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Liu J, Shi C, Wang D, Cui X, Geng L, Cui J, Sun D, Yin Z. Effects of different anesthesia methods on labor process and postpartum serum estrogen and progesterone levels in primiparas with painless labor. Clinics (Sao Paulo) 2024; 79:100442. [PMID: 38996725 PMCID: PMC11301188 DOI: 10.1016/j.clinsp.2024.100442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/08/2024] [Accepted: 06/16/2024] [Indexed: 07/14/2024] Open
Abstract
OBJECTIVE To look into the effects of different anesthesia methods on the labor process and the expression of serum estrogen and progesterone in primiparas with painless labor. METHODS 60 primiparas receiving painless labor were selected as the research objects, and they were divided into either a Spinal & Continuous epidural anesthesia group (n = 30) or a continuous epidural anesthesia group (n = 30), anesthesia is administered using the corresponding anesthesia method. The authors compared serum estrogen and progesterone, inflammatory index expression, pain degree and neonatal health status in different periods. RESULTS At T2 and T3, serum P, LH, FSH and E2 levels in the Spinal & Continuous epidural anesthesia group were signally lower than those in the Spinal & Continuous epidural anesthesia group (p < 0.05). Spinal & Continuous epidural anesthesia group harbored faster onset and longer duration of sensory block and motor block than the Continuous epidural anesthesia group (p < 0.05). SAS and SDS scores of the Spinal & Continuous epidural anesthesia group were clearly lower than those of the Continuous epidural anesthesia group (p < 0.05). VAS score and serum TNF-α, IL-6 levels of pregnant women in the Spinal & Continuous epidural anesthesia group were memorably lower than those in the Continuous epidural anesthesia group at T2 and T3 (p < 0.05). The total incidence of postoperative complications in the Spinal & Continuous epidural anesthesia group was distinctively lower than that in the Continuous epidural anesthesia group (p < 0.05). CONCLUSION Spinal anesthesia combined with continuous epidural anesthesia has a better anesthesia effect in the painless labor of primiparas, which can effectually ameliorate the labor process and the expression of serum estrogen and progesterone.
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Affiliation(s)
- JunYan Liu
- Department of Anesthesiology, Cangzhou Hospital of Integrated TCM-WM·HEBEI, Cangzhou City, Heibei Province, China
| | - ChongLai Shi
- Department of Anesthesiology, Yangxin People's Hospital, Huangshi City, Hubei Province, China
| | - Dan Wang
- Department of Military Casualty Management, General Hospital of Western Theater of Chinese People's Liberation Army, Sichuan City, Chengdu Province, China
| | - XiaoDong Cui
- Department of Anesthesiology, Cangzhou Hospital of Integrated TCM-WM·HEBEI, Cangzhou City, Heibei Province, China
| | - LiLi Geng
- Department of Gynecology, Cangzhou Hospital of Integrated Chinese and Western medicine, Cangzhou City, Heibei Province, China
| | - JingJing Cui
- Department of Anesthesiology, Cangzhou Hospital of Integrated TCM-WM·HEBEI, Cangzhou City, Heibei Province, China
| | - DongMei Sun
- Department of Cardiovascular Medicine, Yanshan People's Hospital, Cangzhou City, Hebei Province, China
| | - Zhuo Yin
- Department of Anesthesiology, DaLian Medical center For Women and Children, Dalian City, Liaoning Province, 116011, China.
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Ma G, Jiang P, Mo B, Luo Y, Zhao Y, Wang X, Shi C, Huang Y. Take-Home Video Shortens the Time to First Ambulation in Patients With Inguinal Hernia Repair Under General Anesthesia: A Retrospective Observational Study. Front Med (Lausanne) 2022; 9:848280. [PMID: 35847805 PMCID: PMC9278018 DOI: 10.3389/fmed.2022.848280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Data on the relationship between take-home video and the time to first ambulation remains scant. Here, we aimed to investigate whether viewed take-home video during pre-hospitalization is independently associated with the time to first ambulation in postoperative patients with inguinal hernia repair under general anesthesia. Methods We retrospectively reviewed and analyzed the relationship between viewed take-home video and the time to first ambulation between September 2020 and October 2021.The independent t-tests or Mann-Whitney U-tests was used to compare the means of two groups (viewed take-home video and non-viewed take-home video). Chi-square test was used to compare the rates between the two groups. We used a linear regression model to see if there was a difference between exposure and outcome variable. Both models were used to observe the effect size of the exposed variable. Subgroup analysis was employed to assess the impact of various factors. Results This study included a total of 120 patients with inguinal hernia repair under general anesthesia following day surgery. The average age of the participants in the two groups was 43.16 and 44.83 years, respectively, and about 82.5% of the patients were male. Our fully adjusted linear regression results showed that individuals in the viewed video group were associated with a decreased time to first ambulation (h) after adjusting for confounders (β = −0.50, 95%CI: −0.83, −0.17; P = 0.004). In addition, the linear regression analysis of the relationship between viewed video and length of stay showed that β = −2.10 (95%CI:CI: −3.85, −0.34; P = 0.021). Similarly, subgroup analysis yielded similar results for the viewed video group patients compared to those in the non-viewed video group. Conclusion Taken together, our findings demonstrated that viewed video could shorten the time to first ambulation, which in turn reduce the length of stay in postoperative patients under general anesthesia.
