1
|
Lee JH, Doo AR, Oh H, Lee H, Ko S. Relationship between intraoperative requirement for anesthetics and postoperative analgesic consumption in laparoscopic colectomy: a randomized controlled double-blinded study. Anesth Pain Med (Seoul) 2024; 19:117-124. [PMID: 38725166 PMCID: PMC11089298 DOI: 10.17085/apm.23146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 05/15/2024] Open
Abstract
BACKGROUND This study investigated the relationship between intraoperative requirement for an inhalational anesthetic (sevoflurane) or an opioid (remifentanil) and postoperative analgesic consumption. METHODS The study included 200 adult patients undergoing elective laparoscopic colectomy. In the sevoflurane group, the effect-site concentration of remifentanil was fixed at 1.0 ng/ml, while the inspiratory sevoflurane concentration was adjusted to maintain an appropriate anesthetic depth. In the remifentanil group, the end-expiratory sevoflurane concentration was fixed at 1.0 vol.%, and the remifentanil concentration was adjusted. Pain scores and cumulative postoperative analgesic consumptions were evaluated at 2, 6, 24, and 48 h after surgery. RESULTS Average end-tidal concentration of sevoflurane and effect-site concentration of remifentanil were 2.0 ± 0.4 vol.% and 3.9 ± 1.4 ng/ml in the sevoflurane and remifentanil groups, respectively. Cumulative postoperative analgesic consumption at 48 h postoperatively was 55 ± 26 ml in the sevoflurane group and 57 ± 33 ml in the remifentanil group. In the remifentanil group, the postoperative cumulative analgesic consumptions at 2 and 6 h were positively correlated with intraoperative remifentanil requirements (2 h: r = 0.36, P < 0.001; 6 h: r = 0.38, P < 0.001). However, there was no significant correlation in the sevoflurane group (r = 0.04, P = 0.691). CONCLUSIONS The amount of intraoperative requirement of short acting opioid, remifentanil, is correlated with postoperative analgesic consumption within postoperative 6 h. It may be contributed by the development of acute opioid tolerance. However, intraoperative sevoflurane requirement had no effect on postoperative analgesic consumption.
Collapse
Affiliation(s)
- Jun Ho Lee
- Department of Anesthesiology and Pain Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - A Ram Doo
- Department of Anesthesiology and Pain Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Hyunji Oh
- Department of Anesthesiology and Pain Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Hyungun Lee
- Department of Anesthesiology and Pain Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Seonghoon Ko
- Department of Anesthesiology and Pain Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| |
Collapse
|
2
|
Declas E, Verdun S, Fauconnier A, Lucot JP. Risk factors for postoperative pain after cystocele repair with mesh. Int Urogynecol J 2023; 34:771-775. [PMID: 36063194 DOI: 10.1007/s00192-022-05285-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Prolapse is a common condition seen in women and its therapeutical management consists first and foremost of surgery. Postoperative pain is one of the most common side effects seen after surgery. The objective of this study was to identify risk factors for postoperative pain after cystocele repair with mesh. METHODS This is a secondary analysis of the multicenter randomized trial PROSPERE, which compared cystocele repair with mesh according to the vaginal or laparoscopic approach. The presence of postoperative pain was assessed by a pain-specific self-reported questionnaire (Questionnaire de Baudelocque). The statistical analysis is based on the Wilcoxon, Chi-squared, and Fisher's tests. RESULTS The prevalence of postoperative pain (pain persisting more than 6 months) was 39% (80 out of 205, 95% CI 32.4-46.1), with 6.3% (13 out of 205) of chronic pain reports. Preoperative pain was the only statistically significant risk factor OR = 2.32 (p = 0,007; 95% CI 1.24-4.36). CONCLUSIONS Surgeons must be careful with preoperative painful prolapse and should inform their patient of the risk of developing postoperative chronic pain.
