OBJECTIVETo compare the differences of postoperative patient-controlled intravenous analgesia for laparoscopic cholecystectomy and gynecological laparoscopy in female patients.

METHODSThis retrospective study included 645 female patients received laparoscopic cholecystectomy or gynecological laparoscopy (laparoscopic oophorocystectomy/myomectomy) between January 2011 and July 2012 in Tongji Hospital. Among them, 207 cases of sufentanil-tramadol patient-controlled intravenous analgesia (PCIA) were enrolled and divided into 2 groups:77 cases in laparoscopic cholecystectomy group, and 130 cases in gynecological laparoscopy group. The pressing frequency and consumption of PCIA, localization and quality of postoperative pain, visual analogue scale (VAS) at 4-6 h, 8-12 h, 18-24 h after surgery, and adverse effect were compared by t-test,χ(2) test, Fisher exact test or Mann-Whitney test.

RESULTSThere was no statistical difference of age, body mass index, and operation time between the two groups (all P > 0.05). As compared with the gynecological laparoscopy group (3 (4)), PCIA pressing frequency was higher in the laparoscopic cholecystectomy group (5 (7)), but there was no statistical difference (Z = -1.747, P = 0.081). PCIA consumption in the laparoscopic cholecystectomy group (79 (33) ml) was higher than that in the gynecological laparoscopy group (48 (30) ml) (Z = -6.267, P = 0.000). The postoperative pain localization and quality were different in the two groups, the patients in the laparoscopic cholecystectomy group experienced dull pain in lower abdomen, but the ones in the gynecological laparoscopy group had distending pain in upper abdomen and piercing pain around scapula. The differences of 4-6 h, 8-12 h, 18-24 h VAS scores in the two groups had no statistical significance (all P > 0.05). The total incidence of postoperative adverse effect between the two groups had no statistical significant difference (laparoscopic cholecystectomy group:11.7%, gynecological laparoscopy group:16.2%) (χ(2) = 0.778, P = 0.378). The incidence of dizziness was higher in the gynecological laparoscopy group (6.2%) than that in the laparoscopic cholecystectomy group (0) (Fisher exact test:P < 0.05).

CONCLUSIONIn the case of sufentanil-tramadol PCIA, laparoscopic cholecystectomy needs more postoperative analgesia, while gynecological laparoscopy has higher incidence of dizziness.

Analgesia, Patient-Controlled ; Cholecystectomy, Laparoscopic ; Female ; Gynecologic Surgical Procedures ; Humans ; Laparoscopy ; Pain Measurement ; Pain, Postoperative ; Retrospective Studies ; Sufentanil ; Tramadol

Objective: To obtain recombinant major surface glycoprotein(rMsg)of Pneumocystis jirovecii(Pj) and survey anti-Pj rMsg IgG and IgM antibodies using enzyme-linked immunosorbent assay (ELISA) among randomly selected sera from Beijing local children under 14 years of age. Methods: ELISA method were established to detect anti-Pj rMsg IgG and IgM antibodies. We randomly selected sera of 201 cases who were under 14 years of age were screened. Results: There were 78 cases in the age group of 1 day to 30 days, 33 cases in the group of 1 month to 12 months, and 90 cases in the group of 1 year to 14 years. The positive rates of anti-Pj rMsg IgG antibody in these three age groups were 10.3%(8/78), 21.2%(7/33), and 41.1%(37/90)respectively(χ²=21.190, P=0.000). The positive rates of anti-Pj rMsg IgM antibody were 6.4%(5/78), 39.4%(13/33), and 76.7%(69/90)respectively(χ²=84.260, P=0.000). The overall positive rates of anti-Pj rMsg IgG and IgM antibodies were 25.9%(52/201)and 43.3%(87/201)respectively(χ²=53.463, P=0.000). Among these, simultaneously IgG positive IgM positive, IgG positive IgM negative, IgG negative IgM positive and IgG negative IgM negative rates were 22.4%(45/201), 3.5%(7/201), 20.9%(42/201), and 53.2%(107/201)respectively. Conclusions The overall serological response rate after Pj exposure, either anti-Pj IgG or IgM antibody positive, was as high as 46.8% in children under 14 years of age in Beijing area. The positive rates of anti-rMsg IgG and IgM antibodies increased with age, with highest rate in age group of more than one years old.