Objective To systematically evaluate effectiveness and safety of nerve block therapy for neck pain. Methods Databases including CENTRAL, PubMed, Ovid, ISI, EBSCO, CBM and CNKI were searched from the date of their establishment to November 2011, and relevant references were also retrieved manually to collect both domestic and abroad randomized controlled trials (RCTs) about nerve block therapy for neck pain. According to the inclusion and exclusion criteria, two researchers independently screened literature, extracted data, and assessed the quality of the included studies. Then the meta-analysis was conducted using RevMan 5.0 software. Results A total of 10 studies involving 625 participants were included. The results of qualitative analysis showed that: a) The short-term effectiveness of the nerve block therapy group was markedly superior to the placebo group, the cognitive therapy group and the transcutaneous electric nerve stimulation (TENS) group; and b) The short-term effectiveness of the combined nerve block therapy was markedly superior to the single nerve block therapy. The results of meta-analysis demonstrated that: a) There was no significant difference between the greater occipital nerve (GON) block group and the C2/3 nerve block group in neither short-term (SMD=−0.13, 95%CI −0.58 to 0.32, P=0.58) nor medium-term effectiveness (SMD=−0.01, 95%CI −0.46 to 0.44, P=0.98); and b): There was no significant difference between the injection with steroids group and the injection without steroids group in both short-term (SMD=0.16, 95%CI −0.13 to 0.44, P=0.28) and long-term effectiveness (SMD=0.27, 95%CI −0.02 to 0.55, P=0.07). Conclusion Current evidence shows nerve block therapy for neck pain is safe and especially good in short-term effectiveness. The combined nerve block therapy is probably more effective, but the effectiveness is not obviously improved by injection with or without steroids, and by different block methods. Due to the limitation of quality, quantity and total sample size of the included studies, this conclusion still needs to be proved by conducting more high quality and large scale studies.
目的 探讨改良区域神经阻滞麻醉在腹股沟疝无张力修补术中的优势和应用价值。方法 回顾性总结和分析2008年2月至2010年3月期间张掖医学高等专科学校附属医院运用改良区域神经阻滞麻醉行腹股沟疝无张力修补59例患者的临床资料。结果 59例患者按照神经阻滞麻醉效果分级标准，Ⅰ级52例，Ⅱ级6例， Ⅲ级1例。7例Ⅱ、Ⅲ级患者在分离腹膜前间隙内侧时自诉疼痛，经静脉给予杜非合剂2 ml后完成手术，但均未更改麻醉方式。术后无皮疹、皮下硬结、精索水肿、阴囊血肿、尿潴留、切口感染等并发症发生。结论 改良区域神经阻滞麻醉下行腹股沟疝无张力修补术效果好、安全性高、操作简单、费用低。
【摘要】 目的 观察密集型银质针松解术结合臂丛神经阻滞麻醉治疗老年肩周炎的疗效。 方法 2007年4月-2008年6月，将120例老年肩周炎患者（gt;60岁）随机分为治疗组、对照组各60例；治疗组采用密集型银质针松解术结合臂丛神经阻滞麻醉治疗，对照组则用单纯密集型银质针松解术治疗。 结果 治疗组痊愈43例、显效15例、好转2例；对照组痊愈41例、显效16例、好转3例。总有效率均为100%。两组疗效差异无统计学意义（Pgt;0.05），治疗组心率血压变化值及疼痛评分均低于对照组，差异有统计学意义（Plt;0.05）。 结论 密集型银质针松解术结合臂丛神经阻滞为治疗老年肩周炎的安全、有效方法。【Abstract】 Objective To investigate the effect of dense silver needle acupuncture therapy combined with brachial plexus nerve block for old patients with shoulder periarthritis. Methods A total of 120 patients with shoulder periarthritis diagnosed in our hospital between April 2007 and June 2008 were randomly divided into treatment group and control group with 60 in each group. Patients in the treatment group were treated with dense silver needle acupuncture therapy combined with brachial plexus nerve block, while patients in the control group were only treated with dense silver needle acupuncture therapy. Results In the treatment group, 43 patients were cured, the treatment produced effect in 15 patients, and improvement could be found in two patients. For the control group, those three numbers were respectively 41, 16 and 3. The effectice rate was 100% in both groups. The difference of effect between the two groups was not statistically significant (Pgt;0.05), while the variation of blood pressure and heart rate and the visual analogue scales in the treatment group were significant lower than these in the control gvroup (Plt;0.05) Conclusion The dense silver needle acupuncture therapy combined with brachial plexus nerve block is safe and effective in treating old patients with shoulder periarthritis.