Collapse
Affiliation(s)
- E Declas
- Obstetrics and Gynecology Department, Saint Vincent de Paul Hospital, Groupe des hôpitaux de l'institut catholique de Lille (GHICL), Boulevard de Belfort, 59000, Lille, France.
| | - S Verdun
- Lille Catholic hospitals, Biostatistics Department-Delegation for Clinical Research and Innovation, Lille Catholic University, Lille, France
| | - A Fauconnier
- Department of Gynecology and Obstetrics, Intercommunal Hospital Centre of Poissy-Saint-Germain-en-Laye, 10 rue du Champ Gaillard, BP 3082, 78300, Poissy Cedex, France
| | - J P Lucot
- Obstetrics and Gynecology Department, Saint Vincent de Paul Hospital, Groupe des hôpitaux de l'institut catholique de Lille (GHICL), Boulevard de Belfort, 59000, Lille, France
| |
Collapse
|
3
|
Hemodynamic stability during menstrual cycle in women undergoing elective surgery. Ann Med Surg (Lond) 2022; 82:104649. [PMID: 36268358 PMCID: PMC9577651 DOI: 10.1016/j.amsu.2022.104649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/05/2022] [Accepted: 09/10/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Hemodynamic changes occur in almost one-third of patients undergoing spinal anesthesia, which are likely to effect vital organ. The aim of this study is to determine the hemodynamic effect of spinal anesthesia during different phases of menstrual cycle. Methods This is a descriptive cross-sectional study, two hundred and seventy-three patients who underwent spinal anesthesia for elective surgery were enrolled in this study. Of all the patients, 141 patients were in the luteal phase and 132 patients were in the follicular phase of their menstrual cycle. Analytical epidemiological study was conducted using questionnaires. Blood pressure and heart rate of patients before, immediately after, and 1 h after spinal anesthesia were recorded, and the data were analyzed using SPSS software. Results In the follicular phase before anesthesia, systolic blood pressure (SBP) was 127.5 ± 3.9, diastolic blood pressure (DBP) was 80.3 ± 6.2 mmHg and heart rate (HR) was 82.0 ± 8.5bpm, while, immediately after the induction of anesthesia following recordings were measured; 109.7 ± 9.13, 71.8 ± 2.8 mmHg and 70.0 ± 8.10bpm, respectively. In the luteal phase, it was 126.9 ± 3.12, 81.6 ± 9.3 mmHg and 80.2 ± 4.4bpm, and 122.0 ± 9.12, 78.6 ± 8.5 mmHg and 75.9 ± 6.5bpm respectively before and immediately after anesthesia, these changes in the menstrual phase was significant (P < 0.001). In the follicular phase an hour after spinal anesthesia, the mean SBP was 100.3 ± 3.9, DBP was 71.2 ± 7.5, MAP was 87.0 ± 4.7 mmHg and HR 67.5 ± 5.7bpm and following was seen in luteal phase; 115.4 ± 1.8, 75.9 ± 2.3, 97.3 ± 3.5 mm Hg and 74.0 ± 7.4bpm, respectively. These values were significantly lower in the follicular phase (P < 0.001). Conclusion Spinal anesthesia in the luteal phase as compared to the follicular phase of the menstrual cycle shows less variation in hemodynamic parameters. Hemodynamic changes occur in almost one-third of patients undergoing spinal anesthesia. Spinal anesthesia in the luteal phase as compared to the follicular phase of the menstrual cycle. Our study did not measure the levels of progesterone and estrogen. Comparative studies including women with circulatory abnormalities, preoperative and postoperative analysis.
