scholarly journals Extraperitoneal versus transperitoneal cesarean section: a retrospective analysis

2020 ◽  
Vol 9 (2) ◽  
pp. 567
Author(s):  
Babita P. Vaswani ◽  
Aditi Trivedi ◽  
Sriram Gopal
Keyword(s):  
Cesarean Section ◽  
Bowel Function ◽  
Nausea And Vomiting ◽  
Transperitoneal Approach ◽  
Surgical Morbidity ◽  
Post Operative Period ◽  
Early Return ◽  
Post Operative Pain ◽  
Operative Recovery ◽  
Delivery Type

Background: Cesarean section is becoming a more common delivery type worldwide. The objective of this study was to compare surgical morbidity in extraperitoneal versus transperitoneal techniques of cesarean section.Methods: A total of 60 patients was included in this study out of which 30 underwent extraperitoneal cesarean section(ECS) and 30 patients underwent transperitoneal cesarean section (TCS) and compared both the techniques with respect to nausea or vomiting intra-operatively, pain score (as measured by visual analogue scale) post operatively, return of bowel function and blood loss.Results: Intra-operative nausea and vomiting was noted in 33.34% of patients in TCS group while none of the patients in ECS group had any such complaints. No difference was noted in average blood loss between the 2 groups. Post-operative pain in ECS was 4.13 as compared to 6.86 in TCS. Return of bowel sounds in ECS group was much earlier (5.46 hours) as compared to TCS group (11.33 hours).Conclusions: We conclude that extraperitoneal technique is advantageous over transperitoneal approach. Decreased nausea and vomiting, early return of bowel function in the post-operative period, decreased post-operative pain allowing early feeding and mobilization are definite benefits of this technique. This further helps in making a relatively smoother post-operative recovery.

Extraperitoneal versus transperitoneal cesarean section in surgical morbidity in a tertiary care centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3397 ◽  
Author(s):  
Bebincy D. S. ◽  
Chitra J.
Keyword(s):  
Postoperative Pain ◽  
Cesarean Section ◽  
Prospective Study ◽  
Tertiary Care ◽  
Bowel Function ◽  
Government Medical College ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Surgical Morbidity ◽  
Medical College

Background: To test the advantages of extraperitoneal cesarean section over transperitoneal cesarean section.Methods: It is a single blinded prospective study. Women who were planned for emergency LSCS in the department of OG, Kanyakumari Government Medical College, Asaripallam were randomly allocated into extraperitoneal cesarean section (ECS) (n=80) or transperitoneal cesarean section (TCS) (n=80) from November 2015 to January 2017 and evaluated.Results: Even though the time taken to deliver the baby was more in ECS group (Average 4:57 minutes) than TCS group (Average 2:05 minutes, there is no change in Apgar score at 1 minute. The postoperative pain measured by VAS was lesser (4.28) in ECS than TCS (7.06). Bowel function returned early in ECS (8.687 hours) than in TCS (16.487 hours) group. None of the cases in ECS group had peroperative vomiting or post-operative wound infection.Conclusions: So, we can conclude that ECS is a better method in experienced hands than the TCS in selected cases.

scholarly journals Comparison of the analgesic effects of Post-operative Morphine, Pre-emptive and Post-operative Paracetamol in Septorhinoplasty Surgery

2015 ◽  
Vol 4 (2) ◽  
pp. 121-25
Author(s):  
Shoja-Al-hagh Taregh ◽  
Mohammad Reza Hadavi ◽  
Shahriyar Omidvari ◽  
Mohammad Ali Daneshforouz
Keyword(s):  
Pain Score ◽  
Acute Pain ◽  
Recovery Room ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Analgesic Effects ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Total Pain ◽  
Significant Difference

Background: According to previous studies there are some different opinions on the pre-emptive effects of paracetamol in controlling post-operative pain, we aimed to compare the analgesic effects of pre-emptive paracetamol with post-operative paracetamol and morphine in patients undergoing septorhinoplasty.Materials and methods: A hundred and six patients aged 15 to 50 were divided into 3 groups. One received 1 g paracetamol 30 minutes before the operation, another group received 1 g paracetamol after the surgery and the control group received 3 mg morphine sulfate in the recovery room after the surgery. The pain severity was recorded for each patient using a 10 slot table. Any signs of nausea and vomiting (N/V) or apnea were closely observed and recorded. Patients with pain score 5 or more received 2 mg morphine intravascularly.Results: There was not any significant difference between the groups in total pain score and N/V (p>0.05). Post-operative morphine intake was significantly lower in pre-emptive group (P<0.05). None of the patients experienced apnea during the study. Conclusion: We concluded that pre-emptive paracetamol can lower the opium consumption in post-operative period but pre-emptive paracetamol cannot reduce the post-operative acute pain noticeably.

