Significant Difference In VAS Scores Research Articles

Effect of subanesthetic dose of esketamine on postoperative rehabilitation in elderly patients undergoing hip arthroplasty

ObjectiveThe majority of individuals with femoral neck fractures opt for total hip replacement to enhance their quality of life. However, this group frequently exhibits perioperative symptoms of pain, anxiety, and sadness, which extends recovery time to some extent. Esketamine, the right-handed monomer of ketamine, is more popular these days due to its sedative, analgesic, and antidepressant properties. There are currently few domestic and international research on the use of esketamine in elderly individuals who have undergone surgery for a femoral neck fracture. In order to further cut the length of the hospital stay and hasten postoperative recovery, this study investigates whether esketamine postoperative analgesia can lessen postoperative pain, anxiety, and depression in older patients having hip replacement.Methods150 patients, ASA physical status I–II, aged ≥ 60 years, no limitation in gender, BMI 18–25 kg/cm2, who underwent selective total hip arthroplasty, according to random number table method, esketamine group (group A) and sufentanil group (group B) were randomized, 75 patients in each group. The two groups received general anesthesia method. At the end of the operation, PCIA was connected for analgesia. In group A, esketamine 2.5 mg/kg was mixed with normal saline to 100 ml. In group B, sufentanil 2.5 ug/kg was mixed with normal saline to 100 ml. Record the VAS scores after operation. Record the first ambulation time, ambulation distance and Patient-controlled Analgesia compression times after operation. The incidence of postoperative adverse reactions such as drowsiness, dizziness, nausea and vomiting, multilingual were recorded. ELISA was used to detect IL-6 and CRP in the morning, 24 h and 72 h after operation. The Hospital Anxiety and Depression Scale (HAD) score and Harris score at 3 days, 1 week and 1 month after operation were followed up.ResultsThere was no significant difference in VAS score and PCA compression times (P > 0.05), but the incidence of nausea, vomiting and dizziness in group B was higher than that in group A (P < 0.05). Compared with group B, the levels of IL-6 and CRP in group A at 24 h and 72 h after operation were significantly decreased (P < 0.05). Postoperative ambulation time and ambulation distance in group A were better than those in group B (P < 0.05). The HAD score of group A was lower than that of group B at 3 days and 1 week after operation (P < 0.05). However, there was no significant difference between the two groups at 1 month after operation (P > 0.05). The Harris score of group A was higher than that of group B at 3 days, 1 week and 1 month after operation (P < 0.05).ConclusionsEsketamine can reduce short-term postoperative anxiety and depression, relieve postoperative pain and stress response, shorten bed rest time after total hip replacement, and accelerate postoperative recovery.

The optimal dose of oxycodone in PCIA after laparoscopic surgery for gastrointestinal cancer in elderly patients: A randomized controlled trial.

To explore the optimal bolus dose of oxycodone for patient controlled intravenous analgesia (PCIA) without background dose in elderly patients after laparoscopic surgery for gastrointestinal cancer. In this prospective, randomized, double-blind, parallel-controlled study, we recruited patients aged 65 years or older. They underwent laparoscopic resection for gastrointestinal cancer and received PCIA after surgery. Eligible patients were randomly divided into 0.01, 0.02, or 0.03 mg/kg group according to the bolus dose of oxycodone in PCIA. The primary outcome was VAS scores of pain on mobilization at 48 h after surgery. Secondary endpoints included the VAS scores of rest pain, the total and effective numbers of press in PCIA, cumulative dose of oxycodone used in PCIA, the incidence of nausea, vomiting and dizziness, as well as patients' satisfaction at 48 h after surgery. A total of 166 patients were recruited and randomly assigned to receive a bolus dose of 0.01 mg/kg (n = 55), 0.02 mg/kg (n = 56) or 0.03 mg/kg (n = 55) of oxycodone in PCIA. The VAS scores of pain on mobilization, the total and effective numbers of press in PCIA in 0.02 mg/kg group and 0.03 mg/kg group were lower than those in 0.01 mg/kg group (P < 0.05). Cumulative dose of oxycodone used in PCIA and patients' satisfaction in 0.02 and 0.03 mg/kg groups were more than those in 0.01 mg/kg group (P < 0.01). The incidence of dizziness in 0.01 and 0.02 mg/kg groups was lower than that in 0.03 mg/kg group (P < 0.01). There were no significant differences in VAS scores of rest pain, the incidence of nausea and vomiting among three groups (P > 0.05). For elderly patients undergoing laparoscopic surgery for gastrointestinal cancer, 0.02 mg/kg bolus dose of oxycodone in PCIA without background infusion may be a better choice.

