Abstract:
OBJECTIVE:The objective of the study was to determine whether transversus abdominis plane (TAP) block reduces postoperative pain when compared with trocar site infiltration of bupivacaine in gynecological laparoscopy. STUDY DESIGN:This was a prospective, randomized, double-blinded clinical trial using patients as their own controls. Women undergoing gynecologic laparoscopy using a 4-port symmetrical technique were randomly assigned to right- or left-sided TAP block using 30 mL of 0.25% bupivacaine with epinephrine. Two cohorts of patients were studied. Cohort 1 consisted of anesthesiologist-administered ultrasound-guided TAP block. Cohort 2 consisted of surgeon-administered laparoscopic-guided TAP block. In both cohorts, contralateral port sites were infiltrated with an equal amount of bupivacaine in divided doses. All patients received intraoperative acetaminophen and ketorolac. Postoperative abdominal pain was assessed at 1, 2, 4, 6, 8, 12, 18, 24, and 48 hours on the block and contralateral sides, before and after palpation, using the 10 point visual analog scale. A 2 point difference in the reported pain scores was considered clinically meaningful. RESULTS:Eighty-eight patients were eligible for statistical analysis: 45 and 43 patients in cohorts 1 and 2, respectively. In both cohorts, most patients reported equal pain on the block side and local side. In cohort 1, there was a statistically significant difference in mean reported pain scores at 2 hours and across time favoring the ultrasound-guided block; however, this did not reach clinical significance. There was no statistically significant difference found at all other time points or when pain scores were objectively assessed after palpation of the incisions. When comparing laparoscopic-guided block with local infiltration, there was no statistically significant difference in reported mean pain scores at all time points or after palpation. CONCLUSION:As part of this multimodal analgesic regimen, neither block method provided a significant clinical benefit compared with trocar site bupivacaine infiltration.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
El Hachem L,Small E,Chung P,Moshier EL,Friedman K,Fenske SS,Gretz HF 3rddoi
10.1016/j.ajog.2014.07.049subject
Has Abstractpub_date
2015-02-01 00:00:00pages
182.e1-9issue
2eissn
0002-9378issn
1097-6868pii
S0002-9378(14)00798-4journal_volume
212pub_type
杂志文章,随机对照试验abstract::Thirteen women with infertility thought due to anovulation were treated with LRH. Etiologic diagnoses of amenorrhea included hypothalamic or "idiopathic" and PCOD. All patients had normal gonadotropins and otherwise normal endocrinologic and infertility evaluations; none had ovulated with clomiphene. Patients were stu...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(79)90819-6
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:Precocious cervical ripening, as defined by cervical shortening on transvaginal sonography, has prompted a broad evaluation of secondary strategies (such as cerclage, vaginal progesterone, or a cervical pessary) to prevent preterm delivery. However, there is still a lack of direct comparisons between individ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.12.007
更新日期:2016-06-01 00:00:00
abstract::This study was undertaken to determine the significance of the changes in nonsuppressible insulin-like activity as measured by the fat pad assay and by the levels of immunoreactive somatomedin C, growth hormone, and human placental lactogen in sera of term normal pregnant women, mothers who delivered prematurely, and ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90087-0
更新日期:1985-10-15 00:00:00
abstract::The possible role of reproductive steroids in the vascular changes o f the estrous and menstrual cycles and of pregnancy has prompted both clinical observations and animal experiments on the influence of sex hormones on the physiology of blood vessels. Research was carried out to develop a method for exposing blood ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(72)90637-0
更新日期:1972-07-01 00:00:00
abstract:OBJECTIVE:Our purpose was to report the cancers arising during a familial ovarian cancer screening program and investigate the tumor's clonality and association with BRCA1 and BRCA2 mutations. STUDY DESIGN:Program participants with a diagnosis of ovarian cancer or peritoneal serous papillary carcinoma were identified ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70663-0
更新日期:1999-04-01 00:00:00
abstract::Chromosomal microarray analysis is a high-resolution, whole-genome technique used to identify chromosomal abnormalities, including those detected by conventional cytogenetic techniques, as well as small submicroscopic deletions and duplications referred to as copy number variants. Because chromosomal microarray analys...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.07.016
