scholarly journals Antibiotic prophylaxis in low risk patients undergoing laparoscopic cholecystectomy

2012 ◽  
Vol 7 (1) ◽  
pp. 12-18
Author(s):  
S Kumar ◽  
PJ Lakhey ◽  
P Vaidya ◽  
BN Patowary ◽  
CR Praveen ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Antibiotic Prophylaxis ◽  
Risk Group ◽  
Low Risk ◽  
Control Group ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B

Laparoscopic cholecystectomy is the 'gold standard' for benign diseases of gallbladder. It has rapidly gained popularity and it is one of the commonly performed operations in Nepal. The need for antibiotic prophylaxis when performing an elective laparoscopic cholecystectomy may not be as important as it is thought in low risk group. Despite, low postoperative infection rate in laparoscopic cholecystectomy in low risk group, the same criteria of antibiotic prophylaxis previously applied to conventional surgery are routinely used for laparoscopic surgery, even though its actual need has not been ascertained. Aim of this study was to assess the efficacy of antibiotic prophylaxis in elective laparoscopic cholecystectomy with respect to postoperative Surgical Site Infection (SSI) in low risk group. Study was carried out in The Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal from May 2005 to June 2006 (14 months).This was a prospective randomized study done on 104 consecutive patients undergoing laparoscopic cholecystectomy. Patients were randomized into case group (group A) and control group (group B) with 52 patients in each group. Two and four patients from Group A and Group B respectively were excluded. In Group A, 50 patients received one gram ceftriaxone intravenously 30 minutes prior to induction of anesthesia and in Group B, all 48 patients received 10 milliliters (ml) of isotonic sodium chloride solution intravenously 30 minutes before induction. In both groups, age, sex, ultrasonogram findings, duration of surgery, American society of anesthesiologists patient classification score, antibiotic administration, bile spillage during surgery, length of postoperative hospital stay and postoperative SSI were recorded. Patients were advised to follow up in Surgical Out-patient Clinic if there was any evidence of SSI within 30 days. SSI was reported and classified as, superficial incisional, deep incisional or space / organ SSI. There were a total of 98 patients included in the study; 50 in Group A and 48 in Group B. In group A, three (6%) patients and in Group B, also three (6.3%) patients had superficial incisional SSI. None of them had deep or organ / space SSI. Comparison of data showed no statistically significant difference between two groups (P- 1.00). DOI: http://dx.doi.org/10.3126/jcmsn.v7i1.5962 JCMSN 2011; 7(1): 12-18

scholarly journals ANTIBIOTIC PROPHYLAXIS IN LAPAROSCOPIC CHOLECISTECTOMY: IS IT WORTH DOING?

2016 ◽  
Vol 29 (3) ◽  
pp. 170-172 ◽  
Author(s):  
Márcio Alexandre Terra PASSOS ◽  
Pedro Eder PORTARI-FILHO
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Antibiotic Prophylaxis ◽  
Infectious Complications ◽  
Low Risk ◽  
Double Blind Study ◽  
Significant Difference ◽  
Risk Patients ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B

ABSTRACT Background: Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis Aim: Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients. Method: Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis. The outcome evaluated were infeccious complications at surgical site. The patients were reviewed seven and 30 days after surgery. Results: There was incidence of 2% in infection complications in group A and 2% in group B. There was no statistical significant difference of infectious complications (p=0,05) between the groups. The groups were homogeneous and comparable. Conclusion: The use of the antibiotic prophylaxis in laparoscopic cholecystectomy in low risk patients doesn't provide any significant benefit in the decrease of surgical wound infection.

scholarly journals COMPARISON OF DURATION OF SURGERY AFTER SINGLE DOSE ANTIBIOTIC PROPHYLAXIS AT DIFFERENT TIME INTERVAL IN PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Suneet Katoch ◽  
Mukesh Kumar Jamwal ◽  
Sanjay Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Dose ◽  
Antibiotic Prophylaxis ◽  
Time Interval ◽  
Duration Of Surgery ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B

