Citrus aurantium blossom may be effective in terms of reduction in preoperative anxiety before minor operation.

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A neck mass is a risk factor for difficult airway during induction of anaesthesia particularly when accompanied with a giant back mass which limits positioning of the patient in the supine position. We report the management of a young woman with known recurrent neurofibroma scheduled for resection of her giant neck and back masses. Unfortunately, her dorsal thoracic mass was too huge to allow adoption of the supine position for induction of anaesthesia. In order to achieve a suitable supine position which is fundamental during airway management, we created a hole in the operating table to fit her giant back mass. Exhibition of this special operating table may help to achieve a suitable position and ease airway management which is not possible with routine tables in cases with giant posterior masses.

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Psychological complications appear to be significant disorders which need prolonged recovery period. They cause disability and impose hospitalized costs on patients. This systematic review was aimed to investigate the effectiveness of medicinal herbs on psychological indices in patients undergoing surgeries. The keywords such as anxiety, depression, aggressive, impulsive, stress, delirium and cognitive in combination with surgery and medicinal plants search terms such as medicinal plant or phyto or herb were used to search for relevant publications indexed in the Institute for Scientific Information (ISI), Scopus and PubMed using EndNote software. A total of 1231 studies with mentioned keywords were added to the bank of the study and after considering inclusion and exclusion criteria, 36 human studies were reviewed. Some medicinal plants such as Passiflora incarnata L., Valeriana officinalis L., Melissa officinalis L., Crocus sativus L., and Rosa damascena Mill. and some herbal formulas like Hochu-ekki-to and Yokukansan and also some phytochemicals such as ω-6 PUFA and Gastrodin reduce the psychological symptoms in several ways in the patients undergoing operation. Most of the clinical studies were carried out on aromatherapy and the others were based on oral administration. Taken together, using medicinal herbs in medical settings before and after surgery is an effective alternative way for alleviating some psychological disorders such as anxiety, depression, aggressive and impulsive behavior, stress, delirium and cognitive dysfunction. However, the surgeons and anesthesiologists must be aware of their interaction and possible complications.