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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over a 2-year period, ultrasound-guided aspiration of painful, presumptively benign ovarian cysts was performed in 18 women < 40 years old. Aspiration was performed either transvaginally (12 patients) or transabdominally (6 patients) depending on the cyst location. Neither anaesthesia nor analgesia were used, and all patients had immediate pain relief, and escaped immediate surgical intervention. None had complications or evidence of malignant cells on cytologic examination, and all were discharged within 24 h of the procedure. The recurrence rate within 1 year of the procedure was 11.1%. The procedure appeared to be a good and safe alternative to surgery.
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PMID:Ultrasound-guided aspiration for relief of pain generated by simple ovarian cysts. 844 43

This study describes the introduction of hysterosalpingo-contrast sonography (HyCoSy) as a first line outpatient investigation of uterine and tubal factors in two fertility units. 136 infertile women had transvaginal scanning before and during the intrauterine injection of contrast medium (Echovist-200). HyCoSy was successfully completed in 132 cases (97%) within a mean time of 12.6 +/- 8.4 (4-50) min. The uterus and its cavity appeared normal in 108 (82%) women. Uterine abnormalities in the remaining 24 women (18%) included structural abnormality (n = 7), fibroids (n = 12) and endometrial polyps (n = 5). A total of 261 fallopian tubes in 132 women were assessed: 186 (71%) appeared patent and 55 (21%) blocked. The remaining 20 (8%) could not be assessed for technical reasons. Polycystic ovaries and ovarian cysts were diagnosed in eight women. The most common adverse effect was mild/moderate pain, similar to period pain, with 24 (18%) women requiring simple analgesia. HyCoSy is a simple and well tolerated outpatient procedure. The technique provides clinically valuable information about tubal patency, ovarian and uterine abnormalities.
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PMID:Hysterosalpingo-contrast sonography (HyCoSy) using Echovist-200 in the outpatient investigation of infertility patients. 903 25

This preliminary report details wxperience with office laparoscopy for female fertility assessment in 183 subjects at an urban Malaysian research clinic. Patients were admitted at about 8 AM and discharged at 3-4 PM after the procedure had been performed. Only 7.7% (14) of the subjects required inhalational anesthetic gases in addition to intravenous sedation and local anesthesia. The pick-up rate for pelvic abnormalities was about 22.4%. At laparoscopy, aspiration of ovarian cysts was carried out in 3 patients, lysis of adhesions in 6, salpingostomy in 3, and cautery of endometriotic spots in 30. 127 of the laparoscopies were performed by the consultant gynecologist, and 55 by medical officers. Minor difficulties occurred with 14 patients, including insufflation difficulty, and difficulty in trocar insertion and visualization. 1 uterine perforation occurred, and mild hemorrhage occurred in 2 patients after lysis and cautery procedures. 1 patient had respiratory depression after intravenous sedation. All complications were managed without hospital admission. It is suggested that all family planning clinics involved in fertility assessment and sterilization feature laparoscopy on an outpatient basis. However, proper training and adequate facilities for resuscitation are mandatory. More clinical triials are needed to discern the most suitable analgesia and anesthesia for office laparoscopy, including the possible use of acupuncture.
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PMID:Office laparoscopic assessment of female fertility. 1227 89

It is reported that ropivacaine, a new amide-linked local anesthetic, can be used safely in patients susceptible to malignant hyperthermia. We report a case of the use of epidural ropivacaine for a gravida with disposition for malignant hyperthermia. A 33-year-old female patient, 11 weeks and 2 days pregnant, was admitted for torsion of the right ovarian cyst. Five years before, she had been prepared for operation for uterine myoma. After premedication with atropine 0.5 mg and hydroxyzine 50 mg i.m. her body temperature increased to 39.0 degrees C, and the operation was postponed. By muscle biopsy she was diagnosed susceptible to malignant hyperthermia. Two months thereafter, the operation for uterine myoma was performed under epidural lidocaine and intravenous propofol anesthesia. Three years ago, she had cesarean section under epidural anesthesia using mepivacaine. This time, the epidural catheter was inserted at L 3-4 interspace, and 10 ml of 1.0% ropivacaine was administrated. After fifteen minutes analgesia was obtained to T 10-L 2. Forty minutes later the operation was performed and the patient was safely anesthetized by ropivacaine. Later at 37 weeks and 3 days pregnancy, cesarean section was performed with epidural ropivacaine.
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PMID:[The use of epidural ropivacaine for a gravida with disposition for malignant hyperthermia]. 1507 78

Abdominal wall lift laparoscopic surgery is often used for patients during pregnancy because it is physiologically superior to CO2 pneumoperitoneum laparoscopic surgery. Operation for adnexal cysts is performed in the 1st trimester. We report seven cases of ovarian cysts during pregnancy, resected using gassless laparoscopic method with a whole abdominal wall lift under combined spinal-epidural anesthesia (CSEA). Combined spinal-epidural anesthesia had several advantages in these cases; 1. In the 1 st trimester, general anesthesia should be avoided. We could manage these cases without general anesthesia nor sedative medications. 2. During pregnancy, it is difficult to estimate the level of sensory blockade by spinal anesthesia. Epidural top-up helped us to easily control the level of sensory blockade. 3. Differential diagnosis of pain related to uterine contraction and postoperative pain is difficult. Post-operative analgesia was established by epidural PCA, thus anti uterine contraction medicines were prophylactically administered in only one of seven cases. There was no particular trouble during the anesthesia and all the operative procedures were performed uneventfully. Based on our limited experiences, CSEA may be a safe and appropriate anesthetic technique for laparoscopic ovarian cystectomy with abdominal wall lift during pregnancy.
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PMID:[Laparoscopic ovarian cystectomy with abdominal wall lift during pregnancy under combined spinal-epidural anesthesia]. 1555 48

Preoperative and postoperative psychological factors, postoperative pain, analgesic consumption, treatment satisfaction were compared in patients treated with intravenous patient-controlled analgesia (IV-PCA) or intramuscular analgesics after laparoscopic ovarian cystectomy. Thirty-one women with laparoscopically operated benign ovarian cysts were recruited in Zonguldak Karaelmas University Faculty of Medicine, Department of Obstetrics and Gynecology. Postoperatively sixteen women received morphine delivered by IV-PCA pump system and 15 women were prescribed another opioid (meperidine) intramuscularly. Two weeks before and one day after the surgery, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were self-administered. Afterwards, the operation visual analog scale (VAS) and satisfaction with pain control scale were recorded. Preoperative BDI and BAI scores of both groups were comparable. Postoperative BDI (7.9 +/- 7.2 versus 13.8 +/- 6.9, P = 0.03) and BAI (11.4 +/- 9.1 versus 17.4 +/- 6.2, P = 0.045) scores were significantly lower in the IV-PCA group. Morphine usage with PCA resulted in significantly higher pain scores than equivalent doses of meperidine administered intramuscularly (2.94 +/- 1.0 versus 1.67 +/- 0.7, P = 0.001). Although higher pain scores were obtained from IV-PCA group, self-reported satisfaction rates were higher in this group (8.3 +/- 1.1 versus 7.4 +/- 1.1, P = 0.04). Involvement of patients in their pain management might increase the awareness of pain but their satisfaction about the control of postoperative pain was significantly improved.
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PMID:Comparison of satisfaction and pain relief between patients-controlled analgesia and interval analgesia after laparoscopic ovarian cystectomy. 1794 89