Abstract:
BACKGROUND:Intravertebral and general anesthesia (GA) are two main anesthesia approaches but both have defects. This study was aimed to evaluate the effect of subarachnoid anesthesia combined with propofol target-controlled infusion (TCI) on blood loss and transfusion for total hip arthroplasty (THA) in elderly patients in comparison with combined spinal-epidural anesthesia (CSEA) or GA. METHODS:Totally, 240 patients (aged ≥65 years, American Society of Anesthesiologists [ASA] I-III) scheduled for posterior THA were enrolled from September 1st, 2017 to March 1st, 2018. All cases were randomly divided into three groups to receive CSEA (group C, n = 80), GA (group G, n = 80), or subarachnoid anesthesia and propofol TCI (group T, n = 80), respectively. Primary outcomes measured were intra-operative blood loss, autologous and allogeneic blood transfusion, mean arterial pressure at different time points, length of stay in post-anesthesia care unit (PACU), length of hospital stay, and patient satisfaction degree. Furthermore, post-operative pain scores and complications were also observed. The difference of quantitative index between groups were analyzed by one-way analysis of variance, repeated measurement generalized linear model, Student-Newman-Keuls test or rank-sum test, while ratio index was analyzed by Chi-square test or Fisher exact test. RESULTS:Basic characteristics were comparable among the three groups. Intra-operative blood loss in group T (331.53 ± 64.33 mL) and group G (308.03 ± 64.90 mL) were significantly less than group C (455.40 ± 120.48 mL, F = 65.80, P < 0.001). Similarly, the autologous transfusion of group T (130.99 ± 30.36 mL) and group G (124.09 ± 24.34 mL) were also markedly less than group C (178.31 ± 48.68 mL, F = 52.99, P < 0.001). The allogenetic blood transfusion of group C (0 [0, 100.00]) was also significantly larger than group T (0) and group G (0) (Z = 2.47, P = 0.047). Except for the baseline, there were significant differences in mean arterial blood pressures before operation (F = 496.84, P < 0.001), 10-min after the beginning of operation (F = 351.43, P < 0.001), 30-min after the beginning of operation (F = 559.89, P < 0.001), 50-min after the beginning of operation (F = 374.74, P < 0.001), and at the end of operation (F = 26.14, P < 0.001) among the three groups. Length of stay in PACU of group T (9.41 ± 1.19 min) was comparable with group C (8.83 ± 1.26 min), and both were significantly shorter than group G (16.55 ± 3.10 min, F = 352.50, P < 0.001). There were no significant differences among the three groups in terms of length of hospitalization and post-operative visual analog scale scores. Patient satisfaction degree of group T (77/80) was significantly higher than group C (66/80, χ = 7.96, P = 0.004) and G (69/80, χ = 5.01, P = 0.025). One patient complained of post-dural puncture headache and two complained of low back pain in group C, while none in group T. Incidence of post-operative nausea and vomiting in group G (10/80) was significantly higher than group T (3/80, χ = 4.10, P = 0.043) and group C (2/80, χ = 5.76, P = 0.016). No deep vein thrombosis or delayed post-operative functional exercise was detected. CONCLUSIONS:Single subarachnoid anesthesia combined with propofol TCI seems to perform better than CSEA and GA for posterior THA in elderly patients, with less blood loss and peri-operative transfusion, higher patient satisfaction degree and fewer complications. TRIAL REGISTRATION:chictr.org.cn: ChiCTR-IPR-17013461; http://www.chictr.org.cn/showproj.aspx?proj=23024.