Collapse
|
4
|
Hashemiyazdi SH, Masoudifar M, Rahimi Z, Honarmand A, Aryafar M. Comparative study of the effect of two different doses of remifentanil on bleeding control in lumbar fusion surgery: A randomized clinical trial. Ann Med Surg (Lond) 2022; 82:104761. [PMID: 36268379 PMCID: PMC9577819 DOI: 10.1016/j.amsu.2022.104761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/12/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Spinal fusion surgery completely prevents movement or friction between the two vertebrae. Remifentanil, a selective drug agonist, suppresses and decreases the vasomotor system upon release of histamine. In this study, the efficacy of remifentanil infusion at doses of 0.1 and 0.3 μg/kg/min in the control of low blood pressure was compared. Methods In this randomized clinical trial, 110 candidates for selective spinal fusion surgery were entered and randomized into 2 groups. The first group received 0.1 μg/kg/min and in the second group 0.3 μg/kg/min remifentanil. The systolic and diastolic blood pressure, pulse rate, SPO2, and surgeon's satisfaction were measured and compared between groups. Results the systolic blood pressure was significantly lower in patients receiving 0.3 μg of remifentanil by the time 30, 45, 60, and 90 min during the surgeries (P < 0.05). No significant difference was observed in terms of PR (P = 0.19) and SPO2 (P = 0.41) between the two groups. We also observed significantly higher duration of surgeries (P = 0.002), duration of anesthesia (P = 0.009), significantly higher bleeding volume (P < 0.001), higher fluid intake (P = 0.01) and higher transfused blood (P = 0.01) in patients that received 0.1 μg remifentanil compared to other patients. Conclusion Here we showed that administration of 0.3 μg/kg/min remifentanil was associated with significantly lower systolic blood pressure during the surgeries. On the other hand, patients that received 0.1 μg/kg/min remifentanil had significantly higher duration of surgeries, duration of anesthesia, significantly higher bleeding volume, higher fluid intake, and also higher transfused blood. Spinal fusion surgery completely prevents movement or friction between the two vertebrae. Remifentanil, a selective drug agonist, suppresses and decreases the vasomotor system. 0.3 μg/kg/min remifentanil was associated with significantly lower systolic blood pressure. Patients that received 0.1 μg/kg/min remifentanil had significantly higher duration of surgeries.
Collapse
Affiliation(s)
- Seyedeh Hamideh Hashemiyazdi
- Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Anesthesiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mehrdad Masoudifar
- Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Rahimi
- Department of Anesthesiology, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azim Honarmand
- Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohamad Aryafar
- Department of Anesthesiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Corresponding author. Islamic Azad University, Tehran, Iran.
| |
Collapse
|
5
|
Ahmadinejad M, Ahmadinejad I, Maghsoudi LH, Soltanian A, Safari M. Complications in Patients with Cardiac Penetrating Trauma. Cardiovasc Hematol Disord Drug Targets 2021; 21:212-216. [PMID: 34906065 DOI: 10.2174/1871529x21666211214155349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/15/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cardiac penetrating trauma is a medical emergency that mostly affects young people. Based on the type of injury and associated complications, it can present as a surgical challenge and can lead to mortality. OBJECTIVE The aim of this study is to evaluate the complications of penetrating heart trauma among patients referred to Shahid Madani Hospital. METHODS In this retrospective descriptive study, the data of penetrating cardiac trauma patients referred to Shahid Madani hospital, Karaj, Tehran, from 2016-2019, were investigated. Information, including age, sex, cause of trauma, traumatized area and complications, was extracted and recorded in a data collection form. The data were evaluated statistically using SPSS v18. RESULTS A total of 44 patients were included in the study, where the mean age of the patients was 25 years. 73.3% of these patients were men and 26.7% were women. Knife stab wounds were the most prevalent cause of the trauma, present in 93.3% of patients. 73.3% of the patients had cardiac tamponade and 20% had a pneumothorax. The right ventricle was the most common site of the injury in 46.7% of the patients. A mortality rate of 3.4% was reported in this study. CONCLUSION The results of this study showed that the highest penetrating heart rate trauma occurred among young people, and the most common cause of the trauma was a knife stab. The most common area of the injury was the right ventricular, and cardiac tamponade was the most common complication.