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:Our aim was to investigate whether the human placenta is permeable to sulindac or its active sulfide metabolite. STUDY DESIGN:Nine pregnant patients (median gestational age [range]: 31.8 [24.3 to 36.4] weeks) were given a 200 mg oral dose of sulindac 5.5 (4.4 to 6.7) hours before 18 intravascular transfusion...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(95)90016-0
更新日期:1995-03-01 00:00:00
abstract::Engaging women in discussions about reproductive goals in health care settings is increasingly recognized as an important public health strategy to reduce unintended pregnancy and improve pregnancy outcomes. "Reproductive life planning" has gained visibility as a framework for these discussions, endorsed by public hea...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.10.004
更新日期:2017-02-01 00:00:00
abstract::A letter is written in response to a report by Drs. Beric, Kupresanin, and Hulka (Am. J, Obslet Gynecol. 114: 273, 1972) which stated that the Karman catheter is not suitable for terminating pregnancies beyond Week 6 of pregnancy. The use of a Karman catheter in terminating pregnancies of 7-10 weeks resulted in 47% t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(73)91070-3
更新日期:1973-05-15 00:00:00
abstract::The ultrafast echo-planar magnetic resonance imaging technology, developed and built in Nottingham, has been used to produce the first snapshot images of the human fetus in utero. The imager, operating at a proton resonance frequency of 22 MHz, produces transaxial views in 64 or 128 milliseconds. These images comprise...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)91209-u
更新日期:1990-08-01 00:00:00
abstract::Highly equivocal results, regarding procedures for the prenatal detection of fetal sexls found in the endocervix, are reported in the literature dating from 1971. The far-reaching genetic and obstetric implications of such procedures led us to investigate endocervical smears from 36 patients (taken during all three t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33486-x
更新日期:1975-05-01 00:00:00
abstract::Evidence suggests an increased risk of ovarian cancer with asbestos exposure. Ovaries and corresponding fallopian tubes were studied by analytic electron microscopy. There was 71.4% agreement between tube and ovary for presence-type of asbestos. The fallopian tube can provide useful information regarding asbestos expo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70559-4
更新日期:1999-08-01 00:00:00
abstract::The effect of progesterone on estrogen-induced uterine blood flow was investigated in repeated experiments in seven nonpregnant, oophorectomized ewes with chronically implanted electromagnetic flow probes and catheters inserted into branches of the uterine arteries. Administered alone, progesterone has no effect on ba...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90617-2
更新日期:1977-06-01 00:00:00
abstract::Effective communication is a hallmark of safe patient care. Challenges to effective interprofessional communication in maternity care include differing professional perspectives on clinical management, steep hierarchies, and lack of administrative support for change. We review principles of high reliability as they ap...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2011.04.021
更新日期:2011-08-01 00:00:00
abstract::A study of fetal activity was undertaken as the first step in a series of physiologic fetal movement studies. A simple, safe, noninvasive, clinically applicable method for studying fetal movement with a tocodynamometer is described. Four basic types of fetal movement have been seen and defined in terms of their durati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90467-1
更新日期:1976-09-01 00:00:00
abstract::We studied differences in the role of genetic factors in prematurity and intrauterine growth retardation with the use of data on 312 Amish singleton live children ascertained from Amish records in Lancaster county, Pennsylvania, between 1969 and 1980. Birth and death certificates were obtained on all children, and inb...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80181-3
更新日期:1987-08-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine the relative efficacy and complications of low-dose heparin and intermittent pneumatic calf compression for the prevention of postoperative venous thrombosis in patients undergoing surgery for gynecologic malignancy. STUDY DESIGN:Randomized trial comparing 107 patients treated with l...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9378(93)90360-u
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:A metaanalysis of randomized trials was conducted to evaluate if the type of hysterectomy, total abdominal hysterectomy or supracervical hysterectomy, has an impact on the development of urinary incontinence. STUDY DESIGN:We searched MEDLINE, EMBASE, CINAHL, Biological Abstract, and the Cochrane Library up t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ajog.2007.09.033
