检索结果-南通市图书馆

The Impact of Single Low Dose IV Magnesium Sulphate Adjuvant to Ultrasound Guided Transverses abdominis Plain Block for Control of Postcesarean Pain

引用

Open Journal of Obstetrics and Gynecology 2017年第3期7卷 269-280页

作者： Tamer Nabil Abd Elrahman Mohamed Abdelaziz Youssry Anesthesia and Intensive Care and Pain Department Faculty of Medicine Ain Shams University Cairo Egypt Obstetrics and Gynecology Department Faculty of Medicine Alexandria University Alexandria Egypt

Objective: The aim of this study is to determine the role of preoperative low dose intravenous MgSO4 when given adjuvant to ultrasound guided transversus abdominis plane (TAP) block in augmenting postcesarean analgesic effects and reducing opioid requirements during the first 24 hours. Subjects and Methods: In this prospective, randomized double blind study, a total of sixty full term pregnant women were recruited for the study underwent caesarean section. Thirty patients were assigned to MgSO4 group (A) and another thirty to placebo group (B). Participants in group (A) received 50 mg/kg MgSO4 in 100 ml isotonic saline intravenous (IV) over 20 minutes prior to induction of general anesthesia by 30 minutes while participants in group (B) received 100 ml isotonic saline (placebo) by the same route and over the same duration as control. Results: Visual Analogue Scale (VAS) was analysed within 24 hours postoperatively. The mean pain score at 6 and 12 hours postoperatively was significantly lower in MgSO4 group compared to control group (40.4 ± 5.12 vs 53.6 ± 4.92;26.1 ± 3.01 vs 35.5 ± 3.98 respectively, p = 0.012, 0.005). Comparing both groups regarding the mean time interval of first rescue analgesia (morphine sulphate) requested by the patients, it was longer in MgSO4 group compared to control group. The total dose of rescue analgesia consumed during 24 hours was analysed and it was significantly higher in control group compared to MgSO4 group (10.1 ± 0.95 vs 6.2 ± 0.87, p = 0.001). Conclusion: We concluded that preoperative low doses (50 mg/Kg) of MgSO4 with general anesthesia combined with ultrasound guided TAP block offer longer postoperative pain free periods thus reducing total opioid consumption. In addition to the safety of the drug to the mother and fetus so we recommend IV MgSO4 as an adjuvant therapy with TAP block.

关键词： Transversus abdominis Plane Block Magnesium Sulphate Postcesarean Analgesia Rescue Analgesia

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Transversus abdominis plane infiltration for laparoscopic gastric banding: A pilot study

引用

World Journal of Gastrointestinal Surgery 2014年第2期6卷 27-32页

作者： Gildasio S De Oliveira Jr Paul Fitzgerald Shireen Ahmad John Kim Rohit Rahangdale Robert McCarthy Department of Anesthesiology Feinberg School of Medicine Northwestern University Department of Surgery Northwestern University

AIM: To estimate an effect size for the transversus abdominis plane(TAP) infiltration on quality of recovery in patients undergoing laparoscopic gastric band surgery. METHODS: The pilot study was a randomized, double blinded, placebo controlled trial. Patients undergoing laparoscopic gastric band surgery were randomized to receive a bilateral TAP infiltration with 20 mL of 0.5% ropivacaine or saline. The evaluated outcomes included quality of recovery-40(QoR-40) at 24 h, postoperative opioid consumption and pain. Data was examined using the Mann-Whitney U test. RESULTS: Nineteen subjects were recruited. There was a positive trend favoring the TAP infiltration group in global QoR-40 scores at 24 h after surgery, median [interquartile range(IQR)] of 175.5(170-189) com-pared to 170(160-175) in the control group(P = 0.06). There also a positive trend toward a lower cumulative opioid consumption in the TAP infiltration group, median(IQR) of 7.5(2.5-11.5) mg iv morphine equivalents compared to 13(7-21.5) in the control group(P = 0.07). Correlation analysis(Spearman's Rho) demonstrated an inverse relationship between 24 h cumulative opioid consumption and global QoR-40 scores,-0.49(P = 0.03). CONCLUSION: The use of multimodal analgesic techniques to reduce opioid related side effects is particularly desirable in morbidly obese patients undergoing gastric reduction surgery. The TAP infiltration seems to have a clinically important effect in reducing postoperative opioid consumption and improve quality of recovery after laparoscopic gastric band surgery in morbid obese patients. Future studies to confirm the beneficial effects of the TAP infiltration in these patients are warranted.

