The Learning Curve and Clinical Safety of Stapled Haemorrhoidectomy: A Prospective Study of 61 Patients

Swiss Surgery ◽  
2002 ◽  
Vol 8 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Hetzer ◽  
Schäfer ◽  
Demartines ◽  
Clavien
Keyword(s):  
Visual Analogue Scale ◽  
Learning Curve ◽  
Prospective Study ◽  
Analogue Scale ◽  
Perioperative Komplikationen ◽  
Postoperative Schmerzen ◽  
Clinical Safety ◽  
Glatte Muskulatur ◽  
Stapled Haemorrhoidectomy ◽  
A Prospective Study

Einleitung: Mit der Stapler-Hämorrhoidektomie (SH) ist ein neues Verfahren zur Behandlung der prolabierenden Hämorrhoiden entwickelt worden. Über Lernkurve, Komplikationsrate und Langzeitverlauf gibt es bis heute nur wenige Berichte in der Literatur. Wir haben deshalb unsere Patienten prospektiv erfasst und ambulant nachkontrolliert. Methoden: Von März 1999 bis Mai 2001 wurde bei 61 Patienten mit Hämorrhoiden II (n = 18), Grad III (n = 38) und Grad IV (n = 5) nach schriftlicher Einwilligung eine SH durchgeführt. Operationszeit und perioperative Komplikationen wurden prospektiv erfasst und mit der Erfahrung des Operationsteams korreliert. Anhand der visual analogue scale (VAS) konnte die postoperative Schmerzintensität gemessen werden. Mittels prä- und postoperativ erhobenen Inkontinenzscore nach Williams und der histologischen Untersuchung des Exzisates wurde nach Sphinkterläsionen gesucht. Ambulante Nachkontrollen erfolgten nach drei Wochen und drei Monaten. Ergebnisse: Operationsdauer und Komplikationsrate nahmen mit zunehmender Erfahrung des Operationsteams deutlich ab. Insgesamt betrug die Komplikationsrate 9.9%. Die durchschnittliche postoperative Schmerzintensität betrug in den ersten vier Tagen 1.9 (min 0, max 8). Die mittlere Hospitalisationsdauer betrug 1,7 Tage (1-5 Tage) und die Rekonvaleszenzzeit zehn Tage (1-31 Tage). In 29 Fällen wurde histologisch glatte Muskulatur, in sechs Fällen Epithel des Analkanals nachgewiesen. Der prä- und postoperative Kontinenzscore wies keine signifikanten Unterschiede auf (1.2 vs 1.0). Schlussfolgerungen: Die SH ist bei korrekter Anwendung und nach Durchlaufen einer Lernkurve von 25 Resektionen ein sicheres Verfahren. Die Vorteile dieser Technik, wie geringere postoperative Schmerzen, kurze Hospitalisations- und Rekonvaleszenzzeit, sind überzeugend, so dass die SH in unserer Klinik einen festen Platz in der Therapie von Hämorrhoiden Grad III und Rezidivhämorrhoiden Grad II gefunden hat.

Pain scores and recovery post tonsillectomy: intracapsular versus extracapsular coblation

2019 ◽  
Vol 133 (09) ◽  
pp. 775-781 ◽  
Author(s):  
M Junaid ◽  
S Sood ◽  
H Walijee ◽  
J Dorgham ◽  
S De
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Visual Analogue Scale ◽  
Prospective Study ◽  
Analogue Scale ◽  
Normal Fluid ◽  
Pain Scores ◽  
Average Pain ◽  
A Prospective Study ◽  
Intracapsular Tonsillectomy

AbstractObjectiveThis study compared post-tonsillectomy pain scores and recovery using the coblation-only technique, comparing extracapsular versus intracapsular approaches.MethodsA prospective study was performed in our paediatric ENT department. Pain scores were recorded on days 0, 2, 4 and 8, using a visual analogue scale ranging from 0 (no pain) to 10 (extreme pain). Information was also collected on: return to normal fluid and solid intake, and any post-operative visits to primary care.ResultsIn total, 101 patients were included in the analysis. Average pain scores were statistically lower on days 2, 4 and 8 in the intracapsular group compared to the extracapsular cohort. The intracapsular cohort also returned sooner to normal fluid and solids intake. The extracapsular group were more likely to visit the general practitioner post-operatively.ConclusionIntracapsular tonsillectomy appears to result in reduced morbidity overall and should be considered as a viable alternative in relevant cases.