High tibial osteotomy with computer navigation for medial gonarthritis

To study significance of computer navigation for improving clinical and radiological results of medial gonarthritis treatment compared to non-invasive methods of lower limb axis correction control. The study included 73 patients who were divided into 2 groups. The main group included 40 patients, the control group - 33 patients. In the main group, high tibial osteotomy was performed using computer navigation, in the control group - using non-invasive techniques. Clinical assessment was carried out according to the KSS, KOOS and VAS scales. We assessed the main reference angles of the lower limb considering X-ray data. Both groups were characterized by postoperative improvement of clinical results according to various scales. Computer navigation provided higher accuracy in most cases. We focused on target correction of 3° valgus. High tibial osteotomy with computer navigation or non-invasive techniques is an effective treatment method for medial gonarthritis. There are no significant differences in clinical results according to the KSS and KOOS scales, as well as X-ray data after correction. We found significant differences in VAS scores.

Effect of nanomaterial assisted comprehensive nursing on the recovery of patients with meniscus injury after knee arthroscopy

To explore the clinical effect of comprehensive nursing intervention on meniscus injury patients undergoing knee arthroscopy. Ninety-one patients with meniscus injuries were selected as research subjects from January 2019 to June 2021 and were divided into a control group (n = 45) and an observation group (n = 46). All patients received routine nursing intervention and wounds were treated with nano-silver antibacterial gel. The observation group received a comprehensive nursing intervention. Based on routine nursing, the rehabilitation effect of the two groups was compared. Meniscus pain, knee function, mental state, and postoperative complications of the two groups were analyzed. Before nursing, there were no significant differences in VAS score, knee joint function, and mental state between the two groups (P &gt;0.05). After comprehensive nursing, the Lysholm score and Tegner score of the observation group were higher than the control group, while the VAS score, SAS, and SDS score were lower than the control group (P &lt;0.05). After comprehensive nursing, the patient’s knee function recovery and the incidence of postoperative complications were significantly reduced. The patient satisfaction with nursing was higher and the overall nursing effect was better than the control group (P &gt;0.05). Comprehensive nursing applied in arthroscopic surgery for patients with knee meniscus injury had a good recovery effect and reduced pain.

An exploration of safety and feasibility of transoral vestibular endoscopy in the treatment of thyroid malignant tumors

Objective:To investigate the safety and feasibility of transoral vestibular endoscopy in the treatment of patients with thyroid malignant tumors. Methods:120 patients with thyroid cancer admitted to Xi 'an Central Hospital from January 2019 to December 2021 were selected and randomly divided into endoscopic surgery group（60 cases） and traditional open surgery group（60 cases）. The general operation conditions, postoperative complications and postoperative quality of life were compared between the two groups. Results:The intraoperative blood loss, indwelling drainage tube time and average length of hospital stay in the endoscopic surgery group were significantly lower than those in the traditional open surgery group （P<0.05）, while the operation time and number of lymph nodes dissected were significantly higher than those in the traditional open surgery group （P<0.05）. There was no significant differences in VAS score at 24h after surgery, white blood cell count, TgAb （+） and temporary hypothyroidism between the two groups at 24 h after operation （P >0.05）. The CRP, total drainage volume, TgAb and serum calcium in the endoscopic surgery group were higher than those in the traditional open surgery group, and the PTH and Tg were lower than those in the traditional open surgery group （P<0.05）.One case of hoarseness,2 cases of extremities numbness, 1 case of subcutaneous effusion and 2 cases of chin nerve injury occurred in the endoscopic surgery group, the total incidence of postoperative complications was 10.00%. Five cases of hoarseness, 11 cases of choking cough limbs numbness, 1 case of drinking water, 1 case of postoperative bleeding and 4 cases of subcutaneous effusion occurred in the traditional open surgery group, the total postoperative incidence of complications was 36.67%, the total incidence of complications in endoscopic surgery group was lower than that in traditional open surgery group （P<0.05）. The total scores of physiological status, social/family status, emotional status, functional status and quality of life in endoscopic surgery group were significantly lower than those in traditional open surgery group （P<0.05）. Conclusion:The application of oral vestibular endoscopy in the treatment of thyroid malignant tumors has the advantages of good surgical status and postoperative recovery, fewer postoperative complications.The patient was well tolerated,with positive safety，this technique has high clinical application value.

