after IL-1β exposure. DEZ alleviated the inflammation and oxidative stress, evidenced by decreased levels of IL-6, TNF-α, ROS, MDA, p-NF-κB p65, NF-κB p65 in nucleus, cox-2 and increased levels of NF-κB p65 in cytoplasm, GSH, SOD1 and SOD2. Moreover, DEZ notably inhibited IL-1β-induced apoptosis of HNPCs. Furthermore, DEZ suppressed the levels of ERS-related proteins. The levels of related proteins in MAPK signaling including p-P38 and p-ERK1/2 were remarkably reduced after DEZ administration. By contrast, PMA crippled the impacts of DEZ on inflammation, oxidative stress and apoptosis of HNPCs induced by IL-1β. Collectively, DEZ ameliorates IL-1β-induced HNPCs injury via inhibiting MAPK signaling.

Effects of Dezocine and Sufentanil on Th1/Th2 Balance in Breast Cancer Patients Undergoing Surgery.

BackgroundIt is very important for breast cancer patients undergoing surgery to choose an opioid that has little effect on the immune system. The aim of this study is to compare the effects of dezocine or sufentanil on postoperative pain and Th1/Th2 balance in patients undergoing breast cancer surgery.MethodsData from 92 breast cancer patients from January 2019 to July 2020 at Foshan Second People’s Hospital (Guangdong, China) were analyzed. Sufentanil (SF) was used in group SF (n = 44) and dezocine (DE) in group DE (n = 48). The Visual Analog Scale (VAS) scores were assessed, and the percentages of Th1 cells and Th2 cells in peripheral blood were detected before anesthesia and at 2, 12, 24, and 48 hours after surgery.ResultsThere was no significant difference in the VAS scores between the two groups at 2, 24, and 48 hours after surgery (P > 0.05). The VAS scores at 12 hours after surgery in group DE were significantly lower than those in group SF with a statistically significant difference (P < 0.05). The percentage of Th1 cells in group DE at 2, 12, 24, and 48 hours after surgery was significantly lower than that in group SF (P < 0.05). The percentage of Th2 cells in group DE at 2, 12, 24, and 48 hours after surgery was significantly lower than that in group SF (P < 0.05). The Th1/Th2 ratio at 2, 12, 24, and 48 hours after surgery was significantly higher in group DE than that in group SF (P < 0.05).ConclusionDezocine for anesthesia induction and postoperative analgesia can maintain the balance of Th1/Th2 more stable than, with the same analgesia efficacy as, sufentanil during the early postoperative period in breast cancer patients undergoing surgery.

Simultaneous Determination of Celecoxib, Dezocine and Dexmedetomidine in Beagle Plasma Using UPLC-MS/MS Method and the Application in Pharmacokinetics.

BackgroundAn efficient, fast and sensitive ultra high-performance liquid chromatography-mass spectrometry (UPLC-MS/MS) method for simultaneous determination of celecoxib (CEL), dezocine (DEZ) and dexmedetomidine (DEX) in beagle plasma were established.MethodsThe beagle dogs plasmawas precipitated by acetonitrile. The column was Acquity UPLC BEH C18 column and the mobile phase was acetonitrile-formic acid with gradient mode, and the flow rate was set at 0.4 mL/min. Under the positive ion mode, CEL, DEZ, DEX and Midazolam (internal standard, IS) were monitored by multiple reaction monitoring (MRM) as the following mass transition pairs: m/z 381.10→282.10 for CEL, m/z 246.20→147.00 for DEZ, m/z 201.10→94.90 for DEX, and m/z 326.10→291.10 for IS.ResultsThis UPLC-MS/MS method had good linearity for CEL, DEZ and DEX. The RSDs of inter-day and intra-day precision were the values of 0.31–7.66% and 0.11–9.63%, respectively; the RE values were from −6.05% to 10.98%. The extraction recovery was more than 79%, and the matrix effect was around 100%. The RSDs of stability were less than 8.96%. All of them met the acceptance standard of biological analysis method recommended by FDA.ConclusionThis UPLC-MS/MS method is an effective tool for the simultaneous determination of CEL, DEX and DEX, and has been successfully applied to the study of pharmacokinetics in beagle dogs.

Effects of Dexmedetomidine on the Pharmacokinetics of Dezocine, Midazolam and Its Metabolite 1-Hydroxymidazolam in Beagles by UPLC-MS/MS.

