Postoperative Adverse Reactions Research Articles

Efficacy and safety of Extrapleural block in patients with coronary artery disease after thoracoscopic surgery.

This study aimed to investigate the efficacy and safety of extrapleural block (EPB) application in patients with coronary artery disease after thoracoscopic surgery. Patients with typical symptoms of angina and myocardial ischemia who underwent thoracoscopic surgery at our institution between December 2018 and December 2020 were screened for eligibility and they received paravertebral blocking (PVB), EPB, and patient-controlled intravenous analgesia (PCIA). Visual analog scale (VAS) scores were used to assess the analgesic effect and safety outcomes included heart rate, incidence of postoperative rescue analgesics, cardiac complications, and adverse reactions such as nausea and vomiting. In total, 76 patients (age: 66.5 [61.3, 71] years; male: 63.2%) were eligible, including the PVB group (n=22), EPB group (n=25), and PVIA group (n=29) with comparable baseline characteristics. There was a significantly higher proportion of patients with a VAS score of 1 in the EPB group compared with the other groups at 4 h (88.0% vs. 10.3% for PCIA and 45.5% for PVB; p < .001) and 6h after the surgery (32.0% vs. 3.4% for PCIA and 13.6% for PVB; p=.012). The preoperative heart rate in the EPB group (81 [71, 94] beats/min) was slightly higher than those in the PVB (76 [70, 85] beats/min) and PCIA groups (76 [69, 84 beats/min]) but without significant difference (p=.193). There was no significant difference in the incidence of rescue analgesia, adverse events, and cardiac complications among the three groups (p=.296, .808, and .669, respectively.) CONCLUSION: Compared with PVB and PCIA, the EPB could more effectively relieve acute pain after thoracoscopic surgery in patients with coronary artery disease and offer comparable safety benefits in the management of postoperative heart rate, adverse events, and cardiac complications.

Combined acupuncture-medicine anesthesia used in thyroid surgery: A systematic review and meta-analysis.

Combined acupuncture-medicine anesthesia (CAMA) is extensively used in thyroid surgery in China. We conducted a systematic review and meta-analysis to assess the efficacy and safety of CAMA. We searched the China National Knowledge Infrastructure (CNKI), VIP database, WanFang database, PubMed, EMBASE, and the Cochrane Library for relevant literature. The term of literature was published before April 18, 2020, and there were no restrictions on publication language, region, or publication year. The inclusion criteria included a randomized controlled trial (RCT) of acupuncture combined with cervical plexus anesthesia. We used RevMan5.3 software for data analysis. If the chi-square test showed no significant heterogeneity (P > .10, I2 < 50%), we used the fixed-effect model to calculate risk ratio (RR) and mean difference. Otherwise, the random-effects model was used. Overall, 18 RCTs involving 1211 patients were included in the study. The anesthesia significant rate (ASR) in the transcutaneous electrical acupoint stimulation (TEAS) plus cervical plexus block anesthesia (CPBA) and electroacupuncture (EA) plus CPBA groups was significantly higher compared with the CPBA group (TEAS + CPBA: P < .001; EA + CPBA: P < .001). The pooled effect values of the intraoperative heart rate (HR) and mean arterial pressure (MAP) were significantly lower in both the TEAS + CPBA and EA + CPBA groups relative to the control group (HR: P = .05, P < .001; the MAP: P = .002, P < .001; respectively). Moreover, the postoperative adverse reaction was markedly lower in the experimental group than in the control group (RR = 0.30, P < .001), and there was no heterogeneity between the two groups (P = .71, I2 = 0%). Combined acupuncture-medicine anesthesia significantly increases the anesthesia significance rate, reduces the intraoperative heart rate, and blood pressure, and reduces the incidence of postoperative adverse reactions. However, more high-quality future studies should be conducted to validate the efficacy and safety of acupuncture combined anesthesia further.

