• Title, Summary, Keyword: total abdominal hysterectomy

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A Effectiveness of Butorphanol and Nalbuphine as Utilized with Ketorolac in Patient Controlled Analgesia after Total Abdominal Hysterectomy (복식 전자궁 절제술 후 통증자가조절을 통하여 Ketorolac과 함께 투여한 Butorphanol과 Nalbuphine의 효과)

  • Kim, Dong-Hee;Park, Choong-Hak
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.263-267
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    • 1998
  • Background: This study was designed to know the dose requirement, analgesic efficacy and side effects of butorphanol and nalbuphine when administered with ketorolac by patient controlled analgesia (PCA) after total abdominal hysterectomy. Methods: Forty women who underwent total abdominal hysterectomy received ketorolac (bolus dose 2.4 mg, lockout interval 10 min) with either butorphanol (bolus dose 0.1 mg) or nalbuphine (bolus dose 1 mg) using PCA pump postoperatively. Results: Total amounts of 48 hr consumption were 8.7 mg (butorphanol)and 61.5 mg (nalbuphine). There were no significant differences between two groups in total ketorolac infusion doses, VAS score and side effects. Conclusions: Both butorphanol and nalbuphine were useful for PCA for postoperative pain control. We may suggest that ketorolac 180 mg with butorphanol 9 mg or nalbuphine 70 mg would be useful for 48 hr postoperative pain control.

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Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

  • Wang, Hui-Ling;Ren, Yan-Fang;Yang, Jun;Qin, Rui-Ying;Zhai, Kai-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2515-2519
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    • 2013
  • The standard surgery for early-stage endometrial cancer is total abdominal hysterectomy (TAH), while total laparoscopic hysterectomy (TLH) is less invasive and assumed to be associated with lower morbidity. This meta-analysis was performed to investigate the effects of TLH versus TAH in women with early-stage endometrial cancer. We searched the PubMed, EMBASE, CBM and Cochrane Review databases for randomized trials assessing the effects of TLH versus TAH in women with early-stage endometrial cancer. The relative risks (RR) with 95% confidence intervals (CIs) from each study were pooled using meta-analysis. In our study, 9 randomized trials with a total of 1,263 patients were included. Meta-analyses showed that TLH was associated with lower risks of major complications (RR = 0.53, 95%CI 0.29-0.98, P = 0.042), total complications (RR = 0.59, 95%CI 0.42-0.82, P = 0.002) and postoperative complications (RR = 0.57, 95%CI 0.40-0.83, P = 0.003). However, there were no obvious differences in risks of intra-operative complications (RR = 0.98, 95%CI 0.62-1.55, P = 0.919) and mortality (RR = 0.96, 95%CI 0.66-1.40, P = 0.835). In conclusion, our results provide new evidence of a benefit for TLH over TAH in terms of major complications, total complications and postoperative complications in endometrial cancer patients.

Treatment of the post-hysterectomy syndrome: a case report (자궁적출술 후 증후군 (Post-hysterectomy syndrome) 환자 1례에 대한 임상 보고)

  • Park, Kwan-Woo;Kim, Song-Baeg;Yoo, Sim-Keun;Seo, Yun-Jung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.18 no.3
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    • pp.225-233
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    • 2005
  • Purpose : Hysterectomy is the most common gynecologic operation in women. Recent research has been directed towards understanding the symptoms after hysterectomy. But the study for treating them was rarely investigated. The purpose of this study was to report a case associated with treatment of the post-hysterectomy syndrome. Methods : A 52-year-old woman, who suffered from headache, dizziness, indigestion, lumbargo, insomnia, hyposthenia et al after total abdominal hysterectomy (TAH), was enrolled in this study. She received oriental treatments such as herbal medicine, acupuncture, moxibustion and dry cupping therapy for 8 days. Results : The symptoms after hysterectomy were markedly reduced by oriental treatments. Conclusion : The present study suggests that oriental treatments have a significant effect on the post-hysterectomy syndrome.

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The Effect of Ultrasound-guided TAPB on Pain Management after Total Abdominal Hysterectomy

  • Gharaei, Helen;Imani, Farnad;Almasi, Fariba;Solimani, Massoud
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.374-378
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    • 2013
  • Background: Incisional pain is particularly troublesome after hysterectomy. A method called transversus abdominis plane block (TAPB) has shown promise in managing postoperative pain. In this study, we evaluated the analgesic efficacy of ultrasound-guided TAPB after hysterectomy at different time points and at each time point separately for 48 hours. Methods: Forty-two patients (ASA I, II) who were electively chosen to undergo total abdominal hysterectomy were divided into 2 groups, control (group C) and intervention (group I). Twenty-one patients underwent TAPB (group I) and 21 patients received only the standard treatment with a fentanyl pump (group C). Both groups received standard general anesthesia. For patients in group I, following the surgery and before emergence from anesthesia, 0.5 mg/kg of ropivacaine 0.2% (about 20 cc) was injected bilaterally between the internal oblique and transverse abdominis muscles using sonography. Pain scores using the Visual Analogue Scale (VAS) and drug consumption were measured at 2, 6, 12, 24, and 48 hours after TAPB. Results: There were no significant differences in demographics between the two groups. VAS scores appeared to be lower in group I, although there was no interaction with time when we compared mean VAS measurements at different time points between group I and group C (P > 0.05). The amount of fentanyl flow was consistently higher in group C, but when we compared the two groups at each time point separately, the observed difference was not statistically significant (P < 0.053). The incidence of vomiting was 10% in group I and 28% in group C. There were no complaints of itching, and sedation score was 0 to 3. There were no complications. Conclusions: This study showed that TAPB did not result in a statistically significant decrease in VAS scores at different time points. TAPB did lead to decreased fentanyl flow, but when we compared the two groups at each time point separately, the observed difference was not statistically significant.

