• Title/Summary/Keyword: Abdominal hysterectomy

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Comparative Study of Postoperative Analgesic Effect of IV-PCA According to Timing of Infusion in Patients with Total Abdominal Hysterectomy (자궁적출술 환자의 진통제 투여시작 시기에 따른 수술 후 통증호소 비교(IV-Patient Controlled Analgesia를 이용하여))

  • Park Jeong-Ok;Lee Pyung-Ae;Cho You-Sook;Park Mi-Mi;Kim Hye-Sook;Park Jee-Won;Min Sang-Kee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.9 no.2
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    • pp.323-334
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    • 2002
  • Purpose: This study was designed to verify preemptive effects of intravenous patient-controlled analgesia (IV-PCA) infusion on postoperative pain in women having a total abdominal hysterectomy. Method: The research design was a nonequivalent control group post test only design. The participants in this study were 50 women who were scheduled for a total abdominal hysterectomy at a University affiliated Hospital in Suwon, Korea. The subjects were divided into two groups. For the experimental group, IV-PCA infusion was started before the skin incision and for the control group. IV-PCA infusion was started after the skin was closed. Each group was evaluated in terms of pain score by the visual analogue scale (VAS) and the number of times they pushed the button for IV-PCA at postoperative hours 1, 2, 3, 6, 12, and 24. The data were collected from July 1 to December 10, 2001. Collected data was analyzed by SPSS/PC + program. Result: 1. There was no difference between the two groups, over six points for the number of times the control button for IV-PCA was used. Group differences and interaction effect were not significant. 2. There was no significant difference in pain scores between the two groups, over seven time points. A significant interaction effect was observed between groups and measurement Points in time. 3. There was a significant difference in the requirements for additional analgesia between the two groups, 32% of the control group received additional analgesia. Conclusion: Preemptive analgesics administration may have a better effect in relieving postoperative pain than the usual analgesic treatment which is started after surgery.

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Comparison of Quality of Pain Using Patient-Controlled Analgesia (PCA) after Total Abdominal Hysterectomy (TAH) (전자궁적출술후 통증자가조절장치 사용에 따른 통증점수 비교)

  • Lee, Jung-Koo;Park, Seok;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.253-257
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    • 1998
  • Background: The purpose of this study was to examine the extent and evaluation of pain after total abdominal hysterectomy (TAH) and to establish correlation between three types of pain; pain at rest, pain with movement and pain with coughing (maximum pain). Methods: The present study compared quality of pain during pain management in 48 patients undergoing TAH. Patients received i.v. meperidine as loading dose in the recovery room and PCA with nalbuphine 90 mg, ketorolac 180 mg, buprenorphine 0.9 mg, droperidol 5 mg, plasma solution A 28 ml for 3 days. The PCA device used was the Baxter infusor$^{(R)}$ (PCA module PC-19-55, 0.5 ml/hr basal rate, 15 minute lockout interval). Patients were then interviewed on Operative Day (OPD), Postoperative Day 1, 2, and 3 (POD 1, 2 and 3) to assess their pain on a visual analogue scale (VAS) of 0 (none) to 10 (worst imaginable). Results: The mean pain score at rest was 2.0 on OPD and decreased to 0.7 on POD 3. The mean pain score with movement was 3.2 on OPD and decreased to 1.6 on POD 3. The mean pain score with coughing was 4.2 on OPD and decreased to 2.2 on POD 3. Conclusions: Patients' experience of three types of postoperative pain emphasizes the need for more effective pain management.

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Effects of Music Listening on Anciety in Partients betore Undergoing Hyterectomy (음악청취가 자궁절제술전 환자의 불안에 미치는 효과)

  • Park, Hyun-Sook;Chio, Euy-Soon
    • Women's Health Nursing
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    • v.3 no.1
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    • pp.72-81
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    • 1997
  • The purpose of this study was to elucidate the effects of musical listening on anxiety in patients undergoing abdominal hysterectomy. On the basis of the research criterias, 46 patients were recruited from Kang-Nam St. Mary's Hospital in Seoul from October 1 to December 31, 1995. 20 patients of them were participated as the experimental group who received musical listening session with self-selected music tapes, while 26 patients as the control group who didn't receive that session. The musical listening sessions composed of 3 periods, the pre-operation evening, just before sleeping, the operation morning. There were no differences between two groups, in terms of age education, religion, the experience of operation, the perception of uterus, and the weight(%). The State-Trait Anxiety Inventory(STAI) was used to measure anxiety on all patients. And serum cortisol levels, fasting blood sugar levels, systolic and diastolic blood pressure were collected at the day before surgery and the operation day. The results were as follows : 1. There were no significant differences in State-Anxiety between the two groups. 2. The differences of serum cortisol level between the day before surgery and the operative day were significantly lower in experimental group than in control group(P=0.03). 3. The level of fasting blood sugar was significantly decreased in experimental group(P=0.01). 4. Systolic blood pressure level was significantly decreased in experimental group(P=0.02). While Diastolic blood pressure level was not significant between two groups. It is suggested imply that the musical listening during the perioperative period may alleviate the perioperative anxiety levels in patients undergoing abdominal hysterectomy.

