RESUMEN
Background and Aims: Paravertebral block (PVB) is the regional anaesthesia of choice for percutaneous nephrolithotomy (PCNL). Erector spinae plane block (ESPB) is also effective for the same. This study aims to compare the analgesic efficacy and ease of performing PVB or ESPB for PCNL surgery. Methods: This study was conducted in 60 patients undergoing PCNL, who were randomised to Group P (n = 30; received ultrasound-guided [USG] PVB) and Group E (n = 30; received USG ESPB) after general anaesthesia. Blocks were administered at T10 level on the side of the surgery using 20 ml of 0.25% bupivacaine. The trachea was extubated at the end of surgery. The primary outcome was analgesia duration, and secondary outcomes were postoperative pain scores, analgesic consumption, ease of block performance, time taken to perform the block and complications between the two groups. Continuous variables were compared using an independent sample t-test, and categorical variables were analysed using Pearson's Chi-square test. Results: Demographic variables were comparable in both groups. The mean (standard deviation [SD]) time of first rescue analgesia in Group P and Group E were 16.6 (20.4)(95% confidence interval [CI]: 9.02-20.32) h and 16.3 (21.8) (95% CI: 8.17-24.51) h, respectively (P = 0.95). The postoperative pain scores and number of doses of analgesics used were comparable between the groups (P > 0.05). The time taken to perform PVB was much longer compared to the time taken to perform ESPB (P = 0.01). Conclusion: USG PVB and ESPB were equally effective for postoperative analgesia for PCNL surgery.
RESUMEN
Prostate cancer (PCa) progresses from a hormone-sensitive, androgen-dependent to a hormone-refractory, androgen-independent metastatic phenotype. Among the many genes implicated, ANXA2, a calcium-dependent phospholipid binding protein, has been found to have a critical role in the progression of PCa into more invasive metastatic phenotype. However, the molecular mechanisms underlying the absence of ANXA2 in early PCa and its recurrence in advanced stage are yet unknown. Moreover, recent studies have observed the deregulation of microRNAs (miRNAs) are involved in the development and progression of PCa. In this study, we found the down-regulation of miR-936 in metastatic PCa wherein its target ANXA2 was overexpressed. Subsequently, it has been shown that the downregulation of miRNA biogenesis by siRNA treatment in ANXA2-null LNCaP cells could induce the expression of ANXA2, indicating the miRNA mediated regulation of ANXA2 expression. Additionally, we demonstrate that miR-936 regulates ANXA2 expression by direct interaction at coding as well as 3'UTR region of ANXA2 mRNA by luciferase reporter assay. Furthermore, the overexpression of miR-936 suppresses the cell proliferation, cell cycle progression, cell migration, and invasion abilities of metastatic PCa PC-3 cells in vitro and tumor forming ability in vivo. These results indicate that miR-936 have tumor suppressor properties by regulating the over expression of ANXA2 in hormone-independent metastatic PCa. Moreover, our results suggest that this tumor suppressor miR-936 could be developed as a targeted therapeutic molecule for metastatic PCa control and to improve the prognosis in PCa patients.
