Cost-effectiveness Analysis of Intraoperative Cell Salvage for Obstetric Hemorrhage

Conclusions The use of cell salvage for cases at high risk for obstetric hemorrhage is economically reasonable; routine cell salvage use for all cesarean deliveries is not. These findings can inform the development of public policies such as guidelines on management of obstetric hemorrhage.
Source: Anesthesiology - Category: Anesthesiology Source Type: research

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AbstractThe aim of this review is to evaluate the effectiveness and safety of uterine manipulators in facilitating total laparoscopic hysterectomy (TLH). A literature search in MEDLINE, EMBASE, Cochrane Library, UpToDate, SpringerLink, ClinicalKey and Elsevier ScienceDirect databases was performed, and articles describing TLH with or without the use of uterine manipulators were retrieved. Complications related to the use of uterine manipulators are numerous, and although uterine manipulator seems to facilitate TLH, the procedure without a uterine manipulator seems to have a comparable safety and effectiveness, although evi...
Source: Updates in Surgery - Category: Surgery Source Type: research
In this study, we hypothesized that preoperative pregabalin reduces inhaled isoflurane requirements. METHODS: We have investigated the effectiveness of preoperative oral pregabalin 150 mg in women undergoing elective open total abdominal hysterectomy under general anesthesia. A prospective, randomized, double-blind, controlled study was conducted in a university hospital. The study included 50 women (18-60 yrs.), ASA I or II, admitted for abdominal hysterectomy under general anesthesia. Exclusion criteria were allergy to pregabalin; calcium channel blockers, antiepileptic drugs, antidepressant drugs, any analgesics, se...
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
Postoperative nausea and vomiting is common with intrathecal morphine use in total abdominal hysterectomy. Which antiemetic is most effective for these patients?BMC Anesthesiology
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news
(Am J Obstet Gynecol. 2018;219(4):405.e1–405.e7.) In the United States, maternal morbidity and mortality are growing public health concerns, with severe maternal morbidity (SMM) affecting>50,000 women in 2014. SMM includes renal failure, shock, sepsis, blood transfusion, and peripartum hysterectomy. Hypertensive disorders of pregnancy are strongly associated with maternal morbidity and mortality and are often responsive to intervention. The primary objective of this study was to evaluate the association between preeclampsia with severe features and SMM at a regional perinatal referral center. They hypothesized th...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mother, Fetus, Neonate Source Type: research
This study aimed to investigate the risk of TOLAC resulting in CD based on cervical dilation during labor for the first CD as well as the indication for the first CD.
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mother, Fetus, Neonate Source Type: research
CONCLUSIONS: We were able to define predictors of admission for patients having LH/RAH managed with an ERAS pathway. Increased ASA physical status, being African American, and increased length of procedure were significantly associated with admission after LH/RAH performed under an ERAS pathway. In addition, the incidences of urgent clinic and ER visits, readmissions, and reoperations within 90 days of surgery were similar for patients who were discharged on the day of surgery compared to those admitted. PMID: 31425219 [PubMed - in process]
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
Hysterectomy is a widely performed surgery and neuraxial anesthesia with intrathecal morphine provides superior quality of recovery. Postoperative nausea and vomiting (PONV) is a frequent problem with intrathe...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
Abstract OBJECTIVE: To examine the rate of opioid use for gynecologic surgical procedures and to investigate persistent opioid use among those women who received an initial opioid prescription. METHODS: A retrospective cohort study using the MarketScan database was performed. MarketScan is a claims-based data source that captures claims from more than 50 million privately insured patients and 6 million Medicaid enrollees from 12 states. We identified women who underwent major and minor gynecologic surgery from 2009 to 2016. Among women who received an opioid prescription, new persistent opioid use was defined...
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research
Conclusion: The QoR after abdominal hysterectomy is similar with either intravenous analgesics or epidural analgesia or TAP block when used with rescue analgesia to manage postoperative pain. TAP block provides superior analgesia and reduces 24-h morphine consumption when compared with parenteral and epidural analgesia.
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
Conclusion: Intravenous administration of granisetron and palonosetron before intrathecal bupivacaine does not attenuate the hemodynamic changes in patients undergoing abdominal hysterectomy. Further, both 5-HT3 receptors antagonists do not have clinically significant effects on the spinal blockade produced by hyperbaric bupivacaine.
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
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