Efficacy of Intra-articular, intra-osseous Injections of Platelet-Rich Plasma in Osteoarthritis Knee: A Randomized Clinical Trial

<h3>Research Objectives</h3> To evaluate the efficacy of intra-articular, intra-osseous Injections of platelet-rich plasma (PRP) and compare its efficacy with intra-articular injection of PRP in OA Knee. <h3>Design</h3> A parallel 2 group, prospective randomized clinical trial. <h3>Setting</h3> A tertiary care teaching hospital in India. <h3>Participants</h3> A total of 64 persons with OA knee with a Kellgren-Lawrence score of 3 were randomized into two groups. <h3>Interventions</h3> Persons in Group-I received 8ml of single intra-articular PRP injection, and persons in Group II received 18 ml of PRP (two-intra-osseous injections (5ml each in femoral-condyle and tibia plateau) and one intra-articular injection (8ml) of PRP (total 18 ml of PRP, for single joint)) the in the target knee joint under fluoroscopic guidance. All persons (n=64) were followed up at 3 and 6 months. <h3>Main Outcome Measures</h3> Clinical outcomes were evaluated using the visual analog (VAS) pain intensity scores and knee injury and osteoarthritis outcome score (KOOS) questionnaire. <h3>Results</h3> There was no disparity between the two groups in baseline demographic and clinical parameters. Both groups demonstrated statistically significant improvement in VAS pain scores and KOOS scores (pain, symptoms, ADL, sport/recreation, and quality of life) at baseline, 3- and 6 months. However, comparing the two groups revealed no significant difference in VAS scores and KOOS scores at six months. Persons in Group-II reported increased injection-associated pain following interventions. Except for injection-associated pain, no other adverse events were reported in any person. <h3>Conclusions</h3> Though both groups showed significant improvement following PRP injections, additional injections of PRP in the subchondral region did not provide additional benefits (pain-relief and KOOS scores) than intra-articular-PRP injections at 6 months. <h3>Author(s) Disclosures</h3> The institutional intramural research grant supported the study.

Comparison of the efficacy of fully endoscopic spine surgery using transforaminal and interlaminar approaches in the treatment of prolapsed lumbar 4/5 disc herniation

BackgroundThere is still much controversy about whether transforaminal or interlaminar fully endoscopic spine surgery can better treat lumbar 4/5 disc herniation. Therefore, this study intends to compare the clinical efficacy of fully endoscopic spine surgery through transforaminal and interlaminar approaches in the treatment of lumbar 4/5 disc herniation.MethodsSeventy-six patients with lumbar 4/5 disc herniation admitted from March 2019 to June 2020 were divided into the transforaminal approach group (endoscopic transforaminal lumbar discectomy, ETLD; 54 cases) and the interlaminar approach group (endoscopic interlaminar lumbar discectomy, EILD; 22 cases) according to different surgical methods. The general clinical data and clinical evaluation scale of the patients were compared.ResultsThe post-operative ODI and VAS scores were significantly better in the EILD group (P < 0.05). The VAS and ODI scores of patients with upper-shoulder and sub-axillary types in the EILD group were superior to those in the ETLD group (P < 0.05), while the VAS and ODI scores of patients with the pre-radicular type were better when they underwent ETLD rather than EILD (P < 0.05). Patients with Lee zone III type in the EILD group had better post-operative ODI scores than those in the ETLD group (P < 0.05), but there was no significant difference in VAS scores (P > 0.05). Patients with Lee zone IV type who underwent EILD had better VAS and ODI scores than those who underwent ETLD (P < 0.05).ConclusionsFor patients with a prolapsed intervertebral disc that belongs to the upper-shoulder type, sub-axillary type, or Lee III or IV type, EILD can achieve better outcomes.

