Administration of Oral Acetaminophen to Reduce Costs for the Hysterectomy Patient at a Community Hospital
This quality improvement project aimed to change the practice of administration route of acetaminophen from intravenous (IV) to oral to patients having a hysterectomy at a community hospital, reduce costs, and maintain postanesthesia care unit pain scores for patients who receive oral acetaminophen comparable to those who receive IV acetaminophen.
Authors: Fukuda H, Takekuma M, Hirashima Y Abstract A 62-year-old Japanese woman developed numbness of the extremities and megaloblastic anemia. She had undergone total abdominal hysterectomy, whole-pelvis radiation therapy and chemotherapy for gynecological cancer 10 years before. Chronic abdominal pain, diarrhea and intermittent small-bowel obstruction had afflicted her for a long time. We diagnosed her with vitamin B12 deficiency anemia and polyneuropathy due to chronic radiation enteritis causing malabsorption. Vitamin B12 injections improved her numbness and anemia. The early diagnosis and treatment of deficie...
CONCLUSION: This is the first evaluation of regret after hysterectomy specifically examining a younger patient population. The study results suggest that patients who are appropriately counselled do not regret their decision to proceed with hysterectomy. PMID: 31734156 [PubMed - as supplied by publisher]
Condition: Ambulatory Laparoscopic Hysterectomy Interventions: Device: Low Impact Laparoscopy; Device: conventional laparoscopy; Other: Visual Analog Scale (VAS) for Pain; Other: Saint-Antoine Pain Questionnaire (QDSA); Other: post-operative questionnaire Sponsor: Hospices Civils de Lyon Not yet recruiting
We present the case of a 40 year old female with a chief compliant of vaginal bleeding and severe abdominal pain after sexual intercourse. She was s/p total laparoscopic hysterectomy 3 months earlier. The history and physical exam were concerning for vaginal cuff dehiscence (VCD).
Alana Nesbitt's seven year nightmare is now over, after she had a hysterectomy to have the Essure device removed. The mother-of-two, from Belfast, said her life became filled with pain.
This study is registered with the Netherlands Trial Registry, number NTR5263.FindingsWe screened patients for enrolment between Dec 3, 2015, and May 31, 2018. Patients completed baseline visits and started treatment between Dec 14, 2015, and July 2, 2018, and the last study visit of the last patient was Oct 4, 2018. Of 149 patients assessed for eligibility, 57 (38%) patients were excluded (predominantly because they did not meet one or several inclusion criteria, most often because of an absence of synovial inflammation or of flare-ups after NSAID washout) and 92 (62%) patients were eligible for inclusion. We randomly assi...
Abstract A 27-year-old woman with sudden back pain was transported to our hospital. Abdominal ultrasonography revealed pregnancy of 28 weeks ’ gestation. Computed tomography demonstrated a type A aortic dissection. Because of progressive fetal deterioration, an emergency cesarean section was forced to perform. The next day, simple hysterectomy followed by an aortic procedure was completed. Valve-sparing aortic replacement and total arch replacement were employed as central operations. The mother and baby are well 9 months postoperatively. Although the strategy for acute type A aortic dissection during pregnancy is co...
Discussion and conclusionThe Authors, as a result of the present study, suggest that office hysteroscopy should be sussessful at the first attempt, because the majority of patients (58%), in case of a failed procedure, do not undergo a repeat hysteroscopy in a reasonable time and important diagnosis, such as that of endometrial cancer, may be missed or delayed. In order to increase the procedure success rate, prior to the scheduled hysteroscopy they recommend to counsel all patients, identifying those who may benefit from pharmacological cervical softening, local anesthetic injection or the use of small caliber hysteroscopes.
Conditions: Pain, Postoperative; Opioid Use Intervention: Drug: Bupivacaine Sponsor: Johns Hopkins University Not yet recruiting