ABSTRACT
Objective To explore the impact of laparoscopic surgery and that of open surgery on the coagulation function and incidence of deep venous thrombosis(DVT) in lower limbs in patients undergoing hysterectomy .Methods From April 2014 to A‐pril 2015 ,110 eligible patients were recruited .There was 57 patients received laparoscopic surgery ,and 53 patients received open surgery for hysterectomy .All patients underwent surgery under the general anesthesia .The APTT ,PT ,FIB ,and D‐dimer was de‐tected at 5 time points:before surgery ,surgery completion ,24 h after surgery ,48 h after surgery ,and 72 h after surgery .All patients were scheduled to ultrasound exam in lower limbs to detect the DVT at 24 ,48 and 72 h after surgery .Results Both groups showed decreased PT at surgery completion as compared with other time points (P0 .05) .Both groups showed increased D‐dimer after surgery compared with that before surgery ;the laparoscopic group showed higher D‐dimer at 24 h after surgery ,and lower D‐dimer at 48 h after surgery than open group(P0 .05) .Conclusion Both the laparoscopic surgery and open surgery will activate the coagulation system , and lead to DVT ;as compared with open surgery ,the laparoscopic surgery could not reduce the incidence of DVT in lower limbs in patients undergoing hysterectomy .
ABSTRACT
Objective To evaluate the feasibility of combining the sedation performed by propofol targeted concentration in-fusion with epidural anesthesia in patients undergoing total pelvic floor reconstruction.Methods A total of 80 eligible patients were recruited and were assigned randomly into the study group(n=40)and the control group(n=40).All patients in both groups were administered epidural anesthesia with the puncture and catheter placing in the space between the 2nd-3rd lumbar vertebras.After the epidural anesthesia,patients in the study group were administered propofol by targeted concentration infusion (TCI)system. The plasma concentration of propofol was modulated to obtain the BIS maintaining between 65-80,and the OAA/S maintaining at 3 scores.The propofol was continuously infused until closing the incision.Values of HR,MAP at different time points in the opera-tion were recorded,and the plasma concentrations of propofol,the incidences of adverse events were recorded.Results The HR and MAP of patients in the study group decreased at T1 (given the anesthetic),T2 (the beginning of the operation),T3 (the beginning of the operation),compared with those at T0 (before the anesthetic)and T4 (30 min after the operation)(P 0.05).BIS of study group was (73.3 ±4.8)-(76.1 ±3.4),and the plasma concentrations of propofol was(1.32 ± 0.29 )μg/mL - (1.52 ± 0.26 )μg/mL.Conclusion The combination of propofol sedation performed by TCI and epidural anesthesia could be safely and effectively used in patients undergoing total pelvic floor reconstruc-tion.