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Wirinaree Kampitak Aree Tanavalee Srihatach Ngarmukos Chavarin Amarase 《The Journal of arthroplasty》2019,34(2):295-302
Background
Peripheral nerve block and local infiltration analgesia (LIA) have an increasing role as part of multimodal analgesia for enhanced recovery after total knee arthroplasty (TKA). We hypothesized that the combination of obturator nerve block (ONB) and tibial nerve block (TNB) would reduce pain and opioid consumption more than ONB or TNB alone when combined with continuous adductor canal block and LIA.Methods
Ninety patients were recruited into the study and received spinal anesthesia, LIA, and continuous adductor canal block. They were further randomized to receive either an ONB (group 1), a TNB (group 2), or both (group 3). The primary outcome was total morphine consumption over the postoperative 24 hours. The secondary outcomes included visual analog scale scores, time to first and total dosage of rescue analgesia, Timed Up and Go test, range of motion, muscle strength test, hospital stay, and patient satisfaction.Results
Eighty-nine patients completed analysis. The median total morphine consumption during the first 24 postoperative hours was 2 mg (interquartile range [IQR] 0-4) in group 3, 4 mg (IQR 2-8) in group 2, and 6 mg (IQR 6-14) in group 1 (P < .001). Posterior knee pain during the first 24 hours postoperatively was significantly lower in group 3 than in group 1 (P = .006). The ability to ambulate and quadriceps strength were significantly better in group 3 than in the other groups.Conclusion
The combination of triple nerve block was superior to double nerve block in improving analgesia and functional outcomes in the immediate postoperative period after total knee arthroplasty, when combined with LIA. 相似文献2.
Comparison of the efficacy and safety of two biphasic defibrillator waveforms for the conversion of atrial fibrillation to sinus rhythm 总被引:5,自引:0,他引:5
The overall efficacy of transthoracic biphasic shocks delivered for conversion of atrial fibrillation (AF) has been demonstrated. We compared 2 different energy waveforms, either the biphasic rectilinear (BRL) waveform or the biphasic truncated exponential (BTE) waveform, in the conversion of AF to sinus rhythm. The relation between energy required for the conversion of AF, the type of biphasic waveform, and patient characteristics were examined. Serum levels of cardiac troponin I were measured before and after cardioversion, as well as postprocedural skin erythema and discomfort. In this prospective trial, 101 patients (mean age 61 +/- 15 years, 72 men [71%]) referred for elective electrical cardioversion of AF were randomized to either a BTE or a BRL device. Shocks were delivered in a step-up fashion beginning with 50 J (then 100 J, 200 J, repeat 200 J, and then crossover to 360 J). One hundred patients were successfully converted to sinus rhythm (99% success rate). There was no difference in efficacy at any energy level used, regardless of the duration of the arrhythmia. In addition, there was no difference in cumulative success. Troponin I did not significantly increase after cardioversion, regardless of the total energy used. A positive correlation between skin erythema and skin discomfort after shock (24 to 48 hours) was seen with increasing cumulative energies. There was also a positive trend toward increasing energy requirements as chest circumference and body mass index increased. Thus, biphasic waveforms are safe and effective at converting AF to sinus rhythm. In this study population, there was no clinical difference between the BRL and the BTE waveforms. 相似文献
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Natthaphon Saetan Sittisak Honsawek Aree Tanavalee Pongsak Yuktanandana Surapoj Meknavin Srihatach Ngarmukos Thanathep Tanpowpong Vinai Parkpian 《International orthopaedics》2014,38(5):1099-1104
Purpose
Recent evidence suggests that angiogenesis and inflammation contribute to the development and progression of osteoarthritis (OA). The purpose of this study was to investigate vascular endothelial growth factor (VEGF) levels in plasma and synovial fluid of patients with knee OA and to determine the relationship of VEGF levels with disease severity in knee OA.Methods
A total of 100 subjects were enrolled in this study (80 knee OA patients and 20 healthy controls). Plasma and synovial fluid VEGF levels were analysed using enzyme-linked immunosorbent assay. VEGF expressions in synovial membrane and articular cartilage samples were assessed using immunohistochemistry.Results
VEGF level in synovial fluid of knee OA patients was tenfold higher than that in paired plasma (P < 0.001). Both plasma and synovial fluid VEGF exhibited a positive correlation with radiographic severity (r = 0.454 and r = 0.727, P < 0.001, respectively). VEGF expression was highly detectable in synovial lining cells and articular chondrocytes of knee OA patients.Conclusions
VEGF levels in both plasma and synovial fluid were positively correlated with the severity of knee OA. Therefore, VEGF may be useful for monitoring OA severity and could play a substantial role in the development and progression of knee OA. 相似文献4.
