Background : Plantar fasciitis or recently called plantar fasciopathy, generally observed with heel spurs because of the deposition of calcium, although the definite pathology is still unknown. Ultrasound-guided injection of conventional corticosteroids was the primary treatment modality, with other emerging substances (e.g. Ozone or Platelet Rich Plasma PRP). Aim of the study: This study was conducted to evaluate the effect of ultrasound-guided injection of local Ozone or Platelet Rich Plasma (PRP) versus conventional corticosteroid in the management of plantar fasciitis. Patient and methods: this a randomized Prospective comparative study has done Al-Azhar university hospitals (Al-Hussein and Sayed Galal), where fifty-one patients have been diagnosed to have plantar fasciitis were included and allocated into one of three groups (17 patients in each group) to receive an ultrasound-guided injection of corticosteroid (control group), platelet-rich plasma (PRP) or Ozone O2-O3. Clinical evaluation and ultrasonographic measurement of the plantar fascia thickness was done before, at one, three and six months next to the injection. Primary outcome included: pain score using the visual analogue score (VAS). While secondary outcomes were plantar fascia thickness and foot quality health status. Results: There was a highly significant decrease in VAS score and plantar fascia thickness, and an increase in foot pain domain of the foot health status (FHSQ) score in corticosteroid and Ozone groups (p < 0.01 respectively) in one month. Regarding 3-month results, there was a highly significant decrease in VAS score plantar fascia thickness, and an increase in FHSQ score in the corticosteroid group (p < