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Huang S.-H.,Lanzhou University | Lu J.,Sichuan Provincial Peoples Hospital and Sichuan Academy of Medical science | Gan H.-Y.,Northwest University for Nationalities | Li Y.,Lanzhou University | And 2 more authors.
Hepatobiliary and Pancreatic Diseases International | Year: 2016

Background Ultrasound-guided transversus abdominis plane (TAP) block is an adjunct therapy to provide effective postoperative analgesia in abdominal surgical procedures. Dexamethasone is a supplement agent that can improve the efficacy of local anesthesia. However, information about its additive effect is limited. This study aimed to compare the analgesic efficiency using ultrasound-guided TAP block with and without perineural dexamethasone for patients who underwent laparoscopic cholecystectomy. Methods Sixty patients who underwent laparoscopic cholecystectomy were randomly divided into three groups: group I, controls; group II, TAP; and group III, TAP+perineural dexamethasone supplement. The requirement of additional analgesia and the first-time request of rescue-analgesia were recorded after operation and the numerical rating scale was evaluated at specific intervals. Results Compared to group I, the first-time requirement of rescue-analgesia in groups II and III was significantly delayed (403.0±230.9, 436.0±225.3 vs 152.3±124.7, P<0.01). Compared with those in group I, patients in groups II and III were associated with lower numerical rating scale pain scores (P<0.01) and less postoperative analgesic consumption (P<0.01). There was no significant difference in the variables mentioned above between groups II and III (P>0.05). Conclusion Perineural dexamethasone has no additive/synergistic effect with subcostal TAP block on analgesic efficacy for the patients undergoing laparoscopic cholecystectomy. © 2016 The Editorial Board of Hepatobiliary & Pancreatic Diseases International

Li Q.,University of Sichuan | Li Q.,Sichuan Provincial Peoples Hospital and Sichuan Academy of Medical Science | He Y.,University of Sichuan | Chen L.,University of Sichuan | Chen M.,University of Sichuan
BMC Cardiovascular Disorders | Year: 2016

Background: This study investigated whether, for patients with severely calcified coronary lesions, use of a cutting balloon (CB) during rotational atherectomy (RA) before placing a drug-eluting stent will improve periprocedural outcomes, compared to RA with a conventional plain balloon. Methods: In a randomized controlled trial, patients with severely calcified lesions of calcium arc ≥180° were apportioned to receive intensive plaque modification with RA and CB (RA + CB; n = 35) or RA with conventional plain balloon (RA; n = 36). Intravascular ultrasound was applied for quantitative or qualitative analyses of percutaneous coronary intervention outcomes. The primary outcome was acute lumen gain after drug-eluting stent. Results: The RA + CB and RA groups were similar in baseline mean arcs of superficial calcium, and minimum lumen cross-sectional areas (CSAs). The mean minimum stent CSA after percutaneous coronary intervention (PCI) of the RA + CB group (5.9 ± 1.7 mm2) was significantly larger than that of the RA group (5.0 ± 1.4 mm2; P = 0.021). Patients in the RA + CB group achieved significantly larger acute CSA gain after PCI (4.5 ± 1.5 mm2) relative to the RA group (3.8 ± 1.5 mm2; P = 0.035). The groups were similar in rates of periprocedural complications, but at the 1-year follow-up the RA + CB had a lower rate of revascularization for restenosis of the target vessel and MACE (5.7 %) than did the RA group (22.2 %, P = 0.046). Conclusion: Aggressive plaque preparation with RA and CB seems to be safe and effective for patients with severely calcified coronary lesions. Trial registration: Current Controlled Trials ChiCTR-INR-16008274. Retrospectively registered 12 April 2016. © 2016 Li et al.

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