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Hysterectomy

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18761. [The effects of conscious sedation by propofol on respiration during abdominal hysterectomy under spinal anesthesia]. (PubMed)

[The effects of conscious sedation by propofol on respiration during abdominal hysterectomy under spinal anesthesia]. The effects of conscious sedation by propofol on respiration were studied in 28 patients undergoing abdominal hysterectomy under spinal anesthesia. The patients were randomly assigned to receive conscious sedation by propofol (Group P, n = 20) or no sedation (Group C, n = 8). After a satisfactory level of analgesia had been achieved, a loading dose of propofol, 0.2 mg.kg-1 (...) rate was 1.7 +/- 0.5 mg.kg-1.h-1. Compared with Group C, the respiratory depression was less in Group P; SpO2 was significantly higher at 25 min after spinal tap and PETCO2 was significantly lower at 30 and 50 min after spinal tap in Group P. A score of patient satisfaction was significantly higher in Group P. Conscious sedation by propofol is a safe and useful supplement to spinal anesthesia for abdominal hysterectomy.

2001 Masui. The Japanese journal of anesthesiology Controlled trial quality: uncertain

18762. A comparison of 25 mg and 50 mg oestradiol implants in the control of climacteric symptoms following hysterectomy and bilateral salpingo-oophorectomy. (PubMed)

A comparison of 25 mg and 50 mg oestradiol implants in the control of climacteric symptoms following hysterectomy and bilateral salpingo-oophorectomy. 1. To compare the effects of 25 mg and 50 mg oestradiol implants on serum follicle stimulating hormone and oestradiol levels; and 2. to assess the relationship of the dose of oestradiol implant and serum oestradiol on the effectiveness and duration of climacteric symptom control.Randomised, double-blind investigation.Forty-four women, who had (...) undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy.The women were randomised to receive either 25 mg (n = 20) or 50 mg (n = 24) oestradiol implants. Follow up consisted of prospective symptom enquiry and hormone assays.Primary: climacteric symptom control: duration and effectiveness; secondary: serum oestradiol and follicle stimulating hormone levels.Serum oestradiol was significantly higher and serum follicle stimulating hormone significantly lower after the fourth month

2000 BJOG Controlled trial quality: uncertain

18763. Analgesic effect of epidural neostigmine after abdominal hysterectomy. (PubMed)

Analgesic effect of epidural neostigmine after abdominal hysterectomy. To evaluate the effects of epidurally administered neostigmine on pain after abdominal hysterectomy.Prospective, randomized, double-blind study.Teaching hospital.45 ASA physical status I adult patients scheduled for abdominal hysterectomy.All patients received identical general and epidural anesthesia. At the end of the surgery, they received epidural bupivacaine (10 mg) with either saline (control group, n = 15), 5 micro g (...) hysterectomy.

2001 Journal of clinical anesthesia Controlled trial quality: uncertain

18764. [Efficacy and safety of two cephalosporins in the perioperative prophylaxis in patients undergoing abdominal or vaginal hysterectomies or gynaecological laparotomies: a prospective randomized study]. (PubMed)

[Efficacy and safety of two cephalosporins in the perioperative prophylaxis in patients undergoing abdominal or vaginal hysterectomies or gynaecological laparotomies: a prospective randomized study]. The aim of this study was to compare efficacy and safety of perioperative antibiotic prophylaxis in patients undergoing abdominal or vaginal hysterectomy or gynaecological laparotomy to improve the prevention of surgical wound infections. One hundred and ninety-nine patients were prospectively

2000 Gynäkologisch-geburtshilfliche Rundschau Controlled trial quality: uncertain

18765. Effect of pre-incision skin infiltration on post-hysterectomy pain--a double-blind randomized controlled trial. (PubMed)

Effect of pre-incision skin infiltration on post-hysterectomy pain--a double-blind randomized controlled trial. In this double-blind placebo-controlled randomized trial, we compared the analgesic effect of preoperative 0.25% bupivacaine (n = 21) skin infiltration with normal saline (n = 19) in patients undergoing abdominal hysterectomy through a lower midline incision. All patients received postoperative patient-controlled analgesia with morphine and were followed for 72 hours. The main outcome (...) measures were morphine consumption and pain score at rest, and the contribution of different components of pain was also assessed prospectively. No statistically significant differences were found. All except one patient (n = 39) could distinguish the different characteristics of somatic and visceral pain. Visceral pain predominated in the first 48 hours. We concluded that local anaesthetic infiltration is not effective in reducing pain after abdominal hysterectomy. Effective postoperative analgesia