journal_name
Chin Med J (Engl)journal_title
Chinese medical journalauthors
Xu CS,Qu XD,Qu ZJ,Wang G,Wang HJdoi
10.1097/CM9.0000000000000688subject
Has Abstractpub_date
2020-03-20 00:00:00pages
650-656issue
6eissn
0366-6999issn
2542-5641pii
00029330-202003200-00004pub_type
杂志文章abstract:OBJECTIVE:To evaluate mice as experimental animals for Chlamydia pneumoniae (C. pneumoniae) infection and investigate the pathogenesis of C. pneumoniae derived pneumonitis. METHODS:Icr mice were inoculated with the C. pneumoniae strain, CWL-029, either intranasally or intravenously. After a single dose inoculation, mi...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2003-03-01 00:00:00
abstract::The environment structure of natural nidi and epidemic areas of hemorrhagic fever with renal syndrome (HFRS) possesses characteristics of topography, hydrology, climate, soil, vegetation, and animals. The natural nidi and epidemic areas of HFRS are distributed mainly in plain and hilly regions under 500 meters above t...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:1994-02-01 00:00:00
abstract:Background:Patients with major depressive disorder (MDD) usually have high risk of suicidality. Few studies have investigated the effects of stressful life events (SLEs) on the risk of suicide in Chinese patients who have developed MDD. This study aimed to investigate the impact of SLEs on suicidal risk in Chinese pati...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:10.4103/0366-6999.229898
更新日期:2018-04-20 00:00:00
abstract:BACKGROUND:Orthostatic intolerance (OI) is a common disease at pediatric period which has a serious impact on physical and mental health of children. The purpose of this study was to investigate the effect of related factors on the prognosis of children with OI. METHODS:The subjects were 170 children with OI, includin...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the feasibility, safety and diagnostic accuracy of pharmacologic stress of (99m)Technetium-MIBI single-photon emission computed tomography (SPECT) with intravenous adenosine triphosphate (ATP) in patients with suspected coronary artery disease. METHODS:The study group included 263 patients who we...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:To discuss the diagnosis and surgical treatment of temporal lobe epilepsy. METHODS:From 1996 to 1998, 36 patients presenting with medically intractable temporal lobe epilepsy were identified by EEG and MR, including volumetric MR, for hippocampal formation. Among them, 16 patients underwent anterior temporal...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:The development of the targeted signal transduction inhibitor STI571 has prompted us to treat chronic myeloid leukemia in different ways. Since STI571 may reverse multidrug-resistance of K562/MDR cells in vitro, we studied the effect of STI571 on multidrug-resistant K562 cells in vivo. METHODS:Multidrug-res...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2006-06-05 00:00:00
abstract:BACKGROUND:The research of cancer in patients on hemodialysis (HD) in China has not been reported. The aim of this study was to investigate the clinical and histological features and outcomes of cancer in Chinese HD patients. METHODS:The study subjects were 49 cancer patients (1.4%) out of 3448 end stage renal disease...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2012-12-01 00:00:00
abstract:Background::Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:10.4103/0366-6999.213959
更新日期:2017-09-20 00:00:00
abstract::Recombinant DNA Yeast-Derived Hepatitis B Vaccine (RYHB vaccine) is comparable to and can replace Plasma-Derived Hepatitis B Vaccine (PHB vaccine) for the prevention of mother-infant transmission of hepatitis B virus (HBV), but the duration of immune efficacy of RYHB vaccine is not clear. This study indicates the long...
journal_title:Chinese medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:A free running asthma screening test is usually used for screening exercise-induced bronchoconstriction. The total serum allergen IgE level can reveal the patient's atopy characteristics. Our study is to evaluate the diagnostic values of the combination of the two tests in asthmatic children and compare this...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:One of the reasons for poor neuroregeneration after central nervous system injury is the presence of inhibitory factors such as Nogo. Here, we tested the inhibition of Nogo by RNA interference both in vitro and in vivo, using recombinant adenovirus-mediated transfection of short hairpin RNAs, to explore a ne...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract::Twin pregnancy with mosaic partial hydatidiform mole (PHM) and survival of two healthy fetuses following in vitro fertilization and embryos transfer (IVF-ET) is a rare situation and is considered a challenge for management. A 32-year-old Chinese woman conceived twin pregnancy following IVF-ET. At 22 weeks' gestation, ...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:During cardiac arrest, the gastrointestinal tract is sensitive to ischemia. Protection of the gastrointestinal tract is a critical factor in determining prognosis following cardiopulmonary resuscitation (CPR). This study seeks to determine the extent of gastrointestinal tract injury and the potential protect...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2012-12-01 00:00:00