Comparison of the effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Demographic Data ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Group A ◽  
Group B

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.

Predictive Models for Post-operative Nausea and Vomiting in Patients Using Patient-controlled Analgesia

2007 ◽  
Vol 35 (4) ◽  
pp. 497-507 ◽  
Author(s):  
YY Lee ◽  
KH Kim ◽  
YH Yom
Keyword(s):  
Predictive Model ◽  
Oral Fluid ◽  
Individual Characteristics ◽  
Nausea And Vomiting ◽  
Patient Controlled Analgesia ◽  
Related Data ◽  
Post Operative Pain ◽  
Post Operation ◽  
History Of ◽  
Post Operative Nausea

This study identified predictive factors for post-operative nausea and vomiting (PONV) in patients using patient-controlled analgesia (PCA) and developed five predictive model pathways to calculate the probability of PONV using decision tree analysis. The sample consisted of 1181 patients using PCA. Data were collected using: a specifically designed check-off form to collect patient-, surgery-, anaesthesia- and post-operation-related data; the Beck Anxiety Inventory® to measure pre-operative anxiety; and a visual analogue scale, to measure post-operative pain. The incidence of PONV was 27.7%. Nine factors were highly predictive of PONV in our five model pathways: gender, obesity, anxiety, history of previous PONV, history of motion sickness, inhalation of nitrous oxide during operation, use of inhalational agents, starting oral fluid/food intake after operation, and post-operative pain. With these five predictive model pathways, we can predict the probability of PONV in an individual patient according to their individual characteristics.

scholarly journals CONTROL OF POST-SURGICAL PAIN

2010 ◽  
Vol 17 (03) ◽  
pp. 400-404
Author(s):  
ALI MIR MANSOURI ◽  
FARNOUSH FARZI ◽  
SHIRIN KHALKHALIRAD ◽  
Katayoon Haryalchi ◽  
Abas Sediginejad
Keyword(s):  
Pain Relief ◽  
Cesarean Section ◽  
Pain Control ◽  
Nausea And Vomiting ◽  
Chi Square ◽  
Double Blind ◽  
Analgesic Effects ◽  
Emergency Cesarean ◽  
Surgical Pain ◽  
Chi Square Test

Introduction: There are many complications for patients with post cesarean section relative pain. So it delays in discharging or increasing in hospital stay. The objective of this study was a comparison between Tramadol and Meperidine according to pain relief or other possible complications in post cesarean section pain control. Materials and Methods: This study was a double blind clinical trial. It arranged for 240 parturients who scheduled for emergency cesarean section with pain after surgery in spite of spinal anesthesia. All patients were in ASA class I. They were divided randomly in two groups .Meperidine (M) and Tramadol (T) groups with 120 patients in each group. After beginning of pain in post anesthesia care unit (VAS> or = 4), in group (T) tramadol 1.5 mg/kg and in group (M) meperidine  .5 mg/kg were injected intravenously. Apart from pain, other drug complications such as shivering, blood pressure changes, itching, nausea and vomiting, drowsiness were recorded one and two hours after injection. Data were analyzed by chi-square test. Results: Relative frequency rate (RFR) of 50% decrease in pain score one hour after intravenous injection was 56.7% in group (T) and 69.2% in group (M) ( P = 0.054). RFR for respiratory depression after one hour was 5.8% in (M) group and 0 in (T) group (P = 0.007). RFR for nausea after one hour was 39.2% in (T) group and 23.3% in (M) group (P = 0.008). RFR for vomiting after one hour was 23.3% in (T) group and 13.3% in (M) group (P= 0.045). RFR for drowsiness after one hour was 25% in (M) group and 3.3% in (T) group (P=0.007). There was no statistically significant relationship after 2nd hour for pain relief, nausea, vomiting and drowsiness between two groups. There was no difference between two groups in RFR for shivering, blood pressurechanges and itching in both two groups. Conclusion: This study illustrates both remedies Meperidine and Tramadol which were effective for pain relief and shivering after cesarean section. But according to high incidence of nausea and vomiting with Tramadol and more analgesic effects of Meperidine than Tramadol, administration of Meperidine is better than Tramadol after cesarean section for pain control.

scholarly journals Comparative Evaluation of Effectiveness of Intravenous Paracetamol and Intravenous Diclofenac as Post-operative Analgesia in Laparoscopic Cholecystectomy