ObjectiveWe developed and validated a sensitive and reliable UPLC-MS/MS method for simultaneous determination of dezocine (DEZ), midazolam (MDZ) and its metabolite 1-hydroxymidazolam (1-OH-MDZ) in beagle plasma and investigated the effect of dexmedetomidine (DEX) on the pharmacokinetics of DEZ, MDZ and 1-OH-MDZ in beagles.Materials and MethodsDiazepam was used as the internal standard (IS); the three analytes and IS were extracted by acetonitrile precipitation and separated on an Acquity UPLC BEH C18 column using acetonitrile-0.1% formic acid as mobile phase in gradient mode. In positive ion mode, the three analytes and IS were monitored by multiple reaction monitoring (MRM). Six beagles were designed as a double cycle self-control experiment with 0.15 mg/kg in the first cycle (Group A). After a 1-week washout period, the same six beagles were slowly injected intravenously with 2 µg/kg DEX in the second cycle (Group B), with continuous injection for 7 days. On the seventh day, 0.5 hr after intravenous injection of 2 µg/kg DEX, the six beagles were intramuscularly given with DEZ 0.33 mg/kg and MDZ 0.15 mg/kg.ResultsUnder the conditions of this experiment, this method exhibited a good linearity for each analyte. The accuracy and precision were all within the acceptable limits in the bioanalytical method, and the results of recovery, matrix effect and stability have also met the requirements.ConclusionThe developed UPLC-MS/MS method for simultaneous determination of DEZ, MDZ and 1-OH-MDZ in beagles plasma was accurate, reproducible, specific, and suitable. DEX could inhibit the metabolism of DEZ and MDZ and increase the exposure of DEZ and MDZ in beagles. Therefore, the change of therapeutic effect and the occurrence of adverse reactions caused by drug–drug interaction should be paid attention to when the drugs were used in combination.

Is dezocine effective and safe in preventing opioids-induced cough during general anaesthesia induction? A protocol for systematic review and meta-analysis

IntroductionCough is often observed when administrating a bolus of opioids. Opioid-induced cough (OIC) is mostly transient, benign and self-limiting, but could be associated with adverse effects. Numerous pharmacological and non-pharmacological...

Effect of chronic alcohol intake on postoperative analgesia in cancer patients: a large sample, retrospective analysis

Objective To evaluate the effect of chronic alcohol intake on postoperative analgesia in cancer patients. Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ male patients, aged ≥18 yr, underwent postoperative intelligentized patient-controlled analgesia management from January 1, 2016 to October 22, 2018, searched from wireless analgesia management system database, were selected.The patients were divided into control group and chronic alcoholic intake group according to the history of chronic alcoholic intake.Combined intravenous-inhalational anesthesia was used during surgery.Patient-controlled intravenous or subcutaneous analgesia was performed with sufentanil.When moderate pain occurred (4 points≤numeric rating scale score≤6 points), the parameters of analgesia pump was regulated for rescue analgesia.When severe pain occurred (numeric rating scale score at rest or during activity≥7 points), dezocine 0.5 mg was intravenously injected as rescue analgesic.The effective pressing times, the number of attempts, consumption of sufentanil and occurrence of moderate or severe pain were recorded.The adverse reactions such as nausea and vomiting, pruritus, dizziness and hypotension were also recorded. Results A total of 1 914 patients were enrolled in this study, with 1 508 cases in control group and 406 cases in chronic alcoholic intake group.Compared with control group, the effective pressing times, the number of attempts, consumption of sufentanil and incidence of moderate or severe pain were increased (P<0.05), and no significant change was found in the incidence of nausea and vomiting, pruritus, dizziness or hypotension in chronic alcoholic intake group (P<0.05). Conclusion Chronic alcohol intake can decrease the efficacy of postoperative analgesia in cancer patients. Key words: Alcohol drinking; Pain, postoperative; Analgesia, patient-controlled

Clinical application of ultrasound-guided fascia iliaca compartment block and proximal popliteal sciatic nerve block on patients undergoing total knee arthroplasty