Effectiveness of High Intensity Hilthera 4.0 Laser Treatment on Patients with Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain. Conservative lines of treatment include non-steroidal anti-inflammatory drugs, corticosteroid injections, Physiotherapy, stretching exercises and using heel pads or orthotics. The purpose of the study is to investigate the effects of high intensity Hilthera 4.0 laser treatment on pain and functional capacity in patients with acute plantar fasciitis. Total 30 participants were randomly recruited and were evaluated before the first treatment session and after 8 sessions of treatment with Hilthera 4.0 Laser. Treatment Parameters are frequency (Hz) 25, one shot emission (MJ) 500, and a total energy 3000W for 15 minutes each session. Outcome measures are VAS score for measuring Pain and Foot Function Index score for measuring Foot Function. IBM SPSS version 16.0 software was used for statistical analysis. Paired sample t-tests are used to measure the pre and post test results. Results shows that there is a significant difference in VAS Score and Foot Function Score pre and post treatment with ‘p’ value &lt; 0.05 when Hilthera 4.0 laser is used for pain and Foot function in patients with Plantar Fasciitis. In conclusion Hilthera 4.0 Laser Therapy is effective in treating pain and Functional limitation in patients with Plantar Fasciitis. KEY WORDS: Plantar Fasciitis, Hilthera 4.0 Laser Therapy, VAS Score, Foot Function Index Score

Poster 220: The Effect of Bone-Void Filler on Anterior Knee Pain Following BPTB Autograft ACL Reconstruction

Objectives:The purpose of the current study is to evaluate and compare the effect of three different bone void fillers; autogenous bone (auto), calcium phosphate cement (cement), and demineralized bone matrix (DBM), on anterior knee pain following anterior cruciate (ACL) reconstruction with bone-patellar tendon-bone (BPTB) autograft.Methods:This is a single-center randomized, controlled trial conducted in 150 patients. Patients undergoing ACL reconstruction with BTPB autograft were equally randomized into the three bone void filler cohorts; 1) auto, 2) cement, or 3) DBM. Baseline day of surgery, postoperative 1 week, and postoperative 1.5, 3, and 6 months VAS scores and KOOS and KUJALA scores at 1.5, 3, 6, and 12 months were evaluated. To compare primary and secondary outcomes between the three groups with auto group as control, an analysis of variance (ANOVA) was performed. A p-value of 0.05 was set to determine statistical significance.Results:An interim analysis was conducted on 70 patients with 6 month follow-up outcomes. There were no significant differences in VAS scores between groups at baseline (p =0.919), 1 week postoperatively (p = 0.75), 1.5 months postoperatively (p = 0.708), 3 months postoperatively (p = 0.529), and 6 months postoperatively (p = 0.115). In addition, no significant differences in KOOS scores were seen between the groups at 1.5 months (p = 0.365), 3 months (p = 0.964), or 6 months (p = 0.917). Similarly, no significant differences in KOOS scores were seen between the groups at 1.5 months (p =0.514), 3 months (p =0.763), or 6 months (p =0.815).Conclusions:There is no difference in the level of anterior knee pain or patient-reported functional outcome scores between the auto, cement and DBM for patellar bone void filling following ACLR with BPTB.

Artificial Intelligence Technology Combined with Ultrasound-Guided Needle Knife Interventional Treatment of PF: Improvement of Pain, Fascia Thickness, and Ankle-Foot Function in Patients.

Objective To explore the effect of artificial intelligence (AI) technology combined with ultrasound-guided needle knife intervention in the treatment of plantar fasciitis (PF) on pain, fascia thickness, and ankle and foot function. Methods A total of 130 patients with PF treated in our hospital from January 2019 to April 2021 were enrolled. The patients were randomly assigned into the control group and the study group. The control group received ultrasound-guided needle knife interventional therapy, and the study group received AI technology combined with ultrasound-guided needle knife interventional therapy. The curative effect, VAS score, plantar fascia thickness, plantar fascia elasticity score, plantar fascia blood flow index, and AOFAS score were investigated. Results The total effective rate of the study group was higher compared to that of the control (P < 0.05). There exhibited no significant difference in VAS score before treatment, but the VAS score of the study group was lower compared to that of the control group at 2, 4, and 8 weeks after treatment. There exhibited no significant difference in plantar fascia thickness before treatment (P > 0.05), but after treatment, the plantar fascia thickness in the study group was lower compared to that in the control (P < 0.05). The plantar fascia thickness in the study group was lower compared to that in the control at 2, 4, and 8 weeks after treatment (P < 0.05). In terms of the plantar fascia elasticity score, there exhibited no significant difference before treatment (P > 0.05), but the plantar fascia elasticity score of the study group was lower compared to that of the control at 2, 4, and 8 weeks after treatment (P < 0.05). There exhibited no significant difference in plantar fascia blood flow index before treatment (P > 0.05), but after treatment, the plantar fascia blood flow index in the study group was higher compared to that in the control (P < 0.05). The plantar fascia blood flow index in the study group was higher compared to that in the control at 2, 4, and 8 weeks after treatment (P < 0.05). There exhibited no significant difference in the AOFAS score before treatment, but after treatment, the AOFAS score of the study group was higher compared to that of the control at 2, 4, and 8 weeks after treatment. Conclusion Patients with PF receive AI technology combined with ultrasound-guided needle knife interventional therapy, which can effectively relieve pain and improve fascia thickness and ankle-foot function. Thus, AI technology combined with ultrasound-guided needle knife interventional therapy has the advantages of convenient operation, safety, and effectiveness, which is worthy of clinical application.

