POST OPERATIVE PAIN –VAS SCORE, ANALGESIA REQUIREMENT, LENGTH OF HOSPITAL STAY AND FOLLOW UP IN OPEN AND LAPAROSCOPIC NEPHRECTOMY.

2021 ◽  
pp. 65-66
Author(s):  
Nadeem Rashid ◽  
Sadaf Ali
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
Laparoscopic Nephrectomy ◽  
Open Group ◽  
Research Centre ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Open Nephrectomy

This was a prospective study conducted in order to evaluate and compare pain scores through visual analogue scale, length of hospital stay and follow up in patients of benign renal disease and early renal malignancy. This study was conducted in the Department of Surgery, Batra Hospital and Medical Research centre, New Delhi. For the purpose of this study, a total number of 80 patients participated willingly after giving written informed consent. Out of these 40 were operated through open route and 40 patients underwent laparoscopic nephrectomy. Patients were grouped based on their route of surgery into open and laparoscopic groups. The comparison between them was made in relation to need for analgesia, hospital stay and convalescence. Follow up was done at 1 week, 4 weeks, 3 months and every six months so as to look for any delayed complications, chronic pain and recurrence in case of malignant disease. Female patients in the reproductive age group were more common in patients operated by laparoscopic route while as males were more common in open nephrectomy group. Laparoscopic group had lesser pain scores but on statistical analysis there were no signicant differences between the two groups. Mean hospital stay was (6.3 ±1.34) days in open group while as (4.2 ±1.22) days in the laparoscopic group. This study demonstrated that acute post operative pain scores were not different statistically between the two groups. Mean length of hospital stay was more in open group as compared to laparoscopic group. The cost of surgery was more in the laparoscopic group in comparison to open nephrectomy group. However, due to brief hospital stay, lesser morbidity, shorter convalescence and overall costs laparoscopic method was more useful in comparison with open route nephrectomy.

scholarly journals APPENDICECTOMY;

2012 ◽  
Vol 19 (01) ◽  
pp. 001-005
Author(s):  
JAHANGIR SARWAR KHAN ◽  
UMAR FAROOQ ◽  
HAMID HASSAN
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
P Value ◽  
Pain Scores ◽  
Post Operative Pain

Objective: The objective of this study was to compare length of hospital stay, pain scores and the rate of wound infectionsbetween laparoscopic and open appendectomy. Design: Randomized Controlled trial. Place and Duration of study: This study wasconducted in surgical unit I Holy Family hospital, Rawalpindi from 1st June 2009 to 31st May 2010. Patients and methods: The patients weredivided into open and laparoscopy groups and their age, sex, time of discharge, pain scores and wound infection rates were compared andanalyzed. Results: Total of 160 patients were included in the study, 80 in each group. There were 58% male and 42% female patients. Mean agewas 22.78 years (±6.2).Post operative pain scores were significantly less in the laparoscopic group (p<0.05). The length of hospital stay in opengroup was 35.10 hrs (±5.4) hours and in the laparoscopic group was 38.70(4.8) hrs with a p value of 0.592.Wound infection was 0.037% in openand 0.025% in the laparoscopic group. Conclusions: Laparoscopic appendectomy is superior in terms of less morbidity and shorter postoperative hospital stay in the setting of an overworked tertiary care surgical floor of a Pakistani hospital.

scholarly journals Comparison of Postoperative Renal Function between Non-Steroidal Anti-Inflammatory Drug and Opioids for Patient-Controlled Analgesia after Laparoscopic Nephrectomy: A Retrospective Cohort Study

2020 ◽  
Vol 9 (9) ◽  
pp. 2959
Author(s):  
Jiwon Han ◽  
Young-Tae Jeon ◽  
Ah-Young Oh ◽  
Chang-Hoon Koo ◽  
Yu Kyung Bae ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Laparoscopic Nephrectomy ◽  
Complication Rates ◽  
Patient Controlled Analgesia ◽  
Pain Scores ◽  
Postoperative Renal Function ◽  
Anti Inflammatory