2000 Anaesthesia and intensive care Controlled trial quality: predicted high

18766. Plasma levels of interleukin-6 and interleukin-10 are affected by ketorolac as an adjunct to patient-controlled morphine after abdominal hysterectomy. (PubMed)

Plasma levels of interleukin-6 and interleukin-10 are affected by ketorolac as an adjunct to patient-controlled morphine after abdominal hysterectomy. Because morphine affects various immune functions, patient-controlled analgesia with morphine may further deteriorate the immune mechanisms after surgery. Therefore, the purpose of this study was to determine differences between morphine patient-controlled analgesia and a combination of morphine and ketorolac in interleukin-6 and interleukin-10 (...) responses, and in analgesia and morphine-related side effects.Prospective study.Twenty-two patients who underwent abdominal hysterectomy were classified randomly into two groups: (1) patient-controlled analgesia with morphine; and (2) patient-controlled analgesia with a combination of morphine and ketorolac. Blood samples to measure cytokines were collected at preoperatively, immediately postoperatively, and 2 hours, 4 hours, and 24 hours postoperatively.Plasma was separated and frozen until

2001 Clinical Journal of Pain Controlled trial quality: uncertain

18767. Non-closure of visceral peritoneum at abdominal hysterectomy. (PubMed)

Non-closure of visceral peritoneum at abdominal hysterectomy. Our purpose was to determine whether non-closure of the visceral peritoneum alters post-operative outcome at abdominal hysterectomy. A prospective, randomized trial was performed. Of the 100 evaluable subjects, 50 had the visceral peritoneum left open whereas 50 were closed. Patients were observed for evidence of morbidity after the operation. Analysis of data was performed with use of the unpaired t-test for continuous variables (...) . The visceral peritonization process at abdominal hysterectomy does not provide immediate post-operative benefits while unnecessarily lengthening surgical time and anesthesia exposure. We suggest that visceral peritonization process can be abolished at abdominal hysterectomy.

2001 International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics Controlled trial quality: uncertain

18768. Comparison of two procedures for laparoscopic-assisted vaginal hysterectomy of large myomatous uteri. (PubMed)

Comparison of two procedures for laparoscopic-assisted vaginal hysterectomy of large myomatous uteri. To evaluate whether laparoscopic bipolar coagulation of uterine vessels (LBCUV) and supracervical amputation improve laparoscopic-assisted vaginal hysterectomy (LAVH).Prospective, randomized, longitudinal study (Canadian Task Force classification II-1).Private practice, university-affiliated hospital.Sixty-four women (age 31-52 yrs) with symptomatic myomatous uteri larger than 12 weeks (...) on bimanual examination.LAVH with or without LBCUV and laparoscopic supracervical amputation followed by trachelectomy.LBCUV and laparoscopic supracervical amputation followed by trachelectomy and removal of the specimen vaginally were performed successfully in 29 women (group A). Hysterectomy was performed successfully in 32 comparable patients (group B) with severing of the round ligament, ovarian ligament, or infundibulopelvic ligament, and preparation of the bladder flap in the laparoscopic phase

2002 The Journal of the American Association of Gynecologic Laparoscopists Controlled trial quality: uncertain

18769. Recurrence of endometriosis in women with bilateral adnexectomy (with or without total hysterectomy) who received hormone replacement therapy. (PubMed)

Recurrence of endometriosis in women with bilateral adnexectomy (with or without total hysterectomy) who received hormone replacement therapy. To estimate the risk of recurrence after administration of hormone replacement therapy (HRT) among women who have had endometriosis and who underwent bilateral salpingo-oophorectomy (BSO).Prospective randomized trial (115 women receiving HRT and 57 not receiving HRT). SETTING; Public university hospital.Women with a histologic diagnosis of endometriosis (...) , but the relationship to the endometriosis recurrence was controversial. Among women receiving HRT, the following risk factors were detected: peritoneal involvement > 3 cm (2.4% recurrence per year vs. 0.3%) and incomplete surgery (22.2% per patient vs. 1.9%).Patients with a history of endometriosis in whom total hysterectomy and bilateral salpingo-oophorectomy have been performed have a low risk of recurrence when HRT is administered. In those patients, HRT is a reasonable option. However, in cases with peritoneal

2002 Fertility and sterility Controlled trial quality: uncertain

18770. A prospective, randomized study of closed-suction drainage after laparoscopic-assisted vaginal hysterectomy. (PubMed)

