• Title/Summary/Keyword: preoperative

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Clinical effect of preoperative intravenous non-steroidal anti-inflammatory drugs on relief of postoperative pain in patients after laparoscopic cholecystectomy: Intravenous ibuprofen vs. intravenous ketorolac

  • Gyeong Geon Lee;Joon Seong Park;Hyung Sun Kim;Dong Sup Yoon;Jin Hong Lim
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.251-256
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    • 2022
  • Backgrounds/Aims: Postoperative pain management is a key to enhanced recovery after surgery. The aim of this study was to evaluate clinical effect of preoperative intravenous (IV) non-steroidal anti-inflammatory drugs (NSAIDs) on relief of postoperative pain in patients after laparoscopic cholecystectomy. Methods: This single center, retrospective study was conducted between September 2019 and May 2020. A total of 163 patients were divided into two groups: Ibuprofen group (preoperative IV ibuprofen, n = 77) and Ketorolac group (preoperative IV ketorolac, n = 86). The primary outcome was postoperative pain score measured immediately in the recovery room. Results: There was no difference in demographic characteristics between the two groups of patients. Postoperative pain score measured immediately in the recovery room was significantly higher in the Ibuprofen group than in the Ketorolac group (mean value: 5.09 vs. 4.61; p = 0.027). The number of patients who needed analgesics immediately in the recovery room was also higher in the Ibuprofen group than in the Ketorolac group (28 [36.4%] vs. 18 [20.9%]; p = 0.036). Conclusions: In this study, preoperative IV injection with ketorolac reduced postoperative pain and analgesic requirement in the recovery room more effectively than that with ibuprofen. However, both showed similar effects on peak pain and pain at discharge. Numbers of patients requiring additional analgesics were also similar between the two groups.

Preoperative Extrapontine Myelinolysis with Good Outcome in a Patient with Pituitary Adenoma

  • Zhou, Ying;Zhu, Yicheng;Wang, Wenze;Xing, Bing
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.161-164
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    • 2016
  • Few preoperative extrapontine myelinolysis (EPM) cases with pituitary adenoma have been reported. No such case had long follow-up to see the outcome of EPM. We reported a 38-year-old man complaining of nausea, malaise and transient loss of consciousness who was found to have severe hyponatremia. Neurologic deficits including altered mental status, behavioral disturbances, dysarthria and dysphagia developed despite slow correction of hyponatremia. Endocrine and imaging studies revealed hypopituitarism, nonfunctional pituitary macroadenoma and extrapontine myelinolysis. Transsphenoidal surgery was performed after three weeks of supportive therapy, when neurological symptoms improved significantly. The patient recovered function completely 3 months after surgery. Our case indicates that outcome of EPM can be good even with prolonged periods of severe neurologic impairment.

A Study on Failure Mode and Effect Analysis (FMEA) for Preoperative Risk Prevention (오류유형 영향분석(FMEA)을 적용한 수술준비 위험예방활동의 효과)

  • Kim, Chang Hee;Lee, Mi Hyang
    • Journal of Korean Academy of Nursing Administration
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    • v.22 no.5
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    • pp.415-423
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    • 2016
  • Purpose: The purpose of this research was to provide patients with safe preoperative preparatory procedures by removing any risk factors from the preparatory procedures by using failure mode and effects analysis, which is a prospective risk-managing tool. Methods: This was a research design in which before and after conditions of a single group were studied, Failure mode and effects analysis were applied for the preparatory procedures done before operations. Results: The preparation omission rate before the operation decreased from 2.70% to 0.04%, and operation cancellation rate decreased from 0.48% to 0.08%. Conclusion: Failure mode and effects analysis which remove any risk factors for patients in advance of the operation is effective in preventing any negligent accidents.

Prediction of Postoperative Pulmonary Function Following Thoracic Operations - Perfusion Lung Scanning Method - (폐관류스캔에 의한 폐절제술후 폐기능 예측)

  • Park, Guk-Yang;Yu, Hoe-Seong;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.209-216
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    • 1986
  • The purpose of this study is to predict postoperative lung function by perfusion lung scanning method. 40 patients who underwent lobectomy or pneumonectomy between 1983-1985 were analyzed. Mean preoperative FEV1 was 2.36 L in lobectomy cases and 1.73 L in pneumonectomy cases. Preoperative and postoperative lung function were measured by routine spirometry in sitting position. Perfusion lung scanning was performed by 99mTc-MAA radioisotope. Postoperative FEV1 and VC were predicted by the formula; Postoperative FEV1 [VC]=Preoperative FEV1 [VC] x percent function of regions of lung not to be resected. In this study, I concluded that perfusion lung scanning is a simple and useful method to predict postoperative ventilatory function after pneumonectomy of lobectomy.

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Midterm Clinical Outcomes after Modified High Ligation and Segmental Stripping of Incompetent Small Saphenous Veins

  • Hong, Ki Pyo
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.398-403
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    • 2015
  • Background: The aim of this study was to evaluate the midterm clinical outcomes after modified high ligation and segmental stripping of small saphenous vein (SSV) varicosities. Methods: Between January 2010 and March 2013, 62 patients (69 legs) with isolated primary small saphenous varicose veins were enrolled in this study. The outcomes measured were reflux in the remaining distal SSV, the recurrence of varicose veins, the improvement of preoperative symptoms, and the rate of postoperative complications. Results: No major complications occurred. No instances of the recurrence of varicose veins at previous stripping sites were noted. Three legs (4.3%) showed reflux in the remaining distal small saphenous veins. The preoperative symptoms were found to have improved in 96.4% of the cases. Conclusion: In the absence of flush ligation of the saphenopopliteal junction, modified high ligation and segmental stripping of small saphenous vein varicosities with preoperative duplex marking is an effective treatment method for reducing postoperative complications and the recurrence of SSV incompetence.

