Background:Continuous femoral nerve block and fascia iliaca compartment block are 2 traditional anesthesia methods in orthopedic surgeries, but it is controversial which method is better. The objective of this study was to compare the practicality, efficacy, and complications of the 2 modalities in hip replacement surgery in the elderly and to assess the utility of a novel cannula-over-needle set.Methods:In this prospective, randomized controlled clinical investigation, 60 elderly patients undergoing hip replacement were randomly assigned to receive either continuous femoral nerve block or continuous fascia iliaca compartment block. After ultrasound-guided nerve block, all patients received general anesthesia for surgery and postoperative analgesia through an indwelling cannula. Single-factor analysis of variance was used to compare the outcome variables between the 2 groups.Results:There was a significant difference between the 2 groups in the mean visual analog scale scores (at rest) at 6 hours after surgery: 1.0 ± 1.3 in the femoral nerve block group vs 0.5 ± 0.8 in the fascia iliaca compartment block group (P < 0.05). The femoral nerve block group had better postoperative analgesia on the medial aspect of the thigh, whereas the fascia iliaca compartment block group had better analgesia on the lateral aspect of the thigh. There were no other significant differences between the groups.Conclusions:Both ultrasound-guided continuous femoral nerve block and fascia iliaca compartment block with the novel cannula-over-needle provide effective anesthesia and postoperative analgesia for elderly hip replacement patients.

Background: Desaturation during painless gastroscopy in aged patients leads to discontinuation of the procedure, prolonged manipulation time and increased risk of severe complications. An endoscopic nasal mask was designed to control hypoxia during the above procedures. A randomized trial was performed to test whether the novel endoscopic mask is helpful for hypoxia during painless gastroscopy in aged patients.Methods: In this randomized, controlled trial, 141 aged patients undergoing painless gastroscopy were randomized into nasal catheter group (69 patients) and endoscopic mask group (65 patients). Primary outcomes were minimum pulse oxygen saturation and incidence of pulse oxygen saturation ≤ 90%.Results: Finally, 134 aged patients were analyzed, including 69 patients in nasal catheter group and 65 patients endoscopic mask group. The minimum pulse oxygen saturation (96.4% ± 4.8%) was higher in the aged endoscopic mask group than in the aged nasal catheter group (94.3% ± 5.6%, P = 0.0075). The incidence of pulse oxygen saturation ≤ 90% did not significantly differ between the endoscopic mask group and nasal catheter group (6.2% VS 15.9%, P = 0.07). There were no severe adverse events in either groups.Conclusion: The endoscopic mask was safely used in aged patients during painless gastroscopy under propofol sedation and significantly improved the minimum pulse oxygen saturation without increasing time to examination or recovery time.

BackgroundThe aim of this study was to compare the novel needle-over-cannula vs. the Braun continuous peripheral nerve block catheter set (Contiplex A) in postoperative analgesics after total knee arthroplasty (TKA).Material/MethodsSixty patients undergoing total knee arthroplasty were randomly assigned to Braun continuous peripheral nerve block catheter set group (Braun Group, n=30) or the novel needle-over-cannula group (Cannula Group, n=30). All the patients in the 2 groups received continuous femoral nerve block (CFNB) for postoperative analgesics.ResultsWe found no significant difference in analgesic effect between the 2 groups. The time of catheter or cannula insertion was shorter in the Cannula Group than in the Braun Group. Four (13.32%) out of 30 patients had failed catheter insertions in the Braun Group compared to none in the Cannula Group. Twelve (46%) out of 26 patients in the Braun Group had serious local anesthetic leakage at puncture sites during 12 h compared to none in the Cannula Group.ConclusionsThe novel needle-over-cannula is effective, convenient, and safe in CFNB after TKA.

BackgroundAwake fiberoptic bronchoscopic tracheal intubation is usually regarded as an effective method in the management of predicted difficult airway. Hypoxia during awake nasal fiberoptic bronchoscopic intubation leads to discontinuation of the procedure, prolonged manipulation time and increased risk of severe complications. The main aim of the study was to test whether the novel endoscopic mask is helpful for hypoxia during the intubation.MethodsThis was a randomized, controlled, multi-center study. 55 patients were recruited, but one patient was lost to follow-up. Finally, 54 patients (19 man and 35 women) were analyzed. After entering the operating room, nasal catheter oxygen-providing was given in the control group, and the treatment group received endoscopic mask oxygen-providing, with a flow rate of 3 L/min, lasting into the end of the intubation. Primary outcomes included mean arterial pressure, heart rate, minimum pulse oxygen saturation and incidence of pulse oxygen saturation ≤ 90%. Secondary outcomes included number of intubation attempts and time to intubation. All outcomes were finally measured.ResultsMinimum pulse oxygen saturation during awake nasal fiberoptic bronchoscopic tracheal intubation was significantly higher in the endoscopic mask intubation group (91.7% ± 4.7%) than that the nasal catheter intubation group (87.6% ± 8.2%, P = 0.031. Furthermore, the incidence of pulse oxygen saturation ≤ 90% was significantly lower in the endoscopic mask intubation group (20.0%, 5/25) than that in the nasal catheter intubation group (51.7%, 15/29, P = 0.037). But mean arterial pressure of during intubation was significantly higher in the endoscopic mask group (100.0 ± 13.3 vs 90.3 ± 21.8, P = 0.049). In addition, there were no differences in the number of intubation attempts (P = 0.45) or time to intubation between the two groups (P = 0.38).ConclusionsThe endoscopic mask was safely used in awake fiberoptic bronchoscopic tracheal intubation, with advantages of stable blood pressure and potential prevention of desaturation. Beginners for the intubation procedure and patients at high risk of hypoxia could benefit from the use of the endoscopic mask.Trial registrationTrial registration: www.chictr.org.cn. Registration No.: ChiCTR-TRC-13004086. Date of Registration: 8th, Sep, 2013.

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