Effects of oxycodone hydrochloride and dezocine on hemodynamics and levels of inflammatory factors in patients receiving gynecological laparoscopic surgery under general anesthesia

We aimed to compare the effects of oxycodone hydrochloride and dezocine on hemodynamics and inflammatory factors in patients receiving gynecological laparoscopic surgery under general anesthesia. A total of 246 patients were divided into group A and B (n=123). Hemorheology indices were recorded 5 min after anesthesia (T0), 1 min after pneumoperitoneum (T1), when position was changed 5 min after pneumoperitoneum (T2), 15 min after pneumoperitoneum (T3), 1 min (T4) and 5 min (T5) after position was restored. Visual analogue scale scores 1, 2, 6, 12, 24 and 48 h after operation were recorded. Postoperative adverse reactions and visceral pain were observed. The expression levels of inflammatory factors were detected by enzyme-linked immunosorbent assay 12 h after operation. Compared with group A, group B had higher heart rate and mean arterial pressure at T2, lower central venous pressure and cardiac output at T1-T3, and higher systemic vascular resistance at T1-T5 (P<0.05). The incidence rate of pain syndrome in group A was lower (P<0.05). Group A had lower tumor necrosis factor-alpha and interleukin-6 expression levels and higher interleukin-10 level than those of group B (P<0.05). For gynecological laparoscopic surgery, oxycodone preemptive analgesia has superior outcomes to those of dezocine.

Retracted: Effect of Hysteroscopic Polypectomy Combined with Mirena Placement on Postoperative Adverse Reactions and Recurrence Rate of Endometrial Polyps: Based on a Large-Sample, Single-Center, Retrospective Cohort Study.

[This retracts the article DOI: 10.1155/2022/1232495.].

Meta-Analysis of Ultrasound Guided Posterior Lamina Block and Erector Spinae Muscles Plane Block for Postoperative Analgesia and Adverse Reactions in Orthopedic Surgery

Meta-Analysis of Ultrasound Guided Posterior Lamina Block and Erector Spinae Muscles Plane Block for Postoperative Analgesia and Adverse Reactions in Orthopedic Surgery

Nutrition management by a multidisciplinary team for prevention of nutritional deficits and morbidity following esophagectomy

This study evaluated the effects of perioperative nutrition management by a multidisciplinary team on nutrition and postoperative complications of patients with esophageal cancer. A total of 239 patients with esophageal cancer who underwent esophagectomy and gastric conduit reconstruction for esophageal or esophagogastric junction cancer between February 2019 and February 2020 were included in the study. They were divided into the experimental group (120 patients) and the control group (119 patients) using the random number table method. Control group patients received routine diet management and experimental group patients received perioperative nutrition management by a multidisciplinary team. The differences of nutriture and postoperative complications between the two groups were compared. At 3 and 7 days after surgery, the experimental group patients had higher total protein and albumin levels (P<0.05), shorter postoperative anal exhaust time (P<0.05), lower incidence of postoperative gastrointestinal adverse reactions, pneumonia, anastomotic fistula, hypoproteinemia (P<0.05), and lower hospitalization costs (P<0.05) than the control group. Nutrition management by a multidisciplinary team effectively improved the nutriture of patients, promoted the rapid recovery of postoperative gastrointestinal function, reduced postoperative complications, and reduced hospitalization costs.

Meta analysis of ultrasound-guided posterior and paravertebral block for postoperative analgesia and adverse reactions in thoracic surgery

Meta analysis of ultrasound-guided posterior and paravertebral block for postoperative analgesia and adverse reactions in thoracic surgery

Effect of Dexmedetomidine Combined with Dezocine for Cervical Plexus Block in Thyroid Surgery

This study mainly explores the clinical effects of dexmedetomidine and dezocine assisted ultrasound-guided nerve block in thyroid surgery. The data from a total of 72 patients who underwent thyroid surgery in our hospital were analyzed. All patients were given ultrasound-guided cervical plexus block anesthesia and divided into three groups. Group A (n=20) and group B (n=22) received dexmedetomidine and dezocine assisted anesthesia respectively, and group C (n=30) was given dexmedetomidine plus dezocine assisted anesthesia. Anesthesia time, operation time and other clinical indicators were compared among the three groups. The results showed that at 12 h and 24 h, group C had a lower degree of pain than groups A and B. The postoperative comfort score of group C was higher compared to groups A and B. The incidence of postoperative adverse reactions reported was lower in group C compared with the other two groups. The above outcomes shows that the combined use of dexmedetomidine and dezocine in ultrasound-guided assisted nerve block during thyroid surgery contributes to better clinical efficacy compared with their single use.

