VAS Score In Group Research Articles

Dexmedetomidine on Continuous Infraclavicular Block after Elbow Arthrolysis

Aim: To evaluate the efficacy of dexmedetomidine in the analgesia of contin-uous infraclavicular brachial plexus block after elbow arthrolysis. Methods: Sixty patients who received unilateral elbow arthrolysis and met inclusion criteria were randomly divided into 2 groups (n = 30): dexmedetomidine + ropivacaine group (group D) and ropivacaine group (group R). The formulation of analgesic pump was 0.2% ropivacaine 240 mL + 2 ug/kg dexmedetomidine in D group and 0.2% ropivacaine 240 mL in R group. The VAS scores at rest, 4 h (T1), 8 h (T2), 12 h (T3), 24 h (T4), 36 h (T5) and 48 h (T6) after operation were recorded, and NRS scores during functional exercise at 24 h (T4), 36 h (T5) and 48 h (T6) after operation were recorded. The incidence of adverse reactions and satisfactory degree of analgesia in two groups were recorded. Results: The success rate of block during catheterization was 100% in both groups. Compared with group R, VAS score of group D at each time point after operation decreased (p < 0.05); NRS score during functional exercise at each time point after operation decreased (p < 0.05); the additional pressing times of analgesic pump within 48 h decreased (p < 0.05); the incidence of dizziness, nausea and vomiting after operation decreased (p < 0.05); and satisfaction degree of analgesia 48 h after operation was higher in group D (p < 0.05). Conclusion: Dexmedetomidine combined with ropivacaine can produce effective analgesic and sedative effects, and reduce the incidence of complications in the analgesia of continuous infraclavicular brachial plexus block after elbow arthrolysis.

Analysis of Optimizing Effects of Dexmedetomidine and Oxycodone on Cytokine Levels in Patients with Laparoscopic Radical Gastrectomy

This study was designed to analyze the effects of dexmedetomidine combined with oxycodone in patients underwent laparoscopic radical gastrectomy for stomach carcinomas. A total of one hundred and twenty (120) patients were recruited and divided into A, B and C groups, using a random number table method, 40 cases in each group. After surgery patients in group A received oxycodone alone, patients in group B received dexmedetomidine combined with oxycodone and patients in group C received dexmedetomidine alone respectively. The Visual Analog Scale score and Ramsay sedative score at 2h, 6h, 24h and 48h after surgery were observed and the effective compressions number of controlled intravenous analgesia was documented. The incidence of side effects was recorded. TNF-α, CRP and IL-6 were evaluated by enzymelinked immunosorbent assay on the day before surgery and in the morning of 1st and 3rd d after surgery. VAS scores in group B were lower than group A and C, the effective compressions number of CIA in group B was less than group A and C, the occurrence of adverse reactions in group B was lower than group A and group C. The postoperative levels of TNF-α, CRP and IL-6 at 72h in group B were lower than group A and C. Dexmedetomidine combined with oxycodone showed improve sedative and analgesic effects with fewer adverse reactions. It can lessen the release of inflammatory cytokines of TNF-α, CRP and IL-6 in the body and has certain clinical application value.

Analgesic efficacy of intraperitoneal vs intravenous dexmedetomidine as adjuvant to levobupivacaine 0.25% in laparoscopic cholecystectomy under general Anaesthesia

Results: VAS score was significantly lower in dexmedetomidine group D, BD from 1hr to 8hr. From 8 hr to 24 hr, VAS score in group IV dexmedetomidine was significantly less than the other groups (P=0.01). In the postoperative period, sedation scores were more in IV dexmedetomidine group as compared to other groups till 4 hrs. The requirement of rescue analgesia in IV dexmedetomidine + IP levobupivacaine was significantly less from zero hrs to 8 hrs. Conclusion: Low bolus dose of IV dexmedetomidine is more efficacious as compared to IP dexmedetomidine (0.5 µg/kg) along with IP bupivacaine in laparoscopic cholecystectomy.

The Effect of the Full-time Nursing Staff Accompanying to Elderly Parturients Combined with Percutaneous Electrical Stimulation

This study is to investigate the effect of the full-time nursing staff accompanying to elderly parturients combined with percutaneous electrical stimulation. In our hospital from January 2017 to December 2017, 95 elderly primiparas were randomly divided into control group (48 cases) and nursing group (47 cases). The control group was given perinatal routine care, the observation group was given full-time nursing staff accompanying combined percutaneous electrical stimulation. The delivery pain score, labor process, postpartum bleeding volume, postpartum urinary retention and neonatal Apgar score were compared between the two groups. When the mother's cervical opening is 3cm, the VAS score of nursing group patients was 8.34±1.28, but the VAS score in control group was 5.16±1.87. However, when the mother's cervical is fully opened, The VAS between the two groups is not statistically different. As can be seen from Table 3, in the nursing group of the whole-process companion nursing combined with the percutaneous electrical stimulation treatment, the time of the labor process is two hours lower than the control group. Postpartum bleeding in nursing group was 159.25±40.23 ml, but postpartum bleeding in nursing group was 210.22±40.46 ml. Therefore, the postpartum hemorrhage in nursing group is obviously reduced. In the nursing group, the number of patients with postpartum urine storage was 2, but in the control group, it rose to 11. These results including the time of labor process, postpartum bleeding and the cases of postpartum retention of urine were statistically different between two groups (P 0.05). The whole course accompanying nursing combined with percutaneous electrical stimulation therapy is used in the natural delivery of elderly parturients to reduce the pain of delivery, shorten the labor process, improve the postpartum hemorrhage and reduce the incidence of postpartum urinary retention. But it had no obvious effect on neonatal Apgar score. In conclusion, the full-time nursing staff accompanying with percutaneous electrical stimulation therapy is safe and reliable.

Clinical study on the effect of different local anesthetics on nerve block in patients with carpal tunnel syndrome

Objective To observe the nerve block effect and intraoperative bleeding of different local anesthetics used in patients with carpal tunnel syndrome (CTS). Methods Sixty patients with CTS were randomly divided into 4 groups with 15 patients in each, namely lidocaine+adrenaline group (group A), lidocaine+dexmedetomidine group (group B), ropivacaine+adrenaline group (group C), ropivacaine+dexmedetomidine group (group D). The onset time, maintenance time, analgesic and sedative effects, night sleep, adverse reactions and intraoperative bleeding were observed. Results The duration of block in group B and D was significantly longer than that in group A and C (P 0.05). The night sleep of group C was acceptable. The VAS score and Ramsay score of group D had no significant change within 48 hours after operation (P>0.05) and the night sleep was good. Conclusion Low dose dexmedetomidine-assisted nerve block can prolong the action time of local anesthetics and provide a good night sleep, but it has no obvious hemostatic efficacy. The combination of ropivacaine and epinephrine can achieve blockade duration, sigificantly decrease the intraoperative blood loss, which will improve patients' comfort and satisfaction. Key words: Carpal tunnel syndrome; Anesthetics; Nerve block effect

Does mesh cage subsidence have any effect on functional outcome in spinal tuberculosis?

Introduction:Occurrence of mesh cage subsidence in patients undergoing anterior column reconstruction following Tuberculosis spine is frequent radiological finding as bone quality of affected vertebrae is poor. This study aims at determining effect of mesh cage subsidence on functional outcome.Methods:Retrospective demographics of 30 patients of consecutive series in age range 4-60 year were collected with Clinical outcome evaluation using VAS, ODI and ASIA scale. 30 patient having Dorsolumbar tuberculosis with vertebral involvement ranging from 1-6 with mean vertebral level involvement of 2.71, underwent anterior column reconstruction through posterior only approach between 2011-15 were reviewed. Patients were followed at regular intervals of 6 weeks, 12 weeks, 6 months & thereafter on yearly basis. They were evaluated for interbody height loss with subsidence, fusion & segmental angle.Results:Clinical parameters i.e. VAS & ODI showed improvement in postoperative period which continued to remain same even after subsidence (P < 0.05). Subsidence was categorized as combined anterior + posterior < 5mm; 5 -10mm; >10mm. ODI at follow up was 8.5 ±4.62, 9 ± 2 and 9 ± 4.2 (P = 0.961) respectively & VAS score in above group was 1.3 ± 0.51, 1.5 ± 1.2 & 1.5 ± 0.7 (P = 0.975) respectively. Subsidence was age, spinal level nonspecific.Conclusion:Study indicates that though Cage subsidence occurs to varying severity due to weakened vertebral bodies, it did not have significant impact on functional outcome in terms of VAS, ODI or radiological evidence of fusion following reconstruction in Spinal tuberculosis.

