We aimed to compare intraoperative sedation and postoperative analgesic effects of brachial plexus block using bupivacaine-dexmedetomidine mixture (BD) versus bupivacaine alone (B) in upper extremity bone surgeries. We conducted a randomized comparative study at Can Tho City, Vietnam. We recruited patients aged 15 to 75 years, ASA (American Society of Anesthesiology) I-III grade, indicating bone surgeries of arm or forearm with supraclavicular brachial plexus block by ultrasound guidance. One hundred eight included patients were randomly divided into two groups: the BD group (54 patients) received a 30 ml mixture of 0.25% bupivacaine and 100 mcg dexmedetomidine, and the B group (54 patients) received 30 ml of 0.25% bupivacaine. The BD group had a sedative OAA/S score (Observer Assessment of Alertness/Sedation Scale) of level 4, accounting for 87% more than group B 37%, and an OAA/S score of level 3 in the BD group with 5 cases (9.3%) compared with 9 cases (16.7%) in group B, statistically significant difference with p<0.05. The onset and duration of sedative time in group BD was 9.8±3.5 and 92.7±34.1 minutes. The mean of postoperative analgesic time was 970.5±309.5 minutes in group BD statistically significantly longer than group B's with 552.7±231.2 minutes (p<0.001). In conclusion, a mixture of bupivacaine-dexmedetomidine in brachial plexus block for arm and forearm surgical fractures had greater sedative and postoperative analgesic effects than that of bupivacaine alone.

Background: In 2018, GOLD addressed the issues of genotypes associated with risk factors for COPD. The genome-wide association study (GWAS) demonstrated an association between COPD and several genetic variants of single nucleotide polymorphisms (SNPs) of the FAM13A gene with the risk of COPD. Objective: To study the single nucleotide polymorphisms rs2869967 and rs17014601 of the FAM13A gene in chronic obstructive pulmonary disease. Subjects and research methods: 80 subjects diagnosed with COPD and 80 subjects determined not to have COPD according to GOLD 2020 criteria; the subjects were clinically examined, interviewed, and identified as possessing single nucleotide polymorphisms using the sanger sequencing method on whole blood samples. Results: The male/female ratio of the patient group and the control group was 79/1 and 39/1, respectively. The percentages of C and T alleles of rs2869967 in COPD patients were 50.6% and 49.4%, respectively. The percentages of C and T alleles of rs17014601 in COPD patients were 31.9% and 68.1%, respectively. At rs17014601, the ratio values of alleles T and C in the disease group and the control group were markedly different, making them statistically reliable (p = 0.031). The rate of CT genotype in the group of patients was considerably higher than that of the control group. The TT homozygous genotype had a lower risk of COPD compared with the other genotypes in the dominant model (ORTT/(CC + CT) = 0.441; CI95% = 0.233–0.833); this difference was statistically significant (p = 0.012). Conclusions: With rs17014601, it is characteristic that the frequency of the T allele appears more than the C allele, and the CT heterozygous phenotype accounts for the highest proportion in rs17014601 and rs2869967 recorded in COPD patients. There is an association between the genetic variant of the SNP FAM13A-rs17014601 and the risk of COPD.