Comparison of laparoscopy-assisted hysterectomies with conventional hysterectomies

To compare operative and early postoperative outcomes of laparoscopic-assisted vaginal hysterectomy [LAVH] and laparoscopy assisted supracervical hysterectomy [LASH] with conventional hysterectomy by laparotomy or vaginally, including patients undergoing total or subtotal hysterectomy for benign gynecologic disease. Three different methods of hysterectomies: laparoscopic, vaginal, and abdominal, were compared at the Department of Obstetrics and Gynecology of Tabriz University of Medical Sciences, Tabriz, Iran, including all patients with indication of uterus removal for benign uterine disease from January 2005 to December 2007. The regional medical research ethics committee approved the study. A total of 288 hysterectomies were performed: 165 [57.3%] abdominal hysterectomy, 85 [29.5%] vaginal hysterectomy, and 38 [13.2%] laparoscopic-assisted hysterectomy. Laparoscopy assisted hysterectomy [LAVH, LASH] was associated with significantly lower early postoperative pain scores and complication rates, less blood loss, short hospital stay, and resulted in lower hospital charge with reusable devices statistically [p=0.03]. Laparoscopy is preferred to abdominal hysterectomy by laparotomy and to vaginal hysterectomy. Though vaginal hysterectomy had less complications and rapid recovery and patient satisfaction as compared with abdominal, but it was limited for multiparous patients with some degree of pelvic organ prolapse

effect of intramuscular ephedrine in prevention of hypotension due to propofol

To evaluate the effect of intramuscular [IM] ephedrine before injection of propofol, to reduce hypotension. It was a prospective, hospital based study conducted during March 2003 to December 2003, at Nikookary Hospital, Tabriz Medical Science University, Iran. This study was performed on one hundred patients who were candidates for elective ophthalmic surgeries randomized to two groups of 50 patients. In one group [group A] ephedrine 10mg [2cc] and in other group [group B] sterile water 2cc were injected intramuscularly. Twenty minutes before induction of anesthesia or before injection of propofol, during intubation, in 1[st], 4[th], 7[th] and 10th minutes of anesthesia blood pressure and heart rate were measured in both groups. The mean values were compared in two groups. There was only one case with significant mean diastolic blood pressure drop at 1[st] minute after intubation in group A comparing with group B. P=0.001. In other cases, differences of mean blood pressures were not significant. Also heart rates in all mentioned minutes were significantly higher in group A than group B. P<0.05]. IM injection of ephedrine before induction of anaesthesia with propofol does not have any significant effect in decreasing of patient's hypotension during operation, however it increases their heart rates. According to the potential hazards of the later complication, especially in old patients, this procedure is not recommended