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Rui Zhou,* Yanhua Peng,* Xuemeng Chen,* Chao Xiong, Wenhu Zhai, Xianjie Zhang, Leqiang Xia, Yukai Zhou Department of Anesthesiology, Deyang People’s Hospital, Deyang City, Sichuan Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yukai Zhou, Department of Anesthesiology, Deyang People’s Hospital, NO. 173, Section 1 of Taishan North Road, Deyang City, Sichuan Province, People’s Republic of China, Tel +8618781054070, Email christianziege@163.comPurpose: Parturients suffer severe pain during the stages of labor, especially the first and second. Epidural anesthesia is an effective method to alleviate labor pain. L2-3, L3-4 and L4-5 spaces have been reported to be the recommendable puncture points owing to the adequate analgesia effect and high safety. However, the speed of pain alleviation via the three points has hardly been determined, which is of great importance to parturients. Thus, the aim of this study is to compare the onset time of parturients’ painless uterine contraction after epidural labor analgesia through different puncture points.Study Design and Methods: It is a prospective, randomized, controlled, and subject- and assessor-blinded study. Totally, 150 subjects scheduled for vaginal delivery are going to be randomly assigned into the L2-3 and L3-4 group. Puncture point in L2-3 group is lumbar 2– 3 space, while in L3-4 group it is lumbar 3– 4 space. Analgesia initiation and maintenance are the same between the two groups. Primary outcome will be percentage of painless uterine contraction 15 min after epidural labor analgesia initiation. Secondary outcomes will be the sensory blocking level, motor blocking score, adverse effects of parturients, drug liquid consumption in unit interval, apgar score and degree of satisfaction of the parturients.Discussion: This study estimates the onset time of parturients’ painless uterine contraction after epidural labor analgesia through L2-3 or L3-4 space. The results may provide a better choice to relieve labor pain as soon as possible.Keywords: labor analgesia, epidural anesthesia, puncture points, rapid analgesia

Dongyong Zhang,1 Jiefu Yu,1 Zhenze Wang,1 Yiwei Wang2 1Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang City, People’s Republic of China; 2Department of Anatomy, Shenyang Medical College, Shenyang City, People’s Republic of ChinaCorrespondence: Dongyong ZhangDepartment of Neurosurgery, The First Affiliated Hospital of China Medical University, Nanjing Bei Street, Heping District, Shenyang City 110001, People’s Republic of ChinaTel +86 24 83283706Fax +86 24 83283133Email zhangdongyong@cmu.edu.cnAbstract: Bilateral basal ganglia hemorrhages are extremely rare and have very poor prognosis. We describe the case of a 52-year-old woman with a history of hypertension who experienced bilateral basal ganglia hemorrhages. We performed bilateral hematoma aspiration by minimally invasive surgery via frontal and temporal puncture points. We discuss the surgical procedure and review relevant literature pertaining to the underlying causes and complications of similar cases.Keywords: preexisting hypertension, intracranial hemorrhage, surgical procedure, hemorrhage aspiration, puncture points