Collapse
Affiliation(s)
- Mojtaba Ahmadinejad
- Department of Surgery, School of Medicine, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj. Iran
| | | | - Leila Haji Maghsoudi
- Department of Surgery, School of Medicine, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj. Iran
| | - Ali Soltanian
- Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj. Iran
| | - Mehdi Safari
- Student Research Committee, Alborz University of Medical Sciences, Karaj. Iran
| |
Collapse
|
6
|
Medina-Diaz-Cortés G, Brancaccio-Pérez IV, Esparza-Estrada I, Barbosa-Camacho FJ, Fuentes-Orozco C, González-Hernández PG, Chejfec-Ciociano JM, Ramírez-Sánchez MV, Sánchez-López VA, Cortés-Flores AO, Álvarez-Villaseñor AS, Chávez-Tostado M, Cervantes-Pérez E, Cervantes-Guevara G, Cervantes-Cardona GA, González-Ojeda A. Differences in Postoperative Pain, Nausea, and Vomiting After Elective Laparoscopic Cholecystectomy in Premenopausal and Postmenopausal Mexican Women. World J Surg 2021; 46:356-361. [PMID: 34731260 DOI: 10.1007/s00268-021-06367-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Postoperative symptoms and pain after laparoscopic cholecystectomy (LC) are common in women. However, there is no evidence of differences in incidence and severity among different age groups. We evaluated whether adverse postoperative symptoms were more common in younger than in older women after LC. METHODS One hundred and fifty premenopausal (mean age 37.6 ± 3.6 y) and 145 postmenopausal women (59 ± 5.2 y) were included in this retrospective cohort study. Clinical and anthropometric parameters were analyzed. Study endpoints were the incidences of postoperative nausea and vomiting (PONV) and pain, and the additional analgesics and antiemetics needed after surgery. RESULTS Body mass index was normal in 42.7% of patients in the younger group and 64.8% in the older group (P < 0.001). Reported pain was more frequent and intense in the younger group throughout the study period (P < 0.01). Additional narcotics were required in 18% of premenopausal versus 7.6% of postmenopausal women (P = 0.001), and the doses used to reduce pain were higher for premenopausal women (P = 0.02). PONV was more frequent in the younger group at 1 and 6 h after surgery (P < 0.005). Rescue antiemetics were required in 29 premenopausal and 13 postmenopausal women (P = 0.01). Hospital stay was shorter for the older patients (P = 0.01). Minor morbidity was observed in both groups (0.7% and 2.1%). There was no mortality. CONCLUSIONS Early PONV and pain after LC were more frequent in premenopausal women, who also required more rescue analgesic and antiemetic medication.
Collapse
Affiliation(s)
- Guillermo Medina-Diaz-Cortés
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Irma Valeria Brancaccio-Pérez
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Isaac Esparza-Estrada
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Francisco José Barbosa-Camacho
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Clotilde Fuentes-Orozco
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Paola Guadalupe González-Hernández
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Jonathan Matías Chejfec-Ciociano
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Marco Vinicio Ramírez-Sánchez
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Veronica Alexandra Sánchez-López
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Ana Olivia Cortés-Flores
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Andrea Socorro Álvarez-Villaseñor
- Medical Auxiliary Coordination of Health Research, Mexican Institute of Social Security, Calle Francisco I. Madero 315, 23020, La Paz, Baja California Sur, Mexico
| | - Mariana Chávez-Tostado
- Department of Human Reproduction, Health Sciences University Center, Universidad de Guadalajara, Calle Hospital 320, 44280, Guadalajara, Jalisco, Mexico
| | - Enrique Cervantes-Pérez
- Department of Internal Medicine, Hospital Civil de Guadalajara Fray Antonio Alcalde, Calle Hospital 278, 44280, Guadalajara, Jalisco, Mexico
| | - Gabino Cervantes-Guevara
- Department of Welfare and Sustainable Development, University Center of the North, University of Guadalajara, Carretera Federal 23, Km 191, 46200, Colotlán, Jalisco, Mexico
| | - Guillermo Alonso Cervantes-Cardona
- Department of Philosophical, Methodological and Instrumental Disciplines, Health Sciences University Center, University of Guadalajara, Sierra Mojada 950, 44340, Guadalajara, Jalisco, Mexico
| | - Alejandro González-Ojeda
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico.
