RESUMO
Large loop excision of the transformation zone (LLETZ) of the uterine cervix is a surgical procedure very frequently performed. Simulation of LLETZ under colposcopic guidance has a major role in training practitioners. The objective was to present an ex vivo model of LLETZ.
Assuntos
Traquelectomia , Displasia do Colo do Útero , Neoplasias do Colo do Útero , Feminino , Gravidez , Humanos , Displasia do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/cirurgia , Colposcopia/métodos , Colo do Útero/cirurgiaRESUMO
BACKGROUND: Simulation now has an important role in theoretical and practical aspects of medical education and training. METHODS: We performed an epidemiological, observational, multicenter study based on nationwide data collection. French obstetrics and gynecologic residents were invited to complete an anonymous survey. RESULTS: We received 305 answers. The most frequently offered gynecology sessions were laparoscopy on pelvitrainer (76%) and pelvic ultrasound (60%) while the most frequently offered obstetric sessions were breech delivery (61%), shoulder dystocia (62%) and postpartum hemorrhage (68%) managements. Regarding session frequency, 29.1% of residents thought that one session per month would be ideal. Two hundred and sixty three residents (96%) considered that simulation-training sessions were beneficial. One hundred and thirty-six residents (49%) had an opportunity to repeat sessions and a majority of them (96%) found a daily benefit following a training simulation session. CONCLUSION: Simulation programs were extremely popular among the surveyed residents. To improve OBGYN resident training, simulation should be an integral part of residency programs.
Assuntos
Ginecologia , Internato e Residência , Obstetrícia , Competência Clínica , Feminino , Ginecologia/educação , Humanos , Motivação , Obstetrícia/educação , GravidezAssuntos
Infecções por Fusobacterium/diagnóstico , Fusobacterium necrophorum/isolamento & purificação , Síndrome de Lemierre/complicações , Analgésicos não Narcóticos/administração & dosagem , Diagnóstico Diferencial , Evolução Fatal , Feminino , Infecções por Fusobacterium/complicações , Infecções por Fusobacterium/patologia , Humanos , Ibuprofeno/administração & dosagem , Influenza Humana/diagnóstico , Síndrome de Lemierre/diagnóstico , Pneumonia/diagnóstico , Insuficiência Respiratória/complicações , Insuficiência Respiratória/diagnóstico , Automedicação , Choque Séptico/complicações , Choque Séptico/diagnóstico , Adulto JovemRESUMO
BACKGROUND: Bilateral ilioinguinal nerve block may be useful to control postoperative pain in gynecologic surgery, especially hysterectomy. METHODS: In a prospective, randomized, double-blind study, we compared the combination of ropivacaine and clonidine (block group) versus saline (control group). The main objective of this study was to compare the total dose of morphine required during the first two postoperative days. All patients received antiemetic prophylaxis and multimodal IV analgesia. RESULTS: Seventy patients were randomized. The total morphine consumption during the first two postoperative days was decreased by 51% in the block group compared with the control group (21 +/- 9 mg vs 41 +/- 24 mg, P < 0.0001). This difference was not only due to morphine titration, but remained significant over the following 2 days. The course of the visual analog scale was equivalent between the two groups. No difference was observed in the side effects of morphine. CONCLUSION: The use of bilateral ilioinguinal nerve block for postoperative analgesia after hysterectomy decreased morphine consumption by one-half during the first two postoperative days without differences in side effects from morphine between groups.
