Intraoperative superior hypogastric plexus block for postoperative pain following gynecological laparotomies

Background & Objectives: The superior hypogastric plexus block (SHPB) has been extensively used for treating pelvic cancer pain and chronic pelvic pain, but not as a modality of postoperative analgesia. Currently, postoperative analgesia following gynecological laparotomies is managed mainly by parenteral NSAIDS, opioids or by epidural block. We propose that the intraoperative superior hypogastric plexus block could be a safe and an effective method for managing postoperative pain in patientsundergoing gynecological laparotomies.Methodology: It was a prospective randomized case control study. Sixty female patients of ages 18-60 y belonging to ASA grade 1 and 2 undergoing gynecological laparotomies were allocated equally into two groups, study and control group. Both groups received general anesthesia. At the end of surgery, the Study Group received. Postoperative pain was assessed with VAS score, patient’s vital parameters and amount of morphine consumed by patient controlled analgesia at 0, 2, 6, 12, 24 and 48 h.Results: The VAS score for pain showed significant difference between Study Group and Control Group at 0 h (p = 0.033), 2 h (p < 0.0001), 6 h (p < 0.0001), 12 h (p < 0.0001) and 24 h (p = 0.003) but not at 48 h (p = 0.085). This showed that the block was more effective up to 24 h. There was significant difference of 33.6% (p < 0.0001) in morphine consumption between study (36.03 mg) and control (54.33 mg) groups.Conclusions: We conclude that superior hypogastric plexus block is a simple, safe and effective without any major complications and has a short learning curve. It has a high success rate for majority of gynecological laparotomies.Citation: Subramanian V, Aggarwal S, Kale S, Parthasarathy AH, Batra A. Intraoperative superior hypogastric plexus block for postoperative pain following gynecological laparotomies. Anaesth. pain & intensive care 2019;23(2):157-161

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Cryotherapy Reduced Postoperative Pain in Gynecologic Surgery: A Randomized Controlled Trial

Pain Research and Treatment ◽

10.1155/2019/2405159 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Apisada Chumkam ◽

Densak Pongrojpaw ◽

Athita Chanthasenanont ◽

Junya Pattaraarchachai ◽

Kornkarn Bhamarapravatana ◽

...

Keyword(s):

Postoperative Pain ◽

Statistical Difference ◽

Controlled Trial ◽

Exploratory Laparotomy ◽

Gynecologic Surgery ◽

Control Group ◽

Study Group ◽

Control Groups ◽

Vas Score ◽

And Control

Objective. To examine the effectiveness of cryotherapy for reducing postoperative pain in patients who underwent exploratory laparotomy for gynecologic surgery. Materials and Methods. Patients who had indication for an exploratory laparotomy gynecologic procedure were selected by attending physicians to undergo abdominal surgery via low transverse skin incision. The participants were randomized into study and control groups with simple random sampling methods. Cold packs were applied at two hours after operation for 6 hours. The visual analog scale (VAS) score was recorded at two, 6, and 12 hours after operation. Result. One hundred cases were recruited and then divided into study and control groups equally. The mean age of both groups was 43 years. There was no difference in demographics data of both groups. Half of the participants in both groups underwent hysterectomies. At two hours after surgery, both groups had similar VAS scores. The study group had a lower VAS score at 6 and 12 hours after surgery than the control group with statistical difference. Morphine consumption within 24 hours after surgery in both the study and control groups was 2.8±3.4 and 3.0±4.4 mg, respectively, with no statistical difference. However the registration time of the first morphine requirement in the study group was statistically more prolonged than that of the control group. The lengths of hospital stay in both groups were similar. There was no complication reported in this study. Conclusion. Cryotherapy can reduce postoperative pain. In this presented study the patients who underwent gynecologic surgery had improved pain relief and prolonged time for the first dose of the analgesic drug.

