Effect of continuous saline irrigation during operation on the incision pain relief after posterior lumbar surgery / 解放军医学杂志

Objective: To explore the effect of continuous saline irrigation and cooling during posterior lumbar surgery using high-frequency electric knife to expose lumbar lamina on postoperative incision pain. Methods: A total of 34 adult patients with lumbar intraspinal tumor were included in present study who received surgical treatment from August 2017 to July 2018 in Changzheng Hospital Affiliated to Navy Medical University, and were randomly divided into irrigated group (n=17) and nonirrigated group (n=17). Patients in irrigated group received continuous normal saline irrigation for cooling surgical field, while those in non-irrigated group did not receive such treatment. The time required for exposure of bilateral lamina, the temperature of tissues around the electrosurgical scalpel, degree of thermal damage of muscle tissue, postoperative C-reactive protein level, the visual analogue scale (VAS) scores at 1st, 2nd and 3rd day after operation, and the amount of analgesics were compared between the two groups. Results: The time required for exposure of bilateral lamina was obviously longer in irrigated group than in nonirrigated group [(29.12±4.68) min vs. (24.94±3.23) min, P0.05) between the two groups. The VAS score and the amount of analgesics were obviously lower in irrigated group than in non-irrigated group at the 1st day after operation (P0.0.5) at the 2nd and 3rd day after operation. Conclusion: Continuous normal saline irrigation may reduce the thermal damage of muscle tissue to some extent after posterior lumbar surgery, and relieve the postoperative pain.

What Should Be Considered to Cause the Early Post-Craniotomy Seizure: Antibiotics (Cefazolin) Irrigation

OBJECTIVE: Post-craniotomy seizure (PCS) is reported only rarely. However, our department noted a 433% increase in PCS for a year beginning September 2010, especially after cerebrovascular surgery. Our goal was to identify the cause of our unusual outbreak of PCS. METHODS: For almost one year after September 2010, cases of PCS increased significantly in our department. We analyzed 973 patients who had received a major craniotomy between January 2009 and November 2011. We included seizures that occurred only in the first 24 postoperative hours, which we defined as early PCS. After verifying the presence of PCS, we analyzed multiple seizure-provoking factors and their relation to the duration and character of seizure activity. RESULTS: Overall PCS incidence was 7.2% (70/973). Cefazolin (2 g/L saline) was the antibiotic drug used for intraoperative irrigation in 88.4% of the operations, and no PCS occurred without intraoperative cefazolin irrigation. When analyzed by operation type, clipping surgery for unruptured aneurysms was the most frequently associated with PCS (80%). Using logistic regression, only 2 g cefazolin intraoperative irrigation (p=0.024) and unruptured aneurysm clipping surgery (p<0.001) were associated with early PCS. The seizure rate of unruptured aneurysm clipping surgery using 2 g cefazolin intraoperative irrigation was 32.9%. CONCLUSION: Intraoperative cefazolin irrigation must be avoided in patients undergoing craniotomy, especially for clipping of unruptured aneurysms, because of the increased risk of early PCS.

An observation of the surgical efficacy for first-staged management of the obstructing carcinoma of the left colon: a report of 68 cases / 第三军医大学学报

0.05) Conclusion Subtotal colectomy and intraoperative colonic irrigation are effective methods for management of obstructing carcinoma in the left colon To select an effective technique depends on the analysis of the practical situations and evaluation of the idiographic complexions.