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- 저자 : ( Deepali Garg ) (검색결과 4 건)
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Hysteroscopy in COVID 19 pandemic: safety concerns
( Rakhi Rai ),( Kallol Kumar Roy ),( Rinchen Zangmo ),( Deepali Garg ) 대한산부인과학회 2022 Obstetrics & Gynecology Science Vol.65 No.1
The coronavirus disease (COVID-19) pandemic is a global health crisis that negatively impacts the health infrastructure by diverting resources to manage this infection. The long-term impact on the health of patients due to a lack of appropriate medical care to avoid COVID-19 infection is already visible in the mortality rates of the general population. The presence of the severe acute respiratory syndrome coronavirus 2 in the female genital tract is not clear. Bubbles produced during hysteroscopy tend to cool down to the temperature of the distension medium and then dissolve. Hence, aerosols are not produced during hysteroscopy, which is usually performed in an office setting. If anesthesia is required, conscious sedation or regional anesthesia should preferably be used to reduce aerosol production. Hence, hysteroscopy is not an aerosol-generating procedure and the risk of COVID-19 infection is low; therefore, hysteroscopy should not be ruled out in emergencies.
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Laparoscopic gynecological surgery in COVID-19 pandemic
Kallol Kumar Roy,Rakhi Rai,Rinchen Zangmo,Archana Kumari,Nilofar Noor,Deepali Garg 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.3
The major concern that has confronted surgeons during the COVID-19 pandemic is the risk of infection duringsurgery. So far, no studies have found SARS-CoV-2 in surgical smoke, and if it was found, whether it was infectious ornot is unknown. To date, no evidence shows that respiratory viruses can be transmitted through a surgical plume oran aerosolized gas. There are various advantages of laparoscopy over laparotomy that must be kept in mind in theCOVID-19 era, such as early recovery and shorter hospital stay, which can greatly help to conserve valuable hospitalresources, and reduced risk of spillage of blood and body fluids, which can help to reduce transmission risk; mostimportantly, the distance between surgeons and between surgeons and patient is greater. Certain precautionarymeasures can be taken to reduce SARS-CoV-2 transmission during laparoscopy. Whenever possible, it should be thesurgical option of choice.
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( Rakhi Rai ),( Kallol Kumar Roy ),( Vinod Nair ),( Garima Kachhawa ),( Rinchen Zangmo ),( Deepali Garg ),( Perumal Vanamail ) 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.4
Objective Laparoscopy has now become a state-of-the-art technique for many diagnostic and therapeutic procedures with known advantages over laparotomy. There is scarce literature from India regarding minilaparoscopy, as per our literature review. Therefore, we performed this study with a 2.9-mm laparoscope to determine its feasibility and efficacy for diagnostic purposes and level II surgeries with the aim of reducing postoperative pain and better cosmesis. Methods This was a prospective study conducted from June 2019 to March 2020. Diagnostic modern minilaparoscopy with a 2.9-mm telescope was performed under general anesthesia by a single surgeon. Operative intervention was performed depending on the intraoperative findings. Results The mean age was 29.3 years. The most common indication for laparoscopy was infertility (98%). Only diagnostic laparoscopy was performed in 76% of patients, while 24% underwent operative laparoscopy. The various operative procedures performed were cystectomy, salpingectomy, ovarian drilling, and adhesiolysis. The mean visual analog scale scores at 1 hour and 2 hours postoperatively and discharge were 1.57±0.59, 1.41±0.51, and 1.29±0.47, respectively. Mild pain was present in 70 (72.2%) patients at the time of discharge, and only one patient had severe pain. Five or more analgesic tablets were required in only 16.5% of patients in the postoperative period. There was no wound infection or port-site hernia at follow-up. Conclusion Modern minilaparoscopy with a 2.9-mm laparoscope is a feasible and safe option for diagnostic laparoscopy and level II gynecological procedures with minimal postoperative morbidity, such as pain and wound infection, and provides good cosmetic outcomes.
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( Nilofar Noor ),( Kallol Kumar Roy ),( Rinchen Zangmo ),( Anamika Das ),( Rakhi Rai ),( Archana Kumari ),( Deepali Garg ),( Sonam Berwa ),( Sushmita Saha ),( Perumal Vanamail ) 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.1
Objective To study the efficacy and safety of 0.5% bupivacaine in paracervical block to reduce immediate postoperative pain after total laparoscopic hysterectomy. Methods A prospective, randomized, double-blind, placebo-controlled study was conducted at a tertiary referral center involving thirty women each in the treatment and placebo groups. Paracervical block with 10 mL of 0.5% bupivacaine (treatment group) or 0.9% saline (placebo group) was administered following general anesthesia and prior to proceeding with total laparoscopic hysterectomy. Visual analogue scale (VAS) scores at 30 and 60 minutes post extubation and mean VAS score (average VAS score at 30 and 60 minutes) were compared. Adequate pain control was defined as mean VAS score ≤5. Additional postoperative opioid requirement, hospital stay, and readmissions were also compared. Results Baseline variables such as age, previous history of cesarean section, operating time, and weight of the specimen were comparable in both groups. VAS scores at 30 (5.0±2.8 vs. 7.0±1.4) and 60 minutes (5.2±2.8 vs. 7.0±0.8) and the mean VAS score (5.1±2.7 vs. 6.8±0.9) were significantly lower in the treatment group. Adequate pain control (mean VAS score ≤5) was 57% higher and additional opioid consumption was 47% lower in the treatment group. No significant difference was found in the duration of hospital stay and readmission rate. Conclusion Paracervical block with bupivacaine was useful in reducing immediate postoperative pain with a 25% reduction in mean VAS score and a 47% reduction in opioid consumption in the first hour after total laparoscopic hysterectomy.
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