Degree Of Postoperative Satisfaction Research Articles

Analgesic Effect of Ropivacaine Pumped in the Sub Rectus Abdominis Muscle Sheath after Abdominoplasty.

Abdominoplasty is a major surgical procedure in plastic surgery. It removes excess skin and fat, tightens abdominal muscles and fascia, restores normal abdominal anatomy and reshapes the distorted abdominal contour. According to the statistics released annually by International Society of Aesthetic Plastic Surgery (ISAPS) in 2020, there are more than 900, 000 abdominal wall plastic surgeries performed every year worldwide. However, the most commonly used analgesic methods, such as oral administration, intravenous analgesia and local infiltration anesthesia, do not provide the satisfactory analgesic results. We found that intra-sheath injection of ropivacaine of the rectus abdomen was effective in reducing postoperative pain. To retrospectively study the analgesic effect of continuous pumping ropivacaine into the intra-sheath space of rectus abdominis after abdominoplasty. A retrospective study was conducted on 67 patients with total abdominal wall plastic surgery admitted to Plastic Surgery Hospital of Chinese Academy of Medical Sciences from February 2020 to August 2021. The patients were from 25 to 56 years old, with a mean age of 38.5, ASA grade 1-2, BMI 27-33kg/m2, and rectus abdominis muscle separation range of 4-8cm. Based on the methods of postoperative analgesia, we divided patients into the following two groups: 29 patients in the conventional intravenous analgesic group (group A) and 38 patients in the rectus abdominis intrathecal analgesic group (group B). Group A received PCA with sufentanil 1.0μg/kg+ normal saline diluted to 100ml. Group B received continuous pumping of ropivacaine (0.2625%) through the rectus sheath internal tube in 100mL of normal saline and continued pumping at a rate of 2mL /h. Visual analog pain score (VAS score), analgesic pump pressure times and the degree of postoperative satisfaction were recorded at T1 (24h) and T2 (48h). The incidence of adverse drug reactions and complications related to nerve block within one week after operation were also recorded. The clinical data of patients with total abdominal wall plastic surgery in two groups were collected and analyzed. The patients in group B overall had lower postoperative VAS score, less analgesic pump usage, less nausea, vomiting, drowsiness and restlessness and a higher degree of postoperative satisfaction than those in group A. Continuous pumping of ropivacaine through rectus sheath can effectively relieve postoperative pain, reduce postoperative adverse reactions and improve postoperative satisfaction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online instructions to Authors www.springer.com/00266 . Body Contouring LOE IV.

Assessment of satisfaction of patients submitted to bichectomy

Objective: The aim this research was assess the level of satisfaction of patients undergoing bichectomy and its repercussions.Material and Methods: A cross-sectional and qualitative study, under protocol number 20707519.5.0000.5207, wascarried out by applying a questionnaire to patients undergoing bichectomy, which made it possible to assess complaints, degree of postoperative satisfaction, satisfaction of family members, time required to perceive results, complications and adverse effects, intensity of postoperative pain, and possibility of being submitted to a new intervention. Results: The sample consisted of 30 patients, among them, 82% sought surgery for aesthetic reasons. Regarding the degree of satisfaction, the majority (70%) were very satisfied, followed by 13.3% who were satisfied, 10% considered normal, 3.3% were dissatisfied and 3.3% very dissatisfied. Regarding the opinion of friends and family, the majority were very satisfied with the result. The adverse effects found were mild, no permanent injury happened, and the pain was mild in the most majority of the sample. Conclusion: Thus, the most majority of patients were satisfied with the results, as well as their family and friends. The results were more evident between the second and third months. No major or permanent damage was observed, suggesting that it is a safe technique when performed well.KEYWORDSAdipose tissue; Aesthetics; Mastication; Patient satisfaction.

Carpal tunnel syndrome: Factors interfering with the surgical response and the satisfaction degree of the operated patient

The Carpal Tunnel Syndrome (CTS) is the most common compressive mononeuropathy of the upper limbs. Nervous compression may cause functional and motor injuries. The surgical intervention is a highly effective therapeutic option. The aim of this study was to evaluate factors that interfere in the surgical response and the degree of postoperative satisfaction.