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Affiliation(s)
- Guozhen Ma
- Day Surgery Care Unit, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- School of Nursing, Philippine Women's University, Manila, Philippines
| | - Pengjun Jiang
- Department of Anorectal Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Beirong Mo
- Department of Nursing, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- *Correspondence: Beirong Mo
| | - Yijun Luo
- Department of Anesthesiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Yongling Zhao
- Department of Gastrointestinal Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Xingguang Wang
- Day Surgery Care Unit, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Chunmiao Shi
- Day Surgery Care Unit, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Yanhui Huang
- Day Surgery Care Unit, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
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Costa F, Pascarella G, Luffarelli P, Strumia A, Biondo G, Piliego C, Alloni R, Agrò FE. Selective spinal anesthesia with hyperbaric prilocaine provides better perioperative pain control than local anesthesia for ambulatory inguinal hernia repair without affecting discharging time: a randomized controlled trial. JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE (ONLINE) 2022; 2:6. [PMID: 37386519 DOI: 10.1186/s44158-022-00034-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/10/2022] [Indexed: 07/01/2023]
Abstract
PURPOSE Local anesthesia is the most used anesthetic technique for inguinal hernia repair, despite its unpredictability. Selective spinal anesthesia with a short-term local anesthetic guarantees rapid recovery, predictable duration and low incidence of side effects. We tried to assess the efficacy of this neuraxial technique in ambulatory setting. METHODS One hundred thirty-two ASA I-III, aged > 18 patients scheduled for inguinal hernia repair have been randomized into two groups receiving unilateral spinal anesthesia with 40 mg of hyperbaric prilocaine (group A) or local anesthesia with mepivacaine (group B). PRIMARY ENDPOINT intraoperative and post-operative NRS. Other outcomes: sensory block onset, need for opiates and deep sedation, surgery duration, and time to discharge. RESULTS Group A: intraoperative NRS was 0 in 100% of patients; post-operative maximum NRS was > 3 in 12.12% of patients. Group B: mean intraoperative NRS was 4; mean post-operative NRS was 2.5. Spinal anesthesia resulted superior in controlling both intraoperative and post-operative pain (p < 0.00001; p = 0.008). Mean time of the motor block resolution in group A was 98 ± 2 min. Mean time to discharge was not significantly different between groups. Surgical time was significantly different between the two groups (mean time of 37 ± 3.2 min group A; 54 ± 6 min group B-p < 0.00001). CONCLUSION Spinal anesthesia group patients had significantly less pain than local anesthesia group, both intraoperatively and post-operatively, without differences in time to discharge, incidence of complications and with improvement of surgical time. More randomized controlled trials are needed to confirm this hypothesis. TRIAL REGISTRATION NCT05136534 . Registered November 29, 2021-Retrospectively registered.
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Affiliation(s)
- Fabio Costa
- Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128, Rome, Italy.
| | - Giuseppe Pascarella
- Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128, Rome, Italy
| | - Paolo Luffarelli
- Department of Pelvic Floor Surgery and Proctology, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128, Rome, Italy
| | - Alessandro Strumia
- Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128, Rome, Italy
| | - Gaspare Biondo
- Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128, Rome, Italy
| | - Chiara Piliego
- Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128, Rome, Italy
| | - Rossana Alloni
- Department of Specialistic General Surgery, Campus Bio-Medico of Rome, via Álvaro del Portillo 21, 00128, Rome, Italy
| | - Felice E Agrò
- Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128, Rome, Italy
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