1
|
Shim JW, Kwon H, Moon HW, Chae MS. Clinical Efficacy of 10 Min of Active Prewarming for Preserving Patient Body Temperature during Percutaneous Nephrolithotomy: A Prospective Randomized Controlled Trial. J Clin Med 2024; 13:1843. [PMID: 38610608 PMCID: PMC11012836 DOI: 10.3390/jcm13071843] [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: 02/07/2024] [Revised: 03/02/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Percutaneous nephrolithotomy (PNL) poses a risk of hypothermia. Additionally, general anesthesia lowers the thresholds for shivering and vasoconstriction, which leads to dysfunction of central thermoregulation. Perioperative hypothermia is associated with adverse outcomes after surgery. In this study, we aimed to demonstrate that prewarming for 10 min can effectively prevent early hypothermia during PNL. Methods: A total of 68 patients scheduled for elective PNL were recruited to this study from January to June 2022, but two patients were excluded because of a change in the surgical plan. After randomization, patients in the prewarming group (n = 32) received warming using a forced-air warming device for 10 min in the preoperative area before being transferred to the operating room, while the controls (n = 34) did not. The incidence of hypothermia within the first hour after inducing general anesthesia was the primary outcome. Perioperative body temperatures and postoperative recovery findings were also evaluated. Results: Early intraoperative hypothermia decreased significantly more in the prewarming group than in the control group (9.4% vs. 41.2%, p = 0.003). Moreover, the net decrease in core body temperature during surgery was smaller in the prewarming group than in the control group (0.2 °C, vs. 0.5 °C, p = 0.003). In addition, the prewarmed patients had a lower incidence of postoperative shivering and a shorter post-anesthesia-care unit (PACU) stay (12.5% vs. 35.3%, p = 0.031; and 46 vs. 50 min, p = 0.038, respectively). Conclusions: Prewarming for 10 min decreased early hypothermia, preserved intraoperative body temperature, and improved postoperative recovery in the PACU.
Collapse
Affiliation(s)
- Jung-Woo Shim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Hyejin Kwon
- Department of Anesthesiology and Pain Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Hyong Woo Moon
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Min Suk Chae
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| |
Collapse
|
2
|
Han J, Lee H. Control Volume Analysis of the Infusion Rate in Cephalic and Median Cubital Veins Based on Infusion Bag Height and Peripheral Venous Catheter Inner Diameter: Application of Bernoulli's Equation and Consideration of Frictional Forces. J Multidiscip Healthc 2023; 16:3609-3618. [PMID: 38034878 PMCID: PMC10684996 DOI: 10.2147/jmdh.s409050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Purpose This pilot study aimed to provide basic data on intravenous infusion nursing by analyzing the infusion rate in the cephalic and median cubital veins depending on the height of the infusion bag and inner diameter of the peripheral venous catheter (PVC). Methods While infusing 0.9% normal saline at 22 °C (room temperature) into elbow cephalic and median cubital veins, the infusion rate may be controlled by adjusting the fluid height and PVC diameter. To assess the validity of the laminar flow assumption, the study estimated the Reynolds number (Re) using the velocity obtained by applying Bernoulli's equation considering the friction coefficient. Results At a constant fluid height, the infusion rate increased with increasing PVC diameter. At a constant PVC diameter, the infusion rate increased with increasing fluid height. In a comparison between the cephalic and median cubital veins at constant fluid height and PVC diameter, the solution was infused at a higher rate into the cephalic vein, which was under lower venous pressure. Conclusion The analysis of the infusion rate according to fluid height and PVC diameter provided basic data on intravenous infusion nursing. The results are expected to provide evidence for the standardization of intravenous infusion nursing.
