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Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To observe the effects of general anesthesia combined with femoral nerve and sciatic nerve block on postoperative awakening quality, stress response and cognitive function in patients with lower limb fractures. Methods: 103 patients with lower limb fractures who were treated in our hospital from July 2020 to July 2021 were aelected, and they were divided into control group（51cases, general anesthesia） and observation group（52 cases, general anesthesia combined with femoral nerve and sciatic nerve block）according to the double color ball method. The changes of hemodynamics, postoperative awakening quality, stress response and cognitive function in two groups were observed, and the perioperative adverse reactions in two groups were recorded. Results: The heart rate（HR）and mean arterial pressure（MAP） in the two groups after induction anesthesia（T2） time points were lower than those before anesthesia（T1）. There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）. HR and MAP in the observation group were lower than those in the control group from immediately（T3） to 60min（T5） after laryngeal mask（P<0.05）. The awakening time in the observation group was shorter than that in the control group, and the incidence of agitation was lower than that in the control group（P<0.05）. The adrenaline（E） and cortisol（Cor） in the two groups in the anesthesia awakening period were higher than those in the anesthesia maintenance period, but the observation group was lower than the control group（P<0.05）. The scores and total scores of visual space and execution, memory, naming, attention, language, abstraction, directional force and delayed recall in the observation group were higher than those in the control group（P<0.05）. Conclusion: General anesthesia combined with femoral nerve and sciatic nerve block for patients with lower limb fracture can stabilize hemodynamics, improve postoperative awakening quality, reduce stress response and influence on cognitive function. [ABSTRACT FROM AUTHOR]

Objective: To investigate the study of influences of dexmedetomidine combined with sevoflurane anesthesia on stress response, hemodynamics and its myocardial protective effects in patients with lower limb fracture. Methods: 116 patients with lower limb fracture were selected. They were divided into control group (n=58) and observation group (n=58) according to the random stratified sampling method, the control group was given dexmedetomidine combined with propofol during anesthesia, the observation group was given dexmedetomidine combined with sevoflurane during anesthesia, hemodynamic indexes, stress response indexes, myocardial indexes, postoperative pain and adverse reactions were compared between the two groups. Results: The heart rate (HR), mean arterial pressure (MAP) of the observation group were lower than those of the control group on the time point of during extubating (T2) ~ 10min after extubation T4 (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). The cortisol (Cor), epinephrine (E) of the two groups were higher than those of before operation 1d after operation, but the observation group was lower than that of the control group (P<0.05). The creatine kinase (CK), lactate dehydrogenase (LDH), cardiac troponin (cTnI) in the observation group were lower than those of the control group 1d after operation (P<0.05). The visual analogue scale (VAS) scores of the observation group were all lower than those of the control group 6 h after operation, 12 h after operation, 24 h after operation (P<0.05). Conclusion: Dexmedetomidine combined with sevoflurane anesthesia can stabilize the hemodynamics of patients with lower limb fracture, reduce the body stress response and postoperative pain, which can also play a certain role in myocardial protection at the same time. [ABSTRACT FROM AUTHOR]