Observation of the Effect of Focused Psychological Intervention Combined with Standardized Pain Nursing on Postoperative Pain Levels and Depression and Anxiety in Patients with Intestinal Obstruction.

Objective The purpose of this study was to investigate the effect of targeted psychological intervention combined with standardized pain care on postoperative pain, depression, and anxiety in patients with intestinal obstruction. Methods 84 patients with intestinal obstruction hospitalized at our hospital from October 2019 to February 2021 were randomly divided into study and control groups. The patients in the control group were treated with routine nursing, and the patients in the study group were treated with focused psychological intervention combined with standardized pain nursing. The pain degree (VAS), depression and anxiety (SDS, SAS) score, sleep quality (PSQI) score, and nursing satisfaction of the two groups before and after intervention were calculated. Results Before intervention, no significant differences in VAS score between the study and control groups were observed. The VAS score of 6 h, 12 h, 24 h, and 48 h dry prognosis in the study group was lower than that in the control group. There was no significant difference in the scores of SDS and SAS between two groups. After intervention, the scores of SDS and SAS in the study group were lower than those in the control group. After intervention, the scores of daytime dysfunction, hypnotic drugs, sleep disorders, sleep efficiency, sleep time, and sleep quality in the study group were significantly lower than those in the control group. The scores of nursing state, nursing technique, nurse-patient communication, and inspection observation in the study group were higher than those in the control. Conclusion The intervention of focused psychological intervention combined with standardized pain nursing on patients with intestinal obstruction can effectively relieve their negative emotion and reduce the degree of postoperative pain. In addition, it can improve patients' sleep quality and enhance patients' satisfaction with all kinds of nursing work.

Abstract No. : ABS3199: Comparison of self-selected music and prefixed music on reduction of perioperative Anxiety in adult Patients undergoing laparoscopic surgeries under general Anaesthesia

Background &Aims:Preoperativeanxiety in patientsis associated with psychological effects.The current study aimed to compare the effects of self selected(SS) musicand prefixed (PF) musicin reducing preoperative anxiety.Methods:In this study, 90 patients posted for laparoscopic cholecystectomy were randomly divided into three groups equally. Patients in group SS and group PF listened toSSand PFfor 20 minutes in preoperative roomrespectively. Music continued until reversal of anaesthesia. Vitals of patients, VASscore for pain and post operative nausea and vomiting (PONV)score were noted at 1st and 2nd hour after surgery.Results:There was a statistically significant difference in anxiety score between SS and PF (p<0.05), between SS and Control(C)(p<0.05) and between PF and C (p<0.05). After music intervention of 20 minutes , heart rate, SBP at T2 was significantly reduced in SS and PF. At T5, thePONVscore was lower in SS and PF than C. There was significant difference in PONV score between SS and C (p<0.0001) and between PF and C (p<0.0003) There was significant difference inVASscore between SS and PF (p<0.05) , between SS and C (p<0.0001) and between PF and C (p<0.0001)Conclusion:SSmusic was more effectiveandenabled to maintain stable haemodynamic parameters throughout the surgery in reducing anxiety than PFmusic. PONV scores were comparable between SS and PFmusicgroups. SS music was more efficient in providing pain relief than PF music.

Analysis of the Need for Postoperative Drainage Application for Hip Arthroplasty: A Systematic Review and Meta-Analysis.