Collapse
Affiliation(s)
- Jeongwon Han
- College of Nursing Science, Kyung Hee University, Seoul, Republic of Korea
| | - Hanna Lee
- Department of Nursing, Gangneung-Wonju National University, Gangwon‑do, Republic of Korea
| |
Collapse
|
3
|
Optimal Intravenous Administration Procedure for Efficient Delivery of Canine Adipose-Derived Mesenchymal Stem Cells. Int J Mol Sci 2022; 23:ijms232314681. [PMID: 36499004 PMCID: PMC9740176 DOI: 10.3390/ijms232314681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022] Open
Abstract
Mesenchymal stem cells (MSC) are currently being investigated for their therapeutic applications in a wide range of diseases. Although many studies examined peripheral venous administration of MSC, few have investigated the detailed intravenous administration procedures of MSC from their preparation until they enter the body. The current study therefore aimed to explore the most efficient infusion procedure for MSC delivery by preparing and infusing them under various conditions. Canine adipose-derived mesenchymal stem cells (cADSC) were infused using different infusion apparatuses, suspension solutions, allogenic serum supplementation, infusion time and rates, and cell densities, respectively. Live and dead cell counts were then assessed by manual measurements and flow cytometry. Efficiency of live- and dead-cell infusion and cell viability were calculated from the measured cell counts and compared under each condition. Efficiency of live-cell infusion differed significantly according to the infusion apparatus, infusion rate, and combination of cell density and serum supplementation. Cell viability after infusion differed significantly between the infusion apparatuses. The optimal infusion procedure resulting in the highest cell delivery and viability involved suspending cADSC in normal saline supplemented with 5% allogenic serum at a density of 5 × 105 cells/mL, and infusing them using an automatic infusion device for 15 min. This procedure is therefore recommended as the standard procedure for the intravenous administration of ADSC in terms of cell-delivery efficiency.
Collapse
|
4
|
He Y, Feng YG, He J, Liang B, Jiang MD, Liu J, Kang YM, Ma LP, Zhang Q, Peng QJ, Yang T, Liu Y, Luo L, Zhang M. Effects of irrigation fluid temperature during flexible ureteroscopic holmium laser lithotripsy on postoperative fever and shivering: a randomized controlled trial. BMC Urol 2021; 21:72. [PMID: 33906652 PMCID: PMC8077842 DOI: 10.1186/s12894-021-00841-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 04/20/2021] [Indexed: 02/08/2023] Open
Abstract
Background Flexible ureteroscopic holmium laser lithotripsy is used to treat urinary tract calculi, but postoperative complications include shivering, fever and infection. To investigate the effects of irrigation fluid temperature on postoperative complications. Methods This randomized controlled trial included 120 consecutive patients undergoing flexible ureteroscopic holmium laser lithotripsy at the Urology Department, Suining Central Hospital, Sichuan, China between January 2017 and July 2019. Patients were randomized 1:1:1 into three groups (17 °C, 27 °C or 37 °C). Primary outcome was fever incidence (body temperature > 37.5 °C) within 48 h after surgery. Secondary outcomes included shivering incidence during recovery from anesthesia, white blood cell count (WBC), serum procalcitonin (PCT) and incidence of suspected infection (temperature > 38.5 °C and PCT > 0.5 µg/L). Results There were 108 patients, (17 °C group, n = 36; 27 °C group, n = 35; 37 °C group, n = 37), received flexible ureteroscopic holmium laser lithotripsy and analyzed. Age, gender distribution, body mass index, ASA grade, stone burden, preoperative creatinine, preoperative core temperature and irrigation fluid volume did not differ significantly between groups. 17 °C, 27 °C and 37 °C groups exhibited significant differences in the incidences of postoperative fever (38.9% vs. 17.1% vs. 13.5%) and shivering (22.2% vs. 5.7% vs. 2.7%) (p < 0.05 for all pairwise comparisons). There was no significant difference of WBC, PCT and incidence of suspected infection in 37 °C or 27 °C group compared with 17 °C group. One case each of flash pulmonary edema and bleeding occurred in 37 °C group. Conclusion Warming the irrigation fluid can reduce the incidence of postoperative fever and shivering, but further studies are needed to determine the optimal temperature. Trial registration The trial was registered at the Chinese Clinical Trials Registry and allocated as ChiCTR2000031683. The trial was registered on 07/04/2020 and this was a retrospective registration.
Collapse
Affiliation(s)
- Yue He
- Department of Urology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China. .,Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu City, 610041, Sichuan Province, People's Republic of China.
