Surgery, gynecology & obstetrics
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Surg Gynecol Obstet · Mar 1983
Comparative StudyReversal of fentanyl induced spasm of the sphincter of Oddi.
We believe it is advisable to avoid narcotics, if possible, in patients with known or suspected gallbladder disease. Occasionally, however, this will not be possible, and narcotic induced spasm of the sphincter of Oddi may require treatment. Except for the stated contraindications of glucagon administration, it seems to be based upon this study and other available data that glucagon is just as effective as naloxone in reversing spasm of the sphincter of Oddi and may be associated with fewer undesirable effects, such as reversal of analgesia and adverse hemodynamic changes. Anticholingergic drugs in man have proved to be of minimal or no benefit in this regard.
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Surg Gynecol Obstet · Feb 1983
Randomized Controlled Trial Comparative Study Clinical TrialThe value of prophylactic antibiotics for simple lacerations.
A prospective study was undertaken to review the efficacy of antibiotics in the treatment of patients with minor lacerations. Four hundred and ninety-nine patients were randomized into two groups. Two hundred and twenty-seven patients in group 1 received cephalexin, 250 milligrams, every six hours for 72 hours. ⋯ Seven of 51 patients, 13.7 per cent, in group 1 and three of 53, 5.7 per cent, in group 2 with mildly contaminated wounds had infections develop. No significant difference was noted between the groups according to the age of the patient, interval since injury, anatomic location or suture technique. Prophylactic, orally administered antibiotics do not decrease the incidence of infection in patients with suture closure of simple lacerations.
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Surg Gynecol Obstet · Jan 1983
Panniculectomy in conjunction with radical cystectomy in the obese patient.
Obesity in the abdominal area causes difficulty not only with the placement of an ileal conduit stoma and conduit length but also with surgical exposure during radical surgery to the pelvis. Such problems may be ameliorated by using a horizontal abdominal dermolipectomy in conjunction with a midline fascial and peritoneal incision and the Turnbull ileal stoma in selected obese patients. The advantages of this technique far outweigh the limited complications which may be encountered.
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Surg Gynecol Obstet · Nov 1982
The effect of general and epidural anesthesia upon neonatal Apgar scores in repeat cesarean section.
One-hundred and ninety-five elective cesarean deliveries were studied to determine the effects of general and epidural anesthesia upon the neonatal condition, as reflected by the one and five minute Apgar scores. Ninety were performed under general anesthesia, 0.5 per cent halothane, 50 per cent nitrous oxide and 50 per cent oxygen; 105 used the epidural technique, 3 per cent chloroprocaine plus 0.75 per cent bupivacaine. All patients were tilted to the left during operation. ⋯ More significantly, no correlation was noted between the duration of anesthesia and the Apgar scores in either group, p greater than 0.1. Specifically, no significant increase was found in depressed infants in the prolonged, greater than or equal to 15 minutes, incision to delivery group, p greater than 0.05. These data seem to suggest that the use of general anesthesia, in the technique described, yields infants with Apgar scores as good as those of infants delivered under regional block anesthesia and that prolonged duration of general anesthesia is not associated with a depression of the Apgar scores.
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Surg Gynecol Obstet · Aug 1982
Randomized Controlled Trial Clinical TrialPovidone-iodine irrigation of the subcutaneous tissue to prevent surgical wound infections.
In a prospective randomized trial, the influence of irrigation of the subcutaneous tissue using povidone-iodine solution upon the development of postoperative wound infection was examined in 592 patients undergoing general surgical operative procedures. No beneficial effect of irrigation with povidone-iodine solution could be demonstrated, nor could it be demonstrated in the group as a whole or in the subgroups according to bacterial contamination.