AIM: To prospectively evaluate the effectiveness and safety of continuous wound infiltration(CWI) for pain management after open gastrectomy. METHODS: Seventy-five adult patients with American Society of Anesthesiolog...AIM: To prospectively evaluate the effectiveness and safety of continuous wound infiltration(CWI) for pain management after open gastrectomy. METHODS: Seventy-five adult patients with American Society of Anesthesiologists(ASA) Physical Status Classification System(ASA) grade 1-3 undergoing open gastrectomy were randomized to three groups. Group 1 patients received CWI with 0.3% ropivacaine(group CWI). Group 2 patients received 0.5 mg/m L morphine intravenously by a patient-controlled analgesia pump(PCIA)(group PCIA). Group 3 patients received epidural analgesia(EA) with 0.12% ropivacaine and 20 μg/m L morphine with an infusion at 6-8 m L/h for 48 h(group EA). A standard general anesthetic technique was used for all three groups. Rescue analgesia(2 mg bolus of morphine, intravenous) was given when the visual analogue scale(VAS) score was ≥ 4. The outcomes measured over 48 h after the operation were VAS scores both at rest and during mobilization, total morphine consumption, relative side effects, and basic vital signs. Further results including time to extubation, recovery of bowel function, surgical wound healing,mean length of hospitalization after surgery, and the patient's satisfaction were also recorded.RESULTS: All three groups had similar VAS scores during the first 48 h after surgery. Group CWI and group EA, compared with group PCIA, had lower morphine consumption(P < 0.001), less postoperative nausea and vomiting(1.20 ± 0.41 vs 1.96 ± 0.67, 1.32 ± 0.56 vs 1.96 ± 0.67, respectively, P < 0.001), earlier extubation(16.56 ± 5.24 min vs 19.76 ± 5.75 min, P < 0.05, 15.48 ± 4.59 min vs 19.76 ± 5.75 min, P < 0.01), and earlier recovery of bowel function(2.96 ± 1.17 d vs 3.60 ± 1.04 d, 2.80 ± 1.38 d vs 3.60 ± 1.04 d, respectively, P < 0.05). The mean length of hospitalization after surgery was reduced in groups CWI(8.20 ± 2.58 d vs 10.08 ± 3.15 d, P < 0.05) and EA(7.96 ± 2.30 d vs 10.08 ± 3.15 d, P < 0.01) compared with group PCIA. All three groups had similar patient satisfaction and wound heal展开更多
AIM: To compare the effectiveness of needle-free incision suture closure with butterfly tape and traditional secondary suturing techniques in treating incision infection. METHODS: Two hundred and twenty-three patients...AIM: To compare the effectiveness of needle-free incision suture closure with butterfly tape and traditional secondary suturing techniques in treating incision infection. METHODS: Two hundred and twenty-three patients with incision infection following hepatobiliary surgery at a tertiary hospital were randomly divided into three groups: 90 patients were closed by needle-free incision suture closure, which gradually closed the incision wound when drainage from incision infection was visibly decreased and healthy granulation tissues had grown; 79 patients were closed by butterfly bandage; another 54 patients were closed by traditional secondary suturing technique. Healing time of incision infection was calculated from the beginning of dressing change to the healing of the incision. RESULTS: Healing time in the needle-free incision suture closure group (24.2 +/- 7.2 d) was significantly shorter than that in the butterfly bandage group (33.3 +/- 11.2 d) and the traditional secondary suturing group (36.2 +/- 15.3 d) (P < 0.05). Healing time in the butterfly bandage group appeared to be slightly shorter than that in the secondary suture group, but the difference was not statistically significant (P > 0.05). CONCLUSION: Needle-free incision suture closure could gradually close the infection wound at the same time of drainage and dressing change, thereby shortening the healing time. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.展开更多
基金Supported by Foundation of Health Department of Zhejiang ProvinceChina+3 种基金No.2011RCA207Foundation of Education Department of Zhejiang ProvinceChinaNo.Y201431914
文摘AIM: To prospectively evaluate the effectiveness and safety of continuous wound infiltration(CWI) for pain management after open gastrectomy. METHODS: Seventy-five adult patients with American Society of Anesthesiologists(ASA) Physical Status Classification System(ASA) grade 1-3 undergoing open gastrectomy were randomized to three groups. Group 1 patients received CWI with 0.3% ropivacaine(group CWI). Group 2 patients received 0.5 mg/m L morphine intravenously by a patient-controlled analgesia pump(PCIA)(group PCIA). Group 3 patients received epidural analgesia(EA) with 0.12% ropivacaine and 20 μg/m L morphine with an infusion at 6-8 m L/h for 48 h(group EA). A standard general anesthetic technique was used for all three groups. Rescue analgesia(2 mg bolus of morphine, intravenous) was given when the visual analogue scale(VAS) score was ≥ 4. The outcomes measured over 48 h after the operation were VAS scores both at rest and during mobilization, total morphine consumption, relative side effects, and basic vital signs. Further results including time to extubation, recovery of bowel function, surgical wound healing,mean length of hospitalization after surgery, and the patient's satisfaction were also recorded.RESULTS: All three groups had similar VAS scores during the first 48 h after surgery. Group CWI and group EA, compared with group PCIA, had lower morphine consumption(P < 0.001), less postoperative nausea and vomiting(1.20 ± 0.41 vs 1.96 ± 0.67, 1.32 ± 0.56 vs 1.96 ± 0.67, respectively, P < 0.001), earlier extubation(16.56 ± 5.24 min vs 19.76 ± 5.75 min, P < 0.05, 15.48 ± 4.59 min vs 19.76 ± 5.75 min, P < 0.01), and earlier recovery of bowel function(2.96 ± 1.17 d vs 3.60 ± 1.04 d, 2.80 ± 1.38 d vs 3.60 ± 1.04 d, respectively, P < 0.05). The mean length of hospitalization after surgery was reduced in groups CWI(8.20 ± 2.58 d vs 10.08 ± 3.15 d, P < 0.05) and EA(7.96 ± 2.30 d vs 10.08 ± 3.15 d, P < 0.01) compared with group PCIA. All three groups had similar patient satisfaction and wound heal
基金Supported by National Nature Science Foundation of China,No.30801111 and No.30972923Science and Technology Sup-port Project of Sichuan Province No.14ZC1337,No.14ZC1335 and No.2014SZ0002-10
文摘AIM: To compare the effectiveness of needle-free incision suture closure with butterfly tape and traditional secondary suturing techniques in treating incision infection. METHODS: Two hundred and twenty-three patients with incision infection following hepatobiliary surgery at a tertiary hospital were randomly divided into three groups: 90 patients were closed by needle-free incision suture closure, which gradually closed the incision wound when drainage from incision infection was visibly decreased and healthy granulation tissues had grown; 79 patients were closed by butterfly bandage; another 54 patients were closed by traditional secondary suturing technique. Healing time of incision infection was calculated from the beginning of dressing change to the healing of the incision. RESULTS: Healing time in the needle-free incision suture closure group (24.2 +/- 7.2 d) was significantly shorter than that in the butterfly bandage group (33.3 +/- 11.2 d) and the traditional secondary suturing group (36.2 +/- 15.3 d) (P < 0.05). Healing time in the butterfly bandage group appeared to be slightly shorter than that in the secondary suture group, but the difference was not statistically significant (P > 0.05). CONCLUSION: Needle-free incision suture closure could gradually close the infection wound at the same time of drainage and dressing change, thereby shortening the healing time. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