Objective To observe the application of ultrasound-guided fascia iliaca compartment block(FICB) and proximal popliteal sciatic nerve block(PPSNB) on patients undergoing total knee arthroplasty. Methods From January 2015 to January 2018, 60 patients scheduled for total knee arthroplasty undergoing laryngeal mask airway(LMA) general anesthesia in the People′s Hospital of Langfang were divided into three groups by the random number table, with 20 cases in each group.Before general anesthesia, every patient received dezocine 5mg iv, group A received FICB, group B received FICB combined with PPSNB(extraparaneural), group C received FICB combined with PPSNB(subparaneural).40mL of 0.375% ropivacaine was injected guiding by ultrasound.The dosage of propofol and remifentanil, time of awake, awake visual analogue scale(VAS), mean arterial blood pressure(MAP) and heart rate(HR) at pre-block(T1), LMA insert(T2), skin incision(T3), femoral bone cutting(T4), LMA remove(T5), and awake stage(T6) were recorded.The incidence of using vasoactive drugs and adverse reaction were also recorded. Results The dosage of propofol and remifentanil, the time of awake and awake VAS in group A, group B and group C were: group A (768.0±8.5)mg, (977±21)μg, (18.4±2.1)min, (4.2±0.7)points; group B (554.0±7.1)mg, (775±12)μg, (12.3±1.6)min, (2.4±0.6)points; group C (530±8.2)mg, (738±15)μg, (11.8±1.7)min, (1.3±0.5)points.The dosage of propofol and remifentanil, time of awake, awake VAS in group B and group C were significantly lower than those in group A (F=29.23, 42.56, 32.42, 19.31, all P<0.05). The awake VAS in group C was lower than that in group B (q=8.12, P<0.05). MAP and HR at T2, T3, T4, T5 and T6 in group B or group C were significantly lower than those in group A (MAP: F=85.66, 78.46, 86.04, 62.75, 61.31; HR: F=26.03, 42.75, 38.04, 29.31, 31.50, all P<0.05). The number of patients who required vasoactive drugs and adverse reaction in group B or group C were significantly lower than those in group A (χ2=11.32, 12.81, 15.24, 15.24, 10.15, all P<0.05). The incidence rates of incision pain at awake stage in group A, group B and group C were: group A(30%), group B(20%), group C(0%), that in group C was lower than group B (χ2=9.87, P<0.05). Conclusion The ultrasound-guided FICB and PPSNB(subparaneural) can obviously reduce the dosage of general anaesthetic and maintain the stability of hemodynamics in patients undergoing total knee arthroplasty.It has effective analgesia and less adverse reactions during sober. Key words: Ultrasonography; Anesthesia and analgesia; Neuromuscular blockade; Arthroplasty, replacement, knee; Comparative study

Effect of dezocine preemptive analgesia in the reconstruction of nasal bone fracture

Objective To explore the safety and efficacy of dezocine preemptive analgesia in the reconstruction of nasal bone fracture. Methods From September 2016 to May 2018, 63 patients with simple nasal bone fracture admitted to the 908th Hospital of PLA Joint Logistics Support Force were selected in the study.The patients were divided into two groups by random number table method: dezocine group(n=32) and control group(n=31). The dezocine group was injected with dezocine before surgery, while the control group was injected with 0.9% sodium chloride solution.The differences of MAP, HR, SpO2 at different time points between the two groups were observed.And the difference of VAS/RSS during operation and 2 hours after surgery were also observed. Results There were no statistically significant differences in MAP, HR and SpO2 between the two groups at different time points(10 min before and 10 min after intramuscular injection) (all P>0.05). During operation and 20 min after operation, the MAP values of the control group were (110.1±16.38)mmHg and (105.28±14.81)mmHg, respectively, which were higher than those of the dezocine group [(102.35±14.25)mmHg and (101.25±13.12)mmHg)], the differences were statistically significant(t=2.259, 2.153, all P 0.05). The HR in the control group during operation and at 20min after operation were (90.81±19.52)times/min, (77.25±18.25)times/min, respectively, which were faster than those in the dezocine group [(85.16±17.25)times/min, (71.36±16.15)times/min], the differences were statistically significant(t=2.074, 2.047, all P 0.05). In the surgery, the RSS score of dezocine group[(4.3±0.6)points] was better than that in control group[(2.1±0.4)points], the difference was statistically significant(t=17.008, P<0.05). The VAS scores in the control group during operation and 20 min after operation were (2.3±0.5)points, (1.5±0.8)points, respectively, , which were lower than those in the control group [(5.5±0.7)points, (2.1±0.6)points](t=20.572, 3.277, all P<0.05). Conclusion Application of dezocine preemptive analgesia in the reconstruction of nasal bone fracture is effective and safe, the hemodynamics is stable and the analgesic effect is definite in the surgery. Key words: Nasal bone; Fractures, bone; Fracture reduction; Preanesthetic medication; Anesthesia and analgesia; Dezocine; Hemodynamics; Comparative study