Effect of Dexmedetomidine on Recovery from Anesthesia in Gynecologic Laparoscopic Surgery

To evaluate the effect of dexmedetomidine on patient recovery from anesthesia in gynecologic laparoscopic surgery. A total of 74 patients who underwent gynecological laparoscopic surgery in our hospital between January 2020 and March 2022 were recruited and assigned via random method to receive either 0.6 μg/ kg of saline (observation group) or 0.6 μg/kg of dexmedetomidine (experimental group) before anesthesia induction during gynecologic laparoscopic surgery, with 37 cases in each group. Outcome measures included postoperative indices (recovery time, awakening time, orientation recovery time and extubation time), Ramsay scores, hemodynamic indices (heart rate, mean arterial pressure, pulse oximetry) at different time points and postoperative adverse events. Dexmedetomidine resulted in significantly shorter respiratory recovery time, awakening time, orientation recovery time and extubation time vs. control treatment (p<0.05). The Ramsay scores in the experimental group were significantly higher than those in the observation group (p<0.05) after treatment. Patients receiving dexmedetomidine showed lower heart rate and mean arterial pressure levels and higher pulse oximetry levels at extubation and 15 min after extubation than the controls (p<0.05). The incidence of postoperative adverse reactions in the experimental group was significantly lower than that in the observation group (p<0.05). Dexmedetomidine effectively shortens the recovery time of respiration, awakening time, recovery time of orientation and extubation time in patients undergoing gynecological laparoscopy and maintains the hemodynamic stability of the body without increasing the risk of postoperative adverse events in patients.

Protective Efficiency Comparison of Direct and Remote Ischemic Preconditioning on Ischemia Reperfusion Injury of the Liver in Patients Undergoing Partial Hepatectomy.

Ischemia reperfusion injury greatly damages liver function and deteriorates the prognosis of patients undergoing partial hepatectomy. This study is to compare the protective efficiency of direct and remote ischemic preconditioning (DIPC and RIPC) on ischemia reperfusion injury of the liver in patients undergoing partial hepatectomy. 90 patients scheduled for partial hepatectomy were enrolled and randomly divided into control (n = 30), DIPC (n = 30), and RIPC (n = 30) groups. Baseline and surgery characteristics were collected, and ischemic preconditioning methods were carried out. Intraoperative hemodynamics, liver function and liver reserve capacity, oxidative stress, and inflammatory responses were measured, and the incidence of postoperative adverse reactions was calculated finally. 10 patients were excluded from the study, and finally, the eligible patients in three groups were 27, 28, and 25, separately. No significant differences were observed in baseline and surgery characteristics among the three groups. SBP and DBP were significantly higher after hepatic portal vein occlusion while they were significantly lower after surgery in the DIPC and RIPC groups compared with that in the control group, SBP and DBP were of great fluctuation at different time points in the control group while they showed much more stabilization in the DIPC and RIPC groups. ALT, AST, and TBIL were significantly decreased on days 1, 3, and 5 after surgery, and ICG R15 was significantly decreased while ICG K value and EHBF were significantly increased on day 1 after surgery in the DIPC and RIPC groups compared with that in the control group. Moreover, antioxidant enzyme SOD was increased, and inflammatory factors TNF-α and IL-1β were decreased 24 hours after surgery in the DIPC and RIPC groups compared with that in the control group. DIPC and RIPC also decreased hospital stays and the incidence of nausea, vomiting, and hypertension. DIPC and RIPC both alleviated ischemia reperfusion injury of the liver and reduced perioperative complications with similar protective efficiency in patients undergoing partial hepatectomy.

The efficacy of cryogenic plasma tonsillectomy in the treatment of obstructive sleep apnea-hypopnea syndrome in children: A meta-analysis.

Obstructive sleep apnea hypopnea syndrome (OSAHS) refers to the apnea and hypopnea caused by partial or complete obstruction of the upper airway collapse during sleep. The cryogenic plasma tonsillectomy is mostly used for the clinical treatment of children with OSAHS. The objective of this meta-analysis is to investigate the clinical efficacy of cryogenic plasma tonsillectomy for OSAHS in children. The literature search was conducted through China National Knowledge Infrastructure (CNKI), Wanfang Database, Embase, PubMed, and Web of Science databases. The search was from the establishment of each database to June 2022. Randomized controlled trials (RCTs) meeting the criteria for partial/total cryo-plasma tonsillectomy for treating patients with obstructive sleep apnea-hypopnea syndrome in children were included, with data extracted. The meta-analysis was performed using the Stata 16.0 and Review Manager 5.4. Seven RCTs were included in this study. The results showed that the partial/complete cryo-plasma tonsillectomy in the experimental group had a better therapeutical effective rate than the control group of patients treated with conventional surgery [Odds ratio (OR) = 2.181, 95% CI: 1.306-3.645, P < 0.05]. Also, in terms of postoperative adverse reactions, the number of adverse reactions in the experimental group was significantly lower than in the control group (OR = 0.445, 95% CI: 0.287-0.689, P = 0.001). The analysis of surgical efficacy showed that the operative time, intraoperative blood loss, and postoperative pain score were all significantly lower than those of the control group. Furthermore, further analysis of the apnea-hypopnea index (AHI) and the lowest oxygen saturation (LSaO2) of the two groups showed that the cryo-plasma tonsillectomy treatment had higher LSaO2 levels than conventional treatment [Standardized mean difference (SMD) = 0.380, 95% CI: 0.094-0.667, P = 0.009]. The application of cryo-plasma tonsillectomy can significantly improve the treatment effect of OSAHS, reducing adverse reactions.

