Objective: To observe the application effects of ultrasound-guided transversus abdominis plane block (TAPB) combined rectus sheath block (RSB) on overweight surgical patients in Gynaecology. Methods: 60 overweight patients underwent selective total open hysterectomy were randomly divided into general anesthesia group (group G) and TAPB combined RSB group (group TR) with 30 patients in each group. General anesthesia was performed routinely in both groups, then no more operations were performed in group G; ultrasound-guided biliteral TAPB combined RSB were performed in group TR. The patients in both groups used patient-controlled intravenous analgesia (PCIA) after operation, which prepared according to standard weight. The intraoperative remifentanil dosage, anaesthesia anabiosis time, the number of PCIA pressing in 24h after operation, early out-of-bed activity time after operation, incidence rate of postoperative nausea and vomiting (PONV) of patients in both groups were recorded. The VAS score during rest and exercise immediately after leaving postanesthesia care unit (PACU), as well as 2h, 4h, 8h, 12h, 24h after operation of patients in 2 groups were compared. Results: The intraoperative remifentanil dosage, anaesthesia anabiosis time, the number of PCIA pressing in 24h after operation, early out-of-bed activity time after operation, and incidence rate of PONV of patients in group TR were all obviously lower than those in group G (P<0.05). The VAS score during rest and exercise immediately after leaving PACU, as well as 2h, 4h, 8h after operation of patients in TR group were obviously lower than those in group G (P<0.05); There had no statistically differences about the VAS score during rest and exercise 12h and 24h after operation between the 2 groups (P>0.05). Conclusions: Ultrasound-guided TAPB combine RSB in overweight surgical patients in Gynaecology can obtain better analgesic effects; At the same time, it can reduce the use of opioids and postoperative adverse reactions, shorten the anaesthesia anabiosis time and promote recovery of patients.

Objective: To observe the clinical application value of sodium, potassium, magnesium, calcium and glucose injection for pregnant women with gestational diabetes (GDM) before cesarean section. Methods: 60 GDM parturients were randomly divided into two groups: sodium, potassium, magnesium, calcium and glucose injection group (experimental group) and lactate Ringer's solution group (control group) with 30 parturients in each group. Preloading was carried out according to 10ml/kg after parturients entering operating room. The mean arterial pressure (MAP) and heart rate of parturients in 2 groups at immediately after entering the operating room (T0), the end of preloading before anaesthesia (T1), 5min after anesthesia (T2), immediately after cord cut (T3) and end of operation (T4) were recorded respectivly. The blood glucose and lactate level of parturients were measured by extracting maternal arterial blood at T0, T3, T4. The occurrence of hypotension, nausea and vomiting, as well as using of vasoactive drugs during operation were also recorded. Results: There was no significant difference in heart rate and MAP between the experimental group and control group at each timing (P>0.05). There was no significant difference in incidence rate of hypotension, nausea and vomiting, as well as utilization rate of vasoactive drugs between the two groups (P>0.05). The blood glucose of parturients in experimental group at T3, T4 were obviously higher than control group, but the lactate levels were obviously lower (P<0.05). Conclusions: Using of sodium, potassium, magnesium, calcium and glucose injection for GDM parturients before cesarean section is beneficial to maintain the circulation stability during operation; it also can improve the blood glucose within the safe range, but does not cause increasing of lactate level.

Objective: To observe the effects of hydromorphone combined with flurbiprofen for postoperative analgesia in orthopedic lower extremity surgery. Methods: 90 cases of orthopedic lower extremity surgery patients were randomly divided into SF group, K group and KH group with 30 patients in each group. The patients in 3 groups used sufentanil (SF group: 2μg/kg~3μg/kg), hydromorphone (K group: 0.12mg/kg~0.14mg/kg) and hydromorphone+flurbiprofen (KH group: 0.12mg/kg+50mg) for postoperative analgesia respectively. The press times of patient-controlled intravenous analgesia (PCIA), VAS score and Ramsay score (2h, 6h, 12h, 24h after operation), as well as adverse reactions (skin itch, drowsiness, dizziness, nausea and vomiting, respiratory depression) of patients in 3 groups were compared. Results: The VAS score at each time point after operation, the press times of PCIA, adverse reactions rate of patients in KH group were all obviously lower than SF group and K group (P<0.05). There was no significant difference about the Ramsay score at each time point after operation of the 3 groups (P>0.05). Conclusions: Hydromorphone combined with flurbiprofen for postoperative analgesia in orthopedic lower extremity surgery is a safe and effective postoperative analgesic method, which can obtain better analgesic effects and less adverse reactions.

Objective: To investigate the efficacy and safety of treating idiopathic trigeminal neuralgia with pulsed radiofrequency combined adriamycin. Methods: 90 idiopathic trigeminal neuralgia patients failed to conservative treatment were randomly divided into adriamycin (ADM) group, pulsed radiofrequency combined adriamycin (PRF+ADM) group and PRF group with 30 patients in each group.The VAS score,PRI score,effective rate and complications of patients in 3 groups were compared. Results: The VAS score, PRI score of patients in PRF+ADM were obviously lower than that of patients in PRF group at each time point after treatment,but the effective rate was obviously higher (P<0.05). The VAS score, PRI score and effective rate had statistical difference between PRF+ADM group and ADM group 1d and 3d after treatment (P<0.05); There had no statistical significance of VAS score, PRI score and effective rate between PRF+ADM group and ADM group at other time point after treatment. There were no obvious complications in 3 groups. Conclusions: Treating idiopathic trigeminal neuralgia with pulsed radiofrequency combined adriamycin can get better short-term and long term effects, as well as higher security, so it is worthy of clinical application.