Evaluation of ultrasound-guided continuous anterior quadratus lumborum block on postoperative analgesia in total hip arthroplasty

Objective To evaluate the effect of ultrasound-guided continuous anterior quadratus lumborum block (QLB) on postoperative analgesia in total hip arthroplasty. Methods Fifty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 65-80 yr, weighing 45-80 kg, scheduled for elective total hip arthroplasty under subarachnoid block, were divided into 2 groups (n=25 each) using a random number table method: ultrasound-guided continuous anterior quadratus lumborum block group (group Q) and routine analgesia group (group R). Anterior QLB was performed at the end of operation in group Q. Patient-controlled intravenous analgesia was performed with sufentanil after operation in two groups.Dezocine was given as rescue analgesic.Ramsay sedation score and the maximum angle for hip flexion and abduction of hip joint were recorded after operation, and the total consumption of sufentanil, requirement for dezocine and occurrence of adverse reactions were recorded within 72 h after operation.The occurrence of QLB-related complications was also recorded. Results Compared with group R, Ramsay sedation score was significantly decreased and the maximum angle for hip flexion and abduction of hip joint were increased at each time point after operation, and the total consumption of sufentanil, requirement for dezocine and incidence of nausea and vomiting were decreased in group Q (P<0.05). No QLB-related complications were found in group Q. Conclusion Ultrasound-guided continuous anterior QLB can produce better postoperative analgesia and reduce postoperative consumption of opioids with fewer adverse reactions in the patients undergoing total hip arthroplasty. Key words: Ultrasonography; Psoas muscles; Nerve block; Arthroplasty, replacement, hip; Analgesia, patient-controlled

Risk factors for postoperative fatigue syndrome in out-patients with painless colonoscopy

Objective To identify the risk factors for postoperative fatigue syndrome (POFS) in out-patients with painless colonoscopy. Methods The out-patients received painless colonoscopy from October 2016 to February 2017 in Northern Jiangsu People′s Hospital were selected.The possible factors related to POFS, such as general situation, present history and past history, intraoperative conditions, postoperative diagnosis, were summarized by reviewing the relevant literature.The questionnaires were completed by preoperative interview, filling in questionnaires by doctors during operation, interview before leaving the hospital, and follow-up phone calls.POFS occurrence and initial fatigue scale and duration were evaluated.The patients were divided into POFS group (group Ⅰ) and non-POFS group (group Ⅱ) according to whether POFS occurred.The risk factors of which P values were less than 0.05 would enter the multivariable logistic regression analysis to stratify the risk factors. Results Four hundred and forty-one patients were enrolled in this study, 129 cases developed POFS, and the incidence was 29.2%.Using dezocine and higher percentage of change in heart rate were the risk factors for POFS, and male and appropriately prolonging the waiting time on the day of examination were the protective factors for POFS. Conclusion Using dezocine and higher percentage of change in heart rate are the risk factors for POFS, and male and appropriately prolonging the waiting time on the day of examination are the protective factors for POFS in out-patients with painless colonoscopy. Key words: Colonoscopy; Postoperative complications; Fatigue Syndrome, chronic; Risk factors

Clinical application of ultrasound-guided femoral nerve and popliteal sciatic nerve block in patients undergoing foot and ankle surgery

