Efficacy of Electrosurgical Bipolar Vessel Sealing for Abdominal Hysterectomy with Uterine Myomas More than 14 Weeks in Size: A Randomized Controlled Trial

Objectives: To compare the use of Electrosurgical bipolar vessel sealing LigaSure™ small jaw instrument (LSJI) with conventional suture ligation in total abdominal hysterectomy (TAH). Methods: In this retrospective study 80 patients who underwent hysterectomy in the Gynecology and Obstetrics Department of Gulhane Education and Research Hospital between April 2017 and August 2018 were included. Two different groups that underwent Electrosurgical bipolar vessel sealing LigaSure™ small jaw instrument (LSJI) and conventional suture ligation in hysterectomy operation were analyzed retrospectively. The parameters evaluated and compared between the two groups include operation time, intraoperative blood loss, duration of hospitalization and incision length. Results: Among the parameters we compared between the two groups, there was no statistically significant difference between the amount of intraoperative blood loss (p:0.68) and the incision length (p:0.65). Among the parameters we compared between the two groups, a statistically significant difference was observed between the operation time (p:0.016) and the duration of hospitalization (p:0.01). Conclusion: Our comparison of LSJI vs. conventional ligation in hysterectomy revealed a significant difference only in operative time, where surgeries involving conventional ligation were shorter. On the other hand, incision length was evaluated in our study which has not been addressed in previous studies. There is also a need for multi-center studies that include more patients and evaluate cost-effectiveness. doi: https://doi.org/10.12669/pjms.38.1.4197 How to cite this:Ulubay M, Kinci MF, Pay RE, Dede M. Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for total abdominal hysterectomy. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4197 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Comparison of Intravenous Lidocaine and Dexmedetomidine Infusion for Prevention of Postoperative Catheter-Related Bladder Discomfort: A Randomized Controlled Trial

10.21203/rs.2.69/v1 ◽

2018 ◽

Author(s):

Shuying Li ◽

Hui Li ◽

Juan Ni ◽

Yushan Ma

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Abdominal Hysterectomy ◽

Urinary Catheterization ◽

Intravenous Lidocaine ◽

Time Points ◽

Randomized Controlled ◽

Significant Difference ◽

Group D ◽

Dexmedetomidine Infusion

Abstract Background: Catheter-related bladder discomfort (CRBD) frequently occurs during recovery in patients who undergo intra-operative urinary catheterization distress. We conducted this study to compare the effect of intravenous lidocaine and dexmedetomidine infusion for preventing CRBD. Methods: 120 patients undergoing elective open abdominal hysterectomy and hysteromyoma requiring urinary bladder catheterization were randomly allocated into three groups of 40 each. Group L received a 2 mg/kg lidocaine bolus followed by infusion of 1.5 mg/kg/h; Group D received a 0.5 mg/kg dexmedetomidine bolus followed by infusion of 0.4 mg/kg/h; Group C received a bolus and infusion of normal saline of equivalent volume. The incidence and different severity (mild, moderate, and severe) of CRBD were assessed on arrival in the postanaesthesia care unit at 0, 1, 2, and 6 h postoperatively. Results: The incidence of CRBD was significantly lower in Group L and Group D compared with Group C at 0, 1, and 2 h. However, there was no significant difference among the three groups regarding the different severity of CRBD at all time points. The requirement of rescue tramadol for CRBD was lower in group L and group D than in group C. The incidence of sedation was significantly higher in Group D compared to Group L and Group C, though no difference in other adverse effects was observed. Conclusions: Intravenous lidocaine and dexmedetomidine infusion reduced the incidence of CRBD as well as the additional tramadol requirement for CRBD, but had no effect on the different severity of CRBD.

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