Splanchnicectomy is a minimally invasive and effective method of treating chronic upper abdominal pain in cancer. It offers good, short-term pain relief, reduces morphine consumption, and improves patients' satisfaction. In the wake of developments in minimally invasive technology, the method has brought a number of new breakthroughs. We reviewed the effect of the success of splanchnicectomy.
Objective To compare the effect of sciatic nerve block (SNB) combined with continuted femoral nerve block (FNB) or continuted adductor canal block (ACB) on pain and motor function after total knee arthroplasty (TKA). Methods A total of 60 patients with TKA-treated osteoarthritis of the knee who met the selection criteria were enrolled between November 2020 and February 2021 and randomised allocated into the study group (SNB combined with continuted ACB) and the control group (SNB combined with continuted FNB), with 30 cases in each group. There was no significant difference in gender, age, body mass, height, body mass index, preoperative Hospital for Special Surgery (HSS) score, femoral tibial angle, and medial proximal tibial angle between the two groups (P>0.05). The operation time, the initial time to the ground, the initial walking distance, and the postoperative hospital stay were recorded. At 2, 4, 6, 12, 24, and 48 hours after operation, the numerical rating scale (NRS) score was used to evaluate the rest pain around the knee joint, the quadriceps femoris muscle strength was evaluated by the freehand muscle strength method, and the knee flexion and extension angles were measured. Results There was no significant difference in the operation time and initial walking distance between the two groups (P>0.05); the initial time to the ground and postoperative hospital stay of the study group were significantly shorter than those of the control group (P<0.05). Except for the 48-hour postoperative NRS score of the study group, which was significantly lower than that of the control group (P<0.05), there was no significant difference in the NRS scores between the two groups at the remaining time points (P>0.05). The quadriceps femoris muscle strength from 4 to 24 hours postoperatively and the knee extension angle from 2 to 6 hours postoperatively of the study group were significantly better than those of the control group (P<0.05); the differences in the quadriceps femoris muscle strength and knee extension and flexion angles between the two groups at the remaining time points were not significant (P>0.05). Conclusion SNB combined with either continuted ACB or continuted FNB can effectively relieve pain in patients after TKA, and compared with combined continuted FNB, combined continuted ACB has less effect on quadriceps femoris muscle strength, and patients have better recovery of knee flexion and extension mobility.
ObjectiveTo determine the effectiveness of continuous intercostal nerve block for pain relief after thoracotomy.MethodsFrom November 2017 to October 2018, 120 patients who received thoracotomy procedure in our hospital were collected, including 60 males and 60 females aged 40-77 (58.10±7.00) years. The patients were randomly allocated into three groups by digital table including a continuous intercostal nerve block group (group A, n=40), a single intercostal nerve block group (group B, n=40), and an epidural analgesia group (group C, n=40). All the groups received the same basic analgesia. The pain scores and rescue analgesic doses were compared.ResultsOn postoperative day (POD) 0, all groups achieved effective pain control, and the visual analogue score was 2.02±0.39 points in the group A, 2.13±0.75 points in the group B and 2.03±0.69 points in the group C (P>0.05). On POD 0-2 and POD 3-4 (without basement analgesia), there was no significant difference between the group A and group C in the pain scores (2.08±0.28 points vs. 1.93±0.53 points, 3.20±0.53 points vs. 3.46±0.47 points, P>0.05), however, the difference between POD 0-2 and POD 3-4 in each group was stastically different (group A, 2.08±0.28 points vs. 3.20±0.53 points; group B, 2.42±0.73 points vs. 5.45±0.99 points; group C 1.93±0.53 points vs. 3.46±0.47 points, P<0.05). In terms of the rescue analgesic doses, there was no significant difference between the group A and group C (220.00±64.08 mg vs. 225.38±78.85 mg, P>0.05); it was larger in the group B than that in the group A and group C (343.33±119.56 mg vs. 220.00±64.08 mg; 343.33±119.56 mg vs. 225.38±78.85 mg, P<0.05).ConclusionMultimodal analgesia is an optimal choice in the initial stage after thoracotomy surgery. Continuous intercostal nerve block is an effective way to pain management in patients with thoracotomy.