Objective To observe the application of ultrasound-guided femoral nerve block(FNB) and popliteal sciatic nerve block(PSNB) in patients undergoing foot and ankle surgery. Methods From August 2015 to August 2017, 60 patients scheduled for foot and ankle surgery undergoing laryngeal mask airway (LMA) general anesthesia in the People′s Hospital of Langfang were randomly divided into 3 groups by the random number table, with 20 cases in each group.Before transfer patients from bed to operating table, A group received dezocine 5 mg iv, B group received FNB combined with PSNB(distal to the sciatic nerve bifurcation), C group received FNB combined with PSNB(proximal to the sciatic nerve bifurcation). A total of 40 mL of 0.375% ropivacaine were injected guided by ultrasound in B group and C group.The time of sufficient sensory block and awake, the dosage of remifentanil and propofol were recorded.Pain was assessed using visual analogue scale (VAS) pre- and post block.The incidence of sleepiness, postoperative nausea and vomiting (PONV), agitation, pain and adverse reaction were also recorded. Results The time of sufficient sensory block and awake, the dosage of remifentanil and propofol in A, B and C group: A group(not measured), (21.6±1.6)min, (1183±17)μg, (665.0±6.7)mg; B group (25.5±2.5)min, (15.3±1.4)min, (635±16)μg, (455.0±6.5)mg; C group (19.6±2.3)min, (14.9±1.5)min, (598±14)μg, (438.0±9.9)mg.The time of awake, the dosage of remifentanil and propofol in B group and C group were significantly lower than those in A group (F=44.07, 52.41, 62.45, all P<0.05). The time of sufficient sensory block in C group was lower than that in B group(t=15.69, P<0.05). The VAS scores at T2, T3 and T4 in A, B and C group: A group (4.5±0.6)point, (8.4±0.5)point, (6.1±0.9)point; B group (2.6±0.5)point, (3.9±0.3)point, (2.4±0.6)point; C group (2.5±0.4)point, (2.3±0.5)point, (1.1±0.5)point.The VAS scores in B group or C group were significantly lower than those in A group (F=52.36, 72.82, 75.41, all P<0.05). The VAS scores at T3 and T4 in C group were significantly lower than those in B group (t=18.42, q=14.55, all P<0.05). The incidence rates of sleepiness, PONV, agitation and incision pain in A, B and C group: A group (25%, 25%, 15%, 15%, 50%); B group(0%, 5%, 0%, 0%, 10%); C group(0%, 5%, 0%, 0%, 0%). The number of patients who had adverse reactions in B or C group were significantly lower than those in A group (χ2=8.51, 8.73, 10.11, 10.11, 9.69, all P<0.05). The incidence rate of incision pain at sober in C group was lower than that in B group(χ2=10.89, P<0.05). Conclusion The ultrasound-guided FNB and PSNB(proximal to the sciatic nerve bifurcation) can obviously shorten the onset time, reduce the dosage of general anaesthetic.It has effective analgesia during transfer of patients from bed to operating table and sober. Key words: Ultrasound; Femoral nerve block(FNB); Popliteal sciatic nerve block(PSNB); Foot and ankle surgery; Laryngeal mask airway(LMA); Distal popliteal sciatic nerve block; Proximal popliteal sciatic nerve block; Ropivacaine

Effect of propofol combined with different analgesic drugs on painless induced abortion and its effect on body motion

Objective To compare the effects of propofol combined with fentanyl or dezocine on painless abortion and the influence on body movement. Methods From July 2016 to May 2017, 240 patients with voluntary painless abortion who aged 19-45 years old in the Second People's Hospital of Linhai, were randomly divided into 3 groups according to the digital table, with 80 cases in each group.D group was given propofol and dezocine; F group was given propofol combined with fentanyl; C group was the control group and was treated with propofol intravenous anesthesia, the three groups were given propofol added according to the specific situation.The operative time, recovery time and the total amount of propofol were compared among the three groups; and the pain visual analogue scale(VAS) at 0min, 15min, 30min, 1h, 3h were comparedamong the three groups; The incidence of respiratory depression and other adverse reactions were statistically analyzed in three groups. Results The operation time, recovery time, the total dosage of propofol in D group were (4.5±0.7)min, (1.2±0.3)min and (136.8±14.5)mg, respectively, which in F group were (4.6±0.8)min, (1.3±0.2)min and (139.6±12.1)mg, respectively, there were no statistically significant differences between the two groups (all P>0.05). The recovery time and total dosage of propofol in D group and F group were lower than those of C group[(2.4±0.6) min, (168.7±18.9) mg](t=25.298, 27.287, 11.977, 27.287, all P<0.05). The VAS scores at postoperative 0min, 15min, 30min, 1h, 3h in D group were lower than those in F group and group (t=34.785, 25.044, 25.043, 22.349, 28.622, 48.809, 42.278, 40.000, 42.278, 40.000, all P<0.05). The VAS scores at postoperative 0min, 15min, 30min, 1h in F group were lower than those of C group(t=36.978, 24.406, 19.846, 24.406, all P<0.05). The incidence rates of nausea, sedentary, respiratory depression, hypotension in D group were 1.3%(1case), 2.5%(2cases), 1.3%(1case), 0.0%(0cases), resperctively, which in F group were 0.0%(0cases), 3.8%(3cases), 3.8%(3cases), 2.5%(2cases), which in D group, F group were lower than those in C group [6.3%(5cases), 16.3%(13cases), 11.3%(9cases), 15.0%(12cases)](χ2=3.925, 3.657, 3.925, 3.657, 5.889, 3.152, 3.152, 3.657, all P<0.05). Conclusion Propofol combined with dezocine and fentanyl used in painless abortion have good effect, and the body movement is less, but propofol combined with dezocine has less postoperative pain degree. Key words: Anesthesia and analgesia; Abortion, induced; Propofol