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Impression cytology and meibomian glands in conjunctivochalasis

European Journal of Ophthalmology ◽

10.1177/11206721211008789 ◽

2021 ◽

pp. 112067212110087

Author(s):

Ersin Muhafiz ◽

Erdinç Bozkurt ◽

Remzi Erten

Keyword(s):

Dropout Rate ◽

Meibomian Gland ◽

Control Group ◽

Study Group ◽

Impression Cytology ◽

Schirmer Test ◽

Significant Difference ◽

Meibomian Glands ◽

And Control ◽

Margin Cytology

Purpose: To evaluate the tear parameters, meibomian glands and lid margin and tarsal conjunctival impression cytology in patients with conjunctivochalasis (CCH). Methods: The study included 57 patients diagnosed with CCH and 35 healthy volunteers. Tear break-up time (TBUT) was measured and Schirmer test was performed. Meibomian gland morphologies, dropout rates, and meiboscores were evaluated using meibography. Finally, impression cytology samples were taken by pressing the impression filters on the lower lid margin and lower tarsal conjunctiva. The samples were evaluated according to the Nelson grading system. Results: Schirmer test was longer and TBUT was shorter in the study group ( p = 0.035 and p < 0.001, respectively). The median of meibomian gland dropout rate was 33.45% (Interquartile range [IQR]; 23.17%–49.75%) and 18.80% (IQR; 12.35%–26.50%) in the study and control groups, respectively ( p < 0.001). There was no significant difference in terms of lid-margin cytology between the two groups ( p = 0.481). In tarsal conjunctiva cytology, the median value of Nelson grade of the study group was 2 (IQR; 1–2) and that of the control group was 1 (IQR; 1–2) ( p = 0.040). When Nelson grade-2 and above was accepted as the pathological limit, it was found that 27.5% of the study group and 15.2% of the control group showed pathological findings ( p = 0.204). Conclusions: In patients with CCH, damage occurs in the tarsal conjunctiva with the effects of redundant conjunctival folds. In these patients, atrophy occurs in the meibomian glands and tear stability is impaired. Therefore, CCH should not be overlooked in clinical practice.

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Effect of Aerosol Inhalation of Budesonide Suspension on Clinical Efficacy, Remission Time of Asthma and Disappearance Time of Rales in Children with Mycoplasma Pneumoniae Pneumonia

Tobacco Regulatory Science ◽

10.18001/trs.7.5.1.75 ◽

2021 ◽

Vol 7 (5) ◽

pp. 3057-3062

Author(s):

TingTing Zheng ◽

XiNi Liu ◽

Xuechun Chen

Keyword(s):

Mycoplasma Pneumoniae ◽

Clinical Efficacy ◽

Oral Treatment ◽

Control Group ◽

Study Group ◽

Aerosol Inhalation ◽

Significant Difference ◽

Disappearance Time ◽

And Control ◽

Mycoplasma Pneumoniae Pneumonia

To investigate the effect of aerosol inhalation of budesonide suspension on clinical efficacy, remission time of asthma and disappearance time of rales in children with mycoplasma pneumoniae pneumonia. Methods: 100 cases of mycoplasma pneumoniae pneumonia in our hospital from February 2019 to February 2021 were randomly divided into study group (n = 50) and control group (n = 50). The control group was given azithromycin intravenous drip followed by oral treatment, and the study group was given aerosol inhalation of budesonide suspension on the basis of the control group. Results: Compared with the control group, disappearance time of rales in the study group, remission time of cough, remission time of asthma and time of hospitalization in the study group were relatively short (P<0.05), and the efficacy in the study group was relatively high (P<0.05). There was no significant difference in the incidence of nausea, vomiting, abdominal pain, diarrhea and hoarseness between the two groups (P>0.05). The improvement of FVCS FEV1 and PEF and other indexes was relatively high in the study group by comparing with the control group (P<0.05). Conclusion: Aerosol inhalation of budesonide suspension in children with mycoplasma pneumoniae pneumonia can effectively enhance the therapeutic effect, promote the improvement of lung function, and reduce the disappearance time of rales and remission time of asthma, so it can be popularized.

