Lancet
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Infection of the upper genital tract after abortion is well recognised, but routine screening for infection before termination is rare, and few centres are aware of the prevalence of post-abortion complications in their population. We undertook a study to assess the prevalence and sequelae of genital-tract infection in patients undergoing termination of pregnancy and to estimate the costs and potential benefits of introducing screening and prophylaxis for the most commonly found organisms. The study in Swansea, UK, was of 401 consecutive patients attending for termination of pregnancy; only 1 patient refused to take part. ⋯ Screening for chlamydial infection before termination of pregnancy is essential. Prophylactic treatment for both chlamydial infection and anaerobic vaginosis should also be considered. Male partners of women infected with chlamydia are often symptom-free, but they must be traced to avoid reinfections.
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Randomized Controlled Trial Clinical Trial
Preoperative morphine pre-empts postoperative pain.
Postoperative analgesia is usually inadequate, perhaps because conventional approaches to pain relief do not take account of underlying mechanisms. Pre-emptive analgesia may prevent nociceptive inputs generated during surgery from sensitising central neurons and, therefore, may reduce postoperative pain. ⋯ Pain sensitivity around the wound was reduced in both preoperative treatment groups compared with the iv post group. We conclude that pre-emptive analgesia with intravenous morphine, by preventing the establishment of central sensitisation during surgery, reduces postoperative pain, analgesic requirements, and secondary hyperalgesia.