| | - You-Gang Feng
- Department of Urology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Jun He
- Department of Urology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Bo Liang
- Department of Urology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Ming-Dong Jiang
- Department of Urology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Jun Liu
- Department of Urology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Yong-Ming Kang
- Department of Urology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Li-Ping Ma
- Operation Room, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Qin Zhang
- Operation Room, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Qi-Jia Peng
- Operation Room, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Tao Yang
- Department of Urology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Yao Liu
- Operation Room, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Li Luo
- Department of Anesthesiology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| | - Min Zhang
- Department of Anesthesiology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China
| |
Collapse
|
5
|
Kapur S, Gruber A, Sekar H, Mafuta J, Lodhi W, Sivashanmugarajan V, Yoong W. Does temperature of distending medium matter in outpatient hysteroscopy? A double-blinded cohort control observational study of room temperature versus warmed saline. J Obstet Gynaecol Res 2020; 46:485-489. [PMID: 31991520 DOI: 10.1111/jog.14207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/13/2020] [Indexed: 11/29/2022]
Abstract
AIM There is little data assessing outcomes of outpatient hysteroscopy using warmed versus room temperature saline. The aim of this study was to determine if the temperature of the distending medium during outpatient hysteroscopy affect ease of procedure, clarity of view, procedural discomfort/pain and patient satisfaction. METHODS This was a double-blinded cohort control quasi-randomized prospective study involving 100 women undergoing outpatient diagnostic and operative hysteroscopy for abnormal uterine bleeding, intrauterine contraceptive devices retrieval and removal of endometrial polyps. Outpatient hysteroscopy was performed either with normal saline either at room temperature (control at 25°C) or warmed to body temperature (37°C). RESULTS Confounding variables such as age, parity, previous cervical surgery, previous vaginal births, menopausal status and indications for hysteroscopy were similar in the room temperature (n = 48) and warmed saline (n = 52) groups. Mean procedure duration (256 vs 233 s), ease of entry (Visual Analogue Scale [VAS] 9.55 vs 9.4) and the clarity of view (VAS 9.02 vs 9.3) were statistically similar in both groups (all P > 0.05) as was discomfort experienced during hysteroscopy (VAS 6.6/10 vs 6.8/10) and at 5 min post-procedure (VAS 4.2/10 vs 3.2/10) (both P > 0.05). The likelihood of recommending the procedure to a friend was similar in both groups (mean VAS 6.9/10 vs 7.2/10; P = 0.1). CONCLUSION The temperature of the distension medium did not influence ease of procedure, clarity of hysteroscopy view, procedural discomfort/pain and patient satisfaction. Patients were not any more likely to recommend the procedure to a friend in the warmed saline compared to the room temperature group.
Collapse
Affiliation(s)
- Shikha Kapur
- Department of Obstetrics and Gynecology, North Middlesex University Hospital, London, UK
| | - Amelia Gruber
- Department of Obstetrics and Gynecology, North Middlesex University Hospital, London, UK
| | - Hasviniya Sekar
- Department of Obstetrics and Gynecology, North Middlesex University Hospital, London, UK
| | - Joadel Mafuta
- Department of Obstetrics and Gynecology, North Middlesex University Hospital, London, UK
| | - Wasim Lodhi
- Department of Obstetrics and Gynecology, North Middlesex University Hospital, London, UK
| | | | - Wai Yoong
- Department of Obstetrics and Gynecology, North Middlesex University Hospital, London, UK
| |
Collapse
|
6
|
|
7
|
Prasanphanich AF, Johnson CT, Krasnopeyev A, Cantara S, Roach C, Gumber S, Chinnadurai R, Galipeau J, Brewster L, Prologo JD. Image-Guided Transarterial Directed Delivery of Human Mesenchymal Stem Cells for Targeted Gastrointestinal Therapies in a Swine Model. J Vasc Interv Radiol 2019; 30:1128-1134.e5. [PMID: 30852052 DOI: 10.1016/j.jvir.2018.09.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/18/2018] [Accepted: 09/28/2018] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To evaluate the feasibility of catheter-directed intra-arterial stem cell delivery of human mesenchymal stem cells (MSCs) to the small bowel in a porcine model. MATERIALS AND METHODS The cranial mesenteric artery of 6 Yucatan minipigs was selectively catheterized under fluoroscopic guidance following cut-down and carotid artery access. A proximal jejunal branch artery was selectively catheterized for directed delivery of embolic microspheres (100-300 μm) or MSCs (0.1-10 million cells). The pigs were euthanized after 4 hours and specimens collected from the proximal duodenum and the targeted segment of the jejunum. The Chiu/Park system for scoring intestinal ischemia was used to compare hematoxylin and eosin-stained sections of jejunum and duodenum. RESULTS Successful delivery of microspheres or MSCs in a proximal jejunal branch artery of the cranial mesenteric artery was achieved in all subjects. Radiopaque microspheres and post-delivery angiographic evidence of stasis in the targeted vessels were observed on fluoroscopy after delivery of embolics. Preserved blood flow was observed after MSC delivery in the targeted vessel. The Chiu/Park score for intestinal ischemia in the targeted proximal jejunal segments were similar for microspheres (4, 4; n = 2) and MSCs (4, 4, 4, 3; n = 4), indicating moderate ischemic effects that were greater than for control duodenal tissue (3, 1; 0, 0, 3, 3). CONCLUSIONS Selective arteriographic deployment of MSCs in swine is feasible for study of directed intestinal stem cell delivery. In this study, directed therapy resulted in intestinal ischemia.
