Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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Randomized Controlled Trial
Comparison of lidocaine spray and paracervical block application for pain relief during first-trimester surgical abortion: A randomised, double-blind, placebo-controlled trial.
Surgical abortion is one of the most frequently performed gynaecological procedures and its associated pain has always been a problem in gynaecology. Here we studied the analgesic efficacy of lidocaine spray and paracervical block (PCB) in patients undergoing first-trimester surgical abortion. A randomised double-blind placebo-controlled study was conducted on 108 women requesting pregnancy termination. ⋯ The median VAS scores during procedure in placebo, lidocaine spray, PCB plus lidocaine spray and PCB groups were 8 (7-9), 5 (4-8), 4 (3-4) and 5 (3-5), respectively. The most effective method of pain relief during first-trimester abortion can be achieved through a combined use of PCB plus lidocaine spray. Therefore, lidocaine spray is a non-invasive complementary anaesthetic method versus traditional PCB for first-trimester surgical abortion.
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Randomized Controlled Trial
Effect of elastic abdominal binder on pain and functional recovery after caesarean delivery: a randomised controlled trial.
The Elastic abdominal binder has been widely employed by clinicians for pain relief, wound complications prevention, improved pulmonary function, and stabilisation. However, these proposed benefits have not been properly examined in women following caesarean delivery. We aimed to examine the effects of post-caesarean elastic abdominal binder use on recovery by comparing post-operative pain, mobility and quality of life. ⋯ What do the results of this study add? In contrast to the results of the previous study, the beneficial effects of abdominal binder on pain reduction, functional recovery, and quality of life following caesarean delivery could not be demonstrated in this study. What are the implications of these findings for clinical practice and/or further research? The use of elastic abdominal binder after caesarean delivery is not associated with reduction of postoperative pain, faster functional recovery, and improved quality of life in our population. Further studies in other population with different characteristics may be worthwhile.
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This study evaluated the surgical and neonatal outcomes of 71 patients diagnosed with placenta accreta before caesarean section with or without placement of a prophylactic abdominal aorta balloon catheter. This study took place at our hospital from January 2013 to May 2015. Thirty patients had a prophylactic balloon catheter inserted (balloon group), and 41 patients did not receive the intervention (control group). ⋯ Impact statement Prophylactic placement of endovascular balloon catheters for controlling intraoperative haemorrhage in women with placenta accreta has been a topic of debate for nearly 2 decades. The most common type of occlusion is internal iliac artery balloon occlusion, only a few studies have focused on intraoperative aortic balloon occlusion This retrospective case-control study included relatively large number of cases and the result shown this technique can effectively reduce intraoperative haemorrhage in patients with placenta accreta, without causing any obvious adverse maternal or neonatal outcomes. It provides another safe and effective method for intraoperative haemorrhage control and even uterine preservation.
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In this study, we conducted a retrospective investigation of all cases of placenta previa and accreta that were treated at a tertiary-level hospital to assess the effectiveness of balloon catheterisation at different levels. We evaluated the surgical and neonatal outcomes of 586 cases of placenta previa and accreta that were treated at our facility. This is the largest study of its kind. ⋯ We also analysed the difference in the complications across different periods of the study period and observed a clear improvement in the operative procedures over time. What the implications are of these findings for clinical practice and/or further research: Our study revealed that the surgeons' proficiency increases over time, leading to improved results and a lower rate of hysterectomy over the course of several years. We recommend that the choice for balloon catheter occlusion be made with caution and after careful consideration.