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the acid-base status of neonates with an Apgar score < or = 3 at 5 minutes and to ascertain whether accompanying acidemia is an important predictor of immediate newborn morbidity and long-term neurologic development. STUDY DESIGN:From January 1984 through December 1991 there were...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70092-3
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to estimate the association of parity with pelvic girdle syndrome (PGS; pain in anterior and bilateral posterior pelvis). STUDY DESIGN:We included 75,939 pregnant women in the Norwegian Mother and Child Cohort Study. Data were obtained by self-administered questionnaires. RESUL...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.03.040
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:We previously demonstrated that chorion releases a factor that inhibits both spontaneous and oxytocin-stimulated myometrial contractility. Here, we investigate the mechanism of action of this unidentified substance. STUDY DESIGN:Myometrial strips from pregnant guinea pigs were mounted in an organ bath and co...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.102
更新日期:2003-01-01 00:00:00
abstract::This study attempts quantification of prostaglandins (PGs) in amniotic fluid antepartum at 24, 26-33, 34-36 weeks of gestation and in labor in 6 normal patients, 6 diabetic patients, 3 patients taking methadone, and 1 patient taking heroin. Results of measurements of PGs showed that in the different weeks of gestatio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33793-0
更新日期:1974-02-01 00:00:00
abstract::We analyzed interview and record review data from 9,823 deliveries to evaluate the relationship between prior history of induced abortion and subsequent late pregnancy outcomes. Complications such as bleeding in the first and third trimesters, abnormal presentations and premature rupture of the membranes, abruptio pla...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)91041-4
更新日期:1983-05-15 00:00:00
abstract::The World Health Organization recommends that countries adopt more effective antiretroviral regimens to increase the effectiveness of the prevention of mother-to-child human immunodeficiency virus (HIV) transmission programs. The 2006 guidelines recommend a tiered approach for the delivery of antiretroviral to pregnan...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,实务指引,评审
doi:10.1016/j.ajog.2007.03.001
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:Maternal floor infarction of the placenta is characterized by gross placental abnormalities and histologic evidence of X-cell proliferation. Previously, pregnancy-associated major basic protein has been localized to the placental X cell and identified at elevated levels in serum and amniotic fluid in all norm...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91716-5
更新日期:1992-11-01 00:00:00
abstract::The effects of various vasodilators on the uterine vascular bed were investigated in nonpregnant, oophorectomized sheep with chronically implanted flow probes and catheters inserted into branches of the uterine arteries. A 1 mug dose of estradiol-17beta (0.224 muM) produces a maximum uterine blood flow response after ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90593-7
更新日期:1976-05-15 00:00:00
abstract:OBJECTIVES:The objectives of this study were to investigate differences in diameter and vasoconstriction of premyometrial versus uteroplacental radial arteries and to evaluate the contribution of nitric oxide (NO) to myogenic tone as a function of vessel location. STUDY DESIGN:Radial arteries supplying either the myom...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/s0002-9378(03)00623-9
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:This study investigates the occurrence of miscarriages over the reproductive life span of women in a population-based study. STUDY DESIGN:A questionnaire was sent in 1994 to a random sample of 3000 Finnish women aged 18 to 44 years (73% response rate). Age-adjusted percentages of women having had miscarriage...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70568-5
更新日期:1999-08-01 00:00:00
abstract::During the period from September, 1974, to January, 1975, we performed 276 deliveries, of which 54% were internally monitored with a spiral type of fetal electrode. Eight of the infants monitored (incidence, 5.4%) developed scalp abscesses. We had had no previous complications associated with the electrodes. An intens...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90527-5
更新日期:1976-11-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to analyze the obstetric and neonatal impact of an opioid detoxification program during pregnancy, as well as to examine variables associated with successful opioid detoxification. STUDY DESIGN:This is a retrospective cohort study of women electing inpatient detoxification and s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.05.026
更新日期:2013-09-01 00:00:00