Akusherstvo i ginekologii͡a
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Akush Ginekol (Sofiia) · Jan 2009
[Effect of small-doses ketamine on postoperative pain management with combinations morphine/ketoprofen or lidol/ketoprofen after major gynecological surgery] [corrected].
We examine the potential beneficial effect of small-doses ketamine on postoperative pain management with combinations morphine/ketoprofen or lidol/ketoprofen after major gynecological surgery. After patient written consent, 50 healthy women, which were scheduled for abdominal gynecological surgery were randomly allocated into two groups depending of postoperative analgesic technique--morphine/ ketoprofen or lidol/ketoprofen. ⋯ Using ketamine during the anesthesia improve quality of postoperative analgesia in accordance with less opioid consumption for the combination morphine/ ketoprofen, but not for the combination lidol/ketoprofen. Adding small doses ketamine to combination morphine/ketoprofen improve postoperative analgesia; reduce morphine consumption and incidences of morphine-related side effects after major gynecological surgery.
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Akush Ginekol (Sofiia) · Jan 2009
[Survival, prognostic factors and modern tendencies in adjuvant treatment of diagnosed endometrial cancer patients with or without lymph node dissection].
Our aim was to research and evaluate very big clinical material for 22 years period (1987-2009) at the National Cancer Center, Gynaecological clinic and Medical University--Departement of Obstetrics and Gynaecology-Varna. We studied some of the most important prognostic factors in patients with endometrial cancer, radically operated with or without lymph node dissection. We compared our results with the results of other authors working in this field. Our aim was by examining the prognostic factors and the survival rate to define and help the choice of the most suitable radical surgical treatment, as well as the application of most suitable adjuvant therapy. ⋯ The radical surgical treatment with lymph node dissection (pelvic and/or paraaortal) gives a better survival rate in intermediate and high risky groups. The extent of the lymph node dissection is an independent prognostic factor. In stage IA and IB, grade 1 and 2, a simple total hysterctomy has the same significance for the survival of patients as the radical hysterectomy with lymph node dissection. In stage IIB endometrial cancers the most suitable treatment is radical hysterctomy with lymph node dissection. The lymph node dissection is of benefit for endometrial cancers grade 3, stage IC, stage II, serous and clear cell carcinomas.