Archives of gynecology and obstetrics
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Arch. Gynecol. Obstet. · Jul 2016
Epidural anesthesia for cesarean section for pregnant women with rheumatic heart disease and mitral stenosis.
Pregnancy increases stress on the circulation of parturient with mitral stenosis secondary to rheumatic heart disease and increases the risk of peripartum heart failure, especially during delivery. This study investigated the epidural anesthesia management for cesarean section in pregnant women with rheumatic heart disease and mitral stenosis. ⋯ Epidural anesthesia was applied successfully for cesarean sections for parturients with rheumatic heart disease and mitral stenosis.
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Arch. Gynecol. Obstet. · Jul 2016
Implementation of enhanced recovery after surgery (ERAS) in gynaecological oncology.
To evaluate the outcomes of enhanced recovery after surgery (ERAS) implementation in a gynaecological oncology centre. ⋯ In total, 265 cases identified; 99 patients followed ERAS and 99 historic controls, managed with a traditional peri-operative approach, the exact same period the year before (vulval surgery excluded, 67 cases). Groups were comparable in demographics and co-morbidities (age, BMI, ASA, WHO), level of surgery and 30 days post-operative complication (grading Clavien-Dindo classification) and readmission rates (p > 0.05). Overall, the post-operative length of hospital stay (LOS) was significantly reduced for patients who followed ERAS (4.29 ± 2.78 days versus 7.23 ± 5.68 days, p < 0.001). Stratification to subgroups was based on the type of surgery, abdominal versus laparoscopic. Those who underwent abdominal surgery and followed ERAS benefited the maximum (LOS: 5.09 ± 2.74 days versus 8.70 ± 5.75, p < 0.001) CONCLUSIONS: ERAS programme is feasible and safe in Gynae-oncology. In this study, there was a reduction of 3.61 (SE: 0.78, CI 95 %) days in the total LOS, in major abdominal Gynae-oncology surgery (level 3 and 4) without affecting complication or readmission rates.
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Arch. Gynecol. Obstet. · Jun 2016
Randomized Controlled TrialEffectiveness of local anesthetic on postoperative pain in different levels of laparoscopic gynecological surgery.
The aim of this study was to assess the effects of preemptive and preclosure analgesia on postoperative pain intensity in patients undergoing different levels of laparoscopic surgery. ⋯ Lidocaine infiltration at port sites had beneficial effects on pain intensity in the early postoperative period after laparoscopic gynecological surgery. However, the results of present study showed that the analgesic effect mechanism of local anesthetic was unrelated to the preemptive analgesia hypothesis.
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Arch. Gynecol. Obstet. · Jun 2016
ReviewRobotic assisted hysterectomy in obese patients: a systematic review.
Robotic hysterectomy is an alternative approach to the management of female genital tract pathology. ⋯ The robotic technique, especially in obese, can optimize the surgical approach and recovery of such patients with equally if not better outcomes compared to open and/or laparoscopic techniques.
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Arch. Gynecol. Obstet. · May 2016
Randomized Controlled TrialCarbetocin versus oxytocin in the management of atonic post partum haemorrhage (PPH) after vaginal delivery: a randomised controlled trial.
The objective of this study is to compare the effectiveness and safety of carbetocin vs. oxytocin in the management of atonic post partum haemorrhage (PPH) after vaginal delivery. ⋯ Carbetocin is a better alternative to oxytocin in management of atonic PPH with non-significant hemodynamic changes or side effects .