The analgesic effect of ultrasound guided fascia iliaca compartment block on postural changes in patients with the femoral neck fracture

Objective To observe the analgesic effect of ultrasound guided fascia iliaca compartment block on postural changes in patients with the femoral neck fracture. Methods From January 2017 to November 2017, 60 patients with femoral neck fracture of American Society of Anesthesiologists(ASA) anesthesia grade Ⅱ-Ⅲ undergoing elective surgery in the Hospital of Yanqing District were selected, and they were divided into the ultrasound guided fascia iliaca compartment block group(F group) and the intravenous dezocine analgesia group(D group) according to the random number table, with 30 cases in each group.The F group received ultrasound guided fascia iliaca compartment block with 30 mL 0.45% ropivacaine mesylate, 30 min before entering the operating room.The D group received intravenous injection of dezocine 0.1 mg/kg, 10 min before entering the operating room.The VAS scores were recorded at entered the operating room(T1), overing the bed (T2), the position for intraspinal anesthesia(T3), and the occurrence of adverse reactions were observed. Results The VAS scores of the F group at T1, T2, T3 were lower than those of the D group[(2.07±0.52)points vs.(2.90±0.80)points, t=4.77, (2.80±0.61)points vs.(3.83±0.59)points, t=6.66, (3.83±0.65)points vs.(5.27±0.58)points, t=9.01], the differences were statistically significant(all P=0.00). There were no complications such as puncture site hematoma and local anesthetic toxicity in the F group.There were 8 dizziness patients (26.67%) and 4 nausea patients (13.33%) in the D group. Conclusion The analgesic effect of ultrasound guided fascia iliaca compartment block relative to intravenous drug on postural changes in patients with the femoral neck fracture is more obvious and has less adverse reactions, and it is suitable for clinical use. Key words: Femoral neck fractures; Nerve block; Ultrasonography; Analgesia

Effect of multimodal analgesia with diclofenac sodium on cognitive function following radical resection for colon cancer in elderly patients

Objective To evaluate the effect of multimodal analgesia with diclofenac sodium on cognitive function following radical resection for colon cancer in elderly patients. Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of either sex, aged 65-80 yr, weighing 45-85 kg, scheduled for elective open sigmoidectomy under general anesthesia, were divided into control group and test group by a random number table method with 30 patients in each group.In test group, diclofenac sodium suppository was administrated rectally before surgery and placed at about 2 to 3 cm above the anal dentate line, diclofenac sodium suppository 50 mg was given at 2 h before surgery and 4 h after surgery, followed by administration once every 12 h until 2 days after surgery.Patient-controlled intravenous analgesia was performed after operation, dezocine 5 mg was intravenously injected when VAS score was more than 4 points within 48 h after surgery.The concentrations of serum interleukin-6 (IL-6), IL-8 and tumor necrosis factor-alpha (TNF-α) were measured by enzyme-linked immunosorbent assay before surgery (T0) and at 2, 6, 12, 24 and 48 h after surgery (T1-5). The postoperative requirement for rescue analgesia, postoperative analgesia satisfaction score, time of passing the first flatus and first postoperative off-bed time were recorded.Cognitive function was assessed at 1 day before surgery and 7 days after surgery, and the occurrence of postoperative cognitive dysfunction was recorded. Results Compared with control group, the serum concentrations of IL-6 at T2-5, IL-8 at T1-5 and TNF-α at T2-4 were significantly decreased, the requirement for rescue analgesia and incidence of postoperative cognitive dysfunction were decreased, and the time of passing the first flatus and first postoperative off-bed time were shortened in test group (P<0.05). Conclusion Diclofenac sodium for multimodal analgesia can improve cognitive function following radical resection for colon cancer in elderly patients. Key words: Diclofenac; Analgesia; Cognition disorders; Colonic neoplasms; Aged

