RESUMO
BACKGROUND: Central lines can be placed through different techniques, either peripherally or centrally. Although they have the same aim, decision to use one of these modalities depends on the patient outcomes. The aim is to compare pain scores between ultrasound-guided central line insertion and peripherally inserted catheter in neonates in a prospective randomized single center study. METHODS: A randomized controlled trial was conducted in neonates requiring central venous access for any of the following reasons: total parenteral nutrition (TPN), antibiotics treatment for at least 7 days and having poor or difficult venous access. The study compared pain difference, in neonates, that were randomized between peripherally and ultra-sound guided centrally placed central lines using the validated pain score N - PASS. RESULTS: 61 neonates were enrolled in the study. US-guided CICC was associated with less pain as reported by the statistically significant lower pain score difference (p-value <0.001) than the standard PICC. Additionally, the US-guided CICC had a higher rate of successful first attempt (pâ=â0.012), lower overall number of attempts (pâ<â0.001), and shorter procedure duration (pâ<â0.001) as compared to standard PICC. CONCLUSION: US-guided CICC is a less painful technique than PICC line insertion associated with higher rate of successful first attempt, lower overall number of attempts and shorter procedure duration.
Assuntos
Cateterismo Venoso Central/métodos , Cateterismo Periférico/métodos , Dor Processual/fisiopatologia , Antibacterianos/administração & dosagem , Cateterismo Venoso Central/efeitos adversos , Cateterismo Periférico/efeitos adversos , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Masculino , Sepse Neonatal , Medição da Dor , Dor Processual/etiologia , Nutrição Parenteral Total/métodos , Síndrome do Desconforto Respiratório do Recém-Nascido , Fatores de Tempo , Ultrassonografia de Intervenção/métodosRESUMO
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by uterine aplasia and aplasia of the upper part of the vagina. It presents with primary amenorrhea in a 46, XX individual. In this paper, we report the cases of two patients with MRKH syndrome treated with the laparoscopic modified Vecchietti technique using the optimized new instruments. A neovagina was successfully created in these two patients. This minimally invasive technique offers improvements in terms of operative time, complications, and functionality.