Florin Vasile Mihăileanu

Background/Objectives: Otosclerosis causes progressive hearing loss through abnormal bone remodeling within the otic capsule and predominantly affects young individuals. Surgical intervention can markedly enhance a patient’s quality of life and socio-economic status. Anesthetic management may involve either general anesthesia or monitored anesthesia care, with the latter enabling real-time assessment of hearing improvement while providing optimal surgical conditions and patient satisfaction. This study examines the efficacy and safety of continuous dexmedetomidine infusion and target-controlled remifentanil infusion for conscious sedation combined with local anesthesia in otosclerosis surgery. Methods: Seventy-four adult patients undergoing otosclerosis surgery were randomly assigned to either the dexmedetomidine group or the remifentanil group. Primary outcomes included patient satisfaction at 24 h post-surgery and surgeon satisfaction with operative conditions. Secondary outcomes comprised hemodynamic effects, the necessity for adjuncts to the proposed sedation protocols, and intra- and postoperative complications. Results: There was no statistically significant difference between the dexmedetomidine and remifentanil groups regarding patient satisfaction (p = 0.943) and surgeon satisfaction (p = 0.069). A strong correlation was observed between surgeons’ assessments and patients’ satisfaction Composite Scores (η² = 0.185, p = 0.003). Dexmedetomidine was more effective in significantly reducing arterial pressure and heart rate without undesirable clinical effects. Conclusions: No significant difference was found between the groups concerning patient and surgeon satisfaction. Dexmedetomidine infusion led to considerable reductions in arterial pressure and heart rate compared to remifentanil.

(1) Background: The quality of life of cancer patients is not only important for their well-being, but it has great influence on the overall survival and response to therapy, considering the adherence to treatment and follow-up. (2) Methods: This research is a prospective study conducted over a period of 6 months involving patients admitted in the Department of Surgery II, Cluj County Emergency Clinical Hospital. The specific questionnaire designed by us for patients with colorectal cancer contains questions about the quality of life and symptoms such as weight loss, pain, constipation, and diarrhoea. (3) Results: Our prospective study included in the analysis 50 patients with colorectal cancer. The CR 29 questionnaire outlined scores below 30 for sore skin, urinary incontinence, dysuria, faecal incontinence, flatulence, discomfort from bowel movement, sexual dysfunction and hair loss. The CR 30 functioning scale depicted high scores for cognitive (100%, 95% CI [0.91–1]), physical (88%, 95% CI [0.75–0.95]), and functional (88%, 95% CI [0.39–0.68]) domains and low scores (<50) for emotional (98%, 95% CI [0.88–0.99]) and social (100%, 95% CI [0.91–1]) functions. (4) Conclusions: The quality of life of patients with colorectal cancer was influenced by socio-economic status, smoking, surgical procedure, and neoplastic pathology.