Effect of thoracic approach to thoracic paravertebral blockade performed via video-assisted thoracoscope on postoperative analgesia in patients undergoing lobectomy

Objective To evaluate the efficacy of the thoracic approach to thoracic paravertebral blockade (PVB) performed via video-assisted thoracoscope on postoperative analgesia in patients undergoing lobectomy. Methods A total of 84 patients of both sexes, aged 44-64 yr, with body mass index of 19.7-24.9 kg/m2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective video-assisted thoracoscopic unilateral lobectomy, were divided into 2 groups (n=42 each) using a random number table method: thoracic PVB group (TP group) and control group (C group). In TP group, the thoracic approach to thoracic PVB was performed on the affected side via video-assisted thoracoscope before closing the chest, and 0.375% ropivacaine hydrochloride 20 ml was injected.Then patient-controlled intravenous analgesia (PCIA) was performed in both groups.PCIA solution contained dezocine 0.6 mg/kg, flurbiprofen axetil 200 mg, palonosetron 0.5 mg and dexamethasone 10 mg in 120 ml of normal saline.The PCA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml/h after a loading dose of 5 ml.Duration of operation was recorded.The peak expiratory flow rate (PEFR) was recorded before surgery and at 6, 24 and 48 h after surgery.The amount of dezocine and pressing times of PCA were recorded at 24 and 48 h after surgery.The occurrence of drowsiness, dizziness, nausea and vomiting was recorded after surgery.Tramadol 2 mg/kg was intravenously injected as rescue analgesic when visual analog scale score≥4 points. Results Compared with group C, the amount of dezocine and pressing times of PCA were significantly reduced at 24 and 48 h after surgery, the requirement for rescue analgesia and incidence of nausea and vomiting were decreased, and the PEFR was increased at 6 h after operation in group TP (P<0.05). Conclusion The thoracic approach to PVB performed via video-assisted thoracoscope can enhance the efficacy of postoperative analgesia in patients undergoing lobectomy. Key words: Nerve block; Pain, postoperative; Thoracoscopy

Application of continuous iliac fascial interstitial obstruction in the placement of anaesthesia in the vertebral canal of the elderly femoral fractures and postoperative analgesia

Objective To investigate the effect of continuous iliac fascia space block on the placement of body position and postoperative analgesia in patients with femoral fractures. Methods 60 patients with senile selective unilateral femoral fracture, aged 68-87 years old, weight 49-70kg, ASA grade II-III were selected, and they were randomly divided into iliac fascia block group (A group) and intravenous analgesia group (B group) according to the digital, 30 cases in each group.The two groups underwent lumbar epidural anesthesia, A group received continuous fascia iliaca compartment block 15 min before the the body position.B group was routinely given combination of lumbar and hard anesthesia.After operation, A group was connected with the automatic infusion pump continuous infusion of 0.2% ropivacaine 0.1mL·kg-1·h-1.B group received controlled intravenous analgesia, postoperative given loading dose of dezocine intravenous infusion of 5mg with automatic injection pump for dezocine 0.01mg·kg-1·h-1.When the patients entered the room (T0) and just after the placement of the body position (T1), the heart rate, diastolic blood pressure and systolic blood pressure were measured and recorded.At postoperative 2, 4, 6, 12, 24 and 48h, the VAS scores and pethidine usage during surgery, the adverse reaction were recorded. Results The heart rate, diastolic pressure and systolic pressure at T1 in A group had no significant change compared with T0 (all P>0.05). The heart rate, diastolic pressure and systolic pressure in the control group (B group) at T1 were significantly higher than at T0(t=5.302, 7.369, 5.629, all P<0.05). At T1, T2, T4, T6, T12, T24 and T48, the pain VAS scores in A group were lower than those in B group (t1=66.401, t2=7.719, t4=25.260, t6=13.170, t12=3.837, t24=3.081, t48=6.202.all P<0.05). The study group had no complications such as puncture hematoma, intoxication of local anesthetic and other complications. Conclusion Continuous iliofascial block can provide continuous analgesia for elderly patients with femoral fractures.It is safe and effective, and is easy to perform.It provides favorable conditions for later operative treatment. Key words: Iliac fascia space block; Femoral fracture; Elderly; Postoperative analgesia

Clinical study of propacetamol and dezocine for the prevention and treatment of vascular crisis in preemptive analgesia after digit replantation