Management of BCG Lymphadenitis (BCG림프선염의 치료)

  • Oh, Jung-Tak;Kim, In-Gyu;Han, Seok-Joo;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.3 no.2
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    • pp.143-147
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    • 1997
  • Bacillus Calmette-Guerin(BCG) lymphadenitis is a complication of post-BCG vaccination and its treatment is still controversial. Eighty patients who had been operated for BCG lymphadenitis from 1987 to 1996 were reviewed. Thirty-one of them were treated with antituberculous drugs(mean duration: 3 months) preoperatively and 49 patients were not given preoperative antituberculous medication. No one was treated with antituberculous drugs postoperatively. Operation methods were excision(72) and partial excision with curettage(8). There was no statistical difference in recurrence rate between groups In two patients(2.5 %) treated with preoperative antituberculous drugs, the lesions recurred after operation. The results suggest that preoperative antituberculous medication does not play any role in the treatment of BCG lymphadenitis and in preventing recurrence in surgically excised cases.

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Preoperative Diagnosis of Congenital Esophageal Stenosis Caused by Tracheobronchial Remnants Using Miniprobe Endoscopic Ultrasonography in a Child

  • Lee, Kun-Song
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.1
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    • pp.52-56
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    • 2012
  • Congenital esophageal stenosis (CES) can be classified into three types based on the etiology of stenosis: tracheobronchial remnants (TBRs), fibromuscular hypertrophy (FMH), and membranous diaphragm (MD). It is important to make a differential diagnosis because the therapeutic plan for CES is determined by its etiology. Most cases of FMH and MD can be managed with balloon dilatation, whereas cases of TBRs require resection and anastomosis. Thus, the preoperative distinction of TBRs is critical. Recently miniprobe endoscopic ultrasonography (EUS) with a maximum diameter of 2.5 mm has been useful for distinguishing TBRs from FMH in pediatric patients with CES. EUS shows hyperechoic lesions indicating TBR cartilage. Miniprobe EUS is recommended for choosing the correct therapeutic method for CES. We report a case of CES due to TBRs in which a preoperative diagnosis was made in a child using miniprobe EUS without any difficulties.

The Effects of Pulmonary Resectional Surgery for Cavitary Tuberculosis on Ventilation and Arterial Respiratory Gases (폐결핵환자에서 폐절제술이 폐기능에 미치는 영향에 관한 연구)

  • 이현우
    • Journal of Chest Surgery
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    • v.6 no.1
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    • pp.7-14
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    • 1973
  • Ventilatory functions and arterial respiratory gases were studied in 24 patients who underwent resectional surgery for pulmonary tuberculosis. Postoperative measurements were made 24 hours, 72 hours and 7 days after surgery and the results were compared to preoperative values. Twenty-four hours postoperatively, there occurred striking increase in respiratory rate, minute ventilation, dead space ventilation and dead space tidal volume ratio, and the increase in minute ventilation was caused primarily by the increase in respiratory rate. However, alveolar ventilation, oxygen consumption, carbon dioxide elimination and respiratory quotient showed no significant postoperative changes although two of the last values showed slight decreases 24 hours after surgery. The lowest arterial oxygen saturation level was obtained 24 hours postoperatively followed by gradual rises but not to the preoperative levels until 7 days after surgery. A decreased arterial carbon dioxide tension with elevated pit was noted 24 hours after surgery, which returned to the preoperative level on the following measurement.

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Prototype Development of a Robotic System for Skull Drilling (로봇을 이용한 두개골 드릴링 시스템의 프로토타입 개발)

  • Chung, Yun-Chan
    • Korean Journal of Computational Design and Engineering
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    • v.17 no.3
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    • pp.198-207
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    • 2012
  • This paper presents an overview of automated robotic system for skull drilling, which is performed to access for some neurosurgical interventions, such as brain tumor resection. Currently surgeons use automatic-releasing cranial perforators. The drilling procedure must be performed very carefully to avoid penetration of brain nerve structures; however failure cases are reported. The presented prototype system utilizes both preoperative and intraoperative information. Preoperative CT image is used for robot path planning. A NeuroMate robot with a six-DOF force sensor at the end effector is used for intraoperative operation. Intraoperative cutting force from the force sensor is the key information to revise an initial registration and preoperative path plans. Some possibilities are verified by path simulation but cadaver experiments are required for validation of this prototype.

Surgical Treatment of Broncholithiasis (기관지 결석증의 외과적 치료)

  • 김주현
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.112-116
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    • 1992
  • I clinically analysed 13 cases of broncholithiasis which treated surgically and found only four cases of broncholithiasis caused by the erosion of the peribronchial lymph node named by extrinsic formation[Group II], and nine cases of broncholithiasis caused by intrinsic formation[group I] which indicates that no evidence of the erosion of the calcified per-ibronchial lymph node into the bronchial tree was found. This study is performed to see any differences between two groups regarding presenting symptoms, locations of broncholith, preoperative diagnosis, a history of pulmonary tuberculosis, a procedure of operation, and chemical compositions of broncholiths from both groups. There was no difference between two groups in the presenting symptoms, the procedure of operation, and chemical compositions of broncholiths. The broncholits from group two is located in the right middle lobe bronchus, and the broncholiths of group one were distributed at various bronchi, In group one, only five cases out of nine had preoperative diagnosis[55.5%], but in group two, all four had preoperative diagnosis. All cases had good postoperative courses without any complication and recurrences.

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