Evaluation of short-term effects of drug-loaded microspheres and traditional transcatheter arterial chemoembolization in the treatment of advanced liver cancer.

Liver cancer is a malignant tumor with high morbidity and mortality. Transcatheter arterial chemoembolization (TACE) is the main method for surgically unresectable liver cancer. In recent years, drug-loaded microspheres have been gradually applied in TACE technology. There are some controversies about the therapeutic effects of drug-loaded microspheres TACE (D-TACE) and traditional TACE. To explore the short-term efficacy of D-TACE and traditional TACE in the treatment of advanced liver cancer. The clinical data of 73 patients with advanced liver cancer admitted to the First and Sixth Medical Centers of Chinese PLA General Hospital from January 2017 to October 2019 were retrospectively analyzed. Among them, 15 patients were treated with D-TACE, and 58 patients were treated with traditional TACE. Clinical baseline characteristics, perioperative laboratory indices, postoperative adverse reactions and postoperative complications were compared between the two groups. There was no statistical difference between the two groups for the postoperative response: The highest postoperative body temperature of the drug-loaded microsphere group was 38.0 ± 0.9℃ and the postoperative highest body temperature of the traditional TACE group was 38.3 ± 0.7℃ (t = -1.414, P = 0.162). For the 24 h postoperative nausea and vomiting after surgery in terms of scoring and postoperative pain scores, the traditional TACE group was higher than the drug-loaded microsphere group (χ 2 = 14.33, P = 0.014; χ 2 = 32.967, P = 0.000) and the two groups had significant statistical differences. The disease control rate at 3 mo after treatment in the drug-loaded microsphere group was 60% and the disease control rate at 3 mo after treatment in the traditional TACE group was 75.9% (χ 2 = 4.091, P = 0.252). There was no statistical difference between the two groups of data. During the follow-up period, the number of interventional treatments received was once in the drug-loaded microsphere group and the traditional TACE group received an average of 1.48 treatments (χ 2 = 10.444 P = 0.005). There was a statistical difference between the two groups. Compared with traditional TACE, D-TACE may have some advantages in the treatment of advanced hepatocellular carcinoma with a large tumor load in the short term, but the long-term clinical efficacy needs additional follow-up studies. In addition, compared with the traditional group, the patients in the drug-loaded microsphere group had better subjective tolerance and could reduce the number of interventional treatments. Therefore, D-TACE is worthy of clinical promotion.

Retracted: Effect of Stellate Ganglion Block Combined with Lidocaine at Different Concentrations for Preemptive Analgesia on Postoperative Pain Relief and Adverse Reactions of Patients Undergoing Laparoscopic Cholecystectomy.

[This retracts the article DOI: 10.1155/2022/6027093.].

Dynamic Incision under Nasal Endoscope and Low-Temperature Plasma Radiofrequency Ablation for Nasal Inverted Papilloma: An Analysis of Differences in Efficacy and the Destructive Effect on Immune Function.