Objective To explore the clinical effect of propacetamol and dezocine for the prevention and treatment of vascular crisis in the preemptive analgesia after digit replantation. Methods 85 cases of patients treated with digit replantation were selected for the study and divided into the propacetamol group (n=45) and the dezocine group (n=40) according to the different postoperative preemptive analgesic method. The two groups were given with propacetamol or dezocine and fentanyl and ondansetron patient-controlled intravenous analgesia (PCIA) respectively. The analgesic and sedative effects were observed between the two groups, and the occurrence of vascular embolism and vascular crisis and the survival rate of replantation were counted. Results There was no significant difference between the two groups in the visual analogue pain score (VAS) at 3 hours after operation (P<0.05). The VAS scores of the two groups were significantly increased at 6 h and 24 h after operation while the VAS score was significantly decreased at 48 h after operation (P<0.05), and the VAS scores were significantly lower in the propacetamol group than those in the dezocine group at 6 h, 24h and 48 h after operation (P<0.05). The difference of the Ramsay sedation scores distribution at 3 hours after operation was statistically significant between the two groups (P<0.05), and the sedative effect was more satisfactory in the propacetamol group. Within 48 h after operation, PCI effective times/actual sub values of the propacetamol group were significantly higher than the dezocine group (P<0.05). The incidence rates of postoperative vascular thrombosis and arterial or venous crisis were 4.44%, 6.67% and 6.67% respectively in the propacetamol group, which were significantly lower than those in the dezocine group with 20.00%, 22.50% and 27.50% (P<0.05). The survival rate of digit replantation, digit replantation at 6 months after treatment were 97.78%, 85.00% which was higher than that of the dezocine group with 91.11%, 75.00% (P<0.05). Conclusions Compared with dezocine, propacetamol can attain the ideal analgesic and sedative effects and improve the survival rate of replantation, which has a significant role in the prevention and treatment of vascular crisis in the adjuvant treatment of postoperative analgesia in digit replantation. Key words: Acetaminophen/AA; Acetaminophen/AD; Morphinans/AA; Morphinans/AD; Analgesia; Finger injuries/SU; Replantation; Vascular diseases/PC

Effect of ultrasound-guided quadratus lumborum block on efficacy of postoperative analgesia after caesarean section

Objective To evaluate the effect of ultrasound-guided quadratus lumborum block (QLB) on the efficacy of postoperative analgesia after caesarean section. Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ parturients, aged 20-39 yr, weighing 50-80 kg, scheduled for elective cesarean section under subarachnoid block, were divided into 2 groups (n=30 each) using a random number table: QLB group (group Q) and control group (group C). Ultrasound-guided bilateral QLBs were performed at the end of surgery, the solution was injected into the compartment between quadratus muscle and psoas major muscles, and 0.25% ropivacaine 1.25 mg/kg was injected to each side in group Q. The parturients in both groups received patient-controlled intravenous analgesia after surgery to maintain the visual analog scale score ≤ 3, and dezocine 5 mg was intramuscularly injected as a rescue analgesic when the visual analog scale score≥4.Bruggrmann comfort scale (BCS) and Ramsay sedation scores were evaluated at 2, 4, 6, 12, 24 and 48 h after operation.The consumption of sufentanil during patient-controlled intravenous analgesia, requirement for rescue analgesia, satisfaction score of analgesia, the number of successfully delivered doses (D1) and the number of attempts (D2) were recorded within 24 h after surgery.D1/D2 was calculated.The development of respiratory depression and over-sedation was recorded.The development of QLB-related adverse reactions and postoperative nausea, vomiting, chest tightness and pruritus was also recorded. Results Compared with group C, BCS scores were significantly increased, the consumption of sufentanil was reduced, D1/D2 was increased, the requirement for rescue analgesia was decreased, and the satisfaction score of analgesia was increased (P 0.05). Adverse reactions such as respiratory depression, over-sedation, nausea, vomiting, chest tightness and pruritus were not found in two groups.Adverse reactions such as hematoma and infection at the puncture site or local anesthetic intoxication were not observed after surgery in group Q. Conclusion Ultrasound-guided QLB can enhance the efficacy of postoperative analgesia after caesarean section, reduce postoperative consumption of opioids and raise the comfort degree for parturients. Key words: Ultrasonography; Psoas muscles; Neuromuscular blockade; Cesarean section; Analgesia, patient-controlled