Background: In this study we compare the duration of surgery   after single dose antibiotic prophylaxis at different time interval in patients undergoing elective laparoscopic cholecystectomy Methods: The present study was conducted at Department of Surgery, Dr RPGMC Kangra at Tanda. The 50 patients admitted for elective laparoscopic cholecystectomy, aging less than 75  years of both the genders were included Results: In the present study, mean duration of surgery of the patients in group A and group B was 59.80±15.91 minutes and 63.12±12.50 minutes Conclusion: Our study we concluded that mean duration of surgery difference was not statistically significant between group A and group B. Keywords:  Duration of surgery, Cholelithiasis,  Cholecystectomy.

Antibiotic Prophylaxis Before Dental Procedures Can Reduce ONJ Incidence.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3613-3613 ◽  
Author(s):  
Vittorio Montefusco ◽  
Francesca Gay ◽  
Francesco Spina ◽  
Maria Teresa Ambrosini ◽  
Massimo Maniezzo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Zoledronic Acid ◽  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Low Risk ◽  
Dental Procedure ◽  
Dental Procedures ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Osteonecrosis of the jaw (ONJ) is a frequent complication in bisphosphonate-treated multiple myeloma (MM) patients. The pathogenesis is unclear, and major risk factors are duration of bisphosphonate treatment and dental procedures. The histology of osteonecrotic bone shows osteomyelitis and inflammatory infiltrates, and, in most cases, presence of Actynomycetes. Since dental procedures are a major risk factor for ONJ development and oral microflora can be involved in the pathogenesis of the disease, we conducted a retrospective observational trial comparing ONJ occurrence and related risk factors in two groups of MM patients, who received zoledronic acid treatment at two Italian hematological centres. In one centre all patients systematically received as antibiotic prophylaxis amoxicillin-clavulanate 1 gm bid or levofloxacin 500 mg once a day starting from one day before to 3 days after any dental procedure (group A, 52 patients), while in the other centre patients did not receive any prophylaxis (group B, 61 patients). Dental procedures were categorized according to their invasivity and their supposed probability to cause ONJ. Extractions, implants, and professional cleanings were considered at high risk, while fillings were considered low risk procedures. Thirty-three group A patients (63%) and 32 group B patients (52%) received high risk procedures; 4 group A patients (8%) and 5 group B patients (8%) received low risk procedures, while 15 (29%) and 24 (39%) patients, respectively, had a denture. The duration of zoledronic acid exposure differed significantly between the two groups, with a median of 26 months for A patients and 12 months for B patients (p<0.0001). In group A no cases of ONJ were observed, while in group B 8 cases (13%) of ONJ were diagnosed, with a significant difference between the two groups (p=0.007). There was a temporal correlation between dental procedure and ONJ, with a median time of 60 days (range 37–990). The relative risk of ONJ after a dental procedure was 4.8 (p=0.01). The pooled analysis of the two groups showed that age, sex, transplant procedure, and thalidomide therapy did not correlate with ONJ. In both groups the presence of dentures was not associated with ONJ. While in group B incidence of ONJ is consistent with data reported in the literature, which range between 7% and 11%, group A patients had an unexpected low occurrence of this complication, despite a significantly longer exposure to zoledronic acid. This finding suggests a possible role of antibiotic prophylaxis in protecting from ONJ after dental procedures. Further, our observation, along with the correlation between dental procedures and ONJ development, can contribute to the proposal of a comprehensive model of ONJ pathogenesis: trauma of the alveolar bone modified by bisphosphonates induces a bacterial translocation with a subsequent induction of infection, inflammation and necrosis. In this perspective, since antibiotic prophylaxis is a simple and low cost precaution, it’s reasonable to propose it as part of standard care to zoledronic acid treated MM patients before any dental procedure.

scholarly journals CHOLECYSTECTOMY;

2017 ◽  
Vol 24 (07) ◽  
pp. 1062-1066
Author(s):  
Bashir Ahmed ◽  
Hamid Raza ◽  
Kamlaish -
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Patient Population ◽  
P Value ◽  
Care Hospital ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Eye Opening ◽  
Group B