关键词： Transversus abdominis plane Infiltration Gastric band Pain Recovery

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Effect of Transverse abdominis Plane Block on Chronic Post-Operative Pain—A Review

引用

Open Journal of Anesthesiology 2017年第2期7卷 23-34页

作者： Darwin Lamichhane Xuelin Yang Zhengliang Ma Medical School of Southeast University Nanjing China Department of Anesthesiology Affiliated Drum Tower Hospital Medical School of Nanjing University Nanjing China

Chronic post-operative pain is a recognized adverse consequence of surgery;managing and preventing it are always a better choice. Proper choice of Anesthetic technique, use of combined anesthesia and pre-emptive analgesia may prevent and decrease the incidence of chronic post-operative pain. Transverse abdominis plane block (TAP Block) is a regional anesthesia technique following abdominal surgeries which involve injection of a large amount of local anesthetics in TAP, an anatomical space between the internal oblique and transverse abdominis muscle. The aim of this review is to show the effect and uses of TAP block as a combined anesthesia and multimodal analgesia in preventing chronic post-operative pain.

关键词： Chronic Post-Operative Pain Transverse abdominis Plane Block Regional Anesthesia Multimodal Analgesia

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Reconstruction of a large defect of the female chest following keloid excision with use of the rectus abdominis myocutaneous flap

引用

Plastic and Aesthetic Research 2017年第5期4卷 85-91页

作者： Quan-Cang Men Shu Liu Ke-Xin Song You-Bin Wang Zhu Lin Liu Hao Xin-Hang Dong Long Xiao Department of Plastic Surgery Peking Union Medical College HospitalBeijing100032China China Meitan General Hospital Affiliated to North China Universityof Science and Technology Beijing100028China.

Aim: This study aimed to investigate the efficacy of the myocutaneous flap of the rectus abdominis in the surgical treatment of a large defect on the female chest following keloid ***: According to the location and size of the keloid on the chest, a myocutaneous flap based on the left or right rectus abdominis muscle was designed and transferred for repair of a chest defect following keloid resection. Radiotherapy was performed in the surgical area on the first and seventh postoperative ***: From January 2015 to March 2016, rectus abdominis myocutaneous flap coverage and early radiotherapy were used to treat 7 cases of keloids on the female chest. A postoperative follow-up of 10-14 months (average 12 months) was conducted. All the flaps survived well without evidence of keloid recurrence, and all patients achieved an improved chest ***:The rectus abdominis myocutaneous flap is a viablemethod for wound closure following resection of large keloids on the female chest.

关键词： Keloid rectus abdominis myocutaneous flap radiotherapy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Swallowing Function before and after Subtotal Glossectomy and Reconstruction with a Rectus abdominis Musculocutaneous Flap: A Case Report

引用

Surgical Science 2019年第8期10卷 271-280页

作者： Kazuhide Matsunaga Hirohisa Kusuhara Akifumi Enomoto Testuji Nagata Takuya Yoshimura Akinori Takeshita Noritaka Isogai Suguru Hamada Norifumi Nakamura Narikazu Uzawa The 2^nd Department of Oral and Maxillofacial Surgery School & Graduate School of Dentistry Osaka University Osaka Japan Department of Plastic and Reconstructive Surgery Kindai University Faculty of Medicine Osaka Japan Department of Oral and Maxillofacial Surgery Kindai University Faculty of Medicine Osaka Japan Department of Oral and Maxillofacial Surgery Nara Hospital Kindai University Faculty of Medicine Nara Japan Department of Oral and Maxillofacial Surgery Field of Maxillofacial Rehabilitation Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan

Purpose: Swallowing function was in a patient with tongue cancer that was evaluated with video fluorography before and after subtotal glossectomy and reconstruction with a rectus abdominis muscuocutaneous flap. Materials and Methods: A 41-year-old man underwent subtotal glossectomy and retained the unilateral posterior mylohyoid and unilateral stylohyoid muscles. The structure of the flap was evaluated postoperatively. To assess swallowing function, video fluorography was performed before surgery, 1 month after surgery and 1 year after surgery. Testing involved 1) ability to hold 10 mL of liquid in the oral cavity, 2) epiglottis turnover, 3) the presence of aspiration, 4) hyoid bone movement, and 5) maximum width of the esophageal entrance. Results: The flap was protuberant postoperatively. The patient was able to hold the test diet in the oral cavity before and after surgery. Epiglottis turnover was good before surgery but insufficient after surgery. Aspiration during swallowing was not observed before or after surgery. At rest, the hyoid bone sagged postoperatively, in comparison with preoperatively. Hyoid bone movement and width of the esophageal entrance decreased after surgery;however, they demonstrated gradual recovery. Conclusions: For good postoperative swallowing function after subtotal glossectomy, it is necessary to perform reconstruction with protuberant flap and to retain the suprahyoid muscles as much as possible.

