OBJECTIVE: A prospective randomized controlled study was conducted to investigate the early postoperative analgesic effectiveness of using liposomal bupivacaine (LB) for local infiltration anesthesia (LIA) in unicompartmental knee arthroplasty (UKA). METHODS: Between January 2024 and July 2024, a total of 80 patients with knee osteoarthritis (KOA) who met the selection criteria were enrolled in the study. Patients were randomly assigned to either the LB group or the "cocktail" group in a 1∶1 ratio using a random number table, with 40 patients in each group. Baseline characteristics, including gender, age, body mass index, operated side, Kellgren-Lawrence grade, and preoperative American Society of Anesthesiologists (ASA) classification, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and knee joint range of motion, showed no significant difference between the two groups ( P>0.05). Both groups received LIA and comprehensive pain management. The surgical duration, incision length, pain-related indicators [resting and activity visual analogue scale (VAS) scores, total dosage of oral morphine, WOMAC scores], knee joint range of motion, first ambulation time after operation, length of hospital stay, and postoperative adverse events. RESULTS: There was no significant difference between the two groups in surgical duration, incision length, first ambulation time after operation, length of hospital stay, total dosage of oral morphine, and pre-discharge satisfaction with surgery and WOMAC scores ( P>0.05). At 4, 12, and 24 hours after operation, the resting and activity VAS scores in the "cocktail" group were lower than those in the LB group; at 60 and 72 hours postoperatively, the resting VAS scores in the LB group were lower than those in the "cocktail" group, with the activity VAS scores also being lower at 60 hours; all showing significant differences ( P<0.05). There was no significant difference in the above indicators between the two groups at other time points ( P>0.05). On the second postoperative day, the sleep scores of the LB group were significantly higher than those of the "cocktail" group ( P<0.05), while there was no significant difference in sleep scores on the day of surgery and the first postoperative day ( P>0.05). Additionally, the incidence of complications showed no significant difference between the two groups ( P>0.05). CONCLUSION The use of LB for LIA in UKA can provide prolonged postoperative pain relief; however, it does not demonstrate a significant advantage over the "cocktail" method in terms of short-term analgesic effects or reducing opioid consumption and early functional recovery after UKA. Nevertheless, LB may help reduce postoperative sleep disturbances, making it a recommended option for UKA patients with cardiovascular diseases and insomnia or other mental health issues.
Aged ; Female ; Humans ; Male ; Middle Aged ; Anesthesia, Local/methods* ; Anesthetics, Local/administration & dosage* ; Arthroplasty, Replacement, Knee/methods* ; Bupivacaine/administration & dosage* ; Liposomes ; Osteoarthritis, Knee/surgery* ; Pain Measurement ; Pain, Postoperative/prevention & control* ; Prospective Studies ; Treatment Outcome

Objective To evaluate the preventive effects of predictive phased intervention on lower extremity deep vein thrombosis in ICU patients.Methods A total of 82 cases of critically ill patients admitted to our hospital from June 2013 to June 2016 were divided into observation group and control group according to the random number table method, with 41 cases respectively. Patients in the observation group received predictive phased intervention, while patients in the control group received routine nursing intervention. After 4 weeks of intervention, the lower extremity deep venous thrombosis rate, lower limb perimeter and blood flow velocity of lower extremity venous were compared between two groups.Results The incidence of lower extremity deep venous thrombosis was 2.44% in the observation group and 19.51% in the control group. The difference between two groups was statistically significant (x2=6.604,P<0.05). After the intervention, the lower limb perimeter of patients in the observation group was (30.01±2.34) cm, which was significantly lower than that of the control group; the venous blood flow velocity of the lower extremity of patients in the observation group was (25.43±3.01) cm/s, which was significantly higher than that of the control group (t=2.285, 2.357;P<0.05).Conclusions Predictive phased intervention has obvious advantages in the prevention of lower extremity deep venous thrombosis in ICU patients and it is worth clinical promotion.

Objective To investigate the factors related to choice of community health service centers (CHSCs) in standardized training general practitioners (GPs) in Shanghai.Methods Totally 152 GPs,(including those of Traditional Chinese Medicine) who completed the residency training in 2013 and signed employment contract with community in Shanghai were surveyed with a self-designed questionnaire.Results Among all the participants,113 (74.3％) attached the greatest importance to the salary level when choosing CHSC,58 (38.2％) expected annual salary more than 120 000 Yuan during the first 3 years.GPs tended to work in the city center(40.1％) or CHSCs near to their home(38.2％),mainly because of the job commuting (59.9％).Considering career development,the CHSCs with high level comprehensive service (51.3％) and with large population (5.0％) were more attractive.GPs paid more attention to the national demonstration community (57.2％) and CHSCs with member ofShanghai outstanding young physician training program(51.7％).In this survey,household register was the main influencing factor for choosing CHSCs,Shanghai natives paid more attention to the location of the community than those not Shanghai natives (61.8％ vs.34.2％),more inclined to CHSCs that close to their house (55.3％ vs.21.1％),non-Shanghai natives preferred authorized strength (51.3％ vs.28.9％).GPs of Western medicine expected higher salary than GPs of TCM (x2 =13.648,P ＜ 0.05),Males expected higher salary than females (x2 =7.799,P ＜ 0.05),Conclusions GPs pay the most attention on salaries and tend to work in the city central area,prefer CHSC with high level comprehensive service and large served population.The main factor influencing GPs to chose CHSCs is the household register,the category of Gps and gender.