abstract::Endometriosis is a prevalent chronic disease that affects approximately 6% to 10% of reproductive-aged women. Although numerous researchers have endeavored to explore the etiology of endometriosis over a century, its etiology still remains an enigma. The exploration of pathophysiologic mechanism and novel therapy for ...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:10.1097/CM9.0000000000000885
更新日期:2020-07-20 00:00:00
abstract:OBJECTIVE:To investigate the use of the Gibbs-Sampler method in evaluating the relationship between clinic events and health risks in a meta-analysis of multiple clinical trials. METHODS:By using a generalized linear model with random-effects, Gibbs-Sampler technique was used in a meta-analysis of multiple clinical tr...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Embryo quality and receptivity of the endometrium are two factors that determine the results of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). There is no consensus of the optimal transfer strategy for normal responders or high responders. The current study aimed to f...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:In dental clinics, dentition defects are commonly restored with conventional porcelain-fused-to-metal fixed bridges. However, Ni-Cr alloy ceramic fixed bridges are known to have several drawbacks such as marginal coloration of the neck, low casting precision and, most seriously, poor biocompatibility. These ...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2008-10-05 00:00:00
abstract:BACKGROUND:The goal of surgery in the treatment of intrinsic cerebral tumors is to resect the maximum tumor volume, and to spare the eloquent areas. However, it is difficult to discover the eloquent areas intraoperatively due to individual anatomo-functional variability both for sensori-motor and language functions. Co...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2011-10-01 00:00:00
abstract::Anastomotic false aneurysm (AFA) of the aorta is a potentially lethal complication after prosthetic grafting. Nineteen aneurysms were encountered in 18 patients within a 30-year period (1960-1991). There were 10 men and 8 women, aged 27-80 years (mean 58 years). In 14 patients, the prostheses were made of silk, in 2 w...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis. METHODS:Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluated by light microscopy and immunohistochemistry. The immunohistochemical studies were perform...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:The primary reasons for local recurrence and therapeutic failure in the treatment of malignant gliomas are the invasion and interactions of tumor cells with surrounding normal brain cells. However, these tumor cells are hard to be visualized directly in histopathological preparations, or in experimental glio...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2012-12-01 00:00:00
abstract::The depth and area-percentage of Alcian blue (AB) staining of glomeruli, the ability of RBC to bind AB and the onset of proteinuria in adriamycin nephrosis in rats were studied. The results showed that the negative charge (NC) on RBC and glomeruli decreased significantly after injection of adriamycin and there was a p...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Gastric intestinal metaplasia (GIM) is generally considered to be the main mucosal background for the development of gastric adenocarcinomas. Using linked color imaging (LCI), we noticed that the color pattern in areas of GIM was purple mixed with white on the epithelium with signs of mist that were detected...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:10.1097/CM9.0000000000000172
更新日期:2019-04-05 00:00:00
abstract:BACKGROUND:Fractional flow reserve (FFR) has become an increasingly important index when making decisions with respect to revascularization of coronary artery stenosis. However, the pressure guidewire used in obtaining FFR measurements is difficult to control and manipulate in certain complex coronary artery lesions, r...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:10.4103/0366-6999.152664
更新日期:2015-03-20 00:00:00
abstract:BACKGROUND:CD4(+)CD25(+) regulatory T cells (Tregs) mediate immune suppression through cell-cell contact with surface molecules, particularly cytotoxic T lymphocyte-associated antigen 4 (CTLA-4), glucocorticoid-induced tumor necrosis factor receptor family-related protein (GITR), and transforming growth factor beta (TG...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2008-02-05 00:00:00
abstract:BACKGROUND:P53 is one of the most studied tumor suppressors in the cancer research, and over 50% of human tumors carry P53 mutations. MDM-2 is amplified and/or overexpressed in a variety of human tumors of diverse tissue origin. The aim of this study was to examine the expression of P53 protein and MDM-2 protein in gli...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2011-08-01 00:00:00
abstract::In present study, we examined the effects of NG-nitro-L-arginine (LNNA), an inhibitor of nitric oxide synthase (NOS), and/or methylene blue (MB), a blocker of guanylate cyclase on the vasodilator response of isolated rat arteries including aorta and mesenteric artery to calcitonin gene-related peptide (CGRP) by in vit...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:To study the effects of skeletal muscle satellite cells implanted into infarcted myocardium on the volume of remnant myocytes. METHODS:Thirty-six adult mongrel canines were divided randomly into implantation group and control group. In the implantation group, skeletal muscle satellite cells taken from the gl...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:: ...
journal_title:Chinese medical journal
pub_type: 社论
doi:10.4103/0366-6999.245275
更新日期:2018-11-20 00:00:00