Journal of minimally invasive gynecology
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J Minim Invasive Gynecol · Jul 2005
Randomized Controlled Trial Clinical TrialEffect of bupivacaine after operative laparoscopic gynecologic procedures.
To evaluate the effect of intraperitoneal installation and periportal infiltration of bupivacaine on postoperative pain and return of bowel function. ⋯ Intraperitoneal installation and periportal infiltration of bupivacaine decrease postoperative pain and hasten the return of bowel function. Both decreased postoperative pain and shortened duration for the return of bowel function are crucial for comfort and discharge of the patient.
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J Minim Invasive Gynecol · Jul 2005
ReviewTrocar-associated injuries and fatalities: an analysis of 1399 reports to the FDA.
Laparoscopic trocars, medical devices used to gain access into the abdominal cavity, are the most common device named in malpractice injury claims associated with laparoscopic procedures. As part of its ongoing adverse event reporting program, the U. S. ⋯ Further study is needed to evaluate the high proportion of reports associated with laparoscopic cholecystectomy. Laparoscopists should retain for evaluation any devices implicated in patient injuries and should ensure that detailed information on adverse events is provided in adverse event reports to the FDA. The FDA's Manufacturer and User Facility Device Experience (MAUDE) database can be a valuable source for information on adverse outcomes associated with medical devices and, given an understanding of its limitation, provides researchers with a viable adjunct to published literature and litigation surveys for obtaining this information.
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J Minim Invasive Gynecol · Jul 2005
Randomized Controlled Trial Clinical TrialUse of sublingual buprenorphine for pain relief in office hysteroscopy.
To assess the efficacy of sublingual buprenorphine in the relief of pain associated with office hysteroscopy. ⋯ Office hysteroscopy with a 3.1-mm flexible hysteroscope is a well-tolerated procedure. Sublingual buprenorphine is not helpful in relieving the pain associated with hysteroscopy but is associated with significant adverse reactions.
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J Minim Invasive Gynecol · Jul 2005
Randomized Controlled Trial Clinical TrialPreemptive analgesia installation during gynecologic laparoscopy: a randomized trial.
To evaluate the efficacy of intraoperative infusion of bupivacaine solution for the relief of pain after operative gynecologic laparoscopy. ⋯ Intraperitoneal bupivacaine administration both immediately after placement of trocars and at the end of surgery was found to be effective in reducing the intensity of AVP but not in reducing STP, APP, or postoperative analgesia consumption after nonadvanced gynecologic laparoscopic procedures. The duration of the analgesic effect of bupivacaine instilled into the peritoneal cavity did not exceed 8 hours and probably was not dose related.
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J Minim Invasive Gynecol · Jul 2005
Comparative StudyOffice hysteroscopic sterilization compared with laparoscopic sterilization: a critical cost analysis.
To evaluate the actual cost difference in performing Essure hysteroscopic sterilization in the office compared with ambulatory surgery using laparoscopic sterilization in the operating room. ⋯ In our institution and in our experience, office-hysteroscopic placement of the Essure device is a more cost-effective method than laparoscopic tubal ligation.