| |
Collapse
|
7
|
Beiranvand S, Karimi A, Vahabi S, Amin-Bidokhti A. Comparison of the Mean Minimum Dose of Bolus Oxytocin for Proper Uterine Contraction during Cesarean Section. ACTA ACUST UNITED AC 2020; 14:208-213. [PMID: 31124424 DOI: 10.2174/1574884714666190524100214] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/02/2019] [Accepted: 05/26/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cesarean section is the most common midwifery operation. The aim of this study is to determine the mean minimum dose of bolus oxytocin for proper uterine contraction during cesarean section. METHODS Patients were divided into two groups: elective cesarean section (n=41) and cesarean section due to difficulty in labor (n=42 patients). Patients underwent spinal anesthesia and oxytocin infusion was begun at 30 drops per minute (20 units of oxytocin per 1000 cc serum), and was also administered as a half-dose in cc to achieve effective contraction of the uterus. Meanwhile, the information of patients including systolic and diastolic blood pressure (SBP and DBP), heart rate and amount of bleeding during the operation was recorded in a questionnaire. RESULTS In the elective cesarean section group, the average SBP was about 117.10mmHg, average DBP 70.50 mmHg, the amount of bleeding during surgery was 623.63mL, and heart rate was 88.88bpm. In the cesarean section group due to difficulty in labor progress, SBP was 113.5 mmHg, DBP 62.69 mmHg, and bleeding was 573.81mL. In addition, 9 patients in the elective group and 3 patients in the lack of progress group, did not require bolus oxytocin. In the lack of a progress group, 8 patients needed more than 5 doses of oxytocin. In addition, about 10 (12%) of all patients had no side effects, and hypotension. CONCLUSION Given that, the minimum effective dose of oxytocin in the elective cesarean section was 1IU, and in those in labor progress was 1-1.5IU, less oxytocin administration represents lesser side effects. It is recommended that patients who are candidates of cesarean section should be administered 1.5IU of oxytocin in the form of bolus.
Collapse
Affiliation(s)
- Siavash Beiranvand
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Arash Karimi
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Sepideh Vahabi
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Arash Amin-Bidokhti
- Department of Cardiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| |
Collapse
|
8
|
Shao Y, Fu YX, Wang QF, Cheng ZQ, Zhang GY, Hu SY. Khubchandani’s procedure combined with stapled posterior rectal wall resection for rectocele. World J Gastroenterol 2019; 25:1421-1431. [PMID: 30918434 PMCID: PMC6429338 DOI: 10.3748/wjg.v25.i11.1421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 02/17/2019] [Accepted: 02/23/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obstructed defecation syndrome (ODS) is a widespread disease in the world. Rectocele is the most common cause of ODS in females. Multiple procedures have been performed to treat rectocele and no procedure has been accepted as the gold-standard procedure. Stapled transanal rectal resection (STARR) has been widely used. However, there are still some disadvantages in this procedure and its effectiveness in anterior wall repair is doubtful. Therefore, new procedures are expected to further improve the treatment of rectocele.
AIM To evaluate the efficacy and safety of a novel rectocele repair combining Khubchandani’s procedure with stapled posterior rectal wall resection.
METHODS A cohort of 93 patients were recruited in our randomized clinical trial and were divided into two different groups in a randomized manner. Forty-two patients (group A) underwent Khubchandani’s procedure with stapled posterior rectal wall resection and 51 patients (group B) underwent the STARR procedure. Follow-up was performed at 1, 3, 6, and 12 mo after the operation. Preoperative and postoperative ODS scores and depth of rectocele, postoperative complications, blood loss, and hospital stay of each patient were documented. All data were analyzed statistically to evaluate the efficiency and safety of our procedure.