Objectives: The aim of our study which is to compare total intravenousanesthesia with target controlled infusion using the drugs Propofol and remifenatnil with thetechniques of volatile induction maintenance anesthesia using sevoflurane and sufentanil inpatients undergoing laparoscopic cholecystectomy procedure, at a tertiary care hospital inKarachi, Pakistan. Study Design: The type of study is a randomized control trial, conductedfor a period of 8 months Period: from June 2015 to January 2016 Setting: at a tertiary carehospital in Karachi Pakistan. Method: The patient population consisted of n=100 patientsbelonging to the ASA class I and II and undergoing laparoscopic cholecystectomy procedure atour institute. The patients were divided into two groups group A consisted of all those patientswho underwent total intravenous anesthesia and group B consisted of patients who underwentvolatile induction maintenance anesthesia. Appropriate blinding measures were taken for thosewho were involved in the post-operative care of the patients, and the patients themselves. Duringthe procedure routine monitoring was done, data was recorded in a pre-designed proforma.Patients were analyzed in the post-operative period for side effects and pain levels. Statisticalanalysis was done using SPSS version 23, a p value of less than 0.05 was considered to bestatistically significant. Results: The patient population consisted of n= 100 patients dividedinto two groups. No statistically significant difference was found between the demographicvariables of the patients of both groups (age, weight, baseline values of blood pressure, heartrate, time duration of surgery and anesthesia). The time for the loss of corneal reflex was longerin the group A (109 +/- 90) as compared to group B (45 +/- 10) having a p value of less than0.001. However the time for opening of the eyes and the duration of post anesthesia care unitwas shorter in group A (420 +/- 130 seconds for eye opening and 45 +/- 15 min for PACU) andin group B (484 +/- 116 seconds for eye opening and 53 +/- 25 mins for PACU) having p valuesof 0.006 (eye opening) and 0.017 (PACU) respectively. In group A n= 44 (88%) of the patientsrequired rescue analgesia, and in group B n= 36 (72%) of the patients required it, having a pvalue of 0.013 respectively. The need for the use of ephedrine and atropine in the pre and portoperative period was similar in both the groups. Conclusion: According to the results of ourstudy we found that each method of anesthesia has its own advantages and disadvantagesand the anesthetist present should weigh the risks and benefits for each patient individually,and use the most beneficial method of administration of anesthesia in the patient undergoinglaparoscopic cholecystectomy procedure, accordingly.

A COMPARATIVE STUDY TO ASSESS THE NEED OF PROPHYLACTIC ANTIBIOTICS IN EARLY INFECTIVE COMPLICATIONS OF LOW RISK ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 3-5
Author(s):  
Hitesh Soni ◽  
J M Mehta ◽  
Saurabh Kalia ◽  
Aditya Shriya
Keyword(s):  
Urinary Tract Infection ◽  
Laparoscopic Cholecystectomy ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotics ◽  
Low Risk ◽  
Pulmonary Infections ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B ◽  
Infective Complications

Background And Objectives: Elective laparoscopic cholecystectomy has a low risk for infectious complications, but many surgeons still use prophylactic antibiotics. The aim of this study was to investigate the necessity and rationale for giving prophylactic antibiotics in early infective complications in low-risk laparoscopic cholecystectomy. Study Design: Low-risk patients were randomly placed into 2 groups: 70 patients (group A ) did not receive any prophylactic antibiotic and 70 patients (group B) received 1 g Ceftriaxone intravenously at the time of induction of anaesthesia. In both groups, incidence of infective complications were recorded and compared. Results: In group A, there were 3 cases of post operative fever and 1 case of wound infection, while there were no cases of pulmonary infections and urinary tract infection. In group B, there were 2 cases of post operative fever and 1 case of wound infection, while there were no case of pulmonary infections and urinary tract infection. No signicant difference existed in the incidence of complications between the groups. Prolonged duration of surgery and Bile or Stone spillage were statistically signicant risk factors in determining post operative infective complications. Conclusions: Use of prophylactic antibiotic does not affect the already low incidence of postoperative infective complications and surgical site infections. Hence, prophylactic antibiotic is not necessary in low-risk elective laparoscopic cholecystectomy

scholarly journals Efficacy of Intraperitoneal Bupivacaine on Pain Relief After Laparoscopic Cholecystectomy

