Complications of Gynecological Laparoscopy

Author(s):  
Rafał Watrowski
Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jae Yen Song ◽  
Hoon Choi ◽  
Minsuk Chae ◽  
Jemin Ko ◽  
Young Eun Moon

Abstract Background Because of the indiscriminate use of opioids during the perioperative period, opioid-free anesthesia (OFA) has been increasingly required. Nevertheless, the studies on the detailed techniques and effects of OFA are not sufficient. The Quality of Recovery-40 (QoR-40) questionnaire is a validated assessment tool for measuring recovery from general anesthesia. However, no study has used the QoR-40 to determine if OFA leads to better recovery than standard general anesthesia. Therefore, we aim to perform this study to determine the effects of OFA using dexmedetomidine and lidocaine on the quality of recovery as well as the various postoperative outcomes. Methods The participants (n = 78) will be allocated to one of the two groups; the study group will receive bolus and infusion of dexmedetomidine and lidocaine, and the control group will receive remifentanil infusion during general anesthesia for gynecological laparoscopy. The other processes including anesthetic and postoperative care will be performed similarly in the two groups. Intraoperative hemodynamic, anesthetic, and nociceptive variables will be recorded. Postoperative outcomes such as QoR-40, pain severity, and opioid-related side effects will be assessed. Additionally, an ancillary cytokine study (inflammatory cytokine, stress hormone, and reactive oxygen species) will be performed during the study period. Discussion This will be the first study to determine the effect of OFA, using the combination of dexmedetomidine and lidocaine, on the quality of recovery after gynecological laparoscopy compared with standard general anesthesia using remifentanil. The findings from this study will provide scientific and clinical evidence on the efficacy of OFA. Trial registration ClinicalTrials.gov NCT04409964. Registered on 28 May 2020


2008 ◽  
Vol 5 (4) ◽  
pp. 261-264 ◽  
Author(s):  
Frank Willem Jansen ◽  
Wendela Kolkman

2005 ◽  
Vol 123 (1) ◽  
pp. 38-41 ◽  
Author(s):  
Marcello Barbosa Barros ◽  
Francisco S. Lozano ◽  
Luis Queral

CONTEXT: Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services. CASES: Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period. DISCUSSION: Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.


2021 ◽  
Vol 50 (3) ◽  
pp. 1921-1932
Author(s):  
Mostafa Abd El-Fattah Ahmed Dwedar ◽  
Mohamed Taher Ismail ◽  
Said Mohamed Taha ◽  
Mahmoud Nashaat Khalaf Abd El-Salam

Pain Practice ◽  
2018 ◽  
Vol 19 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Alba Piroli ◽  
Antonella Mattei ◽  
Gaspare Carta ◽  
Angela D'Alfonso ◽  
Patrizia Palermo ◽  
...  

2011 ◽  
Vol 56 (3) ◽  
pp. 368-375 ◽  
Author(s):  
M. LI ◽  
W. MEI ◽  
P. WANG ◽  
Y. YU ◽  
W. QIAN ◽  
...  

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