We evaluated whether or not routine prophylaxis with 2.5 mg of droperidol would efficiently prevent postoperative nausea and vomiting (PONV). Fifty-two patients scheduled for elective gynecological laparoscopic surgery were eligible for this study. Anesthesia was induced using propofol, fentanyl, and vecuronium, and maintained with sevoflurane in nitrous oxide, fentanyl, and vecuronium. Patients were randomized to one of two groups: group 1 patients (n = 23) received 2.5 mg droperidol intravenously when the surgery was started, while group 2 patients (n = 29) did not receive any droperidol. At the conclusion of the surgery, the patient was extubated on satisfactory emergence from general anesthesia. Any episodes of nausea and vomiting, rescue medications, and adverse effects were recorded until the next morning after the surgery. There were no differences in the duration of anesthesia on surgery between the groups, but the total fentanyl dose in group 1 was higher than that in group 2. Episodes of nausea and vomiting and the need for metoclopramide in group 1 were lower than in group 2, though the total fentanyl dose in group 1 was higher than in group 2. There were no differences in the need for analgesics between the groups. The use of 2.5 mg droperidol safely decreased PONV after gynecological laparoscopy.
Using the method described in this study, we detected asymptomatic AF in numerous patients, and demonstrated that this method is potentially useful in screening outpatients for asymptomatic AF.
abscess cavities, excision of necrotic tissue, and the closure of fistulous tracts are performed [4]. Aortic valve replacement is carried out if the abscesses spread through the aortic valve. In this case, even though preoperative TTE failed to reveal mobile vegetation, intraoperative TEE revealed mobile vegetation and perivalvular abscesses. Therefore, mitral valve replacement, drainage of abscess cavities, and excision of necrotic tissue were recommended.Several studies have reported that TEE has a substantially higher sensitivity and specificity than TTE for detecting vegetation, perivalvular extensions of IE, and the presence of a myocardial abscess [5][6][7]. As prosthetic structures are strongly echogenic, they may prevent vegetation detection [8]. In a large series of prosthetic endocarditis, TEE has shown an 86%-94% sensitivity and an 88%-100% specificity for vegetation diagnosis, while TTE sensitivity was only 36%-69% [9].TEE is a useful tool for the diagnosis of IE after mitral valve plasty and surgical decision making.
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