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Abdominal complex muscle in women with stress urinary incontinence – prospective case-control study

Archives of Medical Science ◽

10.5114/aoms/135708 ◽

2021 ◽

Author(s):

Bartlomiej Burzynski ◽

Tomasz Jurys ◽

Michalina Knapik ◽

Kamil Burzynski ◽

Paweł Rzymski ◽

...

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Muscle Thickness ◽

Isometric Tension ◽

Transversus Abdominis ◽

Control Group ◽

Abdominal Muscles ◽

Study Group ◽

Significant Difference ◽

And Control

IntroductionThis study is designed to assess the percentage share of musculus obliquus externus abdominis, musculus obliquus internus abdominis and musculus transversus abdominis activity among women with stress urinary incontinence using ultrasonography.Material and methodsMaterial and methods: The study is a retrospective analysis of prospective collected data of 84 women aged 23-62 years old. In the study group are women suffering from grade 1 or 2 stress urinary incontinence according to the Stamey classification, the control group consists of women with no micturition disorders. The abdominal muscles activity was measured by using the ultrasound imaging with assessment of muscle thickness.ResultsThe analysis of musculus obliquus externus abdominis in anterolateral abdominal wall activity shows a statistically significant difference between study and control group concerning isometric tension of abdominal muscles (p=0,012) and lower part of abdomen tension (p=0,004). Women with stress urinary incontinence present a higher activity of the musculus obliquus externus abdominis than controls. In the case of the musculus obliquus internus abdominis, statistically significant differences were shown during tension of the lower part of the abdomen (p=0,024). Comparison of activity of the musculus transversus abdominis between study and control groups shows a statistically significant difference during isometric tension of abdominal muscles (p=0,018).ConclusionsThe pattern of activity of the assessed muscles differs between the study group and the control group. In the study group, the activity pattern is concerning the higher activity of the musculus obliquus externus abdominis and the lower activity of the musculus obliquus internus abdominis and musculus transversus abdominis.

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The retrospective study of 93 patients with transmigration of mandibular canine and a comparative analysis with a control group

European Journal of Orthodontics ◽

10.1093/ejo/cjy067 ◽

2018 ◽

Vol 41 (4) ◽

pp. 390-396 ◽

Cited By ~ 4

Author(s):

Paweł Plakwicz ◽

Joanna Abramczyk ◽

Julita Wojtaszek-Lis ◽

Jolanta Sajkowska ◽

Barbara Warych ◽

...

Keyword(s):

Contralateral Side ◽

Permanent Teeth ◽

Control Group ◽

Study Group ◽

Affected Side ◽

Significant Difference ◽

Mandibular Canine ◽

And Control ◽

Primary Canine

Summary Objectives The aim of this study was to evaluate characteristics of patients with unilateral transmigration of a mandibular canine in the largest study group presented until now. Materials and methods The study group consisted of 93 patients with unilateral transmigration of mandibular canine; the control group included 85 non-affected patients. Type of transmigration, status of deciduous and permanent canines, prevalence of missing teeth, class of occlusion, and space conditions were assessed to draw comparisons between groups. Results In this study, 64.5 per cent patients presented type 1 of transmigration; types 2, 3, 4, and 5 were present in, respectively, 23.7, 5.4, 4.3, and 2.1 per cent patients. There was a clear, statistically significant difference (P < 0.0001) between the mean crown and apex migration and angulation for the three groups of canines (transmigrated, contralateral, and control), whereas no differences were observed for the total number of permanent teeth present. In the study group, 73.1 per cent patients retained their primary canine on the affected side and 18.3 per cent on the contralateral side; in the control group, 22.3 per cent subjects had at least one primary canine. There was a statistically significant difference in the distribution of types of malocclusion between the study and the control groups. Conclusions Transmigration of mandibular canine was associated with the presence of retained primary canine on the affected side, higher mesial tilting of contralateral mandibular canine when compared to the canines in the control group. Additionally, higher prevalence of Angle’s Class I occlusion in patients with canine transmigration was recorded.

