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PubMed1983

Hormone response in gynecologic surgery.

We measured plasma arginine vasopressin (AVP), plasma renin activity (PRA), human growth hormone (HGH), immunoreactive insulin (IRI), and blood glucose in 25 gynecologic inpatients. Six were undergoing dilatation and curettage (Group 1), nine were undergoing hysterectomy (Myomata uteri) and receiving acetated Ringer's lactate without glucose (Group 2), and ten were undergoing hysterectomy and receiving acetated Ringer's lactate in 5% glucose (Group 3). The measurements were made the night before the operation, during the operation, and postoperatively. Plasma AVP did not change significantly in Group 1, but it increased in both Groups 2 and 3. PRA showed no significant changes in any group studied. HGH decreased slightly at the end of the operation in Groups 1 and 2, but it increased significantly in Group 3 in the recovery room 1 h after surgery. Blood glucose and insulin remained at normal levels in Groups 1 and 2, but they increased significantly in Group 3. We believe that stress was caused more by greater surgical trauma than by the depth of anesthesia and anesthetic agents in Groups 2 and 3, when compared to Group 1; this is a possible mechanism of the increased AVP secretion. Acetated Ringer's lactate without glucose appeared to cause a more physiologic response during gynecologic surgery than did acetated Ringer's lactate in 5% glucose.

Adult↗
PubMed2002

Relaxation and music reduce pain after gynecologic surgery.

The purpose of this randomized controlled trial was to investigate the effect of three nonpharmacologic nursing interventions: relaxation, music, and the combination of relaxation and music on pain following gynecologic (GYN) surgery. A total of 311 patients, ages 18 to 70, from five Midwestern hospitals, were randomly assigned using minimization to either three intervention groups or a control group and were tested during ambulation and rest on postoperative days 1 and 2. Pain sensation and distress were measured using visual analogue scales. Multivariate analysis of covariance of posttest sensation and distress was used with pretest control and a priori contrasts. The intervention groups had significantly less posttest pain than the control group (p =.022-.001) on both days. The three interventions were similar in their effect on pain. Patients who received the interventions plus patient-controlled analgesia (PCA) had 9% to 29% less pain than controls who used PCA alone. Reduced pain was related to amount of activity (ambulation or rest), mastery of the use of the intervention, and decreased pulse and respiration. Those who slept well had less pain the following day. Nurses who care for GYN surgical patients can provide soft music and relaxation tapes and instruct patients to use them during postoperative ambulation and also at rest on days 1 and 2.

Adult↗