External application of No.II prescription on preoperative detumescence for the treatment of calcaneal fracture through tarsal sinus approach

To explore clinical effect of external application of No.II prescription on preoperative detumescence for the treatment of calcaneal fracture through tarsal sinus approach. From November 2016 to June 2018, 67 patients with calcaneal fracture were divided into control group(32 patients with ice compress) and research group(35 patients with external application of No.II prescription) according to different methods of preoperative detumescence. There were 21 males and 14 females in research group, aged from 36 to 52 years old with an average of (44.07±7.31) years old; the time from injury to clinic ranged from 2 to 6 h with an average of(4.32±1.68) h; 9 patients on the left side and 26 patients on the right side; 20 patients were type II, 15 patients were type III according to Sanders classification; treated with external application of No.II prescription. There were 32 patients in control group, including 22 males and 10 females aged from 40 to 52 years old with an average of (46.79±5.47) years old; the time from injury to clinic ranged from 2 to 5 h with an average of (3.89±1.03) h; 14 patients on the left side and 18 patients on the right side; 19 patients were type II and 13 patients were type III according to Sanders classification; treated by ice compress from admission to the first time of occurrence of skin fold. After disappearance of swelling, patients were treated with open reduction and internal fixation through tarsal sinus approach. Cross-section diameter of foot and ankle between admission and the first time of occurrence of skin fold were recorded and calculated the difference value. VAS score on the 2nd, 4th and 7th day after admission, preoperative prepare time, operative time, period of hospitalization and fracture healing time between two groups were compared. Difference value of cross-section diameter of foot and ankle in research group were (1.72±0.29) cm and (1.69±0.18) cm respectively, while in control group were (1.08±0.21) cm and (0.91±0.37) cm, the level of swelling in research group was better than that of in control group. VAS score on the 2nd, 4th and 7th day after admission in research group were 8.91±0.33, 6.47±1.09, 4.52±0.91 respectively; while in control group were 6.21±0.19, 3.67±1.18, 2.12±1.17 respectively; VAS score in research group was lower than control group. Preoperative prepare time, period of hospitalization and fracture healing time in research group were shorter than control group, while there was no statistical difference in operative time between two groups. During the perioperative period, rational application of No.IIfor the treatment of calcaneal fracture through tarsal sinus approach could effectively relieve wound swelling, shorten preoperative preparation and fracture healing time, alleviate pain, improve patient satisfaction, and achieve remarkable clinical results.

Clinical Efficacy of Physical Factors Combined with Early Psychological Intervention in Treatment of Patients with Chronic Limb Pain

To investigate the clinical efficacy of physical factors combined with early psychological intervention in treatment of patients with chronic limb pain. A total of 132 patients with chronic limb pain admitted to Affiliated Hospital of Hebei University, Baoding, China from June 2014 to June 2017 were enrolled. The patients were divided into control group (n=66) and observation group (n=66) according to the random number table method. Both groups of patients were treated with physical factors, and the patients in the observation group were also treated with early psychological intervention. PHQ-15 pain factor score, visual analog pain score (VAS score), Hamilton depression rating scale (HAMD) and clinical efficacy were compared between two groups. Difference of PHQ-15 pain factor score, VAS score and HAMD score between two groups before treatment were not statistically significant (P=0.091, 0.161, 0.078). At the end of treatment and at 8 weeks of follow-up, PHQ-15 pain factor score, VAS score, and HAMD score of observation group were lower than those of control group, and the differences were statistically significant (P=0.045, 0.014; 0.011, 0.025; 0.030, 0.015). Total clinical effective rates of observation group and control group were 92.43% and 86.37%, respectively, and the differences were statistically significant (P=0.019). Compared with physical factors alone, combination of physical factors and early psychological intervention can significantly alleviate the pain and improve the depression of patients with chronic limb pain. It should be promoted in clinical practices.