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The effectiveness of preoperative individual information on reducing anxiety and pain after hysterectomy: A randomized controlled trial

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n1p67 ◽

2019 ◽

Vol 10 (1) ◽

pp. 67

Author(s):

Hrønn Thorn ◽

Lisbeth Uhrenfeldt

Keyword(s):

Randomized Controlled Trial ◽

Postoperative Pain ◽

Controlled Trial ◽

Anxiety Level ◽

Preoperative Anxiety ◽

Control Group ◽

Study Group ◽

Randomized Controlled ◽

Significant Difference ◽

Individual Information

Background and objective: Preoperative anxiety among gynecological patients is well-known and has a direct correlation with postoperative pain. By minimizing preoperative anxiety, the level of postoperative pain may decrease. The purpose of this study was to evaluate the effect of preoperative structured information and dialogue on patients' anxiety and postoperative pain.Methods: A single-center non-blinded randomized controlled trial. Forty-six women scheduled for hysterectomy were allocated either to the study group or the control group. The study group was given individual information at a preoperative consultation while the control group was given information at admittance. The main outcome was anxiety level and postoperative pain.Results: Forty participants (study group = 20; control group = 20) were analyzed. No statistically significant difference was found in anxiety level within the first 24 h postoperatively or in postoperative pain within four weeks between the groups.Conclusions: Preoperative individual information and dialogue did not result in significant effects in reducing anxiety level nor did it result in lower postoperative pain score.

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Sirolimus influence on hepatectomy-induced liver regeneration in rats

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/s0100-69912014000300012 ◽

2014 ◽

Vol 41 (3) ◽

pp. 203-207 ◽

Cited By ~ 4

Author(s):

Edimar Leandro Toderke ◽

Giorgio Alfredo Pedroso Baretta ◽

Ozimo Pereira Gama Filho ◽

Jorge Eduardo Fouto Matias

Keyword(s):

Liver Regeneration ◽

Negative Influence ◽

Control Group ◽

Cell Multiplication ◽

Study Group ◽

Adult Rats ◽

Ki 67 ◽

Immunohistochemical Markers ◽

Significant Difference ◽

And Control

OBJECTIVE: To evaluate the influence of sirolimus on liver regeneration triggered by resection of 70% of the liver of adult rats. METHODS: we used 40 Wistar rats randomly divided into two groups (study and control), each group was divided into two equal subgroups according to the day of death (24 hours and seven days). Sirolimus was administered at a dose of 1mg/kg in the study group and the control group was given 1 ml of saline. The solutions were administered daily since three days before hepatectomy till the rats death to removal of the regenerated liver, conducted in 24 hours or 7 days after hepatectomy. Liver regeneration was measured by the KWON formula, by thenumber of mitotic figures (hematoxylin-eosin staining) and by the immunohistochemical markers PCNA and Ki-67. RESULTS: there was a statistically significant difference between the 24h and the 7d groups. When comparing the study and control groups in the same period, there was a statistically significant variation only for Ki-67, in which there were increased numbers of hepatocytes in cell multiplication in the 7d study group compared with the 7d control group (p = 0.04). CONCLUSION: there was no negative influence of sirolimus in liver regeneration and there was a positive partial effect at immunohistochemistry with Ki-67.

