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222 Hysterectomy

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**15**

*Denmark* 

Kenneth Jensen and Jens Børglum *Copenhagen University Hospital: Bispebjerg,* 

**Hysterectomy: Advances in Perioperative Care** 

Perioperative medicine is an ever growing field of interest that encompasses the care of the patient preparing for, undergoing and recuperating from surgery. Medical professionals, interest groups and societies each year convene at congresses dedicated to the field of evidence-based perioperative medicine (e.g., www.ebpom.org). Since many interventions during the hospital stay have ramifications extending into the first six months after discharge, many choose to define "perioperative" broadly to include this extended period as well. Our topics of interest are equally broadly defined and include psychological, physiological, anaesthesiological and surgical issues. We have chosen this overview to increase our understanding of the interplay of factors that in all make up the experience of the hysterectomy patients, hopefully to explain and justify the value of treatment regimens.

Much has happened within the past 10 years. In spite of an ever-growing and unwieldy amount of scientific information appearing every month, unmet needs may still be readily identified in many fields of endeavor. To highlight the current evidence, we have performed a Medline search on "hysterectomy" limited to randomized studies published in the past decade. This should expand the evidence-based website www.postoppain.org, which provides an analysis of all randomized studies on abdominal hysterectomy since 1966 (and until 2004). Our aim is to provide the anaesthesia-unqualified reader with an extensive and easily accessible presentation of the psychology, physiology, pharmacology and operative logistics that we find relevant to the subject of hysterectomy; characteristics of the patients, the importance of anaesthetic and surgical techniques, the prevention and treatment of postoperative complaints, and why established treatments may not work. While not striving to be completely exhaustive, our review nevertheless includes a thorough reference list that

Understandably, undergoing surgery is often the cause of great concern for patients. We know that as many as 60% of patients are anxious (Hashimato, 1993), with females, depressed and

**1. Introduction** 

**1.1 Perioperative medicine** 

**1.2 Purpose and methods** 

**2. Psychology** 

may inspire the reader to further in-depth study.

**2.1 Preoperative psychology and coping skills** 
