cortisol-succinate--sodium-salt and Postoperative-Complications

To study the therapeutic effect of glucocorticoid on early postoperative cholangiole cholestasis hyperbilirubinemia after liver transplantation.. Thirteen liver transplantation recipients with serum total bilirubin above 171 micromol/L at two weeks to one month postoperatively were enrolled in this study. After exclusion of liver blood supply anomalies, bile duct complications, and acute rejection and establishment of a pathological diagnosis of cholangiole cholestasis by hepatic biopsy, hydrocortisone sodium succinate was infused. The liver functions of the patients were tested at 1 day before and 1 day and 1 week after the treatment. Hepatic biopsy was performed before and 1 week after the treatment to observe histopathological changes.. The serum levels of total bilirubin decreased significantly after the treatment with glucocorticoid. Pathology of the hepatic biopsy demonstrated the resolution of cholangiole cholestasis 1 week after the treatment.. Glucocorticoid treatment is effective for early postoperative cholangiole cholestasis hyperbilirubinemia after liver transplantation.

Topics: Adult; Aged; Cholestasis, Intrahepatic; Female; Humans; Hydrocortisone; Hyperbilirubinemia; Liver Transplantation; Male; Middle Aged; Postoperative Complications

We prospectively evaluated the effect of low-dose steroids after bronchial sleeve resection in 20 consecutive patients. Ten patients (group I) did not receive steroids. Ten patients (group II) received 10 mg of methylprednisolone intravenously intraoperatively and 10 mg intramuscularly every day for 10 days. In addition, group II patients received 250 mg of hydrocortisone succinate endobronchially before extubation and 5 mg of methylprednisolone daily in an aerosol solution. Bronchoscopy was performed in all patients before extubation, every day for 10 days, and 1 and 3 months after the operation. Bronchial healing was graded endoscopically from grade I (no edema, excellent healing) to grade V (dehiscence). In group I, three patients showed grade I, four had grade II, one indicated grade III, one revealed grade IV (granuloma), and one showed grade V (dehiscence) healing. Mean postoperative hospital stay was 9.7 days. In group II all 10 patients showed grade I healing. Mean postoperative hospital stay was 7.3 days. We conclude that low-dose steroids improve the postoperative course in patients undergoing bronchial sleeve resection.

Topics: Adult; Aged; Anastomosis, Surgical; Bronchi; Bronchoscopy; Female; Humans; Hydrocortisone; Intraoperative Care; Male; Methylprednisolone; Middle Aged; Postoperative Care; Postoperative Complications; Prospective Studies; Wound Healing

An examination was made of the possibility that 100 to 200 ml of intraperitoneal 32% dextran 70 and/or 0.5% hydrocortisone sodium succinate (randomized independently with similar volumes of Ringer's lactate solution) might help to lessen the postoperative formation of adhesions among patients undergoing surgical procedures for peritubal adhesions (n = 76), endometriosis (n = 27), or midtubal occlusion (n = 61). Patients in the first two groups who were given intraperitoneal corticosteroids were also given systemic steroids. Nonparametric comparison of median adhesion scores at operation and at subsequent laparoscopy showed that there was a poorer outcome with dextran than when dextran was not used in every subgroup except one (repeat salpingolysis after previous operation for adhesions), including first operations for adnexal adhesions (Mann-Whitney U = 200, m = 23, n = 26; p less than 0.05). The probability was small (p beta less than 0.002) that an important beneficial effect of dextran was overlooked. Systemic corticosteroids were associated with a consistent trend toward improved outcome, especially in patients who initially had few or no adhesions, such as those operated on for endometriosis (U = 2, m = 7, n = 4; p less than 0.025), but among patients with tubal resections and anastomoses with adnexal adhesions the use of intraperitoneal hydrocortisone alone was associated with a worse outcome (U = 15, m = 12, n = 8; p less than 0.02). Life-table analysis of the accumulating probability of pregnancy showed that no significant difference resulted from adjunct use in any group. The conclusion is that no empiric basis supports the use of intraperitoneal 32% dextran 70 or 0.5% hydrocortisone in the attempt to prevent peritoneal adhesions, but further investigations on the systemic administration of corticosteroids to decrease the formation of adhesions would be useful.

Topics: Adult; Clinical Trials as Topic; Dextrans; Female; Humans; Hydrocortisone; Infertility, Female; Isotonic Solutions; Microsurgery; Postoperative Complications; Pregnancy; Prospective Studies; Random Allocation; Ringer's Lactate; Tissue Adhesions

To assess the effectiveness of verapamil, hydrocortisone sodium succinate, and phosphatidylcholine in the prevention of experimental adhesions.. Randomized trial.. 80 rats.. Laparotomy and intraperitoneal irrigation with saline 40 degrees C, then verapamil hydrochloride 1 mg/kg intravenously 15 min before, during, and after irrigation; or hydrocortisone sodium succinate 50 mg/kg intravenously half an hour before irrigation; or phosphatidylcholine 5.5 mg/kg orally eight days before and seven days after irrigation plus 0.5 mg/ml in the irrigation fluid; or no further intervention.. Development of adhesions two weeks after irrigation, and completeness of wound healing.. Adhesions developed in 13 of 19 control animals; 7 of 20 that were given verapamil; 6 of 20 that were given hydrocortisone; and 3 of 20 given phosphatidylcholine.. Adhesions that developed in rats after laparotomy and intraperitoneal irrigation with saline at 40 degrees C can be significantly reduced by phosphatidylcholine.

Topics: Animals; Female; Hydrocortisone; Peritoneal Diseases; Peritoneal Lavage; Phosphatidylcholines; Postoperative Complications; Rats; Rats, Inbred Strains; Sodium Chloride; Tissue Adhesions; Verapamil

Effect of steroid (Solucortef or Solumedrol) 1g on postoperative pain and pyrexia was investigated in 103 patients after total hip joint or knee joint replacement. In control group without intraoperative steroid administration, 95.0% of the patients suffered postoperative pain, but in group with intraoperative steroid administration, postoperative pain was observed in 33.3% of patients. Supplemental administration of dichlofenac sodium 50 mg could not reduce postoperative pain. Intraoperative administration of a large dose of steroid was also effective in relieving postoperative pyrexia.

Topics: Aged; Female; Fever; Humans; Hydrocortisone; Male; Methylprednisolone Hemisuccinate; Middle Aged; Pain, Postoperative; Postoperative Complications

The effectiveness of intramuscular indomethacin was compared with that of hydrocortisone succinate for the control of edema resulting from experimentally induced surgical trauma in rats. Both drugs produced a significant reduction in tissue water, but no difference could be detected between the effects of the two drugs. These findings indicate the advisability of clinical trials of indomethacin in the control of postsurgical swelling and pain.

Topics: Animals; Edema; Hydrocortisone; Indomethacin; Injections, Intramuscular; Male; Postoperative Complications; Rats; Rats, Mutant Strains