Comparison of the Effect of Combined Cardiovascular Dexmedetomidine and Propofol in Minimally Invasive axillary Odor Surgery with Tumescent Anesthesia

Objective:The effects of combined dexmedetomidine hydrochloride and propofol in minimally invasive axillary odor surgery with tumescent anesthesia.Methods:A total of 46 patients underwent minimally invasive axillary odor surgery by tumescent anesthesia received in the hospital from May 2017 to January 2019 were divided into observation group(23 cases)and control group(23 cases)according to the random number table method.The control group used propofol,and the observation group underwent minimally invasive axillary odor combined with dexmedetomidine hydrochloride by tumescent anesthesia.The changes of arterial blood pressure(MAP),heart rate(HR)and postoperative complications before and after anesthesia were compared and analyzed between the two groups.Results:After anesthesia,MAP and HR in both groups were lower than before anesthesia,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).Compared with the control group,the postoperative complications were less in the observation group,but the difference was not statistically significant(P>0.05).Conclusion:Compared with the use of propofol,the effect of dexmedetomidine hydrochloride combined with minimally invasive axillary odor surgery by tumescent anesthesia is more obvious,and the postoperative recovery is faster with fewer complications.

Mega-Volume Fat Transplantation to the Breast and Buttocks: A New Surgical Technique That Brings New Anesthetic Challenges

Objective: Autologous fat-grafting for the purpose of breast augmentation has gained widespread acceptance as a viable and safe alternative to classical breast implant procedures and has recently been successfully applied to buttock augmentation. Due to the numerous patient re-positionings and widely variable OR time, these procedures present unique challenges for anesthesiologists. Our goal is to discuss the current surgical methods, anesthetic methods, risks and benefits of this procedure. Methods: This is a retrospective cohort study in the setting of the operating room. Twenty-nine consecutive cases of mega-volume fat transplantation, defined as >300 cc to an individual site, performed by one surgeon, were reviewed. Age, Body Mass Index, total fat injected, total operating room time, maximum intraoperative temperature, minimum intraoperative and temperature were measured. RESULTS: Our procedure has enjoyed a 100% patient satisfaction rate. Analysis reveals high variability in age (21 - 57), total fat injected (200 cc - 1990 cc), patient Body Mass Index (18.8 - 42.2) and total operating room time (1:23:00 - 6:14:00) for our procedures. There were no instances of major complications in this cohort. Conclusions: Autologous fat transplantation for the purposes of breast and buttock augmentation is an emerging technique that shows great promise and high patient satisfaction, but providing unique challenges for anesthesiologists and surgeons.

Effect of the tumescent infiltration solution temperature on body temperature

Objective To evaluate the effect of tumescent infiltration solution temperature on core body temperatureafter liposuction.Methods 15 healthy female subjects were randomly divided into 2 groups to receive tumescent infiltration

Characteristics of sildenafil erections in healthy young men

Aim： To determine the effect of sildenafil citrate on the nocturnal penile erections （i.e. time to onset, the duration of erection, and the interval between first and second erections） of healthy young men. Methods： Twenty-two potent men, 23-29 years old, were recruited for the study. All subjects completed three sessions over consecutive nights using the RigiScan monitoring device （Dacomed, Minneapolis, USA）. After a first night of adaptation, night 2 records were their baseline values, and on night 3 they received 100 mg of sildenafil citrate. Statistical comparisons were done between the second and third night data. Results： The mean time to onset of the first erection with sildenafil citrate was （34 ± 18） min, whereas it was （74 ± 24） min （P 〈 0.001） without sildenafil citrate. The number of erections observed during the first 5 h after sildenafil citrate medication was 3.6 ± 0.5 in contrast to 2.4 ± 0.5 with no medica- tion （P = 0.001）. The interval between first and second erections was shorter with sildenafil citrate： （52 ± 26） min vs. （85 ± 34） min （P = 0.01）. The duration of the last erection was statistically significantly longer with the sildenafil citrate： （64 ± 33） min vs. （42 ± 28） min （P 〈 0.01）. Conclusion： Healthy young men achieved erection within 34 min after sildenafil citrate administration, which is shorter than the 1 h interval proposed by the manufacturer. The interval between the first and second erections was shorter and the duration of the last nocturnal erection was longer.