Non-steroidal anti-inflammatory drugs (NSAIDs) can be used as opioid alternatives for patient-controlled analgesia (PCA). However, their use after nephrectomy has raised concerns regarding possible nephrotoxicity. This study compared postoperative renal function and postoperative outcomes between patients using NSAID and patients using opioids for PCA in nephrectomy. In this retrospective observational study, records were reviewed for 913 patients who underwent laparoscopic or robot-assisted laparoscopic nephrectomy from 2015 to 2017. After propensity score matching, 247 patients per group were analyzed. Glomerular filtration rate (GFR) percentages (postoperative value divided by preoperative value), blood urea nitrogen (BUN)/creatinine ratios, and serum creatinine percentages were compared at 2 weeks, 6 months, and 1 year after surgery between users of NSAID and users of opioids for PCA. Additionally, postoperative complication rates, postoperative acute kidney injury (AKI) incidences, postoperative pain scores, and lengths of hospital stay were compared between groups. Postoperative GFR percentages, BUN/creatinine ratios, and serum creatinine percentages were similar between the two groups. There were no significant differences in the rates of postoperative complications, incidences of AKI, and pain scores at 30 min, 6 h, 48 h, or 7 days postoperatively. The length of hospital stay was significantly shorter in the NSAID group than in the opioid group. This study showed no association between the use of NSAID for PCA after laparoscopic nephrectomy and the incidence of postoperative renal dysfunction.

scholarly journals In Terms of Analgesic Requirements — A Comparison Between Laparoscopic Nephrectomy and Open Nephrectomy

2020 ◽  
Vol 23 (1) ◽  
pp. 31-35
Author(s):  
Abdul Matin Anamur Rashid Choudhury ◽  
Tohid Mohammad Saiful Hossain ◽  
Tasmina Parveen ◽  
Mohammed Mizanur Rahman ◽  
Md Safiul Alam Babul
Keyword(s):  
Analogue Scale ◽  
Laparoscopic Group ◽  
Laparoscopic Nephrectomy ◽  
Analgesic Requirement ◽  
Operative Results ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Vas Scores ◽  
Open Nephrectomy ◽  
Hospital Stay Duration

Objective: In this study, we aimed at making a comparison between the laparoscopic nephrectomy and open nephrectomy in terms of post-operative pain and pethidine consumption. Methods: The study has been designed with patients who underwent prospective and randomized laparoscopic and open nephrectomy operation. We assessed the post-operative pain through visual analogue scale (VAS) at the 0st, 2nd, 4th, 8th, 12th, 18th, and 24th post-operative hours. We carefully recorded the intraoperative and post-operative results along with the post-operative pain-relieving analgesic doses. Results: A total number of 30 patients were included in this study. The VAS scores of the two groups did not demonstrate a significant difference, but the analgesic (Pethidine) requirement was significantly lower in the laparoscopic group (p=0.031). The groups demonstrated no difference in terms of adverse effects. Conclusion: Along with similar perioperative results, laparoscopic nephrectomy offers an advantage in case of post-operative pain with regard to analgesic requirement and hospital stay duration. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.31-35

scholarly journals Laparoscopic versus open nephrectomy in resource-constrained developing world hospitals: a retrospective analysis

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Avikar Singh ◽  
Ronald James Urry
Keyword(s):  
South Africa ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
The State ◽  
Laparoscopic Nephrectomy ◽  
Transfusion Rate ◽  
High Grade ◽  
State Sector ◽  
Open Nephrectomy

Abstract Background Laparoscopic nephrectomy is the standard of care for nephrectomy in most developed countries. Its adoption in our setting has been limited due to lack of equipment and expertise. This paper sets out to show that laparoscopic nephrectomy is technically feasible in the state sector in South Africa. Methods A retrospective chart review was performed of all patients having undergone nephrectomy over a five-year period at two state hospitals in KwaZulu-Natal Province, South Africa. Demographic information, pre-operative imaging findings, operative information and post-operative outcomes were analysed. Results Nephrectomy was performed in 196 patients. Open nephrectomy (ON) was the intended surgical approach in 73% (n = 143) and laparoscopic nephrectomy (LN) in 27% (n = 53). The conversion rate from LN to ON was 11% (n = 6). For malignancies, there was no difference in surgical resection margin status across the ON, LN and conversion groups; however, tumour size was larger in the conversion group compared to the LN group. Estimated blood loss and transfusion rates were lower in the LN group. The average length of hospital stay was shorter in the LN group (5 vs 10 days). High dependency unit (HDU) admission rate was lower in the LN group (12.1%) compared to the ON group (50%) and the conversion group (40%). No difference in high-grade complications was noted between the ON and LN groups, and more patients in the LN group (82.5%) had no complications compared to the open group (9.9%). Conclusion LN is non-inferior to ON in terms of operative time, oncology outcomes and high-grade complications. LN is superior in terms of blood loss, transfusion rate, length of hospital stay and overall complication rate. LN appears to show technical feasibility in the state sector and highlights the need for laparoscopic training.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series

