ABSTRACT
OBJECTIVE: To examine the attitudes, beliefs, and expectations of gynecological patients regarding postoperative pain and management. MATERIAL AND METHOD: A prospective study performed in 112 patients undergoing major gynecological surgery, using a preoperative questionnaire regarding expectations toward postoperative pain and management and a postoperative questionnaire regarding actual pain experience, attitudes, and beliefs about pain and management. RESULTS: The majority expected (92%) and experienced (89%) postoperative pain at moderate to very severe levels. The median visual analog scales (VAS) of expected and maximum experienced pain were 6.4 and 6 6, respectively. Ninety-eight percent reported at least moderate pain relief from the analgesics administered. Ninety-two percent were satisfied with their pain management. A significant number held misconceptions about postoperative pain and its management. CONCLUSION: Patients should be preoperatively advised regarding postoperative pain and management. Misunderstandings should be corrected to improve the quality and adequacy of postoperative pain management.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Attitude to Health , Female , Gynecologic Surgical Procedures , Health Knowledge, Attitudes, Practice , Health Status Indicators , Health Surveys , Humans , Middle Aged , Pain/drug therapy , Pain Measurement , Pain, Postoperative/drug therapy , Patient Satisfaction , Postoperative Period , Prospective Studies , Quality of Health Care , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To report a case of myoclonic movements during an induction of anesthesia using propofol. Abnormal movements resulting from propofol are uncommon but there have been a number of such cases since propofol was introduced. CLINICAL FEATURES: An 1-year-old boy with a diagnosis of obstructive sleep apnea was scheduled to undergo adenotonsillectomy. He demonstrated myoclonic movements during anesthetic induction using propofol. He was then given isoflurane and his airway was secured with an endotracheal tube after full muscle relaxation by succinylcholine. The anesthetic maintenance was uneventful as was the emergence. The patient recovered smoothly without neurological deficit. CONCLUSION: Propofol, an intravenous anesthetic, with strong evidence of anticonvulsant property, could, in susceptible patients, under certain conditions, act as a proconvulsant, and should, thus, be avoided or cautiously used in some patients.