Background
The proper time for removing the urinary catheter after gynecologic laparoscopy is unclear.
Objectives
To assess the feasibility of immediate catheter removal after benign gynecologic laparoscopy.
Search Strategy
PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Wanfang Data were searched from inception to November 30, 2021.
Selection Criteria
Only randomized controlled trials published in English or Chinese comparing immediate versus delayed catheter removal after gynecologic laparoscopy for benign diseases were included.
Data Collection and Analysis
The primary outcome was the incidence of postoperative urinary retention (PUR). A random effects model was used to calculate pooled relative risk (RR) and 95% confidence interval (CI).
Main Results
Six studies were included in this meta‐analysis. There was no significant difference in PUR between immediate and delayed catheter removal (RR 1.51, 95% CI 0.37–6.18), but the evidence was of very low quality. Subgroup analysis according to the type of surgery showed a higher rate of PUR with immediate removal after hysterectomy than after other surgeries. Immediate removal was associated a lower incidence of urinary tract infection and a shorter time to mobilization compared with delayed removal.
Conclusions
Immediate removal of the urinary catheter is feasible and beneficial after benign gynecologic laparoscopy.
Background:
Infrared ear thermometry is widely used in clinical practice due to its noninvasive, convenient, and quick sampling. However, its accuracy and feasibility in anesthetized patients have not yet been established.
Methods:
We conducted this cross-sectional study to evaluate the agreement between infrared ear temperature and nasopharyngeal temperature in general anesthetized patients and its performance in intraoperative hypothermia, defined as nasopharyngeal temperature <36°C. Adult female patients who underwent gynecological surgery under general anesthesia were enrolled in this study. Infrared ear temperature by Braun ThermoScan PRO 4000 (Braun GmbH, Kronberg, Germany) and nasopharyngeal temperature were measured simultaneously before, during, and after surgery. The agreement between the two temperatures was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. The diagnostic performance of the infrared ear thermometer for hypothermia was evaluated using receiver operating characteristic (ROC) curve analysis.
Results:
Fifty-six patients with 168 pairs of simultaneous infrared ear and nasopharyngeal temperatures were included in this analysis. The mean infrared ear temperature was consistently higher than the nasopharyngeal temperature throughout surgery, but the differences were small (0.22, 0.13, and 0.06°C before, during, and after surgery, respectively). The ICC between the two temperatures before, during, and after surgery was 0.70, 0.75, and 0.80, respectively, and 93.5% of the differences fell within the 95% limits of agreement of ±0.5°C. An infrared ear thermometer had high diagnostic accuracy for hypothermia, with an area under the ROC curve of 0.95 (95% confidence interval [CI], 0.92-0.98). The cutoff of infrared ear temperature for hypothermia was 36.2°C with a sensitivity of 0.89 (95% CI, 0.71-0.98) and a specificity of 0.87 (95% CI, 0.81-0.92).
Conclusion:
The infrared ear temperature is in good agreement with the nasopharyngeal temperature in general anesthetized patients without hyperthermia and has high performance for detecting hypothermia. An infrared ear thermometer can be a diagnostic tool for intraoperative hypothermia.
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