2021 ◽  
Author(s):  
Jonathan P Scoville ◽  
Evan Joyce ◽  
Joshua Hunsaker ◽  
Jared Reese ◽  
Herschel Wilde ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Chart Review ◽  
Statistical Tests ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Opioid Use ◽  
Pain Scores ◽  
Surgical Methods ◽  
Significant Difference

Abstract BACKGROUND Minimally invasive surgery (MIS) has been shown to decrease length of hospital stay and opioid use. OBJECTIVE To identify whether surgery for epilepsy mapping via MIS stereotactically placed electroencephalography (SEEG) electrodes decreased overall opioid use when compared with craniotomy for EEG grid placement (ECoG). METHODS Patients who underwent surgery for epilepsy mapping, either SEEG or ECoG, were identified through retrospective chart review from 2015 through 2018. The hospital stay was separated into specific time periods to distinguish opioid use immediately postoperatively, throughout the rest of the stay and at discharge. The total amount of opioids consumed during each period was calculated by transforming all types of opioids into their morphine equivalents (ME). Pain scores were also collected using a modification of the Clinically Aligned Pain Assessment (CAPA) scale. The 2 surgical groups were compared using appropriate statistical tests. RESULTS The study identified 43 patients who met the inclusion criteria: 36 underwent SEEG placement and 17 underwent craniotomy grid placement. There was a statistically significant difference in median opioid consumption per hospital stay between the ECoG and the SEEG placement groups, 307.8 vs 71.5 ME, respectively (P = .0011). There was also a significant difference in CAPA scales between the 2 groups (P = .0117). CONCLUSION Opioid use is significantly lower in patients who undergo MIS epilepsy mapping via SEEG compared with those who undergo the more invasive ECoG procedure. As part of efforts to decrease the overall opioid burden, these results should be considered by patients and surgeons when deciding on surgical methods.

Abdominal sacrohysteropexy UV prolapse and preservation of reproduction.

2021 ◽  
Vol 28 (05) ◽  
pp. 652-655
Author(s):  
Robina Ali ◽  
Riffat Ehsan ◽  
Ghazala Niaz ◽  
Fatima Abid
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Uterovaginal Prolapse ◽  
Prolapse Recurrence ◽  
Gynecology And Obstetrics ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Operative Recovery ◽  
Post Operative Complications

Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.

scholarly journals Locked intramedullary nailing technique of the femur without brilliance amplifier at the trauma and orthopedics department of the university hospital of peace series on 35 cases during 1 year

2021 ◽  
Vol 13 (5) ◽  
pp. 95-97
Author(s):  
Augustin Delange Hendrick ◽  
Almenord Pharol ◽  
Khawly Clifford PG ◽  
Augustin Delange ◽  
Pierre Marie Woolley
Keyword(s):  
Hospital Stay ◽  
Intramedullary Nailing ◽  
Femoral Fractures ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Patient Morbidity ◽  
Duration Of Hospitalization ◽  
The Cost ◽  
The University

Femoral fractures increase the length of hospital stay for our patients for several reasons such as lack of blood, economic resources, and lack of infrastructure. The use of a C-arm has been shown to reduce patient morbidity due to early functional recovery and reduced hospital stay. Objective: To develop an intramedullary nailing technique without c-arm with a closed focus to reduce the duration of hospitalization of its patients as well as the cost related to the equipment used for follow-up. Methodology: prospective study on 35 patients for 1 year August 2020 to August 2021 Results: We followed 35 patients in which the mean age was 37.83 years with extremes of 18 and 78 years. The male sex predominates 21 against 14 women or 60% against 40% respectively. The sex ratio is 1.5. A total of 19 diaphyseal fractures (54.3%) were nailed, 9 supracondylar (25.7%) and 7 subtrochanteric (20%). Twenty-seven were closed fractures (71.1%), and 8 were open fractures (22.9%). The length of hospitalization was less than 3 days for 30 patients (85.7%), and more than 3 days for 5 patients (14.3%). Conclusion: We recommend that we promote this closed-hearth technique because it improves the postoperative follow-up of patients. Additionally, it would reduce exposure to radiation from c-arm in hospitals that have this equipment.