Septoplasty alone is not suitable for most structural nasal obstructions

Septoplasty is widely used in the treatment of structural nasal obstructions, and it also has a good effect and a high degree of postoperative satisfaction. However, there a large number of structures demonstrate abnormalities related to structural nasal obstruction, including the external nose, maxilla, nasal cavity and paranasal sinus. Nasal septum deviation is only one signs of structural nasal obstruction and does not represent all possible structural abnormalities of the nasal cavity and its surrounding structure. Septoplasty is only performed to correct deviations of the nasal septum, which in many cases is obviously insufficient in restoring the symmetry of the nasal structure. Therefore, septoplasty alone is not suitable for the treatment of most structural nasal obstructions. Nasal ventilation expansion surgery, which typically covers more abnormal structural correction procedures than septoplasty, should be used when describing the treatment of structural nasal obstruction.

Achilles tendon repair by a minimally invasive technique using Tenolig®

Objective: To assess the degree of postoperative satisfaction of patients with acute Achilles tendon rupture who underwent surgical reconstruction by a minimally invasive technique using Tenolig®. Methods: A retrospective observational study was conducted with 18 patients with acute Achilles tendon rupture diagnosed by a positive Thompson test who underwent surgery. Outcomes were assessed using the American arthopaedic Foot and Ankle Society (AOFAS) score and the Foot Function Index (FFI). Furthermore, quantitative variables were descriptively treated, and patients’ age was correlated with FII and AOFAS score using Spearman’s correlation coefficient at a significance level of 5%. Results: Patients underwent surgery from one to six days after injury and were discharged one day later. Only one patient had a superficial postoperative infection. Patients’ AOFAS scores ranged from 75 to 100 points, and FFI ranged from 0 to 20%. The patient withsuperficial postoperative infection had an AOFAS score and a FFI of 75 points and 20%, respectively. Conclusion: Percutaneous repair of complete Achilles tendon rupture with Tenolig® resulted in high functional scores and a low rate of complications. Level of Evidence IV; Therapeutic Studies; Case Series.

Uterine Preserving Laparoscopic Lateral Mesh Suspension for Uterovaginal Prolapse

Objective: To evaluate the technique of laparoscopic lateral colpo-uterine suspension using a mesh for uterovaginal prolapse; to specify its indications, advantages and complications and to assess its success rate. Patients and methods: This retrospective cohort study included all women treated by uterus preserving laparoscopic lateral suspension with mesh for symptomatic uterovaginal prolapse between January 2008 and June 2016 in tertiary referral hospital Farhat Hached Sousse (Tunisia). The data collected were: preoperatively and postoperatively functional symptoms and prolapse grade (POP-Q) grading system, the degree of preoperative discomfort and postoperative satisfaction, complications rate classified according to the Clavien grading system for surgical morbidity. Results: One hundred and twelve patients were included. Twenty nine women were lost to follow up and were, therefore, excluded from the study. The mean age of the patients was 49.02 ± 6.92 years (29-69). After a mean follow-up of 21 months, the success rate of anatomical reduction with this technique was about 94.8% and 4 cases of recurrent vaginal prolapse was noted, 2 were partially improved. A grade 0 was found in 58.4% and 70.1% of cases respectively at the anterior and middle floor. The rate of success for the anterior and middle floor was respectively 94.8% and 97.4%. Seventy patients (84.3%) were satisfied by the functional outcome and the degree of postoperative satisfaction was 8.1 ± 1.38 (4-10) out of 10. No laparoconversion was necessary. One bladder perforation occurred during dissection requiring preoperative sutures. Three delayed complications were observed (3.6%): two cases of parietal mesh erosions, one case of bladder granulomas. There were no cases of vaginal mesh erosions. Conclusions: The results of this study demonstrate that laparoscopic lateral colpo-uterine suspension in the treatment of genital prolapse has good anatomical and functional results, and is simple, reproducible and safe. But, we need level 1 data comparing this technique to other established surgical procedures for uterovaginal prolapse.

Premedication with midazolam prior to cesarean delivery in preeclamptic parturients: A randomized controlled trial

Background:Anxiety is a concern in obstetrics, especially in preeclamptic mothers. Sedation is not commonly used in parturients for fear of adverse neonatal effect. We investigated maternal and neonatal outcome of midazolam as an adjuvant to spinal anesthesia for elective cesarean delivery.Methods:A prospective randomized controlled trial, in which eighty preeclamptic parturients received either an intravenous dose of 0.035 mg/kg of midazolam or an equal volume of normal saline, 30 min before spinal anesthesia. Maternal anxiety was assessed using Amsterdam Preoperative Anxiety and Information Scale (APAIS); postoperative maternal satisfaction was assessed using Maternal Satisfaction Scale for Cesarean Section (MSSCS). Newborns were assessed using Apgar score, Neonatal Neurologic and Adaptive Capacity Score (NACS), and umbilical artery blood gases.Results:Mothers premedicated with midazolam showed a lower level of preoperative anxiety and a higher degree of postoperative satisfaction than the control group. There were no between-group differences regarding the neonatal outcome.Conclusion:Preeclamptic parturients premedicated with midazolam (0.035 mg/kg) before spinal anesthesia have lower anxiety and higher postoperative satisfaction levels, with no adverse effects on the newborns.