Methods NIP patients (n = 106) admitted between January 2020 and March 2021 were selected and grouped as follows according to the random number table method: a dissection group treated with dynamical-system surgery under nasal endoscope and an ablation group treated with LTPRA. The clinical curative effects of the two procedures were compared, and the related indexes (operation time (OT), intraoperative blood loss (IBL), and length of stay (LOS)) and postoperative adverse reactions (ARs) were counted. In addition, fasting venous blood samples were collected before treatment (T0), as well as 3 (T1) and 7 days after treatment (T2) to detect inflammatory factors (IFs; C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)) and T lymphocyte subsets (CD3+, CD4+, and CD8+). Finally, all patients received a one-year follow-up to compare the differences in prognostic survival rate and disease recurrence rate between groups. Results The ablation group has a similar LOS to the dissection group (P > 0.05), but lower OT and IBL. No marked difference was observed between groups in terms of the total effective rate (P > 0.05), but the adverse reaction rate was higher in the dissection group compared with the ablation group (P < 0.05). Compared with T0, elevated CRP, IL-6, TNF-α, and CD3+ were observed in both cohorts at T1, with lower levels in the ablation group as compared to the dissection group, while CD4+ and CD8+ decreased in both cohorts and were higher in the ablation group (P < 0.05). Meanwhile, the levels of CRP, IL-6, TNF-α, and CD3+ in both groups were lower at T2 compared to T1, whereas those of CD4+ and CD8+ in both groups were higher at T2 compared to T1 (P < 0.05). As indicated by the statistics on prognostic follow-up, the two cohorts of patients showed no evident difference in the 1-year survival rate and disease recurrence rate (P > 0.05). Conclusions Both dynamical-system surgery under nasal endoscope and LTPRA have good therapeutic effects on NIP, but the latter is safer and can effectively reduce the postoperative inflammatory reaction of patients and maintain the stability of immune function, which has higher clinical application value.

Preoperative oral diazepam for intraoperative blood pressure stabilisation in hypertensive patients undergoing vitrectomy under retrobulbar nerve block anaesthesia: study protocol for a randomised controlled trial

BackgroundAs a type of local anaesthesia, retrobulbar nerve block is often used in vitrectomy, with patients remaining conscious during the operation. The increase in systolic blood pressure (SBP) caused by tension and fear during the operation—especially in patients with a history of hypertension—can negatively impact the safety of the procedure, resulting in suprachoroidal haemorrhage or retinal haemorrhage. Diazepam has a sedative effect and can relieve tension during surgery. This study aims to evaluate the efficacy and safety of diazepam for intraoperative BP stabilisation in hypertensive patients under retrobulbar anaesthesia during surgery.MethodsThis single-centre, double-blind, randomised controlled and parallel clinical trial will include 180 hypertensive patients who will undergo vitrectomy with nerve block anaesthesia. Study participants will be randomly allocated in a 1:1 ratio to intervention (patients receiving oral diazepam before the operation) and control (patients receiving oral placebo before the operation) groups. The primary outcome is the effective rate of intraoperative BP control (systolic BP during operation maintained at <160mmHg at all timepoints). The secondary outcomes are the proportion of patients with SBP ≥180 mmHg at any timepoint from operation to 1 h post-operation, the change of mean systolic blood pressure and mean heart rate during operation from baseline, as well as the number of patients with intraoperative and post-operative adverse reactions within 12 weeks of surgery. The logistic regression model will be performed to compare the outcomes.DiscussionThis study will evaluate the efficacy and safety of diazepam for intraoperative BP stabilisation in hypertensive patients under nerve block anaesthesia during surgery. The results of this trial will reveal whether diazepam has a significant effect on intraoperative BP stability in patients with a history of hypertension who require vitrectomy. If the results of this trial are significant, a large-scale multi-centre clinical trial can be designed.Trial registrationChinese Clinical Trial Registry (ChiCTR) ChiCTR2100041772. Registered on 5 January 2021.

Short-term efficacy, safety and survival of laparoscopic radical resection for colorectal cancer patients with bowel obstruction.

To investigate the short-term efficacy of laparoscopic radical resection for colorectal cancer with bowel obstruction and the effects of the surgery on inflammatory factors for improving the clinical treatment of the condition. The data of colorectal cancer patients presenting bowel obstruction (n=167) treated at our hospital from January 2019 to December 2020 were assessed. The patients were divided into a laparoscopic radical resection of colorectal cancer group (LRRCC, n=90) and open surgery group (OP, n=77). Before treatment and on the 1st, 3rd, 5th, 7th and 15th day after treatment, their serum levels of pain factors, neuropeptide Y, prostaglandin E2 and nerve growth factor were measured by a serum biochemistry analyzer, their levels of inflammatory factors including C-reactive protein, interleukin 6 (IL-6), IL-8 and tumor necrosis factor-α by ELISA, and their amount of CD3+, CD4+ and CD8+ T cell subsets were measure by flow cytometry. Anorectal motility was assessed before and 4 and 8 weeks after treatment. Survival rates were assessed using the Kaplan-Meier method. On the 1st, 3rd, 5th, 7th and 15th day after treatment, compared with the OP group, the LRRCC group had lower levels of serum pain factors, inflammatory factors and CD8+T lymphocytes, while their numbers of CD3+ and CD4+ T lymphocytes subsets were significantly increased. Further, the LRRCC group had fewer complications and significantly higher survival rates, demonstrating better efficacy than the OP group. Laparoscopic radical resection was effective and achieved superior outcomes than open surgery in treating colorectal cancer patients with bowel obstruction.

