BACKGROUND Patients undergoing lumbar spine surgery usually suffer severe pain in the postoperative period.The erector spinae plane block(ESPB),first published in 2016,can anesthetize the ventral and dorsal rami of th...BACKGROUND Patients undergoing lumbar spine surgery usually suffer severe pain in the postoperative period.The erector spinae plane block(ESPB),first published in 2016,can anesthetize the ventral and dorsal rami of thoracic nerves and produce an extensive multi-dermatomal sensory block.AIM To assess whether bilateral ultrasound-guided ESPB at a lower thoracic level could improve pain control and quality of recovery in patients undergoing lumbar spine surgery.METHODS A total of 60 patients aged 18-80 years scheduled to undergo lumbar spine surgery with general anesthesia were randomly assigned to two groups:ESPB group(preoperative bilateral ultrasound-guided ESPB at T10 vertebral level)and control group(no preoperative ESPB).Both groups received standard general anesthesia.The main indicator was the duration to the first patient controlled intravenous analgesia(PCIA)bolus.RESULTS In the ESPB group,the duration to the first PCIA bolus was significantly longer than that in the control group(h)[8.0(4.5,17.0)vs 1.0(0.5,6),P<0.01],and resting and coughing numerical rating scale(NRS)scores at 48 h post operation were significantly lower than those in the control group(P<0.05).There was no significant difference between the two groups regarding resting and coughing NRS scores at 24 h post operation.Sufentanil consumption during the operation was significantly lower in the ESPB group than in the control group(P<0.01),while there was no significant difference between the two groups regarding morphine consumption at 24 or 48 h post operation.In the ESPB group,Modified Observer’s Assessment of Alertness/Sedation score within 20 min after extubation was higher and duration in the post-anesthesia care unit was shorter than those in the control group(P<0.01).CONCLUSION In patients undergoing lumbar spine surgery,ultrasound-guided ESPB at a lower thoracic level improves the analgesic effect,reduces opioid consumption,and improves postoperative recovery.展开更多
Objective:Recent studies have shown the important influence of various micro factors on the general biological activity and function of endothelial cells (ECs).Vascular endothelial growth factor (VEGF) and angiogenin ...Objective:Recent studies have shown the important influence of various micro factors on the general biological activity and function of endothelial cells (ECs).Vascular endothelial growth factor (VEGF) and angiogenin (ANG) are classic micro factors that promote proliferation,differentiation,and migration of ECs.The underlying pathophysiological mechanisms and related pathways of these micro factors remain the focus of current research.Data sources:An extensive search was undertaken in the PubMed database by using keywords including "micro factors" and "endothelial cell." This search covered relevant research articles published between January 1,2007 and December 31,2018.Study selection:Original articles,reviews,and other articles were searched and reviewed for content on micro factors of ECs.Results:VEGF and ANG have critical functions in the occurrence,development,and status of the physiological pathology of ECs.Other EC-associated micro factors include interleukin 10,tumor protein P53,nuclear factor kappa B subunit,interleukin 6,and tumor necrosis factor.The results of Gene Ontology analysis revealed that variations were mainly enriched in positive regulation of transcription by the RNA polymerase Ⅱ promoter,cellular response to lipopolysaccharides,negative regulation of apoptotic processes,external side of the plasma membrane,cytoplasm,extracellular regions,cytokine activity,growth factor activity,and identical protein binding.The results of the Kyoto Encyclopedia of Genes and Genomes analysis revealed that micro factors were predominantly enriched in inflammatory diseases.Conclusions:In summary,the main mediators,factors,or genes associated with ECs include VEGF and ANG.The effect of micro factors on ECs is complex and multifaceted.This review summarizes the correlation between ECs and several micro factors.展开更多
文摘BACKGROUND Patients undergoing lumbar spine surgery usually suffer severe pain in the postoperative period.The erector spinae plane block(ESPB),first published in 2016,can anesthetize the ventral and dorsal rami of thoracic nerves and produce an extensive multi-dermatomal sensory block.AIM To assess whether bilateral ultrasound-guided ESPB at a lower thoracic level could improve pain control and quality of recovery in patients undergoing lumbar spine surgery.METHODS A total of 60 patients aged 18-80 years scheduled to undergo lumbar spine surgery with general anesthesia were randomly assigned to two groups:ESPB group(preoperative bilateral ultrasound-guided ESPB at T10 vertebral level)and control group(no preoperative ESPB).Both groups received standard general anesthesia.The main indicator was the duration to the first patient controlled intravenous analgesia(PCIA)bolus.RESULTS In the ESPB group,the duration to the first PCIA bolus was significantly longer than that in the control group(h)[8.0(4.5,17.0)vs 1.0(0.5,6),P<0.01],and resting and coughing numerical rating scale(NRS)scores at 48 h post operation were significantly lower than those in the control group(P<0.05).There was no significant difference between the two groups regarding resting and coughing NRS scores at 24 h post operation.Sufentanil consumption during the operation was significantly lower in the ESPB group than in the control group(P<0.01),while there was no significant difference between the two groups regarding morphine consumption at 24 or 48 h post operation.In the ESPB group,Modified Observer’s Assessment of Alertness/Sedation score within 20 min after extubation was higher and duration in the post-anesthesia care unit was shorter than those in the control group(P<0.01).CONCLUSION In patients undergoing lumbar spine surgery,ultrasound-guided ESPB at a lower thoracic level improves the analgesic effect,reduces opioid consumption,and improves postoperative recovery.
基金a grant from the National Natural Science Foundation of China (No.31271097).
文摘Objective:Recent studies have shown the important influence of various micro factors on the general biological activity and function of endothelial cells (ECs).Vascular endothelial growth factor (VEGF) and angiogenin (ANG) are classic micro factors that promote proliferation,differentiation,and migration of ECs.The underlying pathophysiological mechanisms and related pathways of these micro factors remain the focus of current research.Data sources:An extensive search was undertaken in the PubMed database by using keywords including "micro factors" and "endothelial cell." This search covered relevant research articles published between January 1,2007 and December 31,2018.Study selection:Original articles,reviews,and other articles were searched and reviewed for content on micro factors of ECs.Results:VEGF and ANG have critical functions in the occurrence,development,and status of the physiological pathology of ECs.Other EC-associated micro factors include interleukin 10,tumor protein P53,nuclear factor kappa B subunit,interleukin 6,and tumor necrosis factor.The results of Gene Ontology analysis revealed that variations were mainly enriched in positive regulation of transcription by the RNA polymerase Ⅱ promoter,cellular response to lipopolysaccharides,negative regulation of apoptotic processes,external side of the plasma membrane,cytoplasm,extracellular regions,cytokine activity,growth factor activity,and identical protein binding.The results of the Kyoto Encyclopedia of Genes and Genomes analysis revealed that micro factors were predominantly enriched in inflammatory diseases.Conclusions:In summary,the main mediators,factors,or genes associated with ECs include VEGF and ANG.The effect of micro factors on ECs is complex and multifaceted.This review summarizes the correlation between ECs and several micro factors.
