BackgroundTransversus abdominis plane (TAP) block is reportedly a preferable technique for reducing postoperative pain in abdominal surgeries. The aim of this study was to compare the analgesic efficacy and recovery quality after gynecological surgery by adding dexmedetomidine or fentanyl into an ultrasound-guided TAP block.MethodsWe randomly assigned 100 elective gynecological patients into four groups (TAP, TAP-DEX, TAP-FEN, and control, n=25 in each). TAP blocks were performed postoperatively. The control group received patient-controlled intravenous analgesia (PCIA), the TAP group received TAP blocks with 0.375% ropivacaine, the TAP-DEX group received 0.375% ropivacaine with dexmedetomidine 1 µg/kg, and the TAP-FEN group received 0.375% ropivacaine with fentanyl 1 µg/kg. The primary outcomes were the first request time for PCIA bolus and quality of postoperative recovery assessed using the QoR-40 questionnaire 2 days after surgery. The secondary outcomes were the visual analog scale (VAS) scores at rest across the different time intervals, the total number of PCIA boluses required in 24 and 48 hours postoperatively, and associated complications.ResultsThe first request time for PCIA was significantly longer in the TAP-DEX than in the TAP, TAP-FEN, and control groups (9.86±0.77, 7.86±0.56, 8.79±0.55, and 1.56±0.65 hours, respectively; P<0.01). The QoR-40 scores were highest in the TAP-DEX group (P<0.05). The mean PCIA bolus consumption in the first 24–48 hours was lowest in TAP-DEX group. VAS showed significant differences between TAP-DEX and TAP-FEN groups only at 6 hours (P<0.01).ConclusionThe use of dexmedetomidine as an adjuvant to TAP blocks could facilitate postoperative analgesia and improve the quality of recovery without increasing related complications.
Abstract:To satisfy the need of polymer connection in lightweight automobiles, a study on laser transmission spot welding using polymethyl methacrylate (PMMA) is conducted by using an Nd:YAG pulse laser. The influence of three variables, namely peak voltages, defocusing distances and the welding type (type I (pulse frequency and the duration is 25 Hz, 0.6 s) and type II (pulse frequency and the duration is 5 Hz, 3 s)) to the welding quality was investigated. The result showed that, in the case of the same peak voltages and defocusing distances, the number of bubbles for type I was obviously more than type II. The failure mode of type I was the base plate fracture along the solder joint, and the connection strength of type I was greater than type II. The weld pool diameter:depth ratio for type I was significantly greater than type II. It could be seen that there was a certain relationship between the weld pool diameter:depth ratio and the welding strength. By the finite element simulation, the weld pool for type I was more slender than type II, which was approximately the same as the experimental results.
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