Subject will receive a mid-thigh adductor block method using ropivacaine (0.5%, 15 mL).

Subject will receive a distal-thigh adductor block method using ropivacaine (0.5%, 15 mL).

Postoperative Pain

Ropivacaine is routinely used to perform localized blockade prior to surgery to improve management of postoperative pain.

Ropivacaine

Zale Lipshy University Hospital

Adductor Canal Mid-thigh and Adductor Canal Distal Thigh: Is Cutaneous Sensory Blockade Similar Among Block Techniques?

Use of Neuropen to determine distribution of cutaneous sensation

Post-operative pain score will be measured using a VAS pain scale

Anthony Machi

Assistant Professor

University of Texas Southwestern Medical Center

This group received an Alexis O-Ring Wound Retractor during cesarean delivery.

This group received routine hand-held metal retractors as needed by the surgical team during cesarean delivery.

Surgical Wound Infection

A flexible self-retaining plastic Alexis retractor was used in place of standard surgical retractors.

Alexis O-Ring Wound Retractor

Routine hand-held metal retractors as needed by the surgical team

Standard Surgical Retractors

NHS Information Centre. HES online: maternity data

Alexis O-Ring Wound Retractor for the Prevention of Post-cesarean Surgical Site Infections

Alexis O-Ring Wound Retractor for the Prevention of Post-cesarean Surgical Site Infections: A Randomized Controlled Trial

Assessed as present or absent. Defined as the development of wound infection, seroma, or other wound disruption in patients who underwent a cesarean delivery

Patients are asked to report pain on a scale of 1-10, 1 no pain and 10 the worst pain.

Defined as the amount of blood loss during the cesarean delivery as estimated by the operating surgeons.

Quantified as yes or no; defined as whether or not the surgeons' exteriorized the uterus extra-corporally (removed from abdominal cavity) at any time of the cesarean delivery

Defined as the total length of time in minutes required to perform the cesarean delivery from time of initial skin incision to completion of skin closure.

Score given by pediatrician or pediatric provider to each infant at 1 and 5 minutes of life

Systolic blood pressure greater than 140 and diastolic blood pressure greater than 90 mmHG

The University of Texas Medical Branch, Galveston

Subjects will receive magnetotherapy (MAT). The magnetic pellets will contain an average of ~200 gauss/pellet magnetic flux densities, with a diameter of 1.76 mm. The experimental object will be applied to the reactive region of each of the six selected acupoints as detected by an acupoint detector. The justifications for selecting these acupoints are described below. To achieve a blinding and placebo effect of the subject, the laser device will be switched to "power off" mode (i.e. deactivated laser) for acupoint "stimulation" prior to the application of MAT. Subjects will be asked to wear a pair of laser protective goggles to "blind" them during therapy administration.

Subjects will receive laser auriculotherapy (LAT). A laser device (pointer pulse) will be used in this study. This device has a wavelength of 650 nm, an average output power of 2.5 mW, energy density of 1 minute with 0.54 J/cm2, and a pulse of 10 Hz, which is a common acceptable dosage for clinical use12, 26. This application belongs to a low-energy laser therapy (LLLT), in which the energy level emitted from the device is approximately comparable to a teaching pointer. A 1-minute treatment using the continuous mode of the device will be directly applied to the reactive region of each of the six selected acupoints on the ear. Laser protective goggles will be provided to the subjects and the researchers for eye protection. Similarly, a plaster without magnetic pellets that mimics MAT treatment will be applied on these six acupoints after LAT.

Subjects will receive a combined approach using MAT and LAT. LAT will be administered prior to the application of MAT on the selected auricular points, which would be implemented similar to the procedures in treatment arm 1 and 2.

Subjects will serve as a placebo control, and will receive LAT at "power off" mode (i.e. deactivated laser) for acupoint "stimulation" before the application of plaster without magnetic pellets that mimic MAT treatment.

Knee Osteoarthritis

The magnetic pellets will contain an average of ~200 gauss/pellet magnetic flux densities, with a diameter of 1.76 mm

magnetotherapy

A laser device (pointer pulse) will be used in this study. This device has a wavelength of 650 nm, an average output power of 2.5 mW, energy density of 1 minute with 0.54 J/cm2, and a pulse of 10 Hz, which is a common acceptable dosage for clinical use. This application belongs to a low-energy laser therapy (LLLT), in which the energy level emitted from the device is approximately comparable to a teaching pointer.

laser auriculotherapy

Placebo

Sai Kung District Community Centre

The Neighbourhood Advice-Action Council

Auriculotherapy for Osteoarthritis Knee

The Experiences for Receiving Auriculotherapy for Osteoarthritis Knee: A Randomised Controlled Feasibility Study.

According to the OMERACT III conference, which was conducted to establish a core set of outcome measures for future OA trials, the perception of pain has the highest preference among the core set of efficacy domains. Therefore, pain perception using NRS is adopted in this study as a primary outcome. The use of NRS is also considered as a good first choice to evaluate pain perception for most older adults because of its established psychometric properties, increased ability to discriminate pain levels, and common use in clinical practice. The NRS could be administered in written or verbal form, and it involves asking the subject to select a number, from 1 to 10 to the nearest 0.5 interval, to represent their maximal OA induced knee pain in the recent 2 to 3 days.

The WOMAC is a disease-specific instrument with 24 items. Physical function is quantified using this scale from 0 (no difficulty) to 96 (extreme difficulty), indicating the level of difficulty associated with overall functional activities caused by knee pain (5 items), stiffness (2 items), and physical function (17 items). Thus, higher scores indicate worse pain, stiffness, and functional limitations. The Chinese WOMAC, which has acceptable psychometric properties (Cronbach's alpha exceeds 0.7 for stiffness and physical function domains; and ICC exceeds 0.7 for all domains), will be adopted in this study.

to measure the active and passive range of movement (ROM) of the knees. With the subject in sitting position, active and passive knee extension and flexion ranges will be recorded twice to calculate an average score. To prevent increasing knee joint ROM caused by repeated knee joint measurements, the subject will be allowed to rest for at least 15 minutes between test sessions.

TUGT is performed to assess the ambulation status of the subject. The subject will be requested to get up from a chair and walk at a comfortable and safe pace to a destination 3 meters away, turn around, return to the chair, and sit down again. Two trials will be conducted, that is, the practice trial, and the result of the second trial is recorded with a stopwatch, to the nearest second, as the final score. This test is reported to have a high interrater and intrarater reliability (ICC = 0.99), and has demonstrated a good correlation to the Berg Balance Scale, gait speed, and Barthel Index

As it is identified in the literature that patient's expectations may influence clinical outcome independently of the treatment itself, therefore a short questionnaire of 8 items is designed to assess patient expectations towards the therapies that they are receiving. Questions include how much they believe that the MAT or LAT have helped them manage their problem, and how much faith they had in complementary therapies, using 10 point scales in most items, with higher the scores indicating higher agreement or satisfaction with each item. These items are adapted from existing literature24,35 and modified for use in this study. A panel of five experts (two registered TCM practitioners, one gerontologist, one nurse specialist, one academic) will be invited to assess the content validity of this questionnaire, and test-retest reliability at a 2-week interval will be determined.

isopropyl alcohol/emorragia

Adductor Canal Mid-thigh and Adductor Canal Distal Thigh: Is Cutaneous Sensory Blockade Similar Among Block Techniques?

Alexis O-Ring Wound Retractor for the Prevention of Post-cesarean Surgical Site Infections

Auriculotherapy for Osteoarthritis Knee

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