Lumbar interbody fusion is one of the most commonly used surgical treatment of lumbar disease at present, but the hidden blood loss after surgery is large, accounting for 1/3 or even more than 1/2 of total blood loss. If not monitored and treated for the hidden blood, it can result in anemia and prolong bed time, thereby increasing the chance of infection. This paper summarizes the mechanism, influencing factors, calculation and treatment of hidden blood loss after lumbar fusion, so that the surgeon can have a correct understanding and evaluation of the hidden blood loss for the patients undergoing lumbar intervertebral fusion, and so as to reduce the occurrence of complications. This is very important for helping patients to pass perioperative period smoothly.
Humans ; Lumbar Vertebrae ; Lumbosacral Region ; Occult Blood ; Perioperative Period ; Retrospective Studies ; Spinal Fusion ; Treatment Outcome

OBJECTIVETo evaluate the safety and efficacy of tadalafil on demand and on time in men with erectile dysfunction.

METHODSWe conducted a multi-centered randomized controlled study on 120 ED males, who were assigned to take tadalafil at 10 mg/ 20 mg on demand before sexual activity and at the same dose on time twice a week for 8 weeks. Before and at 4 and 8 weeks after treatment, and 1 month after withdrawal, we obtained the scores on IIEF-5, ED Inventory of Treatment Satisfaction (EDITS) and the short form of Psychological and Interpersonal Relationship Scales (SF-PAIRS) , and compared the safety and efficacy of medication between the two groups of patients.

RESULTSTotally, 110 patients accomplished the trial, 56 in the on-time and 54 in the on-demand group. At 4 and 8 weeks of medication and 1 month after withdrawal, the IIEF-5 scores were improved in both the on-time and on-demand groups, even more significantly in the former than in the latter at 8 weeks of treatment (21.6 +/- 2.9 vs 18.5 +/- 1.7) and 1 month after withdrawal (20.9 +/- 2.1 vs 17.9 +/- 2.3) (P < 0.05). The EDITS scores were significantly higher in the on-time than in the on-demand group at 8 weeks of treatment (31.7 +/- 6.9 vs 28.6 +/- 5.8) and 1 month after withdrawal (30.6 +/- 4.7 vs 27.9 +/- 6.5) (P < 0.05). The scores on the sexual self-confidence, spontaneity and time-concern domains of SF-PAIRS were remarkably improved after medication as compared with the baseline (P < 0.05), even more significantly in the on-time than in the on-demand group at 1 month after withdrawal. Both dosing schedules were well tolerated and no significant differences were observed in safety between the two groups.

CONCLUSIONOn-time dosing of tadalafil is efficacious and well tolerated in the treatment of ED, and has an even better effect than on-demand dosing at 8 weeks of medication and 1 month after withdrawal.

Adult ; Carbolines ; administration & dosage ; therapeutic use ; Drug Administration Schedule ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Middle Aged ; Phosphodiesterase Inhibitors ; administration & dosage ; therapeutic use ; Prospective Studies ; Tadalafil ; Treatment Outcome