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To evaluate the effects of autologous serum usage on throat pain, haemorrhage and tonsillar fossa epithelisation in patients after tonsillectomy.
Thirty-two patients (aged 4–15 years) were included in the study. Tonsillectomy was performed and autologous serum was administered topically to the right tonsillar fossa during the operation, and at 8 and 24 hours post-operatively. The left side served as the control. A visual analogue scale was used to record the patient's pain every day. Each patient's oropharynx was observed on the 5th and 10th post-operative days to examine bleeding and epithelisation.
The pain scores for the side administered autologous serum were significantly lower than those for the control side, on the night following the operation and on the 1st, 2nd, 5th and 6th post-operative days. Tonsillar fossa epithelisation was significantly accelerated on the study side compared with the control side on the 5th and 10th post-operative days.
In tonsillectomy patients, topically administered autologous serum contributed to throat pain relief and tonsillar fossa epithelisation during the post-operative period.
To investigate endoscopic staging, and nitric oxide levels in the polyp tissue, in patients with nasal polyposis undergoing glucocorticoid therapy.
Nasal polyposis was evaluated using endoscopic staging and measurement of polyp tissue nitric oxide levels (chemiluminescence method). Forty-five nasal polyposis patients received either nasal therapy (n = 15), oral therapy (n = 15) or combined therapy (n = 15). Pre-treatment and post-treatment staging and nitric oxide levels were evaluated.
Endoscopic grading indicated significant post-treatment staging improvements in the oral (p = 0.016) and combined (p = 0.016) groups. Post-treatment staging differed significantly between the three groups (p = 0.041), with greater improvements in the oral and combined groups. All groups showed significantly lower post-treatment nitric oxide levels, compared with baseline, but post-treatment levels did not differ significantly between groups. A significant association was found between treatment response and nitric oxide level alteration.
This study demonstrates the favourable effects of glucocorticoids on nasal polyposis, and alteration in nitric oxide tissue levels post-treatment. Nitric oxide level in nasal polyp tissue could be an indicator of treatment response, and may aid surgical decision-making by detecting cases that probably will not respond to medical treatment.
Epidural volume extension via a combined spinal–epidural is the enhancement of a small-dose intrathecal block by an epidural injection of physiological saline solution. We evaluated the effect of epidural volume extension on the combined spinal–epidural technique of providing spinal anaesthesia for Caesarean section with hyperbaric or plain 0.5% bupivacaine.
Patients (n = 240) with height >163 cm received 9 mg and patients <163 cm received 8 mg of bupivacaine. Each study drug was combined with 20 μg fentanyl. Using the combined spinal–epidural technique, Group A (n = 60) received hyperbaric bupivacaine, and Group B (n = 60) received hyperbaric bupivacaine and 10 mL saline epidurally 5 min after subarachnoid injection. Group C (n = 60) received plain bupivacaine and Group D (n = 60) received plain bupivacaine and 10 mL saline epidurally 5 min after subarachnoid injection. An anaesthetist blinded to the anaesthetic solution injected examined the level of analgesia by the pinprick method and motor block with the modified Bromage scale for 30 min after subarachnoid injection, during the intraoperative period and subsequently every 15 min for 135 min during the recovery period.
Time to reach a sensory block at T4 was significantly shorter in Groups C and D than in Groups A (P = 0.003 and 0.017) and B (P = 0.006 and 0.048), respectively. During the intraoperative period, sensory block levels were significantly higher in Group C than in Group A. Recovery was similar in all groups; only onset was faster in Groups C and D.
There was no effect of epidural volume extension on the profile of spinal anaesthesia with the combined spinal–epidural technique for Caesarean section using hyperbaric or plain bupivacaine.
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