International journal of oral and maxillofacial surgery
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Int J Oral Maxillofac Surg · Apr 2014
Randomized Controlled Trial Comparative StudyDonor site analgesia after anterior iliac bone grafting in paediatric population: a prospective, triple-blind, randomized clinical trial.
The aim of this study was to compare the efficacy of femoral nerve block with indwelling catheter-based multiple infiltrations of bupivacaine for postoperative pain management after iliac bone harvesting. Sixty paediatric patients undergoing iliac harvesting were randomized into three groups: group A, preoperative femoral nerve block; group B, multiple bolus infiltration of 0.5% bupivacaine via indwelling catheter at the donor site; group C, controls--single dose of 0.5% bupivacaine infiltration given subcutaneously. The primary outcome measure was postoperative pain intensity at rest and at function. ⋯ Indwelling catheter-based infiltration of bupivacaine was the most efficient method for providing enhanced pain relief after iliac bone graft harvesting. There was no increase in operating time or hospital stay. Femoral nerve block provided the next best results, but had the significant disadvantage of motor nerve blockade.
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Int J Oral Maxillofac Surg · Apr 2014
Preoperative plasma fibrinogen predicts cervical metastasis in patients with stage I/II carcinoma of the tongue.
The aim of this study was to evaluate the association of preoperative plasma fibrinogen levels with clinico-pathological parameters and disease-free survival in patients with oral tongue squamous cell carcinoma (OTSCC). We retrospectively studied 76 patients with OTSCC who underwent a partial glossectomy only, at a single centre, between 1996 and 2007. Among the 76 patients, 30 eventually developed cervical metastasis. ⋯ Multivariate analysis showed that the plasma fibrinogen level remained an independent factor for disease-free survival after partial glossectomy for OTSCC (P=0.029). A high preoperative plasma fibrinogen level is an independent predictor of cervical metastasis after partial glossectomy for OTSCC. A conservative supraomohyoid neck dissection is appropriate in patients with stage I/II carcinoma of the tongue whose preoperative plasma fibrinogen is >300 mg/dl.