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Effects of Preoperative Epidural Block with Low Dose Bupivacaine and Morphine on Postoperative Pain, Plasma Cortisol and Serum Glucose in Total Abdominal Hysterectomy (복식전자궁적출술에서 술전 저용량 국소마취제와 Morphine을 이용한 경막외차단이 술후통증, 혈장 Cortisol, 혈당에 미치는 영향)

  • Park, Han-Suk;Lee, Sung-Chul;Cha, Moon-Seok
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.21-26
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    • 1999
  • Background: Preoperative blocking of surgical nociceptive inputs may prevent sensitization of central nervous system (CNS) and reduce postoperative pain. The stress responses to surgical trauma consist of increase in catabolic hormones and decrease in anabolic hormones. We studied whether preoperative low dose epidural bupivacaine and morphine could affect postoperative pain, changes plasma cortisol, and serum glucose. Methods: Thirty patients undergoing total abdominal hysterectomy were randomly assigned to one of three groups. General anesthesia was induced in all patients and after that, epidural blocks were done except the control group (n=10) patients. Preoperative block group (n=10) received 0.5% bupivacaine 50 mg and morphine 2 mg epidurally as a bolus before operation and followed by 0.1% bupivacaine $5\;mghr^{-1}$ and morphine $0.2\;mghr^{-1}$ for 10 hours. Postoperative block group (n=10) received the same doses of bupivacaine and morphine under the same method postoperatively. Postoperative pain relief was provided with i.v. fentanyl through Patient-Controlled-Analgesia Pump. Postoperative pain by visual analogue scores (VAS), analgesic requirement (first requirement time, total amounts used), side effects, plasma cortisol level and serum glucose level were compared. Results: Until postoperative 6 hrs, VAS of control group was higher than those of the epidural groups. No difference was observed in VAS between the two epidural groups. First analgesics requirement time and total amounts of used analgesics were not different between the two epidural groups, but first analgesic requirement time of preoperative block group was significantly prolonged compared with control group. Plasma cortisol and serum glucose levels were not different among groups. Conclusions: Low dose preoperative epidural bupivacaine and morphine could not reduce postoperative pain, plasma cortisol level and serum glucose level compared with postoperative block group.

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Clinical Experience on Intravenous Patient Controlled Analgesia after Total Abdominal Hysterectomy (전자궁적출술후 시행한 정맥내 통증자가조절법의 임상 경험)

  • Kim, Yun-Hee;Choe, Huhn
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.54-58
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    • 1999
  • Background: We studied 150 patients who received intravenous patient controlled analgesia (PCA) after total abdominal hysterectomy to evaluate pain relief, analgesic consumption, patient's satisfaction and side effects. Methods: We made total 40 ml of analgesic mixture with morphine 40 mg, ketorolac 120 mg, droperidol 3 mg and normal saline. Loading/bolus/basal infusion dose and lockout interval was 2 ml, 1.5 ml, 0.5 ml/hr and 10 min, respectively. Numerical rating scale (NRS) pain score, cumulative analgesic consumption, degree of satisfaction, and incidence of side effects were evaluated. Also, correlation of age and edu ion with analgesic consumption were evaluated. Results: The average pain scores using NRS were $3.1{\pm}1.7$ (6 h), $2.1{\pm}1.5$ (24 h), $1.7{\pm}1.5$ (48 h). The average cumulative analgesic consumption were $11.7{\pm}5.0$ ml (6 h), $23.0{\pm}6.7$ ml (24 h), $32.1{\pm}3.7$ ml (48 h). The degree of satisfaction in postoperative pain control was good in 94% of patients. There was no correlation between degree of satisfaction and analgesic consumption. Also age and level of edu ion did not correlated with analgesic consumption. Conclusions: Intravenous PCA with morphine, ketorolac, and droperidol is an effective method of postoperative pain control because it provides adequate pain relief and a few side effects with high patient's satisfaction. However, age and level of education did not correlated with analgesic consumption.

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Clinical Study of Sobokchugeo-tang's Effects on 4 Cases of Complications of Post-hysterecomy (자궁절제술 후 후유증상을 소복축어탕을 중심으로 치료한 증례 보고)

  • Kim, Ji-Eun;Yang, Seung-Jeong;Cho, Seong-Hee;Park, Kyung-Mi;Song, U-Rim;Jung, Jung-Su
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.3
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    • pp.189-196
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    • 2014
  • Objectives: This study was reported to confirm the effect of Sobokchugeo-tang (SC) on complications of post-hysterecomy. Methods: Four women who were operated a hysterectomy within a month were enrolled in this study. They complained of abdominal pain, lumbago, both leg numbness, dizziness, etc. And received oriental treatments to decrease pain and improve the symptoms. Sobokchugeo-tang 3 times a day was prescribed, their complcation were decreased compared with first visit. Results: A hysterecomy can lead to comlications. They complained of various symptoms. After the treatment, abdominal pain, both leg numbness were rapidly decreased and lumbago, dizziness were improved too. Conclusions: These clinical cases indicated that sobokchugeo-tang was effective in the treatment of women who undertaken a hysterecomy.

