Peri-operative Treatment for Pheochromocytoma

The perioperative management of 81 cases with pheochromocytoma was reviewed including blood pressure and arrhythmia control, blood volume expansion, patient′s general condition improvement and vital signs monitoring. It was stressed that pre and intra operative management was of prime importance in the treatment of pheochromocytoma.

THE OPERATIVE TREATMENT OF SPINAL FRACTURE-DISLOCATION WITHOUT NEUROLOGIC DEFICITS

To evaluate the results of operative treatment of spinal fracture dislocation without neurologic deficits. Methods.Eighteen patients with spinal fracture dislocation were neurologically intact at the time of injury, and all were treated operatively. The fracture sites were:8 cases in cervical spine, 3 cases in thoracic spine, and 7 cases in lumbar spine. Eight patients with cervical injuries had variant degrees of forward slide and kyphotic deformity. Of the 10 thoracic and lumbar fractures, one had lateral dislocation, 4 cases with kyphotic deformities, 5 cases with spinal canal compromise averaged 50% (ranging from 40% to 70%). Results.The average period of follow up was 4.4 years with a range of 11 months to 13 years. All the patients returned to full time work. No patient developed neurologic deterioration. Kyphotic deformity was corrected in the 4 cases, and no progressive kyphosis was noted. There was no operation related complication. The averaged post operative hospitalization time was 13 days. Conclusions. Despite the rare incidence of spinal fracture dislocation without neurologic deficits, we suggested that kind of fracture be considered unstable fracture because of its potential risk of delayed neurologic deterioration and kyphotic deformity, and be treated operatively to restore the sagittal alignment and the stability of the spine.

Correlation between pre-anesthesia anxiety and emergence agitation in non-small cell lung cancer surgery patients

BACKGROUND Preoperative anxiety is a common emotional problem during the perioperative period and may adversely affect postoperative recovery.Emergence agitation(EA)is a common complication of general anesthesia that may increase patient discomfort and hospital stay and may be associated with the development of postoperative complications.Pre-anesthetic anxiety may be associated with the development of EA,but studies in this area are lacking.AIM To determine the relationship between pre-anesthetic anxiety and EA after radical surgery in patients with non-small cell lung cancer(NSCLC).METHODS Eighty patients with NSCLC undergoing surgical treatment between June 2020 and June 2023 were conveniently sampled.We used the Hospital Anxiety and Depression Scale’s(HADS)anxiety subscale(HADS-A)to determine patients’anxiety at four time points(T1-T4):Patients’preoperative visit,waiting period in the surgical waiting room,after entering the operating room,and before anesthesia induction,respectively.The Riker Sedation-Agitation Scale(RSAS)examined EA after surgery.Scatter plots of HADS-A and RSAS scores assessed the correlation between patients’pre-anesthesia anxiety status and EA.We performed a partial correlation analysis of HADS-A scores with RSAS scores.RESULTS NSCLC patients’HADS-A scores gradually increased at the four time points:7.33±2.03 at T1,7.99±2.22 at T2,8.05±2.81 at T3,and 8.36±4.17 at T4.The patients’postoperative RSAS score was 4.49±1.18,and 27 patients scored≥5,indicating that 33.75%patients had EA.HADS-A scores at T3 and T4 were significantly higher in patients with EA(9.67±3.02 vs 7.23±2.31,12.56±4.10 vs 6.23±2.05,P<0.001).Scatter plots showed the highest correlation between HADS-A and RSAS scores at T3 and T4.Partial correlation analysis showed a strong positive correlation between HADS-A and RSAS scores at T3 and T4(r=0.296,0.314,P<0.01).CONCLUSION Agitation during anesthesia recovery in patients undergoing radical resection for NSCLC correlated with anxiety at the time of entering the operating room and before anesthesia induction.

Modified Foerster-Dandy 's operation for treatment of spasmodic torticollis under endoscope-assisting

Objective To study microsurgical effectiveness Foerster-Dandy’s endoscope-assisted operation for treatment of spasmodic torticollis. Methods 183 cases of spasmodic torticollis patients were treated by microsurgical modified Foerster-Dandy’s operation from July 2001 to June 2009,which was randomly

CLINICAL OBSERVATION ON ACUPOINT DIGITAL PRESSING FOR TREATING IRRITABLE SYMPTOMS AND SIGNS OF POSTOPERATION OF MYOPORTHOSIS

Objective: To explore a new effective approach for treatment of the local irritable symptoms and signs resulted from myoporthosis operation. Methods: 263 cases of radial keratotomy outpatients were divided into control group (n=49, 90 eyes) and treatment group (n=214, 412 eyes). Patients of control group were treated with 0.5% Chloramphenicol eye drops, 3 times daily, 1-2 drops/time, and with 0.5% Erythromycine eye ointment every night. In treatment group, patients were treated with acupoint and hand reflection area digital pressing method except with the same eye drops and eye ointment. Body acupoints used were Cuanzhu (BL 2), Yuyao (EX HN 4), Sizhukong (TE 23), Sibai (ST 2) and Taiyang (EX HN 5). The hand reflex areas used were Eye Area, Liver Area, Kidney Area, Spleen Area, Heart Area and Lung Area. Five days constituted a therapeutic course. Results: Following 3 courses (15 days) of treatment, the markedly effective rate and total effective rate of treatment group and control group were 74.51% and 38.89%, 94.17% and 66.67% respectively. There was a significant difference between two groups in the total effective rate (P<0.05), showing the therapeutic effect of treatment group being better than that of control group. Conclusion: Acupoint digital pressing is rather effective in treatment of myoporthosis post operation irritable symptoms and signs.