Avaliação da satisfação a longo prazo dos pacientes submetidos a rinoplastia no Serviço de Cirurgia Plástica da Santa Casa de Misericórdia de Porto Alegre

INTRODUCAO:A rinoplastia, assim como diversos procedimentos esteticos, apresenta parcos estudos objetivos quanto a satisfacao dos pacientes. O objetivo do presente estudo e avaliar o grau de satisfacao a longo prazo dos pacientes submetidos a rinoplastia na Santa Casa de Misericordia de Porto Alegre, em um estudo retrospectivo, utilizando questionario validado. METODO: Foram selecionados todos (n = 119) os pacientes submetidos a rinoplastia no Servico de Cirurgia Plastica da Santa Casa de Misericordia de Porto Alegre, nos anos de 2007, 2008 e 2009, para aplicacao de um questionario validado, com o objetivo de avaliar o grau de satisfacao pos-operatoria. RESULTADOS: Foram contatados 60 (50,42%) pacientes no estudo. Quanto a satisfacao global com o resultado estetico-funcional da rinoplastia, 85,48% dos pacientes afirmaram estar satisfeitos. Estratificando esse valor, foi observado que 88,3% dos pacientes estavam muito ou completamente satisfeitos com o aspecto estetico pos-operatorio do nariz; quanto a funcao nasal pos-operatoria, 83,3% reportaram estar muito ou completamente aptos a respirar pelo nariz; quanto a impressao de amigos e familiares sobre o aspecto final do nariz, 93,3% afirmaram estar muito ou completamente satisfeitos com o resultado; 93,3% afirmaram que raramente ou nunca tiveram limitacao das atividades sociais ou profissionais em decorrencia do aspecto nasal pos-operatorio; 75% afirmaram estar muito ou completamente confiantes de que a aparencia de seu nariz era a melhor possivel de ser obtida; 76,7% afirmaram que definitivamente nao gostariam de alterar a aparencia do nariz com outra cirurgia; e 83,4% afirmaram que definitivamente nao gostariam de alterar a funcao nasal com outra cirurgia. CONCLUSOES: Constatou-se que a rinoplastia realizada no Servico de Cirurgia Plastica da Santa Casa de Misericordia de Porto Alegre apresentou alto indice de satisfacao dos pacientes.

Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients

Thoracic sympathectomy (TS) is the treatment of choice for severe primary hyperhidrosis. However, complications, side effects and satisfaction have not been well defined. To analyze the complications, side effects, satisfaction degree and quality of life of patients after TS for primary upper limb hyperhidrosis. One-year follow-up after 406 consecutive TS for primary upper limb hyperhidrosis. Bilateral TS was completed in all patients. Complications arose in 23 cases (5.6%), with pneumothorax being the most frequent. The success rate after discharge, 6 and 12 months was respectively, 100%, 98.1% and 96.5% for palmo-axillary hyperhidrosis; 100%, 99.3% and 97.8% for isolated palmar hyperhidrosis and 100%, 85.7% and 71.4% for isolated axillary hyperhidrosis. No persistence of hyperhidrosis was observed. Global recurrence was 3.7% (28.5% axillary hyperhidrosis group). Compensatory sweating (CS) appeared in 55% and was not related to the extension of the TS. Being female was a predisposing factor of CS (p<0.004). Excessive dryness appeared at 9% and was associated with extensive TS (P<0.001). Plantar hyperhidrosis improved at 33.6%, worsened at 10% and remained stable during the follow-up. Satisfaction degree decreased with the passage of time and was associated with recurrence. Quality of life was excellent at discharge, 6 and 12 month in 100%, 100% and 97%, respectively. Pneumothorax is the most frequent complication of TS. CS is the main and undesirable side effect, appears with the passage of time, and is not related to the extension of TS. Being female is the only predictor factor of suffering CS. Plantar hyperhidrosis improves initially, although tends to reappear. Excessive dryness appears in extensive TS and does not improve over time. Postoperative satisfaction degree is high but decreases over time owing to the appearance of recurrence. Effectiveness and the absence of CS determine an excellent quality of life. Six percent of the patients regret the surgery because of severe CS. Informing patients of possible side effects before TS is essential.