Gestational Diabetes in a Yorkshire Terrier Dog (요크셔테리어종 개에서 발생한 임신성 당뇨병)

  • Yoon, Won-Kyoung;Suh, Sang-Il;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.32 no.2
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    • pp.180-182
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    • 2015
  • A 3 year-old pregnant female Yorkshire terrier dog was presented with major complaints of polyuria and polydipsia. Laboratory tests found persistent hyperglycemia and glucosuria. Abdominal ultrasound study found 2 dead fetuses. Ovarian hysterectomy was performed to remove the dead fetuses. After ovarian hysterectomy, the level of blood glucose was returned to normal range. In addition, the clinical signs and urine glucose were all disappeared. Based on findings on laboratory tests and follow-up study, the case was diagnosed as gestational diabetes mellitus. To our best knowledge, this is the first case report describing a gestational diabetes mellitus of dog in Korea.

A case of pelvic paragonimiasis combined with myoma uteri and pelvic inflammatory disease (자궁근종과 골반염에 동반된 골반내 폐흡충증 1례)

  • 이연희;박은희
    • Parasites, Hosts and Diseases
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    • v.31 no.3
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    • pp.295-297
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    • 1993
  • Pcrosonimr westermani is a lung fluke of humans that Is usually found in the lunes but may be fecund elsewhere in many unusual locations. A case of pelvic paragonimiasis was found incidentally by surgical intervention of inamatov disease and myoma uteri. She was a 51-year-old Korean woman complaining of lower abdominal pain and intermittent vaginal spotting. Numerous Porosonimus ova were observed in the reseated omentum in the pelvis after total abdominal hysterectomy. It is suggested that pelvic paragonimiasis may be one of causative agents of pelvic inflammatory disease.

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Accidental High Epidural Block -A case report- (우발성 고위경막외차단 경험 1예 -증례보고-)

  • Park, Jung-Goo;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.159-163
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    • 1995
  • Accidental high epidural block is a rare but serious complication. It can result from many factors, which include the volume and concentration of drug, posture, puncture site, age, pregnancy or intra-abdominal mass, and patients' height and weight. We had a case of accidental high epidural block recently. This is a case report which was confirmed by an epiduragram. A healthy 50-year-old woman with a huge uterine myoma was scheduled for a total abdominal hysterectomy under continous epidural analgesia. Epidural catheterization was carried out smoothly. However, an unexpected hypotension was noticed after an epidural injection of 2% lidocaine 25 ml. Thereafter, the patient was intubated and her respiration was controlled during the operation. Using the 5mg of ephedrine, her blood pressure and pulse were well maintained. The scheduled operation was carried out for one hour uneventfully, but after the operation, she felt paresthesia on her hands in the recovery room. To differentiate between the high epidural and the subdural blocks. We injected 5 ml of a water soluble Niopam 300 through the catheter postoperatively. It was observed on the epiduragram that the catheter was placed in the epidural space. It was suggested that the high epidural block was induced from the widespread diffusion through the narrowed epidural space due to the engorgement of the epidural venous plexus by the patient's huge uterine myoma.

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A Case Report : Complications of Chemotherapy after Curative Resection in Patient with Ovarian Carcinoma IV (근치적 절제술 시행한 난소암 환자에서 항암치료 후유증 치험 1례)

  • Lee, Ji-Hyun;Kim, Gun-Hee;Choi, Chang-Min
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.3
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    • pp.124-134
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    • 2014
  • Objectives: We designed this study to evaluate the effect of Korean medical treatment on complications of chemotherapy after curative resection in patient with ovarian carcinoma IV. Methods: The patient got total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) on 9/4 and received chemotherapy on 10/7, 10/28, 11/18. During this period, the patient suffered from anorexia, dyspepsia, nausea, weight loss and insomnia. We treated the patient with herbal medicine and acupuncture. The efficacy of treatment was evaluated with visual analog scale (Vas), weight and 36-item short form health survey instrument (SF-36). Results: After treatment, although the scale values went ups and downs according to chemotherapy schedule, abdominal pain Vas changed 7 to 0, weight changed 46 kg to 51 kg. Also, SF-36 scores increased. Conclusions: This case report shows that the Korean medical treatment is useful in the treatment of complications of chemotherapy after curative resection in patient with ovarian carcinoma IV.