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.