Post-tonsillectomy pain: the first ten days

1995 ◽  
Vol 109 (10) ◽  
pp. 963-964 ◽  
Author(s):  
Abbad G. Toma ◽  
Jonathan Blanshard ◽  
Nick Eynon-Lewis ◽  
M. W. Bridger
Keyword(s):  
Visual Analogue Scale ◽  
Prospective Study ◽  
Analogue Scale ◽  
Day Case ◽  
Painful Experience ◽  
A Prospective Study

AbstractForty-one adults were entered into a prospective study to investigate the pattern of pain over 10 days after elective dissection tonsillectomy. The severity of pain was scored by the patient on a visual analogue scale. The results confirm that tonsillectomy is a very painful experience and the provision of adequate analgesia is of paramount importance, especially if day-case tonsillectomy is performed.

Upper Arm Tourniquet Pain in Local Anaesthetic Surgery

1995 ◽  
Vol 20 (3) ◽  
pp. 413-414 ◽  
Author(s):  
W. E. OGUFERE ◽  
G. E. B. GIDDINS ◽  
J. S. THOM
Keyword(s):  
Visual Analogue Scale ◽  
Prospective Study ◽  
Local Anaesthetic ◽  
Analogue Scale ◽  
Upper Arm ◽  
Tourniquet Pain ◽  
Anaesthetic Procedure ◽  
Idiosyncratic Response ◽  
A Prospective Study

A prospective study was performed on 100 consecutive patients (110 procedures) of the perception of pain from an arm tourniquet during a local anaesthetic procedure. This was assessed subjectively, and objectively using a visual analogue scale. For tourniquet times up to 20 minutes, the tourniquet was well tolerated with only one failure (1% of patients) and all successful patients stated that they would be happy to have a similar procedure again. Unlike previous studies, there appeared to be no correlation between time of tourniquet use and the pain perceived. Rather, there appeared to be an idiosyncratic response to the tourniquet which was borne out by the ten patients who had bilateral procedures at least 6 weeks apart and showed consistently repeatable scores.

Dissection tonsillectomy: pattern of post-operative pain, medication and resumption of normal activity

1998 ◽  
Vol 112 (1) ◽  
pp. 41-44 ◽  
Author(s):  
P. Murthy ◽  
M. R. Laing
Keyword(s):  
Visual Analogue Scale ◽  
Return To Work ◽  
Prospective Study ◽  
Analogue Scale ◽  
Normal Activity ◽  
Pain Medication ◽  
Pain Scores ◽  
Normal Swallowing ◽  
Post Operative Pain ◽  
A Prospective Study

AbstractA prospective study of 99 adults undergoing tonsillectomy was carried out to determine the pattern of post-operative pain, intake of medication and timing of return to work and normal swallowing. The differences in the pain scores, as measured by a visual analogue scale, between every third consecutive day following post-operative day four were found to be highly significant (p<0.001). Sixty-six patients (66.6 per cent) required medication in the form of analgesics and/or antibiotics after the first post-operative day. Sixty-four out of a total of 82 patients (78.2 per cent) returned to work within 14 days of surgery. Ninety-six patients (97 per cent) reported normal swallowing within 14 days of surgery. These results suggest that the majority of adult patients undergoing tonsillectomy can be appropriately advised pre-operatively regarding the probable pattern and duration of post-operative pain and the timescales they can expect to return to work and normal swallowing.

scholarly journals Fitness center use and subsequent achievement of exercise goals. A prospective study on long-term fitness center members

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Liv Riseth ◽  
Tom Ivar Lund Nilsen ◽  
Torunn Hatlen Nøst ◽  
Aslak Steinsbekk
Keyword(s):  
Longitudinal Study ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Goal Achievement ◽  
Fitness Centers ◽  
Fitness Center ◽  
Prospective Association ◽  
A Prospective Study ◽  
The Relationship

Abstract Background Knowledge on the relationship between fitness center use and long-term members’ subsequent goal achievement is limited. Therefore, the aim was to investigate the prospective association between the use of fitness centers during 18 months and subsequent self-reported goal achievement among long-term members. Methods This was a registry- and survey-based longitudinal study of 2851 people who had been members at a Norwegian fitness center chain for more than two years. Fitness center use from December 2016 to June 2018 was obtained from registry data. Subsequent goal achievement was measured in a survey in June 2018, assessed by a 1–100 visual analogue scale, and a score between 0 and 50 was defined as low goal achievement. Results Visiting the fitness center frequently and regularly, and having frequent group activity bookings were associated with higher subsequent self-reported goal achievement. Participants with fewest visits (1–57 days) during 18 months were more likely to report low goal achievement than participants with most visits (118–543 days) (OR = 8.5; 95% CI 6.3–11.4). Fitness trainer bookings was not clearly associated with subsequent goal achievement. Conclusions Frequent and regular long-term fitness center use were associated with higher subsequent self-reported goal achievement.

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