PRILOZI ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 123-129 ◽  
Author(s):  
Marija Toleska ◽  
Andrijan Kartalov ◽  
Biljana Kuzmanovska ◽  
Milcho Panovski ◽  
Mirjana Shosholcheva ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Local Anesthetic ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Intraperitoneal Instillation ◽  
Group A ◽  
Vas Scores ◽  
Group B

Abstract Introduction: Patients undergoing laparoscopic cholecystectomy do experience postoperative pain, especially in the abdomen. Postoperative pain management remains a major challenge after laparoscopic procedures. Administration of intraperitoneal local anesthetic (IPLA) after surgery is used as a method of reducing postoperative pain. In this study, we evaluated the effect of intraperitoneal infiltration of local anesthetic (bupivacaine) for pain relief after laparoscopic cholecystectomy. Material and methods: In this prospective, controlled, and randomized study were included 50 patients aged 25-60 years (35 female and 15 male), scheduled to laparoscopic cholecystectomy with ASA classification 1 and 2. Patients were classified randomly into two groups: group A, which included 25 patients who received intraperitoneal instillation of bupivacaine 0.5% 20 ml; and group B, which included 25 patients who didn’t receive any intraperitoneal instillation. Postoperative pain was recorded using the visual analogue scale (VAS) for 24 hours after laparoscopic cholecystectomy. Results: There was no significant difference with respect to age, weight, and sex; duration of surgery; and anesthesia time. VAS scores at different time intervals were statistically significantly lower at all times in group A compared to group B. There were statistically significant differences in VAS scores between group A and group B at all postoperative time points - 1hr,4 hr,8 hr,12hr and 24hr (p < 0.00001). Conclusion: Intraperitoneal instillation of bupivacaine provides good analgesia in the postoperative period after laparoscopic cholecystectomy.

Comparison of effect of Various Combinations of four drugs i.e IV Ondansetron, Ranitidine, Metoclopramide and Omeprazole, to reduce Gastric Fluid Residual Volume and Gastric Acidity in Elective Laparoscopic-Cholecystectomy patients

2021 ◽  
Vol 15 (7) ◽  
pp. 1760-1763
Author(s):  
Riffat Saeed ◽  
Irfan Ali ◽  
Iram Qamar ◽  
Syed Mehmood Ali ◽  
Amer Latif ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gastric Acidity ◽  
Gastric Fluid ◽  
P Value ◽  
Residual Volume ◽  
Significant Difference ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B ◽  
Group D

Background: Inhaling of gastric contents in lower respiratory tract and larynx results in developing of pulmonary aspiration. The acidity of aspirate contents and its volume determines severity of aspiration and is major cause of post-anesthetic mortality. Objective: To compare the effect of four drugs (ranitidine, IV ondansetron, metoclopramide, omeprazole and metoclopramide) in all possible four combinations, to decrease gastric fluid residual volume and gastric acidity in undergoing laparoscopic-cholecystectomy. Design: It was a clinical randomized trial. Study Settings: Trial was conducted at Department of Anesthesiology and ICU, Sheikh Zayed Hospital, Lahore, for a period of 6 months from 01-07-2019 to 31-12-2019. Patients and Methods: A total of 308 patients from both the genders undergoing laparoscopic cholecystectomy were included in this study. Four equal groups were made by random division of patients. Group A: ranitidine & ondansetron, group B: ranitidine & metoclopramide, group C: omeprazole & ondansetron and group D: omeprazole & metoclopramide. Pre-anesthetic medicine was given to all the patients two hours before surgery. For assessing volume of gastric fluid and its pH, an oro-gastric tube was passed. An informed written informed consent was taken from all the patients. Results: Mean age in this study was 36.40±9.15, 33.23±9.13, 36.82±9.37 and 36.57±9.49 years respectively for Group A,B,C and D. Aspirate had mean quantity of 12.56±5.60 ml/kg, 12.65±5.39 ml / kg, 13.68±5.76 ml/kg and 14.34±6.85 ml/kg and he aspirate mean pH was 2.56±0.55, 2.47±0.58, 2.51±0.57 and 2.45±0.58 respectively for group A,B,C and D. Among both the trial groups, this different was insignificant (p-value > 0.05) for both outcomes. Conclusion: All the drug combinations had no significant difference. However, comparatively less pH and volume of gastric fluid was shown by combination of ranitidine plus ondansetron. Therefore, this combination is recommended before general anesthesia for reducing gastric fluid aspirate in patients undergoing surgery. Keywords: Laparoscopic cholecystectomy, Omeprazole, Ranitidine, Metoclopramide, Ondansetron, gastric fluid acidity, pH, gastric fluid volume

