Objective:To study the application effect of perioperative management based on enhanced recovery after surgery(ERAS)philosophy in the robot-assisted surgery for thoracolumbar fracture.Methods:This was a prospective random control trial(RCT).A total of 80 patients with thoracolumbar fracture admitted to Jiangsu Provincial People's Hospital from January 2020 to January 2025 were selected.They were divided into control group and ERAS group according to random number method,with 40 cases in each group.All of them adopted robot-assisted surgery for thoracolumbar fracture as the main therapeutic scheme.After surgery,the control group adopted routine perioperative management,and the ERAS group adopted perioperative management based on the ERAS philosophy.The postoperative recovery time of physiological function(the time for removing urinary catheter,time for eating,time for exhaling,time for getting out of bed,and length of hospital stay)between two groups were compared.The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were applied to assess the levels of anxiety and depression of the patients in two groups before surgery and at the 1st d,5th d and 7th d after surgery.In addition,the pain score of visual analogue scale(VAS),the incidence of postoperative complication,the scores of psychological state before and at the 7th day after surgery,and patient's satisfaction for diagnosis and treatment during the length of hospital stay as the evaluation of Nursing Scale for Nursing Staff(NSNS)before discharge were compared between the two groups.Results:The time for removing urinary catheter,time for eating,time for exhaling,time for getting out of bed,and length of hospital stay of ERAS group were shorter than those of control group,and the differences were significant(t=3.508,9.171,5.423,10.983,6.675,P<0.05).Before surgery,there were not significant differences in VAS score,SAS score and SDS score between the two groups(P>0.05).The VAS scores at the 1st d,5th d and 7th d after surgery in ERAS group were significantly lower than those in control group(t=5.433,5.882,5.060,P<0.05).At the 7th d after surgery,the scores of SAS and SDS in ERAS group significantly decreased,which were significantly lower than those in control group(t=14.327,13.390,P<0.05).The incidence of postoperative complications in ERAS group was 7.50%(3/40),which was lower than 32.50%(13/40)in control group(x2=7.812,P<0.05).Satisfaction of patients in ERAS group was 95.00%,which was significantly higher than 77.50%in control group(x2=5.165,P<0.05).Conclusion:The perioperative management based on ERAS philosophy can contribute to promote the recovery of postoperatively physiological function,and relieve postoperative pain,and improve postoperatively negative emotional state,and reduce the incidence of postoperative complications,and enhance patient's satisfaction.

Objective:To study the application effect of perioperative management based on enhanced recovery after surgery(ERAS)philosophy in the robot-assisted surgery for thoracolumbar fracture.Methods:This was a prospective random control trial(RCT).A total of 80 patients with thoracolumbar fracture admitted to Jiangsu Provincial People's Hospital from January 2020 to January 2025 were selected.They were divided into control group and ERAS group according to random number method,with 40 cases in each group.All of them adopted robot-assisted surgery for thoracolumbar fracture as the main therapeutic scheme.After surgery,the control group adopted routine perioperative management,and the ERAS group adopted perioperative management based on the ERAS philosophy.The postoperative recovery time of physiological function(the time for removing urinary catheter,time for eating,time for exhaling,time for getting out of bed,and length of hospital stay)between two groups were compared.The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were applied to assess the levels of anxiety and depression of the patients in two groups before surgery and at the 1st d,5th d and 7th d after surgery.In addition,the pain score of visual analogue scale(VAS),the incidence of postoperative complication,the scores of psychological state before and at the 7th day after surgery,and patient's satisfaction for diagnosis and treatment during the length of hospital stay as the evaluation of Nursing Scale for Nursing Staff(NSNS)before discharge were compared between the two groups.Results:The time for removing urinary catheter,time for eating,time for exhaling,time for getting out of bed,and length of hospital stay of ERAS group were shorter than those of control group,and the differences were significant(t=3.508,9.171,5.423,10.983,6.675,P<0.05).Before surgery,there were not significant differences in VAS score,SAS score and SDS score between the two groups(P>0.05).The VAS scores at the 1st d,5th d and 7th d after surgery in ERAS group were significantly lower than those in control group(t=5.433,5.882,5.060,P<0.05).At the 7th d after surgery,the scores of SAS and SDS in ERAS group significantly decreased,which were significantly lower than those in control group(t=14.327,13.390,P<0.05).The incidence of postoperative complications in ERAS group was 7.50%(3/40),which was lower than 32.50%(13/40)in control group(x2=7.812,P<0.05).Satisfaction of patients in ERAS group was 95.00%,which was significantly higher than 77.50%in control group(x2=5.165,P<0.05).Conclusion:The perioperative management based on ERAS philosophy can contribute to promote the recovery of postoperatively physiological function,and relieve postoperative pain,and improve postoperatively negative emotional state,and reduce the incidence of postoperative complications,and enhance patient's satisfaction.

The aim of this study was to develop a formulation to improve the oral absorption of baicalin (BA) by combining a phospholipid complex (PC) and self-emulsifying microemulsion drug delivery system (SMEDDS), termed BA-PC-SMEDDS. BA-PC was prepared by a solvent evaporation method and evaluated by complexation percentage (CP). The physicochemical properties of BA-PC were determined. The synergistic effect of PC and SMEDDS on permeation of BA was studied in vitro with Caco-2 cells and in situ with a single pass intestinal perfusion model. The improved bioavailability of BA in BA-PC-SMEDDS was confirmed in an in vivo rat model. The CP of BA-PC reached 100% when the molar ratio of drug to phospholipid (PP) was ≥1:1. The solubility of BA-PC increased in both water and octanol, and the log P o/w of BA-PC was increased significantly. BA-PC-SMEDDS could be dispersed more evenly in water, compared to BA and BA-PC. Both the Caco-2 cell uptake and single-pass intestinal perfusion models illustrated that transport of BA in BA-PC was lower than that of free BA, while improved significantly in BA-PC-SMEDDS. The relative bioavailability of BA-PC(1:2)-SMEDDS was 220.37%. The combination system of PC and SMEDDS had a synergistic effect on improving the oral absorption of BA.