RESULTS In group A, 42 patients underwent Khubchandani’s procedure with stapled posterior rectal wall resection and 34 were followed until the final analysis. In group B, 51 patients underwent the STARR procedure and 37 were followed until the final analysis. Mean operative duration was 41.47 ± 6.43 min (group A) vs 39.24 ± 6.53 min (group B). Mean hospital stay was 3.15 ± 0.70 d (group A) vs 3.14 ± 0.54 d (group B). Mean blood loss was 10.91 ± 2.52 mL (group A) vs 10.14 ± 1.86 mL (group B). Mean ODS score in group A declined from 16.50 ± 2.06 before operation to 5.06 ± 1.07 one year after the operation, whereas in group B it was 17.11 ± 2.57 before operation and 6.03 ± 2.63 one year after the operation. Mean depth of rectocele decreased from 4.32 ± 0.96 cm (group A) vs 4.18 ± 0.95 cm (group B) preoperatively to 1.19 ± 0.43 cm (group A) vs 1.54 ± 0.82 cm (group B) one year after operation. No other serious complications, such as rectovaginal fistula, perianal sepsis, or deaths, were recorded. After 12 mo of follow-up, 30 patients’ (30/34, 88.2%) final outcomes were judged as effective and 4 (4/34, 11.8%) as moderate in group A, whereas in group B, 30 (30/37, 81.1%) patients’ outcomes were judged as effective, 5 (5/37, 13.5%) as moderate, and 2 (2/37, 5.4%) as poor.
CONCLUSION Khubchandani’s procedure combined with stapled posterior rectal wall resection is an effective, feasible, and safe procedure with minor trauma to rectocele.
Collapse
Affiliation(s)
- Yi Shao
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| | - Yong-Xing Fu
- Department of Neonatal Medicine, Yidu Central Hospital of Weifang, Weifang 262500, Shandong Province, China
| | - Qing-Fa Wang
- Department of Neonatal Medicine, Yidu Central Hospital of Weifang, Weifang 262500, Shandong Province, China
| | - Zhi-Qiang Cheng
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| | - Guang-Yong Zhang
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| | - San-Yuan Hu
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| |
Collapse
|
9
|
Jalili S, Rashtchi V. The Relationship between Menstrual Cycle Phases with Postoperative Nausea and Vomiting after Open Cholecystectomy Surgery. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2018. [DOI: 10.29252/pcnm.8.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
10
|
Abstract
This paper is the thirty-ninth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2016 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses.
Collapse
Affiliation(s)
- Richard J Bodnar
- Department of Psychology and CUNY Neuroscience Collaborative, Queens College, City University of New York, Flushing, NY 11367, United States.
| |
Collapse
|
11
|
Vahabi S, Rafieian Y, Abbas Zadeh A. The Effects of Intraoperative Esmolol Infusion on the Postoperative Pain and Hemodynamic Stability after Rhinoplasty. J INVEST SURG 2017; 31:82-88. [DOI: 10.1080/08941939.2016.1278288] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sepideh Vahabi
- Department of Anesthesiology, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | | |
Collapse
|
12
|
Nadri S, Mahmoudvand H, Vahabi S. Effect of magnesium sulfate on morphine activity retention to control pain after herniorrhaphy. Pain Manag 2017; 7:119-125. [DOI: 10.2217/pmt-2016-0038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: This research was carried out to compare magnesium sulfate (MgSO4) with isotonic saline in terms of pain control after herniorrhaphy. Patients & methods: A randomized double-blind study, in which the patients were blind to all. A total of 100 patients who were candidates of herniorrhaphy were randomized into two groups: experimental and control (50 patients in each). Anesthesia was induced with 20% of 4 cc of morphine. The experimental and control group received postoperative 20% of 2 cc MgSO4 in 2 cc of isotonic saline and 4 cc of isotonic saline, respectively. Result: The administration of postoperative morphine in control group 0.79 ± 1.48 mg was significantly higher to the experimental group 0.17 ± 0.63 mg during the first 24 h (p = 0.01). Conclusion: MgSO4 increased the potency of morphine thereby reducing the amount of postoperative pain killer needed.
