Chang Gung medical journal
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Nausea and vomiting are common chief postoperative complaints. The clinical literature indicates that postoperative nausea and vomiting (PONV) is common after orthopedic surgery. This study examines the clinical therapeutic efficacy of Ondansetron injected intravenously before the end of shoulder arthroscopy as antiemetic prophylaxis to help reduce the incidence of PONV. ⋯ Routine intravenous injection of Ondansetron 30 minutes before completion of shoulder arthroscopy can reduce the incidence of vomiting and overall PONV in patients. Additionally, the patients using Ondansetron demonstrated lower pain intensity and lower analgesic injection needs than the control group.
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Randomized Controlled Trial Comparative Study
Efficacy of intramuscular nalbuphine versus diphenhydramine for the prevention of epidural morphine-induced pruritus after cesarean delivery.
Pruritus is the most common side effect of epidural morphine analgesia. Diphenhydramine is a widely used agent for the treatment of urticarial pruritus. Nalbuphine is a mixed opioid agonist-antagonist and has been reported to be effective in treating opioid-induced pruritus. We compared the effectiveness of intramuscular diphenhydramine and nalbuphine for the prevention of epidural morphine-induced pruritus after cesarean section. ⋯ Nalbuphine proved better than diphenhydramine for prevention of epidural morphine-induced pruritus in patients who underwent cesarean section. Prophylactic intramuscular nalbuphine (10 mg) is effective in decreasing the incidence and severity of pruritus and does not affect analgesia.
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To determine whether magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) are able to distinguish between adenocarcinoma originating from the uterine cervix and endometrium. ⋯ MRI may distinguish between most uterine adenocarcinoma originating from the cervix and endometrium using distinctive characteristics found on T2WI and DCE. When tumors show an ambiguous morphology, the ADC value of the tumor may be helpful for further differentiation.
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Percutaneous radiofrequency trigeminal rhizotomy offers high rates of complete pain relief for classic idiopathic trigeminal neuralgia. When performed under fluoroscopy, it may cause anxiety for an inexperienced neurosurgeon owing to lack of familiarity with the regional anatomy, lack of reliable landmarks on fluoroscopy, and perceived risks associated with inadvertent puncture of neurovascular structures near the foramen ovale. The purpose of this study is to describe a new procedure to maximize patient security and shorten operative time. ⋯ For percutaneous trigeminal rhizotomy, three-dimensional image reconstruction provides for precise placement of the rhizotomy needle in a safe and timely manner, which improves patient comfort and shortens operative time.
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Roughly 60,000 operations are performed at our medical center every year, so making efficient use of operating rooms (OR) is an important issue. Decreasing the cancellation rate of surgery is one method that could increase efficiency. We reviewed all OR cancellations in 2007 to survey the cancellation rates and causes. ⋯ Of all causes of cancellation of surgery, 54.1% were avoidable. Medical teams must communicate better with patients and relatives, identify and treat relevant comorbidities, and make adequate preparations for surgery.