Objective: To evaluate the preemptive analgesia of intravenous tramadol preoperatively in neck-surgery. Methods: Eighty patients, ASAⅠ-Ⅱ,were scheduled for neck-surgery under local anesthesia. Patients were randomly divided into 2 groups (40 cases/group).In group P intravenous tramadol was administered as a bolus dose of 3mg/kg 15min prior to skin incision. Group C received saline as a placebo. The patients-controlled analgesia(PCA) devices were used in all patients after operation. We observed BP, HR,VAS score, the time of first PCA activation, the valid number of press PCA and the total consumption of analgesic after operation. Results:The postoperative VAS was markedly lower in group P compared with the group C in 0-24h( P

Objective To study the methods and clinical effects of joint expansion of double fascia flaps wrapping the Medpor to perform full-ear reconstruction on congenital microtia deformity.Methods 60 patients with congenital microtia deformity were selected.including 22 left ears and 38 right ears.Majority had loss of ear auricle or only partial earlobe.Phase Ⅰ procedures included:temporal-parietal branch was used for the vascular pedicle,and mastoid area behind the ear was moved and expanded for fascia flap.Phase Ⅱ included:the joint expansion of double fascia flap wrapped Medpor to do full-ear reconstruction.Results Flaps survived and no complications for all 60 patients.Reconstructed ears had lifelike appearance and clear anatomical structures.Auriculocephalic angulars positions and sizes were consistent with the healthy ears.None of them had exposed prosthesis and scar contraction.Three-dimensional shapes were good.Conclusions Joint expansion of double fascia flap wrapping Medpor could avoid the chest wall deformity and exposed prosthesis.The fine structure of the reconstructed ear is satisfactory.

Objective To study the methodology and results of the auricle repair with expanded skin flap in mastoid process area and Medpor support in children with congenital malformation.Methods Thirty cases of congenital malformation were enrolled with age ranged from 5～16 years old.Whole auricles were all reconstructed with an expanded skin flap in mastoid process area and Medpor support.Resuits In all successful cases.their repaired auricles had the natural complexion and profile,and the positions were symmetric with healthy one,but in 2 cases(age group of 11-16 years),the expanded skin flap had less skin grafting.Conclusion It is suggested that optional operation time might be selected before 10 years old,because their psychological trauma could be avoided owing to microtia and in that age the size of the expanded flap is larger enough to reconstruct the ear as their auricle iS well-developed.

Objective To discuss the correction of lower baggy eyelid with severe tear trough and eyelid sulcus (groove deformity) and its therapeutic effect.Methods Through incision at the lower eyelid margin,the dissection was performed at the deep surface of the orbicularis muscle to expose the orbital septum and inferior orbital rim periosteum.The orbital fat which was released from orbital septum was repositioned at the inferior orbital rim and fixed on periosteum.If the depression was not completely corrected,the extra orbicularis fixed with periosteum.If the depression was not completely corrected,the extra orbicularis muscle was designed as muscle flap with interior pedicle to further correct the groove deformity.Results 60 cases were treated with no depression or unsmooth deformity.All the cases were followed up for 3-12 months with satisfactory aesthetic effect.Conclusions Orbicularis flap combined with orbital fat reposition is a simple and effective method for correction of tear trough and eyelid sulcus deformity.

Objective To study the effect of five combined operation for anus reconstruction after Miles operation in patients with lower colorectal cancer.Methods 60 patients with lower colorectal cancers received Miles operation,followed by five combined operation for anus reconstruction (internal and external anal sphincter,rectal flap,rectal angle,anus perineal reconstruction).Results 5-6 days after operation,all cases had desire to excretion.2-3 weeks lateral,all cases desired to control excretion and excreted 1 or 2 times per-day.Internal rectum testing showed the static pressure in anus,the constrictive pressure,and the static pressure in rectum were all normal.The survival rate of patients over 5 years was beyond 88％.Conclusions It suggests that five combined operation for anus reconstruction after Miles operation could avoid man-made anus on abdomen.It can improve the patients' life quality,long-term survival rate.And it's also economical method for patients.

Objective To discuss the correction of lower baggy eyelid with severe tear trough and eyelid sulcus (groove deformity) and its therapeutic effect.Methods Through incision at the lower eyelid margin,the dissection was performed at the deep surface of the orbicularis muscle to expose the orbital septum and inferior orbital rim periosteum.The orbital fat which was released from orbital septum was repositioned at the inferior orbital rim and fixed on periosteum.If the depression was not completely corrected,the extra orbicularis fixed with periosteum.If the depression was not completely corrected,the extra orbicularis muscle was designed as muscle flap with interior pedicle to further correct the groove deformity.Results 60 cases were treated with no depression or unsmooth deformity.All the cases were followed up for 3-12 months with satisfactory aesthetic effect.Conclusions Orbicularis flap combined with orbital fat reposition is a simple and effective method for correction of tear trough and eyelid sulcus deformity.

Objective To study the effect of five combined operation for anus reconstruction after Miles operation in patients with lower colorectal cancer.Methods 60 patients with lower colorectal cancers received Miles operation,followed by five combined operation for anus reconstruction (internal and external anal sphincter,rectal flap,rectal angle,anus perineal reconstruction).Results 5-6 days after operation,all cases had desire to excretion.2-3 weeks lateral,all cases desired to control excretion and excreted 1 or 2 times per-day.Internal rectum testing showed the static pressure in anus,the constrictive pressure,and the static pressure in rectum were all normal.The survival rate of patients over 5 years was beyond 88％.Conclusions It suggests that five combined operation for anus reconstruction after Miles operation could avoid man-made anus on abdomen.It can improve the patients' life quality,long-term survival rate.And it's also economical method for patients.