Ngarmukos C Chailurkit LO Chanprasertyothin S Hengprasith B Sritara P Ongphiphadhanakul B 《Clinical endocrinology》2012,77(1):42-46
Background Osteocalcin (OC), an osteoblast‐specific protein, has been demonstrated to affect glucose metabolism in both animals and humans. Studies in animals have shown an effect of undercarboxylated OC (ucOC) on beta‐cell proliferation and insulin resistance. It remains unclear whether OC is associated with the future development of diabetes in humans, as well as the relative importance of ucOC vs OC. Objective The aim of this study was to examine serum OC and its post‐translational forms as potential biomarkers for future the development of type 2 diabetes. Methods This was a nested case–control study using data from the Electricity Generating Authority of Thailand (EGAT). We identified 63 men without diabetes in the exploratory cohort at baseline who developed type 2 diabetes (DM) during the 10‐year follow‐up period from 1998–2008, and also 63 men age‐ and BMI‐matched for a non‐diabetes control group (non‐DM). Serum N‐mid OC and ucOC were measured in baseline blood samples. Logistic regression models were used to explore and identify baseline factors, including OC and ucOC, that predicted the subsequent development of diabetes. Results The mean age and BMI were similar in both non‐DM and DM groups (47·2 ± 0·5 vs 47·8 ± 0·8 years and 25·2 ± 0·5 vs 25·9 ± 0·5 kg/m2, respectively). Only baseline mean serum N‐mid OC (15·2 ± 0·5 vs 13·0 ± 0·5 μg/l, P < 0·05) and fasting plasma glucose (4·92 ± 0·04 vs 5·28 ± 0·07 mmol/l, P < 0·05) were significantly different between the two groups. Multiple logistic regression analysis showed that baseline serum N‐mid OC and glucose, but not ucOC, were independent risk factors for the development of diabetes in this long‐term study cohort. Conclusions Circulating total OC is associated with incident diabetes in men. Further studies to evaluate the potential utility of OC as a biomarker to predict the development of type 2 diabetes are warranted. 相似文献
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Clinical safety and performance of a MRI conditional pacing system in patients undergoing cardiac MRI 下载免费PDF全文
Chi Keong Ching MD FHRS Rabindra Nath Chakraborty MD Tarlochan Singh Kler MD Satchana Pumprueg MD Tachapong Ngarmukos MD Joseph Yat Sun Chan MD Sumit Anand PhD Rakesh Yadav MD Surapun Sitthisook MD Ka Wing Yim MPhil Rakesh K. Jaswal MD Kartikeya Bhargava MD FHRS 《Pacing and clinical electrophysiology : PACE》2017,40(12):1389-1395
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Jasper Tromp Tiew‐Hwa Teng Wan Ting Tay Chung Lieh Hung Calambur Narasimhan Wataru Shimizu Sang Weon Park Houng Bang Liew Tachapong Ngarmukos Eugene B. Reyes Bambang B. Siswanto Cheuk‐Man Yu Shu Zhang Jonathan Yap Michael MacDonald Lieng Hsi Ling Kirsten Leineweber A. Mark Richards Michael R. Zile Inder S. Anand Carolyn S.P. Lam 《European journal of heart failure》2019,21(1):23-36
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