masterThesis
Ventajas trans y post operatoria inmediata del no cierre del peritoneo en pacientes con cesárea en el Hospital José Carrasco Arteaga del IESS - Cuenca, 2010
Fecha
2011Autor
Cárdenas Mateus, Julio César
Institución
Resumen
Objective. To determine the intraoperative and postoperative immediate benefits of non-closure of peritoneum versus closure of peritoneum at caesarean section patients.
Methodology. With a randomized controlled trial design included two groups of 80 pregnant women each to be performed cesarean section: group 1 (G1) is not sutured parietal or visceral peritoneum and group 2 (G2) closure of the two peritoneum. Surgical time was measured in minutes, pain intensity, the requirements for supplementary doses of analgesics and the number of them and finally the restoration of bowel function postoperatively.
Results. The groups were comparable in demographic variables. The average age was 28.3 ± 4.9 years in group 1 (Gl) and 30.5 ± 5.9 years in group 2 (G2) (p = 0.016 NS). In group 1, 43.8% were primiparous and 31.3% in group 2 (p = 0.8 NS). Statistically significant differences were found between the two groups: Group 1 (G1) showed reduction of surgical time (G1: 43.5 ± 6.9 minutes vs. Gl: 55.9 ± 5.27 minutes, p <0.001), decreased intensity of pain in Group I, only 13 patients (16.3%) experienced severe pain compared with 37 patients (46.3%) in group 2 who showed that magnitude of pain, p <0.001), therefore requiring less doses of analgesics used for pain control in G2 48.8% (39 patients) required 44 additional doses of analgesics and in group 1 in 32.8% (18 patients) had to be supplemented with analgesics p value <0.0001. There were no differences with respect to average hours of restoration of intestinal function by auscultation of bowel sounds the same as were between 12 and 24 hours postoperatively. It is suggested further study to track patients and identify long-term complications and their impact on morbidity and obstetric future.
Discussion. The current trend in caesarean section does not close favors parietal and visceral peritoneum in relation to the reduction of surgical time, decreased intraoperative bleeding and postoperative pain