Clinical efficacy of Qingre-Jiedu-Shaoshang ointment combined with hydrophilic silver ion dressing in patients with deep degree II burns

Objective To evaluate the efficacy of Qinre-Jiedu-Shaoshang ointment combined with hydrophilic silver ion dressing in the treatment of deep degree Ⅱ burn. Methods A total of 89 patients with degreeⅡ burn were enrolled, and they were randomly divided into the control group (44 cases) and the treatment group (45 cases). The control group was treated with hydrophilic silver ion dressing. The treatment group was treated with Qinre-Jiedu-Shaoshang ointment combined with hydrophilic silver ion dressing. Both groups were treated continuously for 21 days. The wound healing time and dressing change times of the two groups was observed and recorded. The VAS scale was used to evaluate the degree of wound pain. The serum level of TNF-α and IL-6 were detected by ELISA. Results The total effective rate was 95.56% (43/45) in the treatment group and 77.27% (34/44) in the control group. There was a significant difference between the two groups (χ2=6.375, P=0.012). The healing time of wounds in the treatment group (17.3 ± 1.9 d vs. 22.5 ± 2.2 d, t=11.987) and dressing change times (5.1 ± 0.7 times vs. 7.4 ± 0.8 times, t=15.041) were significantly less than those in the control group (P<0.01). The VAS score of the treatment group at 7, 14 and 21 days after treatment was significantly lower than those of the control group (t values were 10.597, 19.692, 26.510, all Ps<0.001). After treatment, the level of serum TNF-α and IL-6 in the treatment group were significantly lower than those in the control group (t values were 6.412, 8.202 respectively, all Ps<0.01). Conclusions The Qinre-Jiedu-Shaoshang ointment combined with hydrophilic silver ion dressing can effectively promote wound healing, reduce the degree of wound pain, reduce the level of inflammatory cytokines, and improve clinical efficacy. Key words: Burns; Occlusive dressings; Surgical wound infection; Qingre-Jiedu-Shaoshang ointment; Efficacy; Safty

Treatment of knee osteoarthritis with six-step manipulation combined with extracorporeal shock wave

To observe the clinical effect of six-step manipulation combined with extracorporeal shock wave in the treatment of knee osteoarthritis. Seventy-six patients with KOA from December 2016 to June 2018 were divided into control group and treatment group, 38 in each group. The patients in the control group were treated with oral medicine combined with extracorporeal shock wave therapy, while the patients in the treatment group were treated with six-step manipulation combined with shock wave therapy. The VAS score, WOMAC score and clinical efficacy of the two groups were compared before treatment, 1 day, 1 month and 6 months after treatment. There was no significant difference in VAS score and WOMAC score between the two groups before treatment(P>0.05). VAS score and WOMAC score in treatment group were significantly lower than those in control group at 1 day, 1 month and 6 months after treatment, and the difference was statistically significant(P<0.05). Six-step manipulation combined with extracorporeal shock wave therapy can significantly alleviate pain and improve knee function in patients with knee osteoarthritis, and the clinical effect is obvious.