Objective To synthesize the evidence regarding the effect and safety of drainage after the hip arthroplasty in randomized control trials. Background Although the standard of hip replacement has matured in recent years, the need for postoperative drainage is still controversial which also is a clinical problem that needs to be addressed. Design A systematic review and meta-analysis based on the Cochrane methods and Prisma guideline. Data Resources. A systematic search of the Cochrane Library, PubMed, EMBASE, CINAHL, Ovid, Wan Fang database, CNKI, and CBM database was carried out from January 1, 2000, to December, 2021. Review Methods. The quality of included randomized controlled trials was assessed individually by two reviewers independently using criteria recommended in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Results Nineteen randomized control trials involving 3354 participants were included in this analysis. From the above analysis, we can know that compared with nondrainage, there was a statistically significant difference in VAS score on the postoperative first day (SD = −0.6; 95% CI: -0.79, -0.41) and second day (SD = −0.38, 95% CI: -0.58, -0.18), hematocrit reduction (MD =2.89; 95% CI: 1.3, 4.48), blood transfusion rate (OR =1.47; 95% CI: 1.12, 1.92), change of thigh circumstance (SMD = −0.48; 95% CI: -0.66, -0.31), and hospital stay (MD = 1.06; 95% CI: 0.73, 1.39) in drainage. However, there were no statistically significant differences in hemoglobin and hematocrit level, hip function, total blood loss, transfusion volume, dressing use, and complications between them. Conclusion Drainage after hip arthroplasty can reduce swelling in the thigh and relieve pain while no drainage can bring down hematocrit reduction, decrease dressing uses, and shorten the hospital stay which promotes rapid recovery. This review provides a detailed theoretical reference for the proper clinical application of drains and improves the efficient use of resources.

Observation on the Rehabilitation Effect of Athletes with Anterior Cruciate Ligament Injury of the Knee Based on Multidisciplinary Combined Nondrug Therapy.

This study analyzes the rehabilitation effects of athletes with anterior cruciate ligament injury of the knee based on multidisciplinary combined nondrug therapy. For this purpose, 70 athletes with anterior cruciate ligament injury of the knee admitted from September 2019 to December 2020, who were randomly selected, were the subjects of the study. According to the random number table method, they were divided into the control group and observation group, with 35 cases in each group. The control group was given conventional conservative treatment such as braces braking, local physiotherapy, and routine rehabilitation exercise after injury. For the observation group, multidisciplinary combined nondrug therapy was implemented on the basis of the control group. After receiving the intervention, the balance function score of the observation group was significantly higher than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). After receiving the intervention, the functional recovery scores of the knee joint of the observation group were significantly higher than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). Before treatment, there was no significant difference in knee flexion extension, internal rotation, and external rotation between the two groups (P > 0.05). After treatment, flexion extension, internal rotation, and external rotation of the knee joint in the observation group were significantly higher than those in the control group (P < 0.05). There was no significant difference in VAS scores between the two groups before treatment (P > 0.05). After treatment, the VAS score of the observation group was significantly lower than that of the control group (P < 0.05). Multidisciplinary combined nondrug therapy has a good therapeutic effect in the treatment of anterior cruciate ligament injury of the knee for athletes. It can be used as a conservative treatment method to improve the score of balance function and recovery of lacquer joint function, enhance the range of motion of the knee joint, and reduce the VAS.

Analysis of the Effect of Acupuncture and Pressing of Traditional Chinese Medicine on Recovery of Delayed Muscle Soreness in Athletes.

