Bakground : Patient-Controlled Analgesia (PCA) has become popularized for postoperative pain control. Theoretically, addition of a basal infusion would ameliorate the pain control as related to less need for additional demands. Regardless of theoretical background, usefulness of a basal infusion in PCA is controversial. Therefore, in this study we compared the analgesic consumption between PCA only and PCA plus basal infusion and assessed if the use of a basal infusion improves the analgesic efficacy in intravenous PCA. METHODS: 40 patients undergoing caesarian section, were assigned randomly to PCA only group (group 1) and PCA plus basal infusion group (group 2). Group 1 was programmed to deliver 1.5 ml of bolus infusion with 10 minutes of lockout interval and four times per hour of the maximum usage of patient control module. In group 2, 0.5 ml of basal infusion was added to the same PCA. The analgesic solution contained 60 mg of morphine, 180 mg of ketorolac and 5 mg of droperidol in total volume of 60 ml. PCA was started at the time of the peritoneal closure with 2 ml of loading dose in all patients. Postoperative assessments were pain score, sedation score, side effect, total analgesic consumption and the degree of patients, satisfaction. RESULTS: Total analgesic consumption was significantly greater in group 2 than in group 1. Pain score, sedation score, complication and the degree of the satisfaction were almost the same at all time interval in each group. CONCLUSION: We concluded that there was no significant benefit of basal infusion in intravenous PCA after caesarean section.
Analgesia ; Analgesia, Patient-Controlled* ; Cesarean Section* ; Droperidol ; Female ; Humans ; Ketorolac ; Morphine ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Pregnancy

Failure of fixation of intertrochanteric fractures that have been treated with a fixed-angle sliding hip-screw device is frequently related to the position of the lag screw in the femoral head. The purpose of this study is to introduce the concept of the tip-apex distance and to demonstrate its clinical usefulness as a predictor of cutout of the screw used for fixation of the intertrochanteric fractures of the hip. The tip-apex distance is the sum of the distance from the tip of the lag screw to the apex of femoral head on an anteroposterior radiograph and this distance on a lateral radiograph after controlling for magnification. To determine the value of tip-apex distance in the prediction of cutout of the lag screw, 67 intertrochanteric fractures that have been treated with a fixed-angle sliding hip screw device were studied. The minimum duration of follow-up was three months during which period all of the fractures either healed or had failure of the fixation. The average tip-apex distance was 21mm (range,22.8-65.8mm) for the successfully treated fractures compared with 35mm (range,8.4-65.8mm) for those in which the screw cutout. There was strong statistical relationship between an increasing tip-apex distance and the rate of cutout. An unstable fracture, a poor reduction were also associated with a significantly increased risk of failure due to cutout.
Femur ; Follow-Up Studies ; Head ; Hip Fractures* ; Hip*

No abstract available.
Heart Valves* ; Heart*

No abstract available.
Korea* ; Thoracic Surgery*

No abstract available.

No abstract available.

No abstract available.
Acetabulum* ; Arthroplasty, Replacement, Hip*

No abstract available.
Arthroplasty, Replacement, Hip*

One hundred fifty bacteriae isolated in significant numbers from 96 specimens of urine of the 45 in-patients with long-term indwelling catheter were evaluated from January, 1978 to July. 1979 and the following results were obtained; 1. In 20 patients (44.4%), positive urine culture was obtained within 10 days after indwelled catheter in the urinary tract and 97.9% of the patients revealed the positive urine culture within 20 days after that. 2. Of 150 bacterial strains isolated by cultures of the urine, 96% was gram-negative bacteria and 4% was gram-positive. Isolated organisms included klebsiella(27.4%), E.coli(23.3%). proteus(14.7%), pseudomonas(12.0%). coliform bacilli(10.0%). other gram-negative organism (8.6%), staphylococcus(2.7%) and streptococcus (l.3%) in order of frequency. 3. In 4 patients(8.9%), bacteremia was developed. Isolated organism from blood culture and those from urine culture were same. The mortality rate was 50%.
Bacteremia ; Bacteria ; Catheters ; Catheters, Indwelling* ; Gram-Negative Bacteria ; Humans ; Mortality ; Streptococcus ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: Asymptomatic urinary retention in the post-partum period is a relatively common problem. We investigated prospectively the incidence and the various risk factors associated with asymptomatic urinary retention in post-partum. MATERIALS AND METHODS: From Feb. 1999 to Apr. 1999, all pregnant women who visited our hospital for delivery were evaluated. Among them 103 women who had undergone vaginal delivery were evaluated, Exclusion criteria were cesarean section, incidental catheter indwelling during delivery, and symptomatic urinary retention. Residual urine volume was measured using BladderScanTM BVI 2500(Diagnostic Ultrasound co.) within 10 minutes after first voiding in immediate post-partum period. Asymptomatic urinary retention was defined as residual urine volume over 150ml. Pre-partal urinary symptoms and various obstetric parameters were evaluated in asymptomatic urinary retention group and normal group as control. Asymptomatic urinary retention group were followed up daily to monitor their post-void residual urine volume. RESULTS: The incidence of asymptomatic urinary retention after vaginal delivery was 13.6%. Factors associated with asymptomatic urinary retention included second stage of labor, episiotomy, and instrumental delivery. There was no relationship between pre-partal lower urinary tract symptoms and post-partal asymptomatic urinary retention. In patients with asymptomatic urinary retention, catheterization was done for removing residual urine and thus preventing progression of further distension. Post-void residual volume was normalized within 3 days in all patients. CONCLUSIONS: Asymptomatic post-partum urinary retention is a self-limiting phenomenon associated with various traumatic events during hard labor such as prolonged labor, episiotomy, instrumental delivery. Close observation of voiding patterns in patients with risk factors is needed to prevent myogenic failure associated with unrecognized asymptomatic post-partum urinary retention.
Catheterization ; Catheters ; Cesarean Section ; Episiotomy ; Female ; Humans ; Incidence ; Lower Urinary Tract Symptoms ; Pregnancy ; Pregnant Women ; Prospective Studies* ; Residual Volume ; Risk Factors ; Ultrasonography ; Urinary Retention*