Collapse
Affiliation(s)
- Adam F Prasanphanich
- Department of Radiology and Imaging Sciences, Emory University, 201 Dowman Drive, Atlanta, GA 30322
| | - Christopher T Johnson
- Department of Radiology and Imaging Sciences, Emory University, 201 Dowman Drive, Atlanta, GA 30322
| | - Andrey Krasnopeyev
- Division of Animal Resources, Emory University, 201 Dowman Drive, Atlanta, GA 30322
| | - Shraddha Cantara
- Division of Animal Resources, Emory University, 201 Dowman Drive, Atlanta, GA 30322
| | - Cristin Roach
- Division of Animal Resources, Emory University, 201 Dowman Drive, Atlanta, GA 30322
| | - Sanjeev Gumber
- Department of Pathology and Laboratory Medicine, Emory University, 201 Dowman Drive, Atlanta, GA 30322
| | | | - Jacques Galipeau
- Department of Medicine, University of Wisconsin, Madison, Wisconsin
| | - Luke Brewster
- Department of Surgery, Emory University, 201 Dowman Drive, Atlanta, GA 30322
| | - J David Prologo
- Department of Radiology and Imaging Sciences, Emory University, 201 Dowman Drive, Atlanta, GA 30322.
| |
Collapse
|
8
|
Zhang R, Chen X, Xiao Y. The effects of a forced-air warming system plus electric blanket for elderly patients undergoing transurethral resection of the prostate: A randomized controlled trial. Medicine (Baltimore) 2018; 97:e13119. [PMID: 30407328 PMCID: PMC6250554 DOI: 10.1097/md.0000000000013119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Perioperative inadvertent hypothermia in elderly urology patients undergoing transurethral resection of the prostate (TURP) is a well-known serious complication, as it increases the risk of myocardial ischemia, blood loss, and surgical wound infection. We conducted this prospective randomized controlled trial to evaluate the combined effect of a forced-air warming system and electric blanket in elderly TURP patients. METHODS Between January 2015 and October 2017, we recruited 443 elderly male patients undergoing elective TURP with subarachnoid blockade (SAB). These were randomly divided into 3 groups: group E (intraoperative warming using electric blankets set to 38°C; n = 128); group F (intraoperative warming using a forced-air warmer set to 38°C; n = 155) and group FE (intraoperative warming using a forced-air warmer plus electric blankets, both set to 38°C; n = 160). The primary outcome was shivering and their grades. Hemodynamic changes, esophageal temperature, recovery time, incidences of adverse effects, and patient and surgeon satisfaction were also recorded. RESULTS Baseline characteristics showed no significant differences when compared across the 3 groups (P >.05). Compared with groups E and F, both HR and mean arterial pressure (MAP) in group FE were significantly decreased from T6 to T10 (P <.05). Compared with groups E and F, esophageal temperature in group FE increased significantly from T5 to T10 (P <.05). Compared with group E, esophageal temperature in group F was significantly increased from T5 to T10 (P <.05). Compared with groups F and FE, post-anesthesia care unit (PACU) recovery time was longer in group E, while compared with group F, PACU recovery time was shorter in group FE (P <.05). Compared to patients in groups E and F, those in group FE had a significantly lower incidence of arrhythmia and shivering (P <.05). The number of patients with shivering grades 0 to 3 was higher in group E than in other groups, while the number of patients with shivering grade 2 was significantly higher in group F than in group FE (P <.05). Patient and surgeon satisfaction scores were higher in group FE than in groups E and F (P <.05). CONCLUSIONS Use of a forced-air warming system combined with an electric blanket was an effective method with which to retain warmth among elderly TURP patients.