scholarly journals Role of laparoscopy in incisional hernia and relative benefit of the laparoscopic incisional hernia repair to the open incisional hernia repair

2020 ◽  
Vol 7 (7) ◽  
pp. 2165
Author(s):  
Sudhir Singh Pal ◽  
Azad Kumar Mourya
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Mesh Repair ◽  
Laparoscopic Group ◽  
Incisional Hernia Repair ◽  
Visual Analogue Score ◽  
Laparoscopic Incisional Hernia Repair ◽  
Post Operative Pain ◽  
Open Mesh Repair

Background: Incisional hernia is a common complication of abdominal surgery. Historically the open repair with or without mesh was the mainstay of treatment. However, many recently published laparoscopic repair studies have challenged surgeons to re-evaluate which technique provides the best short and long term outcomes.Methods: The study was conducted on 50 patients admitted at GMC Bhopal with approval from college ethical committee.Results: In 50 cases 21 were male and 29 were female. 7 male (14%) and 15 female (30%) patients had undergone laproscopic mesh repair (LMR) and 14 male (28%) and 14 female (28%) patients had undergone open mesh repair (OMR). Total complication in OMR group is 10 (35%) and in LMR group is 2 (9.09%). Mean duration of hospital stay in LMR group was 6.6 days and in OMR group was 15.57 days. Post-operative patients of LMR group returned back to the work early (mean 12 days) compared to OMR group (mean 20.7 days). Mean post-operative day of movement in LMR group was 1 day and in OMR group was 2.03 days. Pain measured using visual analogue score on 3rd post-operative day showed decreased pain score in laparoscopic group (mean 2) compared to open group (mean 5.35).Conclusions: Laparoscopic incisional hernia repair provides lesser post-operative pain, lesser complications, shorter hospital stay and lesser economic impact as they returned to work early. Thus patients have less morbidity and improved quality of life. 

Abstract TP170: Persistently Elevated Factor VIII In Acute Ischemic Stroke Is Associated With Higher CRP, Lower Baseline NIHSS, And Longer Length Of Hospital Stay

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Adrianne M Dorsey ◽  
Amelia K Boehme ◽  
Laurie Schluter ◽  
Karen C Albright ◽  
Tiffany R Chang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Factor Viii ◽  
Hospital Stay ◽  
Acute Ischemic Stroke ◽  
Acute Phase ◽  
Clinical Course ◽  
Length Of Hospital Stay ◽  
Lower Baseline ◽  
Persistent Elevation

Objective: We sought to determine the proportion of patients with elevated factor VIII (FVIII) levels whose FVIII levels remain elevated after the acute phase of stroke, and the patient characteristics that predict sustained elevation of FVIII levels. Background: Factor VIII plays a major role in the fluid phase of blood coagulation. Elevated FVIII has been shown to increase risk of venous and arterial thrombosis. The importance of screening for elevated FVIII after a first thrombotic event especially acute ischemic stroke (AIS) has not been adequately investigated. Design/Methods: We reviewed FVIII levels taken at baseline and follow-up in patients with AIS treated at our stroke center from July 2008 to June 2012. Elevated FVIII was defined as >150%. Baseline demographics, laboratory data, clinical course, outcomes, and time to follow-up were collected in patients with elevated FVIII at baseline and data was compared in patients who had normalized FVIII with patients whose FVIII remained elevated at least 7 days later. Results: Repeat FVIII levels were available for 34/111 patients with elevated FVIII level with AIS. FVIII remained elevated in 68% after a median interval of 110 days. Factors associated with persistent elevation included higher baseline FVIII level (239 vs 185%, p=0.015), elevated CRP (73.3 vs 12.5%, p=0.008), lower baseline NIHSS (4 vs 8, p=0.046), and longer length of hospital stay (8 vs. 3, p=0.0063). Normalization of FVIII was associated with tPA use (54.5% vs 13%, p=0.016). No relationship was found between persistently elevated FVIII and baseline demographics, clinical course and outcomes. Conclusion: Persistently elevated FVIII after AIS may be predicted by higher baseline levels and elevations in CRP. Despite worse baseline stroke severity, patient with normalization of FVIII had similar outcomes as those with persistent elevation, which may be explained by the higher use of tPA in the normalized group. The relevance of elevated FVIII in stroke is not well understood. Our preliminary results suggest elevations persist in the majority and may not merely represent an acute phase reactant.

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