A Study on Blood Stasis Pattern for 159 Hysterectomy Patients (자궁절제술 시행 환자 159명의 어혈증 연구)

  • Choi, Jin-Young;Lee, Jin-Moo;Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.4
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    • pp.122-134
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    • 2009
  • Purpose: The purpose of this study is to know the blood stasis pattern for the patients who had hysterectomy. Methods: Among the patients who had hysterectomy in the department of obstetrics and gynecology, OO medical center from March 3rd 2009 to October 21st 2009, subjects who met inclusion criteria and submitted appropriate questionnaire. We compared blood stasis score and operational method, age, BMI, past operation history of abdominal and pelvic site, parity, whether adhesiolysis, oriental medicine intervention was done. For statistics, we used independent samples t-test, oneway analysis of variances(ANOVA) and SPSS version 13.0 for windows. Results: Blood stasis score of the subtotal hysterectomy group ($44.43{\pm}15.01$) is higher than that of the total hysterectomy group($39.04{\pm}12.46$). Blood stasis score under the age 40($51.88{\pm}12.68$) is higher than 40-49 age patients($40.34{\pm}14.24$) and over the age 50 patients($41.62{\pm}13.46$). There is no statistically significant difference between laparoscopic and abdominal trial, whether adhesiolysis, oriental medicine intervention was done, BMI, past operation history abdominal and pelvic site, parity, chief complaint before hysterectomy, oriental medicine intervention. Conclusion: Through the results showed, when traditional Korean medical doctors use static blood medication, history of hysterectomy and age should be considered as the history of subtotal hysterectomy and younger age tend to have a higher rate of a blood stasis pattern. We need a further study to develop blood stasis indicators with a validated questionnaire, and more subjects involved at multiple institutions.

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A Comparison of Butorphanol and Fentanyl Administered in Conjunction with Ketorojac in Intravenous Patient Controlled Analgesia after Total Abdominal Hysterectomy (복식 전자궁 절제술 후 통증 자가 조절 장치를 통하여 Ketorolac과 함께 투여한 Butorphanol과 Fentanyl의 비교)

  • Kim, Dong-Hee;Min, Hye-Ra
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.60-64
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    • 1998
  • Background: We compared butorphanol and fentanyl for opioids use in patient-controlled analgesia(PCA) with ketorolac to determine a suitable drug combination for postoperative pain control. Methods: Sixty patients were equally divided into 2 Groups. Group 1 (n=30) butorphanol 10 mg with ketorolac 180 mg; Group 2 (n=30) fentanyl 1 mg with ketorolac 180 mg, diluting 100 ml solutions intravenously via PCA pump after total abdominal hysterectomy under general anesthesia. Total infusion dosage of PCA drug, VAS pain scores, and side effects of both group were manitored. Results: Total infusion dosages were as follows: (Group 1) butorphanol 8.3 mg with ketorolac 149.7 mg; (Group 2) fentanyl $646.6\;{\mu}g$ with ketorolac 116.2 mg. The two groups showed similar pain scores auld side effects. Conclusions : Both butorphanol and fentanyl were effective for postoperative pain control using PCA pump, but butorphanol was more economical. The putative potency ratio of butorphanol to fantanyl was 12.8 : 1.

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A Clinical Study on Case 4, Hospitalized after Total Hysterectomy (자궁적출술 후 입원 관리를 한 환자 치험 4례)

  • Kim, Mi-Rim;Lim, Eun-Mee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.4
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    • pp.109-120
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    • 2014
  • Objectives: The purpose of this study is to report the effect of Korean medicine treatments on Postoperative symptoms. Methods: The patient was treated with herbal medicine, acupuncture and electronic moxibustion. The efficacy of treatment was evaluated with visual analogue scale (VAS), the degree of symptom relief and presence or absence of symptoms. Results: After hospital care with korean medicine treatments, symptoms such as fatigue, lower abdominal pain, thirst, hot flush, cold hypersensitivity of hands and feet and tinnitus were disappeared. Conclusions: To promote physical strength and reduction of fatigue, intensive hospital care with korean medicine treatment seems to be effective. After discharge, continued outpatient treatment for complications of surgery and menopausal disorder seems to contribute to quality of life and satisfaction for patient who undergoing hysterectomy.

