Effects of infusion of different fluids during controlled hypotension on gastric intramucosal pH and postoperative gastroenterological function

The present study was aimed to investigate the effects of infusion of different fluids combined with control-led hypotension on gastric intramucosal pH （pHi） and postoperative gastrointestinal function in patients undergo-ing hepatocarcinoma surgery. Forty-five patients （ASAⅡ） scheduled for surgical resection of hepatocarcinoma undergoing controlled hypotension were randomly assigned to three groups and received infusion of 20 mL/kg Ringer’s solution （R group）, 6% HAES（H group） or 6% Voluven group （W group）. Intragastric PgCO2, pHi, he-matocrit and hemoglobin were measured. The significant decrease of pHi and increase of PgCO2 were produced at 1 and 2 h after controlled hypotension in the R group （P 0.05 or P 0.01）. The time of bowel movement af-ter operation was shorter in the W group than the R group. Meanwhile, we also did not find obvious difference in blood gas indexes among the three groups. The infusion of HAES and Voluven during controlled hypotension could improve gastrointestinal perfusion and accelerate the recovery of postoperative gastrointestinal function.

Differential effects of controlled hypotension on gastric intramucosal pH and post-operational gastrointestinal functional under two different anesthesia methods

Objective： To observe the effects of controlled hypotension on gastric intrarnucosal pH and post-operational gastrointestinal functions using two specific anesthesia methods. Methods： Thirty patients（ASA II ）scheduled for ectomy of hepatocarcinoma, were randomly assigned to two groups： epidural block combined with intravenous anesthesia group（E group） and inhalation anesthesia group（G group）. Gastric PgCO2 and phi were monitored at different time points, before theintravenous induction of controlled hypotension, after 1 h and 2 h, and 1 h after the termination of controlled hypotension. In the meanwhile, the artery blood gas was analyzed. Results： There was no significant difference in blood gas indexes between E group and G group. However, phi decreased significantly after I h and 2 h of controlled hypotension（P 〈 0.05）, and during the same periods PgCO2 increased significantly（P 〈 0.05 or P 〈 0.01）, the time of bowel movement and defecating deferred significantly shorter in G group patients, when compared with E group patients. Conclusion： Epidural block in combination with general anesthesia can improve gastrointestinal blood flow during controlled hypotension and facilitates post-operational recovery of gastrointestinal functions.

Observation on the Efficacy of Autologous Blood Transfusion Combined with Controlled Hypotension in Patients with Spinal Internal Fixation during the Outbreak of New Coronavirus Pneumonia in Western Guangxi (in Guixi)

Objective: To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. Methods: 30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. Results: 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). Conclusion: During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant.

Clinical Study on Composite Salvia Miltiorrhizae Injection (复方丹参注射液) in Preventing Nitroglycerin Controlled Hypotension for Lowering Arterial Partial Pressure of Oxygen Induced by Hypotension

Objective: To observe the effects of Salvia miltiorrhizae composita (SMC) on blood gas variations of nitroglycerin (NTG) controlled hypotension. Methods: Sixteen patients who were arranged to undergo operation under general anesthesia in controlled hypotension condition were randomly divided into the control group (n=8) and the SMC group ( n=8). NTG was used to create controlled hypotension in both groups and blood pressure decreased by about 30% compared with the control values. Patients in the SMC group were administered intravenously with SMC (16 ml) before the utilization of NTG. Results: Significant PaO 2 decrease and Pa etCO 2 increase were observed in the control group during the controlled hypotension period. However, blood gas values in the SMC group did not obviously change. Conclusion: SMC can prevent the side effects of NTG on blood gas.

Hypervascular aoustic tumor

objective: To explore the surgical treatment of hypervascular acoustic tumor (HAT). Methods: In past ten years (1975–1985) there were 90 patients with unilateral acoustic tumors were treated by surgery. Among them (4 cases of HAT and 86 cases of nonhypervascular acoustic tumors, NHATs) were retrospectively reviewed and clinical characteristics, radiological and surgical finding were compared. Results: HATs presented at a younger age than NHATs (28±10 vs. 54±17 years old) (P<0.01). MRI showed that HATs was solid, without tumor cyst, and larger than NHATs significantly (P<0.05). The surface of HATs consistently showed multiple flow voids representing large draining veins. The characteristic angiographical findings of HATs were extensive tumor vessels, tumor stains and early filling of draining veins; Vertebrobasilar arteries supplied HATs. The authors preferred the control hypotension anaesthesia to remove HATs and got total resection of 4 cases of HATs successfully. No patients has needed transfusion or suffered any other complications after operation. Conclusion: HATs was a solid tumor presented at young. Angiographical findings may provide characteristic manifestation, and could be managed by control hyper- tension in one-stage surgical approach.

Acute Pulmonary Embolism Caused by Local Resection of Choroidal Melanoma

Uveal melanoma is the most malignancy in adults, with 6-7 cases/million people.^-~j common primary ocular an annual incidence of The choroid is the most common site of involvement occurring in more than 90% patients.TM We conducted a retrospective study for uveal melanoma at Yongren Eye Center from 1997 to 201 I. A total of 682 cases of uveal melanoma were recorded. Among them, 176 （25.8%） cases received local resection surgery. Most of them survived after surgery and had good recovery. However, life-threatening complication of acute pulmonary embolism （APE） occurred in 3 choroidal melanoma patients shortly after surgery. Till now, to the best of our knowledge, there are few reports of severe postsurgical complications of choroidal melanoma.