Objective To evaluate the efficacy of ultrasound-guided sacral block in the obese patients by comparing it with the traditional positioning method.Methods Sixty obese patients,aged 25-50 yr,weighing 56-80 kg,with body mass index ≥ 30 kg/m2,scheduled for elective anorectal surgery,were randomly divided into 2 groups (n =30 each) using a random number table:ultrasound-guided sacral block group (group U) and traditional positioning method group (group T).The sacral canal puncture point was located via either ultrasonic or traditional positioning method.After successful puncture,1％ lidocaine 20 ml was injected.The number of patients in whom puncture was successful at first attempt and the number of patients in whom the time for puncture ≤ 1 min were recorded.The adverse reactions were observed.The efficacy of sacral block was evaluated.Results Compared with group T,the success rate of puncture at first attempt was significantly increased (P ＜ 0.05),and no significant changes were found in the number of patients in whom the time for puncture ≤ 1 min or efffcacy of sacral block in group U (P ＞ 0.05).No adverse reactions were found in the two groups.Conclusion Ultrasound-guided sacral block can raise the success rate of puncture at first attempt and provide similar efficacy of block in the obese patients when compared with the traditional positioning method,and thus has significant clinical value.

Objective To investigate the clinical effects of painless concept in nursing of patients underwent urology outpatient surgeries. Methods From June to December 2014, according to the outpatient number, 100 patients underwent urology outpatient operation in our hospital were randomly divided into the control group and the observation group, with 50 cases in each group. Patients in the control group received routine nursing, while patients in the observation group received standardized pain assessment on the basis of routine nursing. Intervention measures were carried out and preemptive analgesia was used. Adverse drug reactions were evaluated and dealt with. Degree of pain, and satisfaction with pain control pf patients were assessed. The difference of 10 clinical nurses in knowledge and attitude towards pain management before and after the intervention was evaluated.Results The number of patients in the observation group with postoperative pain score ≥5 points and needing pain medication was 3 cases, while the number in the control group was 22 (χ2=19.26,P<0.01). The number of patients whose satisfaction score >90 was 46, while it was 38 in the control group (χ2 =4. 762, P<0. 05 ) . After training, the scores of 10 clinical nurses in pain management knowledge and attitude were significantly increased from (17.58±4.0) to (34.00±5.3) (t=7.820,P<0.01). Conclusions By promoting painless conception in outpatient operating nursing, we provide the patients with a scientific, standardized, and feasible working style of pain control. The overall satisfaction is improved, and pain management knowledge attitude of nurses in outpatient department are enhanced.