Subject(s)
Anesthesia, Epidural/adverse effects , Anesthesia, Spinal/adverse effects , Ependymoma/complications , Paraplegia/diagnosis , Paraplegia/etiology , Spinal Cord Neoplasms/complications , Adult , Ependymoma/diagnosis , Female , Humans , Incidental Findings , Paraplegia/chemically induced , Pregnancy , Puerperal Disorders/diagnosis , Puerperal Disorders/etiology , Spinal Cord Neoplasms/diagnosisABSTRACT
The authors report a new case of cardiac sarcoma treated by cardiac transplantation. This treatment has been proposed for these malignant tumours of poor prognosis when simple excision is impossible, with variable results. This patient is in good general condition 20 months after transplantation. Transplantation is a therapeutic procedure which should be considered in malignant tumours limited to the heart.
Subject(s)
Heart Neoplasms , Heart Neoplasms/surgery , Heart Transplantation/methods , Sarcoma/surgery , Adult , Echocardiography, Transesophageal , Heart Neoplasms/diagnosis , Humans , Male , Prognosis , Sarcoma/diagnosis , Treatment OutcomeABSTRACT
A prospective study was carried out in 120 patients undergoing elective thoracotomy for parenchymal disease. Patients were randomized into three groups: A (control group), B (epidural analgesia), C (freezing of intercostal nerves). Subjective pain relief was assessed on a linear visual analog scale. Analgesic requirements were evaluated during the 12 days following surgery, or until discharge if earlier. The vital capacity (VC) and forced expiratory volume in 1 s (FEV1) were measured on the day before operation and on the 1st, 2nd, 3rd and 7th postoperative days (POD). Subjective pain relief was significantly better in Group B in comparison with Group A (P < 0.05) or C (P < 0.05). Group C had the lowest score on the 11th and 12th POD but differences were not statistically significant. Requirements for intravenous analgesics were lower in Group B than in the control group (P < 0.05) during the first 3 POD, and in group C than in the control group the day of operation (P < 0.05). Oral analgesic requirements, when compared with controls, were lower in group B during the first 5 POD, and lower in group C on the 3rd and the 4th POD (P < 0.05). Cryoanalgesia led to a slight but not significant increase in VC and FEV1. Epidural analgesia led to a significant increase when compared with controls in FEV1 during the first 3 POD, and in FVC on the 7th POD (P < 0.05). It is concluded that epidural analgesia led to the best pain relief and restoration of pulmonary function after thoracotomy.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Analgesia, Epidural/methods , Hypothermia, Induced/methods , Pain, Postoperative/therapy , Thoracotomy , Elective Surgical Procedures , Forced Expiratory Volume , Humans , Intercostal Nerves , Middle Aged , Pain Measurement , Prospective Studies , Respiratory Function Tests , Vital CapacityABSTRACT
We report the fracture of the poppet of a Lillehei-Kaster prosthesis. A 40 years old man was operated upon for endocarditis of the mitral valve. A Lillehei-Kaster tilting disc valve was implanted. Three years later the disc fractured and the two parts escaped in the aorto-iliac axis. Emergency surgical procedure permitted implantation of a Wessex bioprosthesis and removal of the fragments with good results.