A Clinical Study of Uterine Myoma Cases For Total Abdominal Hysterectomy(TAH) (자궁근종에 의한 전자궁적출술 적응증 환자의 보존적 한방치료 증례)

  • Jung, Min-Yung;Sohn, Young-Joo
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.4
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    • pp.256-268
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    • 2006
  • Purpose : The purpose of this study was to investigate the clinical application of Traditional Korean Medicine(TKM) treatment to uterine myoma for TAH. Methods : Two patients were diagonosed as uterine myoma for TAH in other Obstetrics & Gynecology hospital. They were treated by herbal medicine with each diagonosis in our hospital, and the first case was also treated by acupuncture, moxibustion and herbal acupuncture. Results : After TKM, the uterine myoma size of the first case was reduced($12.2^{\ast}7.3cm{\to}9^{\ast}7cm$) significantly. And all the symptom of uterine myoma, Gonadotropin-releasing hormone(Gn-RH)'s side effects were improved. The metrorrhagia of the second case was stopped, and was not repeated during six month. The second symptoms of metrorrhagia were improved. So, the two cases don't need to have a TAH. Conclusion : The results indicate that TKM can be effective for the management of uterine myoma for TAH without operation. Further study will be investigated in TKM for healing uterine myoma for TAH completely.

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Small Bowel Strangulation after Free TRAM Breast Reconstruction in Post-hysterectomy Patient: A Case Report (전자궁적출술을 시행받은 환자에서 횡복직근 유리피판을 이용한 유방재건술 후 발생한 소장 교액의 증례)

  • Kim, Min-Ho;Jin, Ung-Sik;Myung, Yu-Jin;Chang, Hak;Minn, Kyung-Won
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.531-534
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    • 2011
  • Purpose: The rectus abdominis myocutaneous flap is currently the most commonly used donor site of immediate and delayed breast reconstruction surgery, for its versatility and ease of handling, as well as sufficient blood supply. Despite many advantages of rectus abdominis flap, morbidity of donor site is considered as inevitable shortcoming. The authors recently faced a devastating complication, small bowel obstruction that led to strangulation, after delayed breast reconstruction with free transverses rectus abdominis myocutaneous (TRAM) flap. And we would like to report it, because abdominal pain after TRAM flap is a common symptom and can be overlooked easily. Methods: A 56-year-old female patient who had history of receiving total abdominal hysterectomy 20 years ago underwent delayed breast reconstruction with TRAM flap transfer. She complained abdominal discomfort and pain from third postoperative day, postoperative small bowel obstruction that arose from strangulated bowel and prompt emergency operation was done. Results: After resection of the strangulated bowel and reanastomosis, quickly her symptoms were relieved, and there were no further problems during her hospital stay. 7 days after her emergency operation she was discharged. Conclusion: In patients with previous abdominal surgical history, prolonged ileus can lead to bowel strangulation, so surgeons should always consider the possibility, and must be aware of abdominal symptoms in patients who receive free TRAM flap operations.

A Survey on Post Gynecology Surgery Patient in Oriental-Western Cooperative Medicine (부인과 수술 후 한방 입원치료 환자에 대한 분석)

  • Lee, Seung-Hwan;Lee, In-Sun;Cho, Hye-Sook;Bae, Geung-Mee;Kim, Chul;Park, Sung-Hwan
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.4
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    • pp.157-172
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    • 2009
  • Purpose: The purpose of this study is to analyze the status of cooperative treatment of western-oriental medicine in post gynecological surgery. Methods: This study is conducted by investigating the hospitalized patient's medical chart and OCS dated from March 2008 to May 2009 in obstetrics and gynecology of oriental medicine department in Dong-Eui medical center. The total patient number was 58. Results: Out of 58 women, 74.1% complained abdominal pain and discomfort, 24.1% complained headache and dizziness, 22.4% complained lumbago, 22.4% complained lethargy and fatigue. There were 63.8% women in the age group between 41 to 50 and 20.7% women in the age group between 31 to 40. 53.4% women hospitalized for less than 7 days, 43.1% women hospitalized for 8 to 14 days. 53.4% had uterine myoma, 20.7% had more than two types of complex diseases and 19.0% had adenomyosis uterine. 60.3% had total hysterectomy and 27.6% had simple hysterectomy. 64.9% had abdominal surgery, 17.5% had laparoscope surgery and 15.8% had hysteroscope surgery. 62.8% of 43 women complained abdominal pain and discomfort, 78.6% of 14 women complained headache and dizziness, 46.2% of 13 women complained lumbago, 84.6% of 13 women complained lethargy and fatigue improved to VAS 0-3. Conclusion: The results has shown that it is necessary to have cooperative treatment of both western-oriental medicine for the effective treatment in managing post gynecological surgery. The further study in data collection and manual development is needed.

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