关键词： Subtotal Glossectomy Rectus abdominis Musculocutaneous Flap Swallowing Function Hyoid Bone Movement Width of the Esophageal Entrance

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Comparison of breast reconstruction using ipsilateral and contralateral pedicle transverse rectus abdominis musculocutaneous flaps

引用

Plastic and Aesthetic Research 2017年第9期4卷 155-160页

作者： Ramesh Omranipour Sima Mashayekhi Mahtab Vasigh Sadaf Alipour Habibollah Mahmoodzadeh Cancer Institute Tehran University of Medical SciencesImam Khomeini HospitalTehran 13145-158Iran.

Aim: Breast reconstruction has several beneficial effects on psychosocial well-being and quality of life. The ultimate goal has always been to create the most natural breast mound. Thus in many centers, the unilateral pedicled transverse rectus abdominis myocutaneous (TRAM) flap remains the most common technique for breast reconstruction. Our objective was to retrospectively compare the outcomes of ipsilateral and contralateral pedicle TRAM flaps. Methods: The total of 110 patients underwent unilateral breast reconstruction with pedicle TRAM flap at Cancer Institute of Tehran University of Medical Science from January 1996 to June 2011. Premorbid risk factors, postoperative outcomes and demographic data were assessed. The analysis of the recordings was done by SPSS 20. Results: Out of 110 patients who were included in the study, 87 had ipsilateral and 23 contralateral pedicle TRAM flaps. The incidence of flap complications that did not require surgical intervention was 19.7% in ipsilateral and 30.4% in contralateral pedicle TRAM flap. The incidence of flap loss requiring revision was significantly higher in contralateral group (P = 0.001). Major complications were noted in 11.5% of the ipsilateral pedicle TRAM patients and 26.1% of the contralateral group (P < 0.001). Minor complications were noted in 17.2% of the ipsilateral pedicle TRAM patients and in 34.8% of the contralateral group (P < 0.001). Total early hospital stay was longer in contralateral pedicle TRAM flaps (7.66 days vs. 10.68 days, P = 0.83). H igher c omplications were e ncountered i n c ontralateral p edicle T RAM flaps compared to ipsilateral pedicle TRAM patients (39.1% vs. 19.5%, P = 0.001). The type of pedicled TRAM flap (ipsilateral vs. contralateral), had significant effect on complications (odds ratio = 0.007, P = 0.002) while other variables had no significant effect on the incidence of complications. Conclusion: This study indicates that the overall outcome and mid-term morbidity-free surv

关键词： Breast reconstruction transvers rectus abdominis musculocutaneous flap unilateral pedicle TRAM flap ipsilateral pedicle TRAM flap

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Sternal Reconstruction of Deep Sternal Wound Infections Following Median Sternotomy by Single-stage Muscle Flaps Transposition

引用

Chinese Medical Sciences Journal 2014年第4期29卷 208-213页

作者： Song Wu Feng Wan Yong-shun Gao Zhe Zhang Hong Zhao Zhong-qi Cui Ji-yan Xie Department of Cardiac Surgery Peking University Third Hospital

Objective To assess clinical effectiveness of using bilateral pectoralis major or plus rectus abdominis muscle flaps in treating deep sternal wound infection(DSWI) following median sternotomy. Methods Between January 2009 and December 2013, 19 patients with DSWI after median sternotomy for cardiac surgery were admitted to our hospital, including 14 males(73.7%) and 5 females(26.3%), aged 55±13(18-78) years. According to the Pairolero classification of infected median sternotomies, 3(15.8%) patients were type II, and the other 16(84.2%) were type III. Surgical procedure consisted of adequate debridement of infected sternum, costal cartilage, granulation, steel wires, suture residues and other foreign substances. Sternal reconstruction used the bilateral pectoralis major or plus rectus abdominis muscle flaps to obliterate dead space. The drainage tubes were placed and connected to a negative pressure generator for adequate drainage. Results There were no intraoperative deaths. In 15 patients(78.9%), bilateral pectoral muscle flaps were mobilized sufficiently to cover and stabilize the defect created by wound debridement. 4 patients(21.0%) needed bilateral pectoral muscle flaps plus rectus abdominis muscle flaps because their pectoralis major muscle flaps could not reach the lowest portion of the wound. 2 patients(10.5%) presented with subcutaneous infection, and 3 patients(15.8%) had hematoma. They recovered following local debridement and medication. 17 patients(89.5%) were examined at follow-up 12 months later, all healed and having stable sternum. No patients showed infection recurrence during the follow-up period over 12 months. Conclusion DSWI following median sternotomy may be effectively managed with adequate debridement of infected tissues and reconstruction with bilateral pectoralis major muscle or plus rectus abdominis muscle flap transposition.

关键词： median sternotomy deep sternal wound infections sternal osteomyelitis sing-stage pectoralis major muscle flap rectus abdominis muscle flap

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：