Effects of propofol combined with lidocaine on hemodynamics, serum adrenocorticotropic hormone, interleukin-6, and cortisol in children.

BACKGROUNDChildren are a unique patient population. Anesthesia for pediatric abdominal surgery has long been achieved mainly with intravenous amiodarone and propofol alone or combined with other anesthetics. The incidence of complications and postoperative adverse reactions is relatively high owing to the imperfect development of various protocols for children. Choosing the most appropriate anesthesia program is an important means of reducing adverse reactions.AIMTo explore the clinical value of propofol combined with lidocaine-assisted anesthesia in pediatric surgery.METHODSA total of 120 children who underwent abdominal surgery at our hospital from January 2016 to March 2018 were selected and divided into groups A and B using the random number table method, with 60 patients in each group. Group B received ketamine for anesthesia, while group A received ketamine, propofol, and lidocaine. The pre- and postoperative heart rate (HR); mean arterial pressure (MAP); arterial oxygen saturation (SpO2); serum adrenocorticotropic hormone (ACTH), interleukin-6 (IL-6), and cortisol (Cor) levels; restlessness score during the recovery period [Paediatric Anesthesia Emergence Delirium Scale (PAED)]; and adverse reactions were compared between the two groups.RESULTSThe HR, MAP, and SpO2 Level at five minutes before initiating anesthesia were compared between groups A and B, and the difference was not statistically significant (P > 0.05). At 10 and 20 minutes after anesthesia initiation, the HR and MAP were lower in group A compared with group B (P < 0.05). The differences in preoperative serum ACTH, IL-6, and Cor levels between groups A and B were not statistically significant (P > 0.05); however, the postoperative serum ACTH, IL-6, and Cor levels in group A were lower compared with group B (P < 0.05). Furthermore, the visual analog scale scores of group A at 2 h and 8 h postoperative were lower than those in group B, and the differences were statistically significant (P < 0.05). The mean PAED score in group A was lower than that in group B (P < 0.05), and the incidence of restlessness in group A was 23.33% lower than that in group B (36.67 %) (P < 0.05). The incidence of adverse reactions was lower in group A than in group B (6.25% vs 16.25%). CONCLUSIONThe anesthetic effect of propofol combined with lidocaine and ketamine in pediatric surgery was better than that of ketamine alone, and had less influence on hemodynamics and pediatric stress response indices, lower incidence of restlessness in the recovery period, and lower incidence of adverse reactions.

Clinical random trial of thumbtack needling therapy for analgesia after cesarean section

To observe the analgesic effect of thumbtack needling therapy and the quality of life in puerpera underwent cesarean section. One hundred and thirty-five puerpera underwent cesarean section were randomly divided into a medication group, a sham-thumbtack needling group and a thumbtack needling group, 45 cases in each group. In the medication group, the patient control analgesia (PCA) was given. In the thumbtack needling group, on the base of the regimen as the medication group, acupuncture with thumbtack needles was applied to lower abdominal point (Extra), Zusanli (ST36), Sanyinjiao (SP6), Geshu (BL17), Shenshu (BL23) and Dachangshu (BL25). The needles were retained for 48 hours. During the needle retaining, the sites with the needle embedded were pressed and kneaded for 3 times, 1 min each time, at the interval of 4 to 12 h. In the sham-thumbtack needling group, the sham-thumbtack needles were used; the acupoint selection, operation and treatment course were all the same as the thumbtack needling group. The visual analogue scale (VAS) scores of incision pain and ute-rine contraction pain, the incidence of postoperative adverse reactions, the amount of vaginal bleeding and milk amount in lactation were observed at each time point after the operation separately in each group. Compared with the medication group, the VAS score of incision pain was decreased 8, 12 and 24 h after operation (P<0.05), the VAS score of uterine contraction pain was decreased 8, 12, 24 and 48 h after operation (P<0.05), the lactation score was increased in 24 to 48 h after operation (P<0.05) in both the sham-thumbtack needling group and thumbtack needling group. Compared with the sham-thumbtack needling group, the VAS score of incision pain was decreased 8, 12 and 24 h after operation (P<0.05), the VAS score of uterine contraction pain was decreased 24 and 48 h after operation (P<0.05) in the thumbtack needling group. Compared with those from 2 to 24 h after operation, the vaginal bleeding amount was decreased and the lactation score increased from 24 to 48 h after operation (P<0.05) in all of the three groups. The conventional PCA combined with thumbtack needling therapy obtained better analgesic effects on incision dynamic pain and uterine contraction pain in patients after cesarean section as compared with either the simple PCA or the combined treatment with sham-thumbtack needling and medication, and both the thumbtack needling and the sham-thumbtack needling therapy can increase the milk amount of lactation from 24 to 48 h after operation.