In this study, we have analyzed numerous effects of the acupuncture and pressing of traditional Chinese medicine on recovery of delayed muscle soreness in athletes. To implement this idea, a total of 84 athletes with delayed muscle soreness treated in our hospital from January 2018 to June 2020 were included. According to the random number table method, they were divided into the experimental group and the control group: among them, 42 cases were in the experimental group and were treated by TCM acupuncture. In the control group, 42 athletes used rehabilitation training. Compared with serum CK levels in the control group, serum CK levels in the experimental group decreased after training, and there was a significant difference (P < 0.05). After intensive training in the control group (P < 0.05), it indicated that acupuncture and pressing of traditional Chinese medicine was effective in the recovery of fatigue after exercise, which was significantly better than that in the control group. The serum testosterone value of the experimental group before intensive training had no significant difference, but the serum testosterone value of the moxibustion group of male athletes after intensive training was significantly higher than that of the control group (P < 0.05). Female athletes have a low blood testosterone base and are less affected by the gonad axis. There was no statistically significant difference in RPE scores before treatment. After treatment, the RPE score of the experimental group decreased rapidly (P < 0.05), which was statistically significant compared with the control group (P < 0.05). There was no significant difference in VAS scores before treatment. After treatment, the VAS score in the experimental group decreased rapidly (P < 0.05) compared with the control group (P < 0.05). After treatment, compared with the control group, the experimental group had a decrease in calf circumference, an increase in muscle strength, and an increase in the range of motion (P < 0.05). Acupuncture and pressing of traditional Chinese medicine have obvious clinical application value in the treatment of delayed muscle soreness in athletes, and they have great clinical application value. Muscle injury is a common disease of athletes.

Preemptive analgesic effect of ultrasonography-guided transversus abdominis plane block performed by adding dexamethasone to bupivacaine

The objective of this study was to evaluate the preemptive analgesic effect of ultrasound-guided transversus abdominis plane block performed with bupivacaine or adding dexamethasone on bupivacaine in laparoscopic cholecystectomy. This retrospective study was conducted on a total of 84 patients who underwent ultrasound-guided TAP block in laparoscopic cholecystectomy. Patients were divided into two groups: Group Bupivacaine (Group B) and Group Bupivacaine+Dexamethasone (Group B+D). Intraoperative hemodynamic changes, intraoperative remifentanil consumption, postoperative visual analog scale scores, tramadol consumption in 24 hours postoperatively, and postoperative first analgesic time were obtained from the records and compared between the groups. There were no statistically significant differences between both groups in terms of intraoperative heart rate, mean arterial pressure, oxygen saturation, and end-tidal CO2 values. Postoperative visual analog scale scores, doses of remifentanil and total tramadol, and time of receiving the first analgesic were similar. Dexamethasone can be added to the bupivacaine for the TAP block without major side effects. Adding dexamethasone to bupivacaine in transverse abdominis plane block performed in laparoscopic cholecystectomy procedures did not create a significant difference in VAS score. We think that the use of dexamethasone does not have an additional analgesic effect. However, our results should be supported by further studies.

Functional Outcome of Proximal Humerus Fracture Managed Surgically by Joshi's External Stabilizing System

INTRODUCTION: The ideal management of proximal humerus fracture is still controversial despite various treatment options. Conservative treatment with slab is fraught with shoulder stiffness and malunion while surgical treatment with plates and nail is fraught with infection and blood loss. Therefore, Joshi External Stabilization System (JESS) being a minimally invasive percutaneous procedure can be the ideal treatment for these fractures. MATERIAL AND METHODS: This prospective and observational hospital based study was carried out in Orthopedics Department, Universal College of Medical Sciences Teaching Hospital (UCMS-TH) from December 2018 to January 2021. All patients with traumatic proximal humerus fracture who fulfilled the inclusion criteria were enrolled in the study and were treated with JESS. Fracture was classified according to Neer classification and functional outcome was assessed according to Constant Murley Score (CMS) system. Post-operatively patients were regularly followed at 6 weeks, 3 months and 6 months. RESULTS: There was statistically significant difference in VAS score (p&lt;0.05) measured at six weeks, three months and six months; and CMS (p&lt;0.05) at three months and six months. There was statistically significant difference between fracture type (Neer type) and fracture union (p&lt;0.05). But the association between functional outcome and type of fracture was statically insignificant (p&gt;0.05). CONCLUSION: Displaced proximal humerus fracture when treated surgically with JESS has good functional and radiological outcome. It produces less pain, less stiffness and greater Range of Motion (ROM).

Displaced proximal humerus fractures in older patients: reverse total shoulder arthroplasty or nonoperative treatment?

