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Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure
OBJECTIVE: The aim of this study was to investigate factors preventing delayed hemorrhage after the loop electrosurgical excisional procedure (LEEP). METHODS: Medical records of patients who underwent LEEP at one university affiliated hospital from October 2013 to January 2015 were reviewed. Patient...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313370/ https://www.ncbi.nlm.nih.gov/pubmed/28217677 http://dx.doi.org/10.5468/ogs.2017.60.1.87 |
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author | Lee, Yong Jae Park, Yunjin Lee, In Ok Yoon, Jung Won Lee, Jung Yoon Kim, Sang Wun Kim, Sunghoon Kim, Young Tae Nam, Eun Ji |
author_facet | Lee, Yong Jae Park, Yunjin Lee, In Ok Yoon, Jung Won Lee, Jung Yoon Kim, Sang Wun Kim, Sunghoon Kim, Young Tae Nam, Eun Ji |
author_sort | Lee, Yong Jae |
collection | PubMed |
description | OBJECTIVE: The aim of this study was to investigate factors preventing delayed hemorrhage after the loop electrosurgical excisional procedure (LEEP). METHODS: Medical records of patients who underwent LEEP at one university affiliated hospital from October 2013 to January 2015 were reviewed. Patients with or without delayed hemorrhage were classified. LEEP was performed either in an operating room under general anesthesia or in a procedure room with local anesthesia in the outpatient clinic. Delayed hemorrhage was defined as excisional site bleeding occurring between 1 and 30 days after the LEEP requiring intervention such as electro-cauterization, gauze packing, or application of another hemostatic agent. RESULTS: During the study period, 369 patients underwent LEEP. Twenty-three (6.2%) patients with delayed hemorrhage returned to our hospital either to the outpatient clinic or to the emergency unit. A third of the population (103, 27.9%) underwent LEEP in the operating room under general anesthesia without injection of local anesthesia. The remaining patients (266, 72.1%) underwent LEEP with local anesthesia (lidocaine HCl 2% with epinephrine 1:100,000) in the office procedure room. Patients given local anesthesia including epinephrine had significantly lower delayed hemorrhage compared to patients with general anesthesia without injection of local anesthesia (P=0.001). Hemostats, such as fibrin glue or patch, were used for the majority of patients (346, 93.8%) during the procedure. However, using hemostats was not statistically associated with delayed hemorrhage (P=0.163). CONCLUSION: Local anesthesia with the powerful vasoconstrictor epinephrine is effective not only to control perioperative bleeding, but also to prevent delayed hemorrhage after LEEP. |
format | Online Article Text |
id | pubmed-5313370 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-53133702017-02-18 Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure Lee, Yong Jae Park, Yunjin Lee, In Ok Yoon, Jung Won Lee, Jung Yoon Kim, Sang Wun Kim, Sunghoon Kim, Young Tae Nam, Eun Ji Obstet Gynecol Sci Original Article OBJECTIVE: The aim of this study was to investigate factors preventing delayed hemorrhage after the loop electrosurgical excisional procedure (LEEP). METHODS: Medical records of patients who underwent LEEP at one university affiliated hospital from October 2013 to January 2015 were reviewed. Patients with or without delayed hemorrhage were classified. LEEP was performed either in an operating room under general anesthesia or in a procedure room with local anesthesia in the outpatient clinic. Delayed hemorrhage was defined as excisional site bleeding occurring between 1 and 30 days after the LEEP requiring intervention such as electro-cauterization, gauze packing, or application of another hemostatic agent. RESULTS: During the study period, 369 patients underwent LEEP. Twenty-three (6.2%) patients with delayed hemorrhage returned to our hospital either to the outpatient clinic or to the emergency unit. A third of the population (103, 27.9%) underwent LEEP in the operating room under general anesthesia without injection of local anesthesia. The remaining patients (266, 72.1%) underwent LEEP with local anesthesia (lidocaine HCl 2% with epinephrine 1:100,000) in the office procedure room. Patients given local anesthesia including epinephrine had significantly lower delayed hemorrhage compared to patients with general anesthesia without injection of local anesthesia (P=0.001). Hemostats, such as fibrin glue or patch, were used for the majority of patients (346, 93.8%) during the procedure. However, using hemostats was not statistically associated with delayed hemorrhage (P=0.163). CONCLUSION: Local anesthesia with the powerful vasoconstrictor epinephrine is effective not only to control perioperative bleeding, but also to prevent delayed hemorrhage after LEEP. Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society 2017-01 2017-01-19 /pmc/articles/PMC5313370/ /pubmed/28217677 http://dx.doi.org/10.5468/ogs.2017.60.1.87 Text en Copyright © 2017 Korean Society of Obstetrics and Gynecology http://creativecommons.org/licenses/by-nc/3.0/ Articles published in Obstet Gynecol Sci are open-access, distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Lee, Yong Jae Park, Yunjin Lee, In Ok Yoon, Jung Won Lee, Jung Yoon Kim, Sang Wun Kim, Sunghoon Kim, Young Tae Nam, Eun Ji Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure |
title | Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure |
title_full | Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure |
title_fullStr | Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure |
title_full_unstemmed | Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure |
title_short | Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure |
title_sort | delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313370/ https://www.ncbi.nlm.nih.gov/pubmed/28217677 http://dx.doi.org/10.5468/ogs.2017.60.1.87 |
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