[Factors affecting selection of tracheostomy after mandibular tumor operation: a retrospective study].

PURPOSE: To assess the factors affecting selection of tracheostomy after mandibulectomy. METHODS: The clinical data of 165 patients who were divided into intubated group and tracheostomy group were collected from January 2008 to December 2012 in Shanghai Ninth People's Hospital, including demographics, smoke habits, alcohol consumption, pulmonary disease, American Society of Anesthesiologists (ASA) physical status classification, history of jaw operation, length of surgery, preoperative radiotherapy, free flap reconstruction, resection over the anterior midline, and radical neck dissection. The postoperative outcomes, such as the duration of keeping tube, the length of ICU stay, the length of hospital stay, and the number of complications and death were collected. Statistical analysis was performed using SAS version 9.2 software package. RESULTS: There were 81 patients in intubated group and 84 patients in tracheostomy group. Three factors that might be associated with selection of tracheostomy after mandibulectomy were preoperative radiotherapy (OR: 3.51, 95% CI: 1.34-9.20), free flap reconstruction (OR: 3.99, 95%CI: 1.84-8.65), and resection over the anterior midline of the jaw (OR: 20.08, 95%CI: 6.52-160.35)(P<0.05). CONCLUSIONS: Tracheostomy was suitable for patients who received preoperative radiotherapy, free flap reconstruction and resection over the anterior midline after mandibular tumor resection were factors in considering of tracheotomy.

Post-Exposure Exercise Fails to Ameliorate Memory Impairment Induced by Propofol and Ketamine in Developing Rats.

BACKGROUND: This aim of this study was to determine the effects of ketamine-propofol combination on learning and memory, as well as exercise, on anesthetic neurotoxicity. MATERIAL/METHODS: A ketamine-propofol combination was administered once (group SKP, Single Ketamine Propofol) on P7 (postnatal day 7) or in 3 treatments on P6, P8, and P10 (group MKP, Multiple Ketamine Propofol). Rat pups in group C (Control) received equivalent volumes of normal saline in 3 injections on P6, P8, and P10. Rats designated MKPR (Multiple Ketamine Propofol and running) and CR (Control and running) began running exercise on P21 on wheels. Learning and memory was assessed by Morris water maze and fear conditioning tests. Hippocampal neurogenesis of rats was detected by BrdU immunofluorescence. RESULTS: MKP rats had longer latency to platform than group C during training in the Morris water maze; SKP rats stayed in the target quadrant longer than MKP rats during testing (P<0.05). Rats in running groups had shorter latency than non-running rats, but running had no interaction with anesthesia exposure. CONCLUSIONS: Repeat ketamine-propofol combination doses increase risk of memory impairment in developing rats. Running has no impact on anesthetic neurotoxicity.