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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)87-91
Number of pages5
JournalObstetrics and Gynecology Science
Volume60
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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Local Anesthesia
Epinephrine
Hemorrhage
General Anesthesia
Operating Rooms
Ambulatory Care Facilities
Cautery
Fibrin Tissue Adhesive
Injections
Vasoconstrictor Agents
Hemostatics
Lidocaine
Medical Records
Hospital Emergency Service

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynaecology

Cite this

Lee, Yong Jae ; Park, Yunjin ; Lee, In Ok ; Yoon, Jung Won ; Lee, Jung Yoon ; Kim, Sang Wun ; Kim, Sunghoon ; Kim, Young Tae ; Nam, Eun Ji. / Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure. In: Obstetrics and Gynecology Science. 2017 ; Vol. 60, No. 1. pp. 87-91.
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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.",
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Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure. / Lee, Yong Jae; Park, Yunjin; Lee, In Ok; Yoon, Jung Won; Lee, Jung Yoon; Kim, Sang Wun; Kim, Sunghoon; Kim, Young Tae; Nam, Eun Ji.

In: Obstetrics and Gynecology Science, Vol. 60, No. 1, 01.01.2017, p. 87-91.

Research output: Contribution to journalArticle

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AU - Park, Yunjin

AU - Lee, In Ok

AU - Yoon, Jung Won

AU - Lee, Jung Yoon

AU - Kim, Sang Wun

AU - Kim, Sunghoon

AU - Kim, Young Tae

AU - Nam, Eun Ji

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N2 - 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.

AB - 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.

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