BackgroundReverse total shoulder arthroplasty (RTSA) for proximal humerus fractures (PHFs) in older patients has been shown to be an effective treatment modality. Recent studies have questioned the superiority of RTSA over nonoperative treatment. The purpose of this study was to compare outcomes after RTSA and nonoperative treatment of PHF. MethodsA retrospective case-matched review of 72 displaced PHFs who underwent either RTSA or nonoperative treatment between August 2016 and August 2019 was conducted. Nine RTSA and 6 nonoperative patients were excluded. Thirty-seven RTSAs in 36 patients (1 bilateral) were compared to twenty patients who met operative criteria for RTSA but did not elect to undergo surgery. ResultsMean VAS pain scores decreased significantly in both groups at the final follow-up. Although there was no statistically significant difference in VAS scores at the time of most-recent follow-up between the two cohorts (1.5 RTSA vs. 1.9 nonop, P = .49), patients who underwent RTSA had a more rapid improvement in pain than nonoperative patients. RTSA patients had significantly lower VAS scores at 2 weeks (2.7 ± 3.1 vs. 5.6 ± 3.2, P = .03), 6 weeks (1.7 ± 2.8 vs. 4.1 ± 3.4, P = .02), and 3 months (1.6 ± 2.8 vs. 3.7 ± 3.2, P = .04) postoperatively. RTSA patients also had better forward flexion (125.4 ± 26.4° vs. 92.1 ± 35.1°, P = 0.001) and abduction (87.1 ± 11.6° vs. 75 ± 13.4°, P = .002) than nonoperative patients at the final follow-up (minimum 6 months). There was a statistically significant difference in mean American Shoulder and Elbow Surgeons scores after RTSA compared with nonoperative patients at the time of final follow-up for acute RTSA and for 3- and 4-part fracture subgroups. Eight patients (21.6%) experienced a complication after RTSA, of which 3 required revision surgery. Discussion/ConclusionOlder patients with displaced PHF have significant improvement in pain and function after both RTSA and nonoperative treatment although RTSA does come with a greater risk of complications. Patients who undergo RTSA have a greater increase in overhead motion and abduction and experience a more rapid improvement in pain, with significantly lower pain scores in the early postoperative period.

Efficacy of laparoscopic guided transversus abdominis plane block in post operative analgesia requirement in elective laparoscopic cholecystectomy

Background: Minimal invasive surgery has many advantages. In order to maintain and control pain, one of the most effective technique is Transversus abdominis plane (TAP) block technique. Aim of the study was to demonstrate the efficacy of laparoscopic guided transversus abdominis plane block in post-operative analgesia requirement in elective laparoscopic cholecystectomy.Methods: It was a hospital based prospective interventional study. Sample size was calculated at 0.05 α error and 80% study power assuming mean difference of VAS score between TAP block +/A group and TAP block- /B group is 1 and standard deviation of VAS score 1.3 among patients undergoing elective laparoscopic cholecystectomy.Results: A total of 60 patients were enrolled in this study. The mean age of group A was 48.56 years and for group B was 43.53 years. In group A 80% patients were females and for group B 83.3% patients were females. There was significant difference in VAS score at immediate post operation, at 1 hour, at 6 hours, at 18 hours and at 24 hours as p value was &lt;0.0001 for all these groups. The mean VAS score was recorded less in group A at all the time duration compared to group B.Conclusions: With advantages like maximum safety, efficacy, potential for lower visceral injury risk and shorter operational time and other numerous advantages (decreased analgesic requirements, etc.) laparoscopic-guided TAP block counts as an ideal abdominal field block in the patients.

Traditional Chinese medicine orthopedic rehabilitation treatment for senile osteoarthritis based on the Big Data

Objective: To study and analyze the effect of traditional Chinese medicine orthopedic rehabilitation therapy on senile osteoarthritis from the analysis of big data. METHODS: Seventy elderly patients with osteoarthritis admitted to our hospital from March 2015 to March 2017 were enrolled. The grouping method is a random number table method, which is divided into an experimental group and a reference group, each of which is 35 cases. The patients in the reference group were treated with nimesulide orally, and the patients in the experimental group were treated with traditional Chinese medicine orthopedics. The clinical effects of the two groups were compared. RESULTS: The effective rate of treatment in the experimental group (97.14%) was significantly higher than that in the reference group (82.86%). The difference between the two groups was statistically significant (P<0.05). There were significant differences in VAS scores and JOA scores between groups, and P < 0.05. Conclusion: The treatment of senile osteoarthritis patients with traditional Chinese medicine orthopedics has achieved remarkable results. The quality of life of patients has been significantly improved, the treatment efficiency has been improved, and the pain of patients has been alleviated. It is worthy of clinical reference and further popularization.