A Comparative Observation on Wound Healing After Surgery for Necrotizing Fasciitis: Kangfuxin Liquid Gauze versus Vaseline Gauze.

Objective: To evaluate the effectiveness of Kangfuxin Liquid (a traditional Chinese medicine) gauze and Vaseline gauze in wound healing after necrotizing fasciitis surgery. Method: The study was conducted at The First Affiliated Hospital of Baotou Medical College between February 2020 and February 2022. A total of 54 patients diagnosed with necrotizing fasciitis were randomly assigned to the Vaseline gauze group as the control group, and the Kangfuxin Liquid gauze group as the experimental group. Various aspects of treatment efficacy, wound healing conditions, healing indicators, pain scores, inflammation markers, and adverse reactions were compared between the two groups. Results: The total effective rate in the experimental group (100.00%) was significantly higher than that in the control group (77.78%), with a statistically significant difference The experimental group showed lower scores for secretion, granulation tissue morphology, redness, and swelling compared to the control group, with statistical significance. Additionally, the experimental group exhibited faster slough separation, new epidermis formation, and overall wound healing compared to the control group, with statistical significance. Visual analog scale (VAS) scores on postoperative days 3, 7, 9, and 14 were significantly lower in the experimental group than in the control group. Before treatment, there was no statistically significant difference in the levels of interleukin-17 (IL-17), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) between the two groups. However, after treatment, both groups exhibited a decrease in inflammatory markers, and the experimental group had significantly lower levels of IL-17, IL-6, and TNF-α compared to the control group). Furthermore, the incidence of adverse reactions in the experimental group (3.70%) was significantly lower than that in the control group (22.22%). Conclusion: The utilization of Kangfuxin Liquid gauze in wound healing after necrotizing fasciitis surgery effectively promotes wound healing, provides precise therapeutic effects, significantly reduces patient pain, improves inflammation, and exhibits minimal adverse reactions, thus demonstrating high safety. Therefore, the application of Kangfuxin Liquid gauze in this clinical context is highly recommended.

Effect and safety of ultrasound-guided continuous stellate ganglion blockade on neurovascular headache.

OBJECTIVE: To analyze the effect and safety of ultrasound-guided continuous stellate ganglion blockade (CSGB) on neurovascular headache. METHODS: The clinical data of 137 patients with neurovascular headache treated in the First Affiliated Hospital of Hebei North University from March 2019 to October 2021 were analyzed retrospectively. According to the treatment schemes, the patients were assigned to the control group (69 cases, treated with flunarizine combined with Oryzanol tablets), or the observation group (68 cases, treated with ultrasound-guided CSGB on the basis of the treatment to the control group). The efficacy, headache symptoms, negative emotions, cerebral artery blood flow velocity, vasoactive substance levels and adverse reactions of the two groups were compared. Univariate and logistic multivariate analyses were conducted to explore the risk factors for recurrence of neurovascular headache after treatment. RESULTS: The observation group showed a notably higher total effective rate than the control group (95.59% vs. 84.06%, P<0.05). In contrast to the control group, the observation group had notably lower self-rating depression scale (SDS) and Self-Rating Anxiety Scale (SAS) scores and showed notably lower posterior cerebral artery (PCA), middle cerebral artery (MCA), basilar artery (BA) and anterior cerebral artery (ACA) levels (P<0.05). After the treatment, the observation group showed higher levels of serum 5-hydroxy tryptamine (5-HT) and Beta-Endorphin (ß-EP) than the control group, but a lower serum neurotensin (NT) level than the control group. Moreover, the incidence of adverse reactions in the two groups was not greatly different (10.29% vs. 5.80%). The observation group showed a lower recurrence rate within 6 months after treatment than the control group (5.88% vs. 18.84%, P<0.05). Univariate and logistic multivariate analyses showed that occupation (physical labor), smoking history and sleep quality (poor) may be the risk factors for recurrence of neurovascular headache after treatment (OR>1, P<0.05), while CSGB may be the protective factor (OR<1, P<0.05). CONCLUSION: Ultrasound-guided CSGB has obvious analgesic effect on patients with neurovascular headache, which can shorten the duration of headache, improve the cerebral artery blood flow velocity, regulate the levels of vasoactive substances, relieve negative emotions, and lower the recurrence rate, with a high safety.

Protective Effect of Targeted Fluid Therapy on Patients with One-Lung Ventilation.