Objective: Through the analysis of the effect of combined spinal and epidural anesthesia on white blood cell (WBC), albumin (ALB), C-reactive protein (CRP), procalcitonin (PCT) in lower extremity fracture surgery, to explore the application value of combined spinal and epidural anesthesia in the operation of lower limb fracture. Methods: From December 2018 to October 2019, 88 elderly patients with hip fracture operation were selected and divided into observation group (n=48) and control group (n=40) according to different anesthesia methods. The control group received general anesthesia, while the observation group received combined spinal and epidural anesthesia. WBC, CRP, ALB and PCT were used as observation indicators, combined with postoperative pain and intraoperative anesthesia to the response of combined spinal and epidural anesthesia in lower limb fracture operation. Results: The resting pain scores of the observation group at 4 h, 24 h and 48 h after operation in the observation group were significantly lower than those of the control group (P<0.05). The sensory block time, block time and pain recovery time of the observation group were significantly lower than those of the control group (P<0.05). There were no significant differences in WBC and ALB compared between the observation group and the control group at 1 and 7 d after operation (P>0.05). The serum CRP and PCT levels in the observation group were significantly lower than those in the control group at 1 and 7 d after operation (P<0.05). Conclusion: The application of combined spinal-epidural anesthesia anesthesia in lower limb fracture surgery does not affect the expression of WBC and ALB, but can reduce the blood concentration of CRP and PCT, it can improve the anesthetic effect, play a analgesic role, prolong the postoperative painless time, so that promoting the recovery of patients. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To study the changes of bone mineral density ( BMD) and its significance in patients after lower limb fracture operation． Methods One hundred and two lower limb fracture patients at the Department of Orthopedics，the First Affiliated Hospital of Dalian Medical University from October 2014 to October 2017，were admitted to the study，including 55 males and 47 females． They were from 20 to 60 years old，with an average of 43. 5 ±12. 5 years． Among those，84 cases were unilateral fracture，18 cases were bilateral fractures． There were 22 cases of open injury and 80 cases of close injury． The operations were performed in 2 hours to 7 days after the fracture． They were followed up at the 1，2，3，6，and 12 months after the operation． BMD of the both calcaneus was measured using ultrasonic bone densitometry． BMD of the both calcaneus was measured in 39 healthy outpatients at the same period，and the average was used as the control． The change of BMD after fractures was observed，and the influencing factors were analyzed． Results 1) BMD of the patients with unilateral lower limb fracture decreased rapidly from 1 to 3 months． The decrease was slow in the period from 3 to 6 months，and the lowest point was at the end of 6 months after the operation． BMD increased slowly from 6 to 12 months，but it was still lower at 12 months than at the level of preinjury． Comparing the BQI value among the healthy limb，the affected limb，and the controls in 1，2，3，6，and 12 months after the operation group，the difference was statistically significant，and the difference between any two groups was statistically significant ( P < 0. 05) ． ( 2) in patients with unilateral lower limb fractures，the BQI value ins male was higher than that in females，but the difference was not statistically significant ( P > 0. 05) ． ( 3) There was not significant difference of BMD of the healthy limb and the affected limb between the different anatomic sites of single side fracture ( P > 0. 05) ． BMD of the unilateral fracture was higher than that of bilateral fracture，and the difference was statistically significant ( P < 0. 05) in 2，3，6，and 12 months after the operation． ( 4) BMD in Gustilo-Anderson type Ⅲ of the open injury was significantly different compared with that of the close injury in 2，3，6， and 12 months after operation ( P < 0. 05) ． BMD in Gustilo-Anderson type I and II of open injury was not statistically different compared to the closed injury ( P > 0. 05) ． Conclusion In the healing process of lower limb fracture，BMD of the lower limb decreases rapidly in 1 － 3 months，slowly in 3 － 6 months，and increases slowly in 6 － 12months． It may be related to the decrease of limb activity，the decrease of mechanical stress，and the degree of soft tissue injury around the fracture． Anatomical site of fracture and gender may have no significant influence on the changes of BMD． It is necessary to have early exercise and combination drug therapy in order to prevent the decrease of BMD and the occurrence of disused osteoporosis．` [ABSTRACT FROM AUTHOR]

Objective: To analyze the analgesic effect of combined spinal epidural anesthesia (CSEA) and lumbar plexus-sciatic nerve blocks (LPSB) on the elderly patients with lower limb orthopedic surgery. Methods: 158 cases of elderly patients with surgical treatment of lower limb fracture in our hospital were chosen. The patients were randomly divided into two groups (combined spinal epidural anesthesia was performed in the combined spinal epidural anesthesia (CSEA) group and the lumbar plexus and sciatic nerves were blocked in the lumbar plexus-sciatic nerve blocks (LPSB) group. The onset of sensory-motor block, success in providing adequate anesthesia, hemodynamic changes, first analgesic request time and VAS socrewere recorded. Results: One patient in the CSEA group and three patients in the LPSB group required general anesthesia due to failed block of each patient were observed. There was no significant differences in the success of providing adequate anesthesia between two groups. The onset of sensory-motor block and the first analgesic request time were significantly later in the LPSB group than CSEA group. However, the duration of analgesia in the LPSB group were longer than CSEA group, the VAS score in LPSB group was significantly lower than CSEA group. Conclusions: The lumbar plexus-sciatic nerve blocks could provide effective unilateral anesthesia and offer a beneficial alternative to combined spinal epidural anesthesia in patients undergoing lower limb orthopedic surgery. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)