Preparatory and after treatment in operative cases . ed in the bladder and ledinto a conveniently placed vessel. Fig. 334 shows the clampsrolled in the gauze and the retention catheter in situ. Patients who have been subjected to vaginal hysterectomy,after which clamps are left in situ, suffer considerable pain, neces-sitating the administration of opiates. The anodyne should begiven in sufficient quantity to control the symptom. It is wise toadminister hypodermically one-third of a grain of morphia underthe skin, before narcosis is recovered from, as the restlessnesssconsequent to the pain, t
Preparatory and after treatment in operative cases . ed in the bladder and ledinto a conveniently placed vessel. Fig. 334 shows the clampsrolled in the gauze and the retention catheter in situ. Patients who have been subjected to vaginal hysterectomy,after which clamps are left in situ, suffer considerable pain, neces-sitating the administration of opiates. The anodyne should begiven in sufficient quantity to control the symptom. It is wise toadminister hypodermically one-third of a grain of morphia underthe skin, before narcosis is recovered from, as the restlessnesssconsequent to the pain, together with the semi-consciousness, mayresult in disturbance of the clamps. Administration of the opiateshould be repeated as the indications present. Peritoneal pain isvery severe and the crushing of the broad ligaments within thejaws of the clamps creates a condition of affairs which it is easy VAGINAL HYSTERECTOMY 533 to understand would provoke much suffering. Defecation is notlikely to occur for forty-eight hours, for obvious reasons, and the. Fig. 334.—Hysterectomy Clamps Rolled in Gauze. (Kelly and Noble.) introduction of enemata should be carefully executed under asep-tic precautions. The catheter is changed for a second sterile one at the end 534 GYNECOLOGICAL OPERATIONS BY PERINEAL ROUTE of twenty-four hours, at which time the bladder is lavaged withboric acid solution. At the end of another twenty-four hours thecatheter is removed, the bladder again irrigated, and the gauzeroll and clamps removed. For the purpose the gauze is thoroughly soaked with an anti-septic solution (corrosive sublimate 1 in 2,000). The clamps willbe found quite coated with secretion and rust. The intra-abdom-inal portions of the clamps are in a similar condition, and shredsof crushed tissue cause the blades to stick rather firmly. In re-moving the clamps this should be borne in mind. After thehandles are affixed to the blades the locks are released withoutmaking any downward traction. If th
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