Objective: To evaluate the protective effect of target-directed fluid therapy on the lungs and postoperative rehabilitation in elderly patients with single-lung ventilation undergoing total endoscopic radical resection of esophageal cancer. Methods: Seventy elderly patients who underwent total endoscopic radical resection of esophageal cancer from January 2017 to December 2019 in our hospital were selected and divided into two groups by the random number table method: the goal-directed fluid treatment group (group G, n = 35) and the control group (group C, n = 35). Venous blood was extracted before surgery (T1), at the end of free esophagus (T2) by thoracoscopy, at the end of abdominal surgery (T3), and at the end of surgery (T4). IL-6 and IL-10 levels were detected by ELISA. The clinical pulmonary infection score (CIPS) was used to evaluate the pulmonary inflammation on the second day after surgery and the occurrence of complications. Duration of antibiotic use and length of hospital stay were recorded. Results: At T1, there were no significant differences in IL-6 and IL-10 levels between the two groups (P > 0.05). At T2, the IL-6 level in group G increased to 26.65 ± 1.80 pg/ml but was significantly lower than that in group C (32.28 ± 3.22 pg/ml) (P < 0.01). At T3 and T4, IL-6 and IL-10 levels in group G were significantly lower than those in group C (P < 0.01). The CIPS score of group G was lower than that of group C (1.5 ± 1.0 vs 2.7 ± 1.4), and the duration of antibiotic use in group G was shorter than that in group C (211.2 ± 15.4 vs 232.6 ± 18.7 h), with statistical significance (P < 0.01). The incidence of complications in group G was lower than that in group C (28.6% vs 40.0%), and the length of hospital stay in group G was shorter than that in group C (10.5 ± 1.7 vs 11.2 ± 1.9 days), but there was no significant difference between the two groups (P > 0.05). Conclusion: Target-directed fluid therapy inhibited inflammatory cytokine levels and had better lung protection, but no significant benefit in the complications or the length of hospital stay was observed.

Anesthetic Effect of the Fascia Iliaca Compartment Block with Different Approaches on Total Hip Arthroplasty and Its Effect on Postoperative Cognitive Dysfunction and Inflammation.

Objective: The objective of this article is to make a comparison of the anesthetic effects of the inside and outside fascia iliaca compartment block (FICB) in total hip arthroplasty (THA) and to study the effect of the different approaches of the FICB on postoperative cognitive dysfunction (POCD) and serum inflammatory cytokines in THA patients. Methods: A total of 60 patients who received THA treatment from January 2021 to December 2021 were divided into two groups, namely, Inside group (inside approach of the FICB) and Outside group (outside approach of the FICB), according to the different approaches of the FICB. Forty-eight hours after surgery, we compared the use of ropacaine dosage, visual analogue scale (VAS) score, the use of patient-controlled analgesia (PCA), mini-mental state examination (MMSE) score, the incidence of POCD, and the serum levels of IL-1, IL-6. Secondary indicators include surgical indicators and the quality of anesthesia cannula. Results: The ratio of re-fix the catheter, intubation time, and the use of ropacaine dosage at 48 h after surgery in the Outside group were significantly higher than that in the Inside group (p < 0.05), while the depth of cannulation in the Outside group was significantly lower than that in the Inside group (p < 0.05). VAS scores were comparable between the Inside and the Outside groups, except at 24 h after surgery. The use of PCA from 24 to 48 h after surgery in the Outside group was significantly higher than that in the Inside group (p < 0.05). The MMSE score and the incidence of POCD in the Outside group were higher than that in the Inside group. At the same time, the serum IL-1ß levels at 1 and 6 h after surgery and the serum IL-6 levels at 1, 6, 24, and 48 h after surgery in the Outside group were significantly higher than that in the Inside group (p < 0.05). Conclusion: Compared with the outside approach of the FICB, the inside approach of the FICB has better anesthetic effect, better postoperative analgesia, fewer postoperative analgesics, lower incidence of POCD, and lower serum cytokines during the treatment of THA patients.

Intravenous lidocaine infusion for pain control after laparoscopic cholecystectomy: A meta-analysis of randomized controlled trials.

BACKGROUND: This meta-analysis aimed to assess the efficiency and safety of intravenous infusion of lidocaine for pain management after laparoscopic cholecystectomy (LC). METHODS: A systematic search was performed in PubMed (August 1966-2017), Medline (August 1966-2017), Embase (August 1980-2017), ScienceDirect (August 1985-2017), and the Cochrane Library. Only randomized controlled trials (RCTs) were included. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Meta-analysis was performed using Stata.11.0 software. RESULTS: A total of 5 RCTs were retrieved involving 274 patients. The present meta-analysis indicated that there were significant differences between groups in terms of visual analog scale scores at 12hours (weighted mean difference [WMD]=-0.743, 95% CI: -1.246 to -0.240, P = .004), 24hours (WMD=-0.712, 95% CI: -1.239 to -0.184, P = .008), and 48hours (WMD=-0.600, 95% CI: -0.972 to -0.229, P = .002) after LC. Significant differences were found regarding opioid consumption at 12hours (WMD=-3.136, 95% CI: -5.591 to -0.680, P = .012), 24hours (WMD=-4.739, 95% CI: -8.291 to -1.188, P = .009), and 48hours (WMD=-3.408, 95% CI: -5.489 to -1.326, P = .001) after LC. CONCLUSION: Intravenous lidocaine infusion significantly reduced postoperative pain scores and opioid consumption after LC. In addition, there were fewer adverse effects in the lidocaine groups. Higher quality RCTs are still required for further research.