ABSTRACT
Objective To evaluate the clinical effect and safety of oxycodone in the anesthesia for percutaneous microwave ablation (PMWA) in liver cancer when the scope of ablation involving liver capsule.Methods Thirty-eight patients scheduled for percutaneous microwave ablation of liver cancer abutting capsule, including 32 males and 6 females, aged 41-75 years, with ASA grade Ⅰ or Ⅱ.Patients were randomly divided into 2 groups:oxycodone group (group O,n=20) and fentanyl group (group F, n=18).Before the puncture, a loading dose of oxycodone 0.1 mg/kg was given intravenously in group O, a loading dose of fentanyl 1 μg/kg was given intravenously in group F.After successful puncture, both groups were induced by Propofol 1.5 mg/kg, followed by Propofol infusion at 4-7 mg·kg-1·h-1 in two groups.The changes of MAP, HR, SpO2 and RR before, during and after operation were recorded.Body movement and respiratory depression were recorded.The total amount of propofol,the postoperative recovery time, postoperative nausea and vomiting, and postoperative 4 h VAS scores were recorded.Results There was no significant difference in general condition and intraoperative condition of ablation operation between the two groups.The incidences of respiratory depression and body movement in group F were significantly higher than those in group O.There was no significant difference in the incidences of postoperative nausea and vomiting between the two groups.VAS score 4 h after operation in group F [(3.9±2.0) score] was significantly higher than that in group O [(1.7±0.9) score] (P＜0.01).There was no significant difference in HR between the two groups at each point.Compared with before surgery, the MAP during surgery in group F was significantly increased (P＜0.05),the RR during surgery in groups F and O were significantly lower (P＜0.01 or P＜0.05).The RR during surgery in group F was significantly lower than that in group O(P＜0.05),but there was no significant difference at the other points between the two groups.Conclusion Oxycodone can be used safely and effectively for percutaneous microwave ablation of liver cancer when the scope of ablation involving liver capsule.It has lower incidence of respiratory depression, effectively alleviates intraoperative pain and reduces postoperative pain.
ABSTRACT
Ascariasis is probably the most common helminthic infestation of man, but it seldom causes severe illness. Pathologic conditions of Ascaris may be caused by adult worms, eggs or larvae. We describe a case of Ascaris egg granulomas that were found incidentally on the surface of the liver in a 75-year-old woman who had undergone a segmentectomy for an intrahepatic stone. Grossly, there were several yellowish calcific nodules of 0.4 cm in diameter on the lateral surface of the left lobe of the liver. Microscopically, the lesions were located in the hepatic capsule and consisted of fibrocalific nodules with many eggs. The eggs were round to oval, thick-shelled and measured 50~75x30~50 um. Most of the morphologically preserved eggs were fertilized eggs, but they had smooth shells without external protein coats. This case is of interest for the unusual location of the lesion, the presence of eggs without mammillation, and the association with the intrahepatic stone.