ObjectiveTo evaluate the clinical efficacy and safety of the inguinal approach versus classical pubic approach for obturator nerve block (ONB) in transurethral resection of bladder tumors (TUR-BT).MethodsDatabases including PubMed, The Cochrane Library, EMbase, Web of Science, WanFang Data, CNKI and VIP databases were electronically searched to identify randomized controlled trials using ONB in TUR-BT from inception to May 2020. Two reviewers independently screened literature, extracted data, and assessed risk bias of included studies. Meta-analysis was performed by using Stata 14.2 software.ResultsA total of 7 studies involving 474 patients were included. The meta-analysis results showed that there was no significant difference between inguinal approach and pubic approach in terms of the ONB success rate (RR=1.06, 95%CI 0.96 to 1.17, P=0.23), while the one-time success rate of puncture of inguinal approach was higher than that of pubic approach (RR=1.47, 95%CI 1.01 to 2.15, P=0.04). Compared with the pubic approach, the overall complications of inguinal approach were lower (RR=0.24, 95%CI 0.08 to 0.71, P=0.01). However, no significant difference was found between the two groups in terms of subcutaneous hematoma (RR=0.46, 95%CI 0.08 to 2.66, P=0.38).ConclusionsThe current evidence indicates that the success rate of one puncture of inguinal approach is higher than that of pubic approach, and the overall complications of the inguinal approach are much lower than that of the pubic approach. However, the above conclusions are still required to be verified through more high-quality studies due to the limited quantity and quality of included studies.
Objective To compare the anesthetic effects of traditional digital block with single-injection digital block in digital injury patients for subcutaneous digital blocks. Methods Patients with one or two digits injured were randomized to the traditional digital block group and single-injection digital block group. All of the blocks were conducted by one investigator. The patients and outcome assessor were blinded to the treatment allocation. Both of the per-protocol-population (PP) analysis and the intention-to-treatment (ITT) analysis were performed to compare the two block techniques in terms of the pain during infiltration, the onset time of anesthesia and the failure rate of anesthesia. Results A total of 93 patients (109 digits) were included with 51 (61 digits) in the traditional block group and 42 (48 digits) in the single-injection block group.Two patients (3 digits) dropped out. Both of the PP analysis and ITT analysis showed that no significant difference between the two groups were detected in terms of the pain during infiltration, the onset time of anesthesia and the failure rate of anesthesia (P﹥0.05). Conclusions The subcutaneous single-injection digital block is as effective as the traditional digital block, but is much easier to perform. This technique is indicated for the digital anesthesia of palmar aspect distal to the proximal digital crease and dorsal aspect of the distal and middle phalanxes.
ObjectiveTo systematically evaluate the analgesic efficacy of local infiltration analgesia versus femoral nerve block for total knee arthroplasty. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 4, 2016), WanFang Data, CBM, and CNKI were searched to collect randomized controlled trials (RCTs) about the analgesic efficacy of local infiltration analgesia versus femoral nerve block for total knee arthroplasty from inception to April 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. The meta-analysis was conducted using RevMan 5.3 software. ResultsA total of 13 RCTs involving 1 001 patients were included. The results of meta-analysis showed that: There were no significant differences in pain scores at rest (SMD=0.02, 95%CI -0.23 to 0.27, P=0.86), morphine consumption on movement (MD=-1.85, 95%CI -4.67 to 0.97, P=0.20), incidence of post-operative nausea and vomiting (RD=0.02, 95%CI -0.03 to 0.08, P=0.41) and incidence of post-operative knee infection (RD=0.01, 95%CI -0.02 to 0.03, P=0.60) between the two groups, but he local infiltration analgesia group had lower length of stay than the femoral nerve block group with statistical difference (SMD=-0.24, 95%CI -0.41 to -0.07, P=0.005). ConclusionLocal infiltration analgesia provides similar postoperative analgesia after total knee arthroplasty to femoral nerve block. However, due to the limited quantity of the included studies, the above conclusion still need to be verified by more high quality studies.