A prospective, randomized study of closed-suction drainage after laparoscopic-assisted vaginal hysterectomy. To estimate whether closed-suction drainage of the pelvis after laparoscopic-assisted vaginal hysterectomy reduces the risk of postoperative morbidity.Prospective, randomized study (Canadian Task Force classification 1).Teaching medical center.Three hundred twenty-four women.Laparoscopic-assisted vaginal hysterectomy.The 160 women in group 1 had closed-suction (Jackson-Pratt) drains (...) . A statistically significant difference in analgesic requirement was found, with more oral analgesics taken by women in group 2.Prophylactic surgical drainage may not be necessary to prevent postoperative morbidity after laparoscopic-assisted vaginal hysterectomy when prophylactic and postoperative antibiotics are given. A drain still has its role in gynecologic laparoscopy in selected women, such as in those with persistent ooze from raw surfaces, bowel injury, or frank pus in the abdomen.

2002 The Journal of the American Association of Gynecologic Laparoscopists Controlled trial quality: uncertain

18771. Does the opioid-sparing effect of rectal diclofenac following total abdominal hysterectomy benefit the patient? (PubMed)

Does the opioid-sparing effect of rectal diclofenac following total abdominal hysterectomy benefit the patient? The aim of this prospective, double-blind, randomized, placebo-controlled clinical trial was to investigate the opioid-sparing effects of rectal diclofenac following total abdominal hysterectomy.Forty ASA I-II patients, aged 20-60 yr, were randomized to receive identical-looking suppositories of either diclofenac 75 mg or placebo, twice daily. All patients were given a standardized

2002 British Journal of Anaesthesia Controlled trial quality: predicted high

18772. Effect of peri- and postoperative epidural anaesthesia on pain and gastrointestinal function after abdominal hysterectomy. (PubMed)

Effect of peri- and postoperative epidural anaesthesia on pain and gastrointestinal function after abdominal hysterectomy. In a double blind study we have investigated the effects of epidural local anaesthesia (LA), when added to general anaesthesia (GA) and postoperative paracetamol and NSAID, on postoperative pain and gastrointestinal function in patients undergoing open hysterectomy. Sixty patients were randomized into three study groups: GA, and postoperative paracetamol and NSAID (GA, n=20

2001 British Journal of Anaesthesia Controlled trial quality: uncertain

18773. Autologous blood transfusion in radical hysterectomy with and without erythropoietin therapy. (PubMed)

Autologous blood transfusion in radical hysterectomy with and without erythropoietin therapy. To investigate whether preoperative treatment with erythropoietin facilitates the collection of a sufficient amount of autologous blood in a short period of time.Forty-one women scheduled for radical hysterectomy were randomized to preoperative autologous blood donation with or without preoperative recombinant human erythropoietin therapy. All patients were scheduled to deposit three units of blood

2002 Obstetrics and Gynecology Controlled trial quality: uncertain

18774. Changes in blood volume and hematocrit during acute preoperative volume loading with 5% albumin or 6% hetastarch solutions in patients before radical hysterectomy. (PubMed)

Changes in blood volume and hematocrit during acute preoperative volume loading with 5% albumin or 6% hetastarch solutions in patients before radical hysterectomy. The impact of acute preoperative volume loading with colloids on blood volume has not been investigated sufficiently.Before surgery, in 20 patients undergoing major gynecologic procedures, volume loading was performed during anesthesia by infusing approximately 20 ml/kg of colloid at a rate of 90 ml/min (group I: 5% albumin solution

2001 Anesthesiology Controlled trial quality: uncertain

18775. Usefulness of a pediatric colonoscope for routine colonoscopy in women who have undergone hysterectomy. (PubMed)

Usefulness of a pediatric colonoscope for routine colonoscopy in women who have undergone hysterectomy. Colonoscopy can be difficult in some women who have undergone hysterectomy, which can be associated with a fixed, angulated sigmoid colon caused by postoperative pelvic adhesions. Our goal was to determine whether colonoscopy is easier and more comfortable for women after hysterectomy when performed with a pediatric colonoscope, which is thinner in diameter and more flexible than a standard (...) "adult" colonoscope.One hundred women with a history of hysterectomy undergoing outpatient colonoscopy were randomized in unblinded fashion to colonoscopy with a standard colonoscope (CF-100L or CF-Q140L, Olympus) or with a pediatric colonoscope (PCF-100, Olympus). All procedures were performed by a faculty endoscopist and timed. After examination, the endoscopist graded procedure difficulty, and patients were given a questionnaire that assessed their experience.The cecum was intubated more

