ABSTRACT
The authors evaluated word articulation ability in 33 patients undergoing integrated (chemo-radio-surgical) treatment for carcinoma of the oral cavity. Speech was intelligible in 22 patients. Severe language distortion was observed in 11 patients.
Subject(s)
Mouth Neoplasms/surgery , Phonation , Speech Intelligibility , Combined Modality Therapy/adverse effects , Humans , Mouth Neoplasms/drug therapy , Mouth Neoplasms/radiotherapy , Surgical Procedures, Operative/adverse effectsABSTRACT
The consensus conference on blood saving has allowed us to formulate some interesting guidelines. The autologous and homologous transfusion require the patient's consent. For volemic replacement crystalloid solutions are used for phlebotomies below 10-15%, and colloid solutions for those greater than 10-15% of the blood mass. Severe isovolemic hemodilution (Ht < 20%) necessitates the reduction of the dosage of some drugs. A limit of Hb around 9 g/dl after phlebotomy may be acceptable in the absence of cerebral and coronary vascular disease. Phlebotomies are therefore possible also when the Hb values are 10 g/dl (Ht 30%). Hb values around 7 g/dl in the late postoperative period (from day 3 to 6) may be accepted only if well tolerated. The blood salvaged during surgery and at the beginning of the postoperative phase must always be centrifugated, washed and microfiltered. Subsequently, in the first 8 hours it is possible to reinfuse red cells after sedimentation and microfiltration. The techniques of predeposit, hemodilution and recovery are valid especially if associated with careful control of postoperative bleeding by means of aspiration under controlled pressure (at minimum negative values and sometimes positive ones), monitoring of blood loss from drainage and application of elastic compression bandages.
Subject(s)
Blood Transfusion, Autologous , Blood Loss, Surgical/prevention & control , Female , Hematocrit , Hemodilution , Humans , Informed Consent , Intraoperative Care , Postoperative Care , Preoperative CareSubject(s)
Anesthesia, General , Ketamine , Sulpiride , Adolescent , Adult , Aged , Cardiovascular System/drug effects , Consciousness/drug effects , Drug Evaluation , Drug Synergism , Humans , Middle Aged , Wakefulness/drug effectsABSTRACT
Notes on drugs relating to the adrenergic system are followed by an account of the chemical, pharmacological and clinical features of a new beta2-stimulant, Salbutamol. Employment of this drug to prevent bronchospastic crises in 10 asthmatic patients subjected to narcosis is reported. An original technique was used: oral administration preoperatively, inhalation in the immediate preoperative period, topically on the trachea, and inhalation and oral adminstration post-operatively. Satisfactory results were observed in all 10 cases and support for the use of Salbutamol in anaesthesiology is given.