Using Tallquist Haemoglobin Scale for Estimating Intraoperative Blood Loss in Liposuction

Introduction: Intraoperative blood loss remains as a concern for all surgeons. Proper estimation of intraoperative blood loss is critical and can be challenging, especially if the blood is mixed with other fluids such as tumescent fluid in liposuction cases. In such cases, proper estimation of intraoperative blood loss will lead to fewer mistakes in fluid resuscitation. In this article, Tallquist Haemoglobin Scale was tried to estimate intraoperative blood loss in liposuction. Objectives: Proper estimation of intraoperative blood loss in liposuction cases. Method: Tallquist Haemoglobin Scale will be tried to estimate the approximate intraoperative blood loss in liposuction cases using a mathematical formula that considers total fluid loss, patient’s preoperative haemoglobin and the reading from Tallquist kit. Results: Tallquist Haemoglobin Scale can be considered as a valid method for proper estimation of intraoperative blood loss in liposuction cases, the thing that will lead to correct fluid resuscitation and fewer complications. Conclusion: Proper estimation of intraoperative blood loss leads to fewer mistakes in fluid resuscitation and fewer related complications of under or overcorrection. Tallquist Haemoglobin scale is a trusted, cheap and fast method for proper estimation of intraoperative blood loss in liposuction cases.

Endovenous laser ablation of great saphenous vein with ultrasound-guided perivenous tumescence： early and midterm results

Background Endovenous laser ablation （EVLA） is an improved method to treat varicose great saphenous veins （GSV） with a high satisfactory rate. This study aimed to evaluate the efficiency and safety of treatment by EVLA procedures with ultrasound-guided perivenous tumescence. Methods Thirty-one patients （31 limbs） with symptomatic varicose vein primary to chronic venous insufficiency （CVI） treated with EVLA were prospectively studied. The entire procedure was performed under ultrasound-guided tumescent local anesthesia. The patients were evaluated with a 18 month follow-up postoperation using clinical examination and venous duplex ultrasonography. Pain scores and quality of life （QOL） were recorded using visual analog scale （VAS） and the chronic venous insufficiency questionnaire （CIVIQ） at 1 week, 1 month, and 12 months after operation. Results All patients tolerated EVLA procedure well. The overall success occlusion rates of GSV were 92%, 94%, and 94% at 1, 12, and 18 months follow-up, respectively. The score of CIVIQ one week preoperation was 69.14±11.44 while that of CIVIQ one month postoperation was 85.32±4.89. The life quality has significantly improved after the operation of EVLA （t=12.71, P 〈0.05）. The VAS one month after treatment was lower than 1 week before therapy （t=8.048, P 〈0.05）. Major complications such as deep vein thrombosis and skin burns were not found. Most of the complications were minor and improved quickly. Conclusions This refinement type of EVLA procedure is a safe and effective treatment with a high satisfaction rate; it displayed noteworthy features including shortening hospitalization, early ambulant activity, and preferable occlusion rates.

Consecutive nightly measurements are needed for accurate evaluation of nocturnal erectile capacity when the first-night laboratory recording is abnormal

Multiple measurements of nocturnal penile tumescence and rigidity(NPTR)are widely accepted as a method to differentiate psychogenic erectile dysfunction(ED)from organic ED.However,direct evidence remains limited regarding the first-night effect on NPTR measurement using the RigiScan.Here,we evaluated the first-night effect on the results of NPTR measurement to validate the necessity of NPTR measurement for two consecutive nights,particularly when abnormal first-night measurements are recorded in a laboratory setting.We retrospectively reviewed 105 patients with a complaint of ED,who underwent NPTR measurement using the RigiScan in the Department of Infertility and Sexual Medicine,the Third Affiliated Hospital of Sun Yat-sen University(Guangzhou,China),for two consecutive nights,during the period from November 2015 to May 2016.NPTR parameters were collected and analyzed.We found that more effective nocturnal erections were detected during the second night than during the first night(P<0.001).Twenty percent of all patients had no effective erection during the first night,but exhibited at least one effective erection during the second night.The negative predictive value of NPTR measurement during the first night was 43.2%;this was significantly lower than that on the second night(84.2%;P=0.003).Most NPTR parameters were better on the second night than on the first night.The first-night effect might be greater among patients younger than 40 years of age.In conclusion,two consecutive nightly measurements of NPTR can avoid a false-abnormal result caused by the first-night effect;moreover,these measurements more accurately reflect erectile capacity,especially when the first-night record is abnormal in a laboratory setting.