Clinical effect of Suvarna Bindu Prashan

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Patil Aniket ◽  
Dindore Pallavi ◽  
Arbar Aziz ◽  
Kadam Avinash ◽  
Saroch Vikas
Keyword(s):  
Physical Health ◽  
Eating Habits ◽  
Control Group ◽  
Inform Consent ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Immune Booster ◽  
Mental And Physical Health ◽  
Apparently Healthy

The quest for excellence in mental and physical health is not new. We find various references and formulations in Ayurvedic classics meant for promoting mental and physical health of a child. Suvarna Prashan is one of the formulations explained in age old Ayurvedic classic Kashyap Samhita. This formulation is very widely used now days as a memory and immune booster for children. But there is very little systematic documented study which can be used to evaluate the efficacy of the formulation. Suvarna Bhasma was prepared in Ayurved Rasayani Pharmacy, Pune. Madhu and Ghrita were collected from KLE Ayurveda Pharmacy, Belgaum. Suvarna Bindu Prashan was prepared in KLE Ayurved pharmacy, Belgaum. It contains Suvarna Bhasma, Ghrita and Madhu. Twenty apparently healthy male and female children with age group of three to four years were ready to sign inform consent form were selected into two groups each. Subjects in Group A received Suvarna Bindu Prashan where as Group B (Control group) did not receive any treatment. Both the groups were observed for six months. Children in Suvarna Bindu Prashan group showed significant reduction in the scores of eating habits, behavior, mood, temperament and scores of event of illness. However there was no significant difference in the score of sleeping habit. There was significant increase in IQ percentage.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

EFFECT OF YOGA ON CARDIOVASCULAR EFFICIENCY

2019 ◽  
pp. 12-16
Author(s):  
Brij Bhushan Singh ◽  
Shubi Mirja ◽  
Samiya Husain
Keyword(s):  
Statistical Technique ◽  
Step Test ◽  
Control Group ◽  
Significant Difference ◽  
Post Test ◽  
Group A ◽  
Cardio Vascular ◽  
Level Of Significance ◽  
Group B ◽  
Experimental Group

The purpose of this study was to investigate the effects of yogic practices on cardio-vascular efficiency. Material and methods: Total Forty (40) subject’s boys/girls were selected as the sample of the study through the random sampling and their age ranged between 20 to 25 years from the Department of Physical Education, Aligarh Muslim University, Aligarh. The subjects were divided into two groups comprising 20 subjects in each group, namely group “A” (the experimental group) performs yogic practices (Asanas, Pranayamas and Kriyas) and group “B” (the control group) served as control. Statistical technique: for the assessment of the cardiovascular efficiency through Harvard step test pre and post-test was conducted and t-test was applied for the analysis. Result: revealed that there exist a significant difference between group A and group B, at .05 level of significance. On the basis of the pre and post-test among experimental and control group, experimental group found better than the control group on cardiovascular efficiency and significant result were found in this study.

Sign in / Sign up

Export Citation Format

Share Document