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Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure

Authors
 Yong Jae Lee  ;  Yunjin Park  ;  In Ok Lee  ;  Jung Won Yoon  ;  Jung Yoon Lee  ;  Sang Wun Kim  ;  Sunghoon Kim  ;  Young Tae Kim  ;  Eun Ji Nam 
Citation
 Obstetrics & Gynecology Science, Vol.60(1) : 87-91, 2017 
Journal Title
 Obstetrics & Gynecology Science 
ISSN
 2287-8572 
Issue Date
2017
Keywords
Anesthesia, local ; Delayed hemorrhage ; Loop electrosurgical excisional procedure
Abstract
OBJECTIVE: The aim of this study was to investigate factors preventing delayed hemorrhage after the loop electrosurgical excisional procedure (LEEP). METHODS: Medical records of patients who underwent LEEP at one university affiliated hospital from October 2013 to January 2015 were reviewed. Patients with or without delayed hemorrhage were classified. LEEP was performed either in an operating room under general anesthesia or in a procedure room with local anesthesia in the outpatient clinic. Delayed hemorrhage was defined as excisional site bleeding occurring between 1 and 30 days after the LEEP requiring intervention such as electro-cauterization, gauze packing, or application of another hemostatic agent. RESULTS: During the study period, 369 patients underwent LEEP. Twenty-three (6.2%) patients with delayed hemorrhage returned to our hospital either to the outpatient clinic or to the emergency unit. A third of the population (103, 27.9%) underwent LEEP in the operating room under general anesthesia without injection of local anesthesia. The remaining patients (266, 72.1%) underwent LEEP with local anesthesia (lidocaine HCl 2% with epinephrine 1:100,000) in the office procedure room. Patients given local anesthesia including epinephrine had significantly lower delayed hemorrhage compared to patients with general anesthesia without injection of local anesthesia (P=0.001). Hemostats, such as fibrin glue or patch, were used for the majority of patients (346, 93.8%) during the procedure. However, using hemostats was not statistically associated with delayed hemorrhage (P=0.163). CONCLUSION: Local anesthesia with the powerful vasoconstrictor epinephrine is effective not only to control perioperative bleeding, but also to prevent delayed hemorrhage after LEEP.
Files in This Item:
T201700424.pdf Download
DOI
10.5468/ogs.2017.60.1.87
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
김상운(Kim, Sang Wun) ORCID logo https://orcid.org/0000-0002-8342-8701
김성훈(Kim, Sung Hoon) ORCID logo https://orcid.org/0000-0002-1645-7473
김영태(Kim, Young Tae) ORCID logo https://orcid.org/0000-0002-7347-1052
남은지(Nam, Eun Ji)
박윤진(Park, Yunjin)
이용재(Lee, Yong Jae) ORCID logo https://orcid.org/0000-0003-0297-3116
이인옥(Lee, In Ok)
이정윤(Lee, Jung-Yun) ORCID logo https://orcid.org/0000-0001-7948-1350
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154679
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