Collapse
|
9
|
Singh R, Asthana V, Sharma JP, Lal S. Effect of irrigation fluid temperature on core temperature and hemodynamic changes in transurethral resection of prostate under spinal anesthesia. Anesth Essays Res 2015; 8:209-15. [PMID: 25886228 PMCID: PMC4173604 DOI: 10.4103/0259-1162.134508] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Hypothermia is a frequent observation in elderly males undergoing transurethral resection of prostate (TURP) under spinal anesthesia. The use of irrigating fluids at room temperature results in a decrease body temperature. Warmed irrigating solutions have shown to reduce heat loss and the resultant shivering. Such investigation was not much tried in low resource settings. Aim: To compare the resultant change in core temperature and hemodynamic changes among patients undergoing TURP surgery under spinal anesthesia using warm and room temperature irrigation fluids. Settings and Design: Randomized prospective study at a tertiary care center. Methods: This study was conducted on 40 male patients aged 50-85 years undergoing TURP under spinal anesthesia. Of which, 20 patients received irrigation fluid at room temperature 21°C and 20 patients received irrigation fluid at 37°C after random allocation. Core temperatures and hemodynamic parameters were assessed in all patients at preoperative, intra-operative, and postoperative periods. Intra-operative shivering was also noted in both groups. Statistical Analysis: Unpaired and Paired Student's t-test. Results: For patients who underwent irrigation with fluid at room temperature Core temperature drop from 36.97°C in preoperative to 34.54°C in postoperative period with an effective difference of 2.38°C. Among patients who received warmed irrigation fluid at 37°C had core temperature drop from 36.97°C to 36.17°C and the effect of fall was 0.8°C. This difference was statistically significant (P < 0.001). Shivering of Grades 1 and 2 was observed in nine patients, of Group 1 while only three patients had Grades 1 and 2 shivering in Group 2. The hemodynamic parameters were similar in the two groups and did not reach significant difference. Conclusion: Use of warm irrigation fluid during TURP reduces the risk of perioperative hypothermia and shivering.
Collapse
Affiliation(s)
- Rajeev Singh
- Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Veena Asthana
- Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Jagdish P Sharma
- Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Shobha Lal
- Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| |
Collapse
|
10
|
Abstract
Hysteroscopic surgery is pivotal in management of many gynecological pathologies. The skills required for performing advanced hysteroscopic surgery (AHS), eg, transcervical hysteroscopic endometrial resection (TCRE), hysteroscopic polypectomy and myomectomy in the management of menorrhagia, hysteroscopic septulysis in fertility-related gynecological problems and hysteroscopic removal of chronically retained products of conception and excision of intramural ectopic pregnancy ought to be practiced by contemporary gynecological surgeons in their day-to-day clinical practice. AHS is a minimally invasive procedure that preserves the uterus in most cases. Whilst the outcome is of paramount importance, proper training should be adopted and followed through so that doctors, nurses, and institutions may deliver the highest standard of patient care.
Collapse
Affiliation(s)
- Mark M Erian
- Teaching and Research Department, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Glenda R McLaren
- University of Queensland and Mater Mothers Hospital, Brisbane, Australia
| | | |
Collapse
|
11
|
Identifying Predictors of Unacceptable Pain at Office Hysteroscopy. J Minim Invasive Gynecol 2014; 21:586-91. [DOI: 10.1016/j.jmig.2013.12.118] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 12/02/2013] [Accepted: 12/16/2013] [Indexed: 11/21/2022]
|
12
|
Reversible myoclonus in a patient undergoing transcervical hysteroscopic surgery. Neurol Sci 2013; 34:1815-7. [PMID: 23344744 DOI: 10.1007/s10072-013-1299-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 01/07/2013] [Indexed: 10/27/2022]
Abstract
We describe a 58-year-old woman who underwent hysteroscopic myomectomy to treat a large submucosal leiomyoma. A hypotonic glycine solution was instilled to distend the uterus. At one hour after the distending medium infusion started for hysteroscopic resection an electrolytic imbalance developed. One hour later myoclonus developed predominantly involving the bilateral sternocleidomastoidei and abdominal muscles. The patient was alert and cooperative; jerks were spontaneous and triggered by sensory stimuli. The electroencephalographic and brain computed tomography was normal. The clinical characteristics of her myoclonus resemble reticular reflex myoclonus, a form of subcortical myoclonus originating from the lower brainstem reticular formation. Given her severe hyponatremia we conjecture that she had symptomatic metabolic myoclonus caused by electrolytic disturbance. The case report we present underlines the need to detect in time and promptly treat neurological symptoms such as myoclonus suggesting resorption syndrome, an uncommon event complicating transcervical hysteroscopic surgery and urologic procedures.
Collapse
|
13
|
Fonseca M, Andrade C, Crispi C. Reply from the authors. Br J Anaesth 2011. [DOI: 10.1093/bja/aer076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
14
|
Hahn RG. Cold irrigating fluids during endoscopy. Br J Anaesth 2011; 106:751-2; author reply 752. [PMID: 21498499 DOI: 10.1093/bja/aer077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|