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Intraoperative Intercostal Nerve Block for Postoperative Pain Control in Pre-Pectoral versus Subpectoral Direct-To-Implant Breast Reconstruction: A Retrospective Study

Medicina ◽

10.3390/medicina56070325 ◽

2020 ◽

Vol 56 (7) ◽

pp. 325 ◽

Cited By ~ 1

Author(s):

Jin-Woo Park ◽

Jeong Hoon Kim ◽

Kyong-Je Woo

Keyword(s):

Postoperative Pain ◽

Breast Reconstruction ◽

Intercostal Nerve ◽

Control Group ◽

Intercostal Nerve Block ◽

Nerve Blocks ◽

Vas Score ◽

Vas Scores ◽

Lower Maximum ◽

And Control

Background and Objectives: Patients undergoing mastectomy and implant-based breast reconstruction have significant acute postsurgical pain. The purpose of this study was to examine the efficacy of intercostal nerve blocks (ICNBs) for reducing pain after direct-to-implant (DTI) breast reconstruction. Materials and Methods: Between January 2019 and March 2020, patients who underwent immediate DTI breast reconstruction were included in this study. The patients were divided into the ICNB or control group. In the ICNB group, 4 cc of 0.2% ropivacaine was injected intraoperatively to the second, third, fourth, and fifth intercostal spaces just before implant insertion. The daily average and maximum visual analogue scale (VAS) scores were recorded by the patient from operative day to postoperative day (POD) seven. Pain scores were compared between the ICNB and control groups and analyzed according to the insertion plane of implants. Results: A total of 67 patients with a mean age of 47.9 years were included; 31 patients received ICNBs and 36 patients did not receive ICNBs. There were no complications related to ICNBs reported. The ICNB group showed a significantly lower median with an average VAS score on the operative day (4 versus 6, p = 0.047), lower maximum VAS scores on the operative day (5 versus 7.5, p = 0.030), and POD 1 (4 versus 6, p = 0.030) as compared with the control group. Among patients who underwent subpectoral reconstruction, the ICNB group showed a significantly lower median with an average VAS score on the operative day (4 versus 7, p = 0.005), lower maximum VAS scores on the operative day (4.5 versus 8, p = 0.004), and POD 1 (4 versus 6, p = 0.009), whereas no significant differences were observed among those who underwent pre-pectoral reconstruction. Conclusions: Intraoperative ICNBs can effectively reduce immediate postoperative pain in subpectoral DTI breast reconstruction; however, it may not be effective in pre-pectoral DTI reconstruction.

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The Efficacy of Intravenous Tranexamic Acid in Reduction of Blood Loss in Women at High Risk of Postpartum Hemorrhage

QJM ◽

10.1093/qjmed/hcaa056.014 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

K M Diab ◽

R M Mohamed ◽

A G Abdelhay

Keyword(s):

Blood Loss ◽

Cesarean Section ◽

Tranexamic Acid ◽

Maternal Mortality ◽

Vaginal Delivery ◽

Control Group ◽

Study Group ◽

Control Groups ◽

Significant Difference ◽

And Control

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p < 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p < 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p < 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p < 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p < 0.001), Reduction in Hematocrite was significantly less in study group than control group (p < 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.

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A Comparative Study of Relationship between Micronutrients and Gestational Diabetes

ISRN Obstetrics and Gynecology ◽

10.5402/2012/470419 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 14

Author(s):

Farideh Akhlaghi ◽

Seyyed Majid Bagheri ◽

Omid Rajabi

Keyword(s):

Gestational Diabetes ◽

Pregnant Women ◽

Gestational Age ◽

Control Group ◽

Study Group ◽

Inclusion Criteria ◽

Control Groups ◽

Significant Difference ◽

Micronutrient Concentration ◽

And Control

In this paper, we studied the relation between the micronutrient and gestational diabetes. Therefore, we measured micronutrient concentration including Ni, Al, Cr, Mg, Fe, Zn, Cu, and Se in serum of women with gestational diabetes between 24 and 28 weeks of gestational age (study group) who had inclusion criteria and comparison with micronutrient levels in normal pregnant women with same gestational age (control group). Results showed that there was no significant difference between the serum micronutrient level (Ni, Al, Cr, Mg, Zn, Cu, Se) in study and control groups except serum level of iron which in serum of gestational diabetic women was lower than normal pregnant women and difference was significant.

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