Collapse
Affiliation(s)
- Sedigheh Nadri
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hormoz Mahmoudvand
- Department of Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Sepideh Vahabi
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| |
Collapse
|
13
|
Vahabi S, Eatemadi A. Nanoliposome encapsulated anesthetics for local anesthesia application. Biomed Pharmacother 2017; 86:1-7. [DOI: 10.1016/j.biopha.2016.11.137] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 11/28/2016] [Accepted: 11/28/2016] [Indexed: 12/14/2022] Open
|
14
|
Cheraghi M, Negahdari B, Daraee H, Eatemadi A. Heart targeted nanoliposomal/nanoparticles drug delivery: An updated review. Biomed Pharmacother 2017; 86:316-323. [DOI: 10.1016/j.biopha.2016.12.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/04/2016] [Accepted: 12/05/2016] [Indexed: 12/23/2022] Open
|
15
|
Namdari M, Eatemadi A, Soleimaninejad M, Hammed AT. A brief review on the application of nanoparticle enclosed herbal medicine for the treatment of infective endocarditis. Biomed Pharmacother 2017; 87:321-331. [PMID: 28064105 DOI: 10.1016/j.biopha.2016.12.099] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/13/2016] [Accepted: 12/22/2016] [Indexed: 12/18/2022] Open
Abstract
Herbal medicines have been routinely employed all over the world dated back from the ancient time and have been identified by patients and physicians for their excellent therapeutic value as they have lower adverse effects when compared with the modern medicines. Phytotherapeutics requires a scientific technique to deliver the active herbal extract in a controlled manner to avoid repeated administration and increase patient compliance. This can be reached by fabricating a novel drug delivery systems (NDDS) for herbal components. NDDSs does not only decrease the repeated dose to overcome ineffectiveness, but also help to increase potency by decreasing toxicity and elevating drug bioavailability. Nano-sized DDS of herbal drugs have a potential application for improving the activity and countering the problems related to herbal medicines. Hence, application of nanocarriers as an NDDS in the traditional herbal medicine system is important to treat more chronic diseases like infectious endocarditis.
Collapse
Affiliation(s)
- Mehrdad Namdari
- Department of Cardiology, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Ali Eatemadi
- Department of Medical Biotechnology, School of Medicine, Lorestan University of Medical Sciences, Khoramabad, Iran; Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran; Razi Herbal Medicine Research Center, Lorestan University of Medical Science, Khorramabad, Iran.
| | - Maryam Soleimaninejad
- Babol University of Medical Sciences, Babol, Iran; Student of Research Committee, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Aiyelabegan T Hammed
- Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
16
|
Vahabi S, Eatemadi A. Effects of anesthetic and analgesic techniques on cancer metastasis. Biomed Pharmacother 2016; 87:1-7. [PMID: 28040593 DOI: 10.1016/j.biopha.2016.12.073] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 12/11/2016] [Accepted: 12/19/2016] [Indexed: 12/16/2022] Open
Abstract
The rate of mortality and morbidity among cancer patients is at an alarming rate and its ratio of incidence is increasing as a result of its effects of metastasis and recurrence in its patients. Several factors including anesthetic agents and analgesia techniques have been identified as causative agents for cancer metastasis. In this mini-review, we will summarize some of the available effects of anesthetic and analgesic techniques on cancer metastasis as derived from experimental cell culture and live animal data and also form clinical studies.
Collapse
Affiliation(s)
- Sepideh Vahabi
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran; Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Eatemadi
- Department of Medical Biotechnology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran; Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
17
|
Phyto-anesthetics: A mini-review on herb–anesthesia drug interactions. Biomed Pharmacother 2016; 84:1885-1890. [DOI: 10.1016/j.biopha.2016.10.100] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 10/31/2016] [Accepted: 10/31/2016] [Indexed: 02/06/2023] Open
|