2018 ◽  
Vol 6 (2) ◽  
pp. 6
Author(s):  
Kalpana Kharbuja ◽  
Mahesh Sharma ◽  
Nil Raj Sharma
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
P Value ◽  
Anesthesia Induction ◽  
Chi Square ◽  
Rescue Analgesia ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Intravenous Paracetamol

Introduction: Though the development of minimally invasive surgery  has revolutionized the field of surgery,  post-operative pain is still a significant issue. Unlike in the past, concerns about adverse effects have limited the role of opioids in post-operative pain management. This study aims to compare the effectiveness of intravenous paracetamol and  diclofenac as postoperative analgesia in laparoscopic cholecystectomy. Methods:One hundred and twenty eight patients of American Society of Anesthesiologists (ASA) categories I and II  included in this study  were divided into two groups. Anesthesia induction and maintenance were standardized. The first group received 15mg/kg (maximum 1gm) intravenous paracetamol and the second group received 2mg/kg (maximum 75mg) intravenous diclofenac 30 minutes prior to ending of surgery. A questionnaire was responded by patients and chart was maintained by visual analogue scale. Mann Whitney U test was used to analyze quantitative data and Chi-square test for categorical data. P value <0.05 was considered statistically significant. Results:  Profiles of hemodynamic changes were almost similar in both groups with respect to heart rate and blood pressure. However, paracetamol infusion provided hemodynamic stability in post-operative period. We observed statistically significant differences  in visual analogue scale between the two groups. Most of the patients in paracetamol group had low mean pain scores in post-operative period and provided an extended analgesia compared to diclofenac. No serious postoperative complication was observed in  paracetamol group.   Conclusion: Administration of intravenous paracetamol has better and prolonged analgesic effect  with low mean pain score and less requirement for rescue analgesia compared to diclofenac.

Getting Your Grumble Back

2016 ◽  
Vol 36 (3) ◽  
pp. 255-261
Author(s):  
Stacy Evans ◽  
Erica Yager ◽  
Leonie Sutherland ◽  
Marty Downey
Keyword(s):  
Abdominal Surgery ◽  
Chart Review ◽  
Bowel Function ◽  
Surgical Patient ◽  
Bedside Nurse ◽  
Acute Care Nurses ◽  
Early Return ◽  
Cooking Shows ◽  
Potential Benefits ◽  
Consistent Basis

Purpose of study: Viewing the surgical patient holistically within their environment of care, the bedside nurse is aware of the possible complication of postoperative paralytic ileus that can lead to patient discomfort and increased medical costs. Acute care nurses observed postoperative patients watching televised cooking shows on a consistent basis and questioned if there was a mind–body link between bowel function and watching cooking shows. Design of Study: The study used an observational approach to examine the return of bowel sounds for postoperative patients. Method: Ninety-four patients that underwent abdominal surgery participated. A questionnaire was administered to capture total hours postsurgery of patient viewing cooking shows followed by chart review for age, height, weight, information specific to surgery, and documented first postsurgical flatus. Findings: This study found that non–bariatric general surgery patients who watch cooking shows during hospitalization are significantly more likely to experience return of appetite and stomach sounds within 1 day postsurgery than patients who do not watch cooking shows. Conclusions: Based on the results of this study, the authors suggest that, when possible, patients who receive non–bariatric abdominal surgery be encouraged to watch cooking shows to experience the potential benefits such as early return of bowel functioning.

scholarly journals The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Muzaffer Gencer ◽  
Ayşe Yeşim Göçmen
Keyword(s):  
Opioid Receptor ◽  
Recovery Room ◽  
Control Group ◽  
Analgesic Requirement ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Analgesic Agents ◽  
Vas Scores ◽  
Μ Opioid Receptor ◽  
Analgesic Use

Abstract Background In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n = 60) was patients given tramadol (1–2 mg/kg) for post-operative analgesia, and the second group (control group) (n = 60) was initially prescribed only fentanyl (1 μg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24th hour post-operative period. Results Demographic data and peri-operative variables were similar in both study group (p < 0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94 ± 15.34 pg/mL (max:489.92 ± 22.36 pg/mL, min: 94.56 ± 11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room (p < 0.05), 1st (p < 0.05) and 3rd hours (p < 0.05).The VAS scores were lower in the tramadol group compared to the control group (p < 0.05).Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p < 0.05) for arrival at the recovery room and 1st hour. Patients in the tramadol group needed a second pain killer much later than patients in the control group. Conclusions Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date: 26/11/2019).

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