International journal of clinical and experimental medicine
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Patients with giant retroperitoneal liposarcomas are considered at great risks of perioperative complications and require meticulous anaesthetic management. There have been few reports about anaesthetic management of giant retroperitoneal liposarcoma. We present the case of a 66-year-old patient who suffered from a giant retroperitoneal liposarcoma (diameter 45 cm and weigh 4.5 kg), needing a resection surgery under general anesthesia. ⋯ The surgery was completed uneventfully and the patient recovered smoothly. After reviewing the literature, we summarize FloTrac/Vigileo(TM) monitoring system is useful to help anaesthesiologists adjust infusion rate to maintain the stability of circulatory state. Anesthetic monitoring, fluid management and temperature control need to be focused in the anesthetic management.
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The surgical methods of degenerative lumbar spinal stenosis include spinal decompression with or without instrumented or non-instrumented spinal fusion. Previous meta-analysis and systematic reviews have reported the contrast between surgical management and nonsurgical management for degenerative lumbar spinal stenosis, while no literature did among surgical managements. And it is evidenced that whether fusion should be added to spinal decompression in patients of lumbar spinal stenosis is still divisive. So our purpose is to identify whether spinal fusion with or without decompression has a better effect than decompression alone for patients with degenerative lumbar spinal stenosis. ⋯ This meta-analysis provides robust evidence of a better clinical outcome but a higher reoperation rate for spinal fusion compared with decompression alone.
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The flexible laryngeal mask airway (FLMA) is becoming more and more popular in general anesthesia during surgery of head, neck and upper chest. But very limited information has been published about whether muscle relaxant was necessary or not for anesthesia with FLMA. To investigate whether low-dose muscle relaxant is necessary in preventing ventilation leak of FLMA in radical mastectomy, forty-eight female patients undergoing radical mastectomy were enrolled in the study. ⋯ Peak airway pressures and ventilation leak volumes at 10, 20 and 30 minutes were lower in LD-MR group than those in non-MR group (P < 0.05). No difference was found between LD-MR and non-MR group in terms of emergence time, FLMA extraction time, and maximum tidal volumes before FLMA extraction. The results show that low-dose rocuronium could reduce the ventilation leak for mechanical ventilation with FLMA during radical mastectomy without prolonging the emergence time.
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To determine the minimum alveolar concentration (MAC) of sevoflurane required for 50% blockade of the adrenergic response (BAR) to surgical incision in patients treated with neoadjuvant chemotherapy prior to radical gastrectomy. ⋯ Neoadjuvant chemotherapy reduced the MAC-BAR value of sevoflurane in gastric cancer patients by enhancing the inhibitory effect of sevoflurane on the stress response.
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To observe intraoperative and postoperative analgesic effect of ultrasound-guided subcostal transversus abdominis plane (TAP) block in gastric cancer patients undergoing open gastrectomy. ⋯ Ultrasound-guided subcostal transversus abdominis plane block has the advantages of accurate localization and high success rate. Clinical application of this technique in open gastrectomy can significantly decrease intraoperative and postoperative dosage of analgesics and exert desirable analgesic effect.