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1.
Acta Obstet Gynecol Scand ; 93(4): 345-50, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24575769

RESUMO

OBJECTIVE: To determine if transversus abdominis plane anesthetic blockage (TAP block) diminishes early postoperative pain scores and facilitates ambulatory management following total laparoscopic hysterectomy. DESIGN: Randomized triple blind trial. SETTING: Gynecological endoscopy unit at a referral center for laparoscopic surgery. POPULATION: A total of 197 patients. METHODS: Comparison of a treatment group receiving TAP block with bupivacaine 0.25% and placebo group with comparably placed bilateral injection of sterile saline solution. MAIN OUTCOME MEASURES: Pain scores at discharge 24, 48 and 72 h after surgery, opioid requirement after procedure. RESULTS: Patients who had TAP block had a significant reduction in their pain score at discharge compared with the placebo group (p = 0.017). There were no significant differences in the pain scores between groups at 24 h (95% CI 1.36-0.133, p = 0.237), 48 h (95% CI 0.689-0.465, p = 0.702) and 72 h (95% CI -0.631 to 0.223, p = 0.347). No differences were found between the groups regarding opioid requirements following the procedure (χ(2)  = 3.62, p = 0.46). CONCLUSION: Although TAP block after a total laparoscopic hysterectomy reduced the pain score at discharge compared with placebo, its role in this setting is debatable due to the possible lack of clinical significance of the small difference found.


Assuntos
Músculos Abdominais/inervação , Procedimentos Cirúrgicos Ambulatórios , Anestésicos Locais/administração & dosagem , Bloqueio Nervoso Autônomo , Bupivacaína/administração & dosagem , Histerectomia/efeitos adversos , Laparoscopia , Dor Pós-Operatória/tratamento farmacológico , Adulto , Idoso , Analgésicos Opioides/administração & dosagem , Bloqueio Nervoso Autônomo/métodos , Método Duplo-Cego , Feminino , Humanos , Histerectomia/métodos , Injeções , Laparoscopia/efeitos adversos , Tempo de Internação/estatística & dados numéricos , Pessoa de Meia-Idade , Morfina/administração & dosagem , Medição da Dor , Dor Pós-Operatória/etiologia , Falha de Tratamento
2.
Rev. Fac. Nac. Salud Pública ; 26(1): 56-68, ene.-jun. 2008. graf, mapas, tab
Artigo em Espanhol | LILACS | ID: lil-636906

RESUMO

Objetivo: obtener un constructo de salud para clasificar hogares de la ciudad de Medellín según sus condiciones de vida y salud. Materiales y métodos: para la creación del constructo de salud, se partió de los datos obtenidos en la Encuesta de Calidad de Vida, Medellín, 2004, de donde se seleccionaron las variables referentes a condiciones de vida y determinantes de la salud. Se realizó un análisis de componentes principales para escoger aquellos que explicaban la mayor variabilidad de los hogares; posteriormente se hizo el análisis de conglomerados en dos pasos para agrupar los hogares según sus condiciones de vida y salud. Resultados: las correlaciones observadas estaban en la dirección prevista. Doce componentes principales explican el 69% de la variabilidad de los datos, aportando una mayor proporción de variabilidad las variables de las condiciones de vida. En Medellín se identificaron cinco tipologías de hogares que comparten las mismas condiciones de vida y salud. Conclusión: las técnicas multivariantes permiten concluir que la clasificación de los hogares de Medellín en cinco tipologías con respecto a los determinantes de la salud ofrece oportunidades para la formulación de programas de intervención a escala poblacional.


Objective: to obtain a health profile to classify homes of Medellín city, according to similarities due to life and health conditions. Materials and methods: for the creation of a health profile, information was taken from the data collected in the Quality of Life Survey, Medellín, 2004, where variables referring to life conditions and health determinants were selected. An analysis of mean components was made to choose those that explained the greater variability among homes, then a cluster analysis in 2 steps was performed to group the homes according to their life and health conditions. Results: the observed correlations appeared in the expected directions. A total of 12 components explain 69% of the variability of the data, contributing to a greater proportion of variability the variables of life conditions. In Medellín, 5 types of homes were identified sharing the same conditions of life and health. Conclusion: multivariant techniques allow to conclude that Medellín’s home classification into 5 types regarding their determinants of health provides opportunities to make formulation of intervention programs at the population level possible.


Assuntos
Condições Sociais , Gestão de Recursos Humanos
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