Effect of Patient-Controlled Epidural Analgesia (PCEA) Based on ERAS on Postoperative Recovery of Patients Undergoing Gynecological Laparoscopic Surgery.

Objective: To explore the effect of patient-controlled epidural analgesia (PCEA) based on enhanced recovery after surgery (ERAS) on the postoperative recovery of patients undergoing gynecological laparoscopic surgery. Methods: Between January 2019 and December 2020, 90 patients scheduled for gynecological laparoscopic surgery and assessed for eligibility were recruited and randomly assigned at a ratio of 1 : 1 to receive either conventional analgesic management (regular group) or PCEA based on ERAS (ERAS group). Comparisons of postoperative rehabilitation indicators, visual analogue scale (VAS) score, self-care ability, complications, and nursing satisfaction were conducted between the two groups. Results: The ERAS group had significantly shorter first exhaust time (FET), first defecation time (FDT), out-of-bed activity time (OAT), and length of stay (LOS) versus the regular group (P < 0.05). The VAS scores were significantly decreased after treatment, with lower results observed in the ERAS group (P < 0.05). The level of self-responsibility, self-concept, self-care skills, and health knowledge increased significantly in both groups after the intervention, and the ERAS group showed significantly higher results than the regular group (P < 0.05). The total incidence of complications in the ERAS group was significantly lower than that in the regular group (P < 0.05). Eligible patients given PCEA based on ERAS were associated with a higher nursing satisfaction (97.78%) versus conventional analgesic management (82.22%) (P < 0.05). Conclusion: The application of ERAS for postoperative PCEA management in gynecological laparoscopy provides promising results by effectively enhancing the quality of surgery and promoting rapid postoperative recovery, with a good safety profile.

[Effect of L-arginine on diabetic rats].

OBJECTIVE: To observe the effect of L-arginine on diabetic rats. METHODS: Forty adult male Lewis rats were randomized equally into diabetic and normal control groups, and the former rats were treated intraperitoneally with streptozotocin to induce diabetes mellitus. Seven days later, half of the diabetic and normal rats were injected intraperitoneally with L-arginine at the daily dose of 1 g/kg, while the remainder were given saline instead. All the rats were euthanized on 10 days after L-arginine or saline treatment, and their body weight, plasma protein, arginine and sugar, food and water intake were analyzed. RESULTS: Diabetic rats had obviously decreased body weight, plasma protein and arginine but increased blood sugar and food and water intakes in comparison with the control rats. L-arginine significantly increased plasma protein and arginine, decreased food and water intakes, but failed to prevent weight loss and blood sugar increment in diabetic rats as compared to their saline-treated counterparts. L-arginine supplementation did not result in any changes other than arginine elevation in the control rats. CONCLUSION: L-arginine supplementation can partially improve polydipsia and polyphagia and increase plasma protein in diabetic rats.

[Clinical observation on treatment of diabetic foot by integrative Chinese and Western Medicine].

OBJECTIVE: To observe the efficacy of integrative Chinese and western medicine (ICWM) in treating diabetic foot. METHODS: Sixty-three patients were randomly divided into the treated group (n = 33) and the control group (n = 30). Both groups were treated by same baseline treatment with vasodilator, anti-agglutination agents and external treatment, to the treated group, Chinese drugs were given additionally according to the Syndrome Differentiation. RESULTS: In the treated group, the treatment showed markedly effective in 12 patients, effective in 18 and ineffective in 3, the total effective rate being 90.0%, while in the control group, the corresponding numbers were 9, 14, 7 and 76.7%, comparison between the two groups showed significant difference (chi 2 = 15.8, P < 0.05). The case number of Grade II, III and IV in the treated group reduced, and those recovered to Grade 0 increased, as compared with those in the control group, the difference was significant (P < 0.05). Patients with healing of ulcerative wound and fresh wound granulation in the treated group, as compared with those in the control group, the difference was significant (P < 0.05). Levels of fasting blood glucose and blood glucose 2 hrs after meal were all improved in both groups, which showed significant difference as compared with those before treatment (P < 0.05). CONCLUSION: The efficacy of ICWM treatment in treating diabetic foot was better than the treatment of western medicine alone.