Effect of Femoral Nerve Block with Different Concentrations of Chloroprocaine on Early Postoperative Rehabilitation Training After Total Knee Arthroplasty.

BACKGROUND Patients experience severe pain in early postoperative rehabilitation after total knee arthroplasty (TKA). This study aimed to compare the effect of femoral nerve block with different concentrations of chloroprocaine on postoperative rehabilitation in patients with TKA. MATERIAL AND METHODS Ninety patients who only received unilateral TKA were randomly and equally divided into C1 (1% chloroprocaine 0.2 ml/kg), C2 (2% chloroprocaine 0.2 ml/kg), or NS (0.9% sodium chloride solution 0.2 ml/kg) groups. The patients received rehabilitation 3 times a day on days 3-6 after surgery, and femoral nerve block was performed with corresponding solution 10 min before each training session. We recorded the maximum knee flexion angles (MKFA) and maximum knee extension angles (MKEA) during active exercise on day 7 after surgery, as well as the incidence of MKFA ³100°, American knee society (AKS) scores, and postoperative rehabilitation satisfaction. Adverse effects after administration in each group were also recorded. RESULTS Compared with group NS, patients in group C1 and C2 had larger MKFA during active exercise on day 7 after TKA, and had better rehabilitation satisfaction (P<0.05). MKEA, the incidence of MKFA ≥100°, and AKS scores showed no significant differences in the 3 groups. There were more patients with decline of muscle strength in group C2 (P<0.05), and no other adverse reactions were recorded. CONCLUSIONS Chloroprocaine for femoral nerve block can be safely used in rehabilitation after TKA and to improve the knee flexion angle in the early postoperative period. Because they may have fewer adverse effects, 1% chloroprocaine 0.2 ml/kg may be preferred.

A Single-Center Observational Clinical Study on Factors Associated with Regional Cerebral Oxygen Saturation in Full-Term Newborn Infants During Birth Transition.

BACKGROUND Hypoxic hypoperfusion injury in the brain is a cause of potential injury and even death in the growth period of newborns. Therefore, monitoring regional cerebral oxygen saturation (CrSO2) during this period is particularly important. This observational clinical study from a single center aimed to investigate the factors associated with CrSO2 in full-term newborn infants during birth transition. MATERIAL AND METHODS We enrolled 84 full-term newborn infants delivered by cesarean section. We started the stopwatch with the obstetrician clamping the newborns' umbilical cords and recorded the values of newborns' CrSO2, pulse oxygen saturation (SpO2), pulse rate (PR), end-tidal carbon dioxide (EtCO2), and respiratory rate (RR) at 2 min, 5 min, and 10 min. We weighed the newborns before they left the operating room and used statistical methods to compare the correlation between each observation factor. RESULTS Pearson correlation coefficients between CrSO2 and SpO2 measured at 2 min, 5 min, and 10 min were 0.491, 0.599, and 0.587, respectively (P<0.01). Pearson correlation coefficients between CrSO2 and EtCO2 measured at 2 min, 5 min, and 10 min were -0.304, -0.443, and -0.243, respectively (P<0.05). Regardless of a newborn's weight, PR, or RR, the correlation between any of those factors and the value of CrSO2 measured at the corresponding time point had no significance (P>0.05). CONCLUSIONS This study showed a correlation between CrSO2 and SpO2 and CrSO2 and EtCO2 during birth transition of full-term infants delivered by elective cesarean section, but CrSO2 had no significant correlation with neonatal weight, PR, or RR.