Effect of Increasing Povidone-Iodine Exposure on Corneal Epithelium and Impact on Donor Rim Cultures.

The purpose of this study was to assess the effect of a second povidone-iodine (PVP-I) application at the time of donor tissue recovery on overall tissue quality and to analyze the rate of positive fungal and bacterial rim cultures before and after implementing increased PVP-I exposure. The left cornea was recovered after a single application of PVP-I, while the right cornea was recovered after double PVP-I application in research-consented donors. The epithelial cell death rate was estimated using viability assay in corneal whole mounts under 10× objective (n = 5). Clinical characteristics of epithelium, stroma, and endothelium; positive rim culture rate; and incidences of infectious postoperative adverse reactions were compared for a period of 14 months before and after implementation of increased PVP-I protocol. The average epithelial cell death rate was unaltered between single and double PVP-I exposure groups. We observed a modest 10% increase in the number of tissues with mild edema after implementation of increased PVP-I exposure. Nonetheless, the percentage of tissues with moderate or severe edema was unaltered. The average positive rim culture rate decreased from 1.17% to 0.88% (P = 0.075) after implementation of the double PVP-I soak procedure. There has been only one report of infectious postoperative adverse reactions since this procedure change. By contrast, there were 5 reports for a period of 14 months before implementation of this protocol. These results indicate that new donor preparation methods with an additional 5 minutes of PVP-I exposure do not affect tissue quality, reduce positive rim cultures, and lead to lower incidence of postoperative infection.

Effect of Comprehensive Nursing Approach in Perioperative Stage of Patients with Hepatocellular Carcinoma Interventional Therapy.

Objective To examine the efficacy of a complete nursing strategy during the perioperative phase for patients undergoing interventional treatment for hepatocellular cancer. Methods Sixty patients who were diagnosed with liver cancer and underwent interventional therapy in our hospital between February 2019 and December 2021 were recruited in this trial. All study subjects were numbered according to the time when the patients first came to our hospital, and were equally divided into a comprehensive group and a conventional group based on the odd and even number of the last number, with 30 cases in each group. Those in the conventional group received conventional nursing care, whereas patients in the comprehensive group received comprehensive nursing care. Before and after the nursing intervention, the quality of life, pain, and patient satisfaction in both groups were compared. Results The quality of survival scores, including physical, emotional, role, social, and cognitive function scores of patients in the comprehensive group, were significantly higher than those in the conventional group (P < 0.05); there was no statistically significant difference in numeric rating scales (NRS) scores between the two groups compared before treatment (P > 0.05). After treatment, the NRS scores of patients in the study group were significantly lower than those of patients in the control group (P < 0.05); before the intervention, the difference between the emotional state scores of patients in the two groups was not significant and not statistically significant (P > 0.05), while the emotional state of patients in both groups improved after the intervention, and the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) scores of patients in the comprehensive group were lower than those in the conventional group (P < 0.05); the total incidence of adverse reactions in the comprehensive group (10.00%) was significantly lower than that in the conventional group (46.67%) (P < 0.05); and the total satisfaction of patients in the comprehensive group (93.33%) was significantly higher than that of patients in the conventional group (73.33%) (P < 0.05). Conclusion The intervention of a comprehensive nursing approach in the perioperative period for patients with liver cancer is remarkable as it can relieve patients' psychological burden and pain, ensure a smooth operation, improve patients' postoperative quality of life, and also help to reduce the risk of postoperative adverse reactions, effectively enhancing patients' satisfaction, and thus deserves to be promoted in clinical practice.