2002 Gastrointestinal endoscopy Controlled trial quality: uncertain

18776. Comparison of ovarian cyst formation in women using the levonorgestrel-releasing intrauterine system vs. hysterectomy. (PubMed)

Comparison of ovarian cyst formation in women using the levonorgestrel-releasing intrauterine system vs. hysterectomy. To analyze the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) on ovarian cyst formation, endometrial thickness and the size of uterus and uterine fibroids by ultrasonography.This was a prospective, randomized trial comparing the LNG-IUS and hysterectomy in 236 women (age range 35-49 years) referred for menorrhagia. Transvaginal ultrasound examination (...) was used to study the presence of ovarian cysts, uterine size, endometrial thickness, and the size of the uterus and uterine fibroids during a 12-month follow-up period.At baseline examination, 12 ovarian cysts were detected, eight in the LNG-IUS group and four in the hysterectomy group. During the follow-up period, 14 new cysts had emerged at 6 months and 14 new cysts had emerged at 12 months in the LNG-IUS group, whereas the corresponding figures in the hysterectomy group were three and eight

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2002 Ultrasound in Obstetrics and Gynecology Controlled trial quality: uncertain

18777. Comparison of one- and two-layer vaginal cuff closure and open vaginal cuff during laparoscopic-assisted vaginal hysterectomy. (PubMed)

Comparison of one- and two-layer vaginal cuff closure and open vaginal cuff during laparoscopic-assisted vaginal hysterectomy. To evaluate clinical outcomes of three surgical techniques during laparoscopic-assisted vaginal hysterectomy.Prospective, randomized study (Canadian Task Force classification I).Medical school-affiliated hospital.Four-hundred twenty-seven women.By means of a computer-generated randomization code, patients were assigned immediately before operation to one of three groups (...) , frequency of pelvic and urinary tract infection, dyspareunia, postcoital spotting, vaginal discharge, and morbidity of the cuff (cellulitis, abscess formation, bleeding, hematoma, dehiscence). Operating time was greatest for two-layer closure. The frequency of postoperative granulation of cuff tissue and vaginal discharge was greater for group 1 than for the other two groups.Two-layer closure of the vaginal cuff during laparoscopic-assisted vaginal hysterectomy is associated with fewer instances

2002 The Journal of the American Association of Gynecologic Laparoscopists Controlled trial quality: uncertain

18778. Effect of pre-operative anxiolysis on postoperative pain response in patients undergoing total abdominal hysterectomy. (PubMed)

Effect of pre-operative anxiolysis on postoperative pain response in patients undergoing total abdominal hysterectomy. In a double blind, placebo-controlled trial, we have assessed the effects of pre-operative anxiolysis on postoperative pain scores in 112 ASA I-II women, aged 18-65 years, scheduled to undergo total abdominal hysterectomy. Subjects were randomly allocated to receive either oral diazepam 10 mg (n=56) or placebo (n=56) pre-operatively. Postoperative anxiety, pain scores

2002 Anaesthesia Controlled trial quality: predicted high

18779. A prospective randomized study comparing retroperitoneal drainage with no drainage and no peritonization following radical hysterectomy and pelvic lymphadenectomy for invasive cervical cancer. (PubMed)

A prospective randomized study comparing retroperitoneal drainage with no drainage and no peritonization following radical hysterectomy and pelvic lymphadenectomy for invasive cervical cancer. To evaluate the postoperative morbidity and lymphocyst formation in invasive cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy (RHPL) with no drainage and no peritonization compared with retroperitoneal drainage and peritonization.Between July 1999 and May 2000, 100

2002 The journal of obstetrics and gynaecology research Controlled trial quality: uncertain

18780. [Effect of low-dose intravenous ketamine in postoperative analgesia for hysterectomy and adnexectomy]. (PubMed)

[Effect of low-dose intravenous ketamine in postoperative analgesia for hysterectomy and adnexectomy]. To evaluate the efficacy of low dose ketamine (0.15 mg/Kg i.v.) as a pre-emptive pain relief after general anesthesia.Sixty-nine gynecological surgery patients were enrolled in this prospective, double-blind study. All received total intravenous anesthesia and were randomized to group A (n = 23) to receive preoperative ketamine, to group B (n = 23) to receive postoperative ketamine or to group

2002 Revista española de anestesiología y reanimación Controlled trial quality: predicted high

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