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

Comparative evaluation of efficacy of topical 5% amlexanox oral paste and 0.1% triamcinolone acetonide oral paste in the treatment of oral ulcers

Background: Recurrent aphthous stomatitis (RAS) is a common condition of the mucosa of oral cavity. The present study was aimed to compare efficacy of triamcinolone acetonide 0.1% and 5% amlexanox in management of recurrent aphthous stomatitis (RAS). Materials & Methods: The present study was conducted on 48 patients with history of recurrent aphthous stomatitis. Patients were divided into 2 groups of 24 each. Group I was prescribed topical application of 0.1% triamcinolone acetonide and groupie was given topical application of 5% amlexanox. Both were to be applied on ulcers three times a day for 5 minutes. Patients were evaluated on 1st day, 4th day and 7th day for pain, size and erythema. Results: Group I had 10 males and 14 females and group II had 12 males and 12 females. The difference was non- significant (P>0.05). The mean VAS score in group I on 1st day was 5.2, in group II was 6.4. On 4th day it was 3.2 in group I and 3.6 in group II. It was 1.4 in group I and 2.0 in group II on 7th day. The difference was significant (P0.05). On 1st day, there was severe erythema seen in both groups. On 7th day, it was mild in both groups. Conclusion: Both 5% amlexanox and 0.1% triamcinolone acetonide found to be effective in reducing size, erythema and pain in cases of aphthous ulcers.

Effect of transversus abdominis plane block on chronic postoperative pain after inguinal hernia repair

Aim: The aim of the study is to evaluate the effect of transversus abdominis plane block on chronic postoperative pain after inguinal hernia repair. Methods: Prospective randomized double blinded study is conducted on 40 male patients posted for inguinal hernia repair under spinal anaesthesia. Divided into 2 equal groups. Group I received USG TAP block with 20 ml of 0.25% bupivacaine whereas Group II received 20 ml of normal saline (Placebo) at the end of surgery. Postoperative VAS scores, analgesic consumption, DN4 scoring at 3 and 6 months to evaluate chronic pain were studied.Results: Forty male patients were enrolled. Postoperative VAS scores of Group I had improved scores than Group II. Analgesic consumption is also reduced in Group I compared to Group II (156.6 ± 48.3 vs 282.1 ± 43.2) which was statistically significant. Incidence of neuropathic pain in Group II was 5% at 3 months and 10% at 6 months; whereas in Group I one patient scored ‘3’ at 3 months which reduced to ‘2’ at 6 months. No restriction of daily activities present in Group I patient.Conclusion: USG TAP block provided better postoperative VAS scores and analgesic consumption, along with the reduction in incidence of chronic pain than placebo.

Comparison of two treatment modalities for treatment of dentinal hypersensitivity following periodontal therapy.

Brief Background To evaluate and compare efficacy of 1.23% Acidulated Phosphate Fluoride (APF) gel with iontophoresis and topically applied calcium sodium phosphosillicate in the treatment of dentinal hypersensitivity. Materials and Methods In this clinical study, a total of 72 participants with dentinal hypersensitivity (DH) after periodontal treatment were included. 36 participants were assigned to the test group, treated with 1.23% APF gel iontophoresis and 36 participants were in the control group, treated with topical application of calcium sodium phosphosillicate. The VAS score was measured using tactile, air blast and cold-water test at baseline, 2 weeks and 2 months. Results Inter group comparison showed, statistically significant reduction in difference from baseline to 2 weeks follow-up and baseline to 2 months follow-up in VAS score in test group as compared to control group (p&lt;0.001) except for difference from baseline to 2 weeks in air blast test where test and control group showed same reduction. Difference from 2 weeks to 2 months showed no statistically significant reduction in both groups. Intra group comparison showed, statistically significant reduction in baseline to 2 weeks and baseline to 2 months in both groups and from 2 weeks to 2 months no statistically significant reduction in VAS score in both groups. Summary and Conclusions Within the limitation of the study, it can be concluded that iontophoresis with 1.23% APF gel is more effective. Key Words: 1.23 % APF gel;Calcium Sodium Phosphosilicate;Chronic periodontitis; Dentinal hypersensitivity, Periodontal therapy; VAS score

Comparison of ultrasound-guided serratus anterior plane block and erector spinae plane blockperioperatively in radical mastectomy

Objective: To compare the perioperative effects of ultrasound-guided serratus anterior plane block (SAPB) and erector spinae plane block (ESPB) in radical mastectomy. Methods: One hundred and fifty patients,undergoing radical mastectomy from May 2016 to Jan 2019,the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, were randomly divided into SAPB group, ESPB group and control group. Patients in SAPB group and ESPB group were received corresponding blocks before induction of general anesthesia. The control group was only received routine general anesthesia without any block. Patient-controlled intravenous analgesia (PCIA) was performed in all the patients postoperatively. The VAS score at rest or coughing and Ramsay score at 2, 4, 8, 12, 24, 48 h after operation were compared among the three groups. The intraoperative dosages of propofol and remifentanil,press times and sufentanil cumulative dosage of PCIA in 48 hours after operation, postoperative rehabilitation indicators and adverse effects were all compared. Results: In all the three groups,the VAS scores at rest and coughing increased first and then decreased 2 h to 48 h after operation. The VAS scores in SAPB group and ESPB group were lower than that in control group (P<0.05), whereas, no significant difference was observed between SAPB group and ESPB group (P>0.05). For Ramsay score, among the three groups, there were no significances of the main effects of group and time point, as well as interaction effect (all P>0.05). The intraoperative dosages of propofol and remifentanil in SAPB group and ESPB group were lower than those in control group (P<0.05), the press times and sufentanil cumulative dosage of PCIA after operation were also lower than those in control group (P<0.05). There was no significant difference in feeding time after operation among the three groups (P>0.05). The times of first anal exhaust, ambulation and hospitalization after operation in ESPB group and SAPB group were significantly shorter than those in control group (P<0.05). However, there was no significant difference between ESPB group and SAPB group in postoperative rehabilitation indicators mentioned above (P>0.05). The incidences of skin itching and nausea in ESPB and SAPB groups were lower than those in control group (P<0.05). There was no difference in the incidence of vomiting among the three groups (P>0.05). Conclusions: Both SAPB and ESPB can provide good and safe analgesia for radical mastectomy,with equivalent performances in analgesia and adverse effect.

Percutaneous curved vertebroplasty in the treatment of thoracolumbar osteoporotic vertebral compression fractures: a prospective study

Objective To investigate the clinical effect of percutaneous curved vertebroplasty in the treatment of thoracolum-bar osteoporotic vertebral compression fractures (OVCFs). Methods All of 85 patients with single thoracolumbar vertebral OVCFs who met the admission criteria from January 2017 to July 2018 were divided into three groups according to the random dig-its table method. They were treated with percutaneous curved vertebroplasty, routine unipedicular PVP and routine bipedicular PVP respectively. There were 25 patients in the percutaneous curved vertebroplasty group, 6 males and 19 females; aged 56-80 years, with an average age of 70.6±9.7 years. Fracture vertebral body distribution: T10 2 cases, T11 4 cases, T12 3 cases, L1 9 cases, L2 3 cases, L3 1 case, L4 1 case and L5 2 cases. There were 32 patients in the routine unipedicular PVP group, 6 males and 26 fe-males; aged 58-75 years, with an average age of 69.5±9.3 years. Fracture vertebral body distribution: T10 2 cases, T11 4 cases, T12 5 cases, L1 11 cases, L2 6 cases, L3 1 case, L4 1 case and L5 2 cases. There were 28 patients in the routine bipedicular PVP group, 5 males and 23 females; aged 59-81 years, with an average age of 69.8±8.8 years. Fracture vertebral body distribution: T10 2 cases, T11 4 cases, T12 4 cases, L1 10 cases, L2 4 cases, L3 1 case, L4 1 case and L5 2 cases. The operation time, injected cement volume, in-traoperative blood loss were recorded and analyzed. Preoperative, postoperative 1 week and 3 months visual analogue scale scores and oswestry disability index were adopted to value the clinical improvements. Preoperative, postoperative 1 week and 3 months relative vertebral height and kyphosis correction, and the cement leakage rate were measured and analyzed. Results There was no significant difference in the data of gender, age, VAS scores, ODI and distribution of fracture vertebrae among the three groups (P>0.05), and the baseline data was comparable. The average VAS score in the percutaneous curved vertebroplasty group was 2.3±0.5 at 1 week after surgery, that of the routine unipedicular PVP group was 2.4±0.4 and that of the routine bipe-dicular PVP group was 2.4±0.4; the average ODI in the percutaneous curved vertebroplasty group was 19.8%±3.9%, that of the routine unipedicular PVP group was 20.0%±4.1% and that of the routine bipedicular PVP group was 19.9%±3.8%; they were lower than the preoperative data, which were statistically significant (P 0.05). Operation time 39.10±2.00 min vs 38.70±1.70 min, injected cement volume 3.60±0.11 ml vs 3.50±0.13 ml and blood loss 5.10±0.30 ml vs 5.00±0.40 ml of the percutaneous curved vertebroplasty group and the routine unipedicular PVP group were less than those of the routine bipedicular PVP group, which were statistically significant (P<0.05). Conclution Percutaneous curved vertebroplasty could achieve satisfactory clinical outcomes for OVCFs, with advantages of less operation time, less blood loss, limited X-ray expo-sure, less injected cement volume, and more balanced augmentation for stabilization of the affected vertebrae and total verte-bral column. Key words: Thoracic vertebrae; Lumbar vertebrae; Osteoporosis; Spinal fractures; Vertebroplasty

Effect of perioperative dexamethasone on nausea, vomiting and pain after total knee arthroplasty

To investigate the effect of perioperative dexamethasone on nausea, vomiting and pain after unilateral total knee arthroplasty and to evaluate its safety. From February 2014 to June 2016, 100 patients with unilateral advanced osteoarthritis treated by total knee arthroplasty were divided into two groups: 50 patients in dexamethasone group including 27 males and 23 females, aged (72.30±7.02) years, were given intravenous drip of dexamethasone 10 mg before operation; 50 patients in saline group, including 26 males and 24 females, aged (71.30±6.08) years, were given the same amount of saline at the corresponding time. The VAS scores of pain at rest and at 45 degrees of knee flexion were recorded at 2, 4, 6, 8, 12, 24, 36 and 48 h after operation. Vomiting, antiemetic drugs and opioids were recorded at 0 to 24 h and 24 to 48 h after operation. The side effects and complications were recorded. All the 100 patients were followed up for an average of 14.5 months. VAS score of pain at rest in dexamethasone group was lower than that in saline group at 8, 24 and 48 h after operation (P<0.05); VAS score of dexamethasone group at 45 degrees after knee flexion was lower than that of saline group at 8 and 48 h after operation(P<0.05); VAS score of dexamethasone group at rest and 45 degrees after knee flexion was lower than that of saline group(P<0.05). The dosage of opioids and total opioids in dexamethasone group was lower than that in saline group at 0 to 24 h, 24 to 48 h after operation (P<0.05). The proportion of nausea and vomiting occurred at 0 to 24 h and 24 to 48 h after operation, and the proportion of antiemetic required at 0 to 24 h after operation had statistical significance between two groups(P<0.05). The total antiemetic dosage of dexamethasone group was less than that of saline group(P<0.05). As of the last follow-up, no complications such as infection, gastrointestinal ulcer and bleeding occurred in the two groups. Preoperative systemic application of dexamethasone can effectively reduce pain and nausea and vomiting after TKA without increasing postoperative complications.

The effect of dural release on extended laminoplasty for the treatment of multi-level cervical myelopathy

ObjectiveThe effects of dural release on extended laminoplasty for the treatment of multi-level cervical myelopathy were explored and discussed.MethodPatients, who underwent extended laminoplasty combined with dural release for the treatment of multi-level cervical myelopathy (35 cases, group A), were compared with patients who underwent simple extended laminoplasty (38 cases, group B). The JOA score, improvement rate, VAS score, distance of retroposition of the spinal cord, cervical lordosis were compared between the two groups.ResultsDural laceration occurred to five patients during surgery, three in group A and two in group B; cerebrospinal fluid leakage occurred to five patients, three in group A and two in group B. All patients were followed up for 10 to 48 months (mean 20.3 months). JOA scores and VAS scores in the last follow up period were significantly improved in the two groups than preoperative scores (p < 0.05). The improvement rate and JOA scores in group A were significantly higher than group B, while VAS scores in group A were significantly lower than group B (p < 0.05). There were no significant differences in cervical lordosis in the two groups in the last follow up (p > 0.05), and the distance of retroposition of the spinal cord in group A was higher than B (p < 0.05). No shut-up of the ‘door’ of vertebral lamina occurred in the period of follow-up.ConclusionDural release on extended laminoplasty can achieve retroposition of the spinal cord for multi-level cervical myelopathy, which is more effective than simple extended laminoplasty.

Comparison of two methods for endoscopic full-thickness resection of gastrointestinal lesions using OTSC

Background and aims: The aim of this study was to compare and analyze the feasibility and safety of two methods of endoscopic full-thickness resection (EFTR) for the management of challenging epithelial and subepithelial neoplasms that are not amenable to resection techniques.Material and methods: This was a retrospective case series study of patients who underwent one of two methods of EFTR, resection using ESD knives and post-resection closure with OTSC (Group 1), or closure with OTSC and secondary EFTR with snare (Group 2).Results: Of 11 patients, six were in Group 1 and five in Group 2. The mean time of the EFTR procedure was 76.83 ± 34.97 min in Group 1 which is significantly longer than that of Group 2 (p = .0128). The mean time of OSTC closure and length of hospital stay of Group 1 were also longer compared to Group 2, but the difference was not significant. Complete resection (R0) and technical success rates of Group 1 and Group 2 were 83.3% and 100% (p = .338), respectively. VAS scores of Group 1 immediately after the operation and after 24 h are significantly higher than those of Group 2 (p = .047 and p = .009, respectively). In Group 1, one patient had delayed perforation which led to fever and pneumoperitoneum, and one patient developed abdominal pain. No complications associated with the endoscopic procedure were observed in Group 2.Conclusion: EFTR of pre-resection closure are potentially faster compared with the concept of applying closure after EFTR. Larger prospective controlled studies comparing these two techniques are warranted in the future.

Zoledronic acid combined with percutaneous kyphoplasty in the treatment of osteoporotic compression fracture in a single T12 or L1 vertebral body in postmenopausal women.

To investigate and analyze the clinical effects of zoledronic acid (ZOL) in combination with percutaneous kyphoplasty (PKP) in the treatment of OVCF in postmenopausal women. Included in this study were 101 postmenopausal women patients with T12 or L1 OVCF who received PKP in our hospital between August 2015 and July 2017. They were randomly assigned to a zoledronic acid (ZOL) group (n= 50) or a control group (n= 51). Patients in ZOL group were treated preoperatively with IV infusion of 5mg ZOL in combination with 0.25μg/d calcitriol and D3 600mg/d calcium carbonate for a year. Patients in the control group were treated with the same dose of calcitriol and calcium carbonate D3 without ZOL. There was no statistically significant difference in age, height, weight, body mass index (BMI), menopause age, and the fractured vertebral body between the two groups. At 6 and 12months after treatment, bone mineral density (BMD) in ZOL group was higher than that in the control group (p< 0.01); bone markers (NMID, P1NP, and β-CTX) and the VAS score in ZOL group were significantly lower than those in the control group. No new fracture occurred in ZOL group. The incidence of recompression vertebral fracture (RVF) in the control group was 11.7%, while no RVF was detected in any patient in ZOL group. Mild adverse reactions in ZOL group were significantly higher than those in the control group, but all of them were relieved after symptomatic treatment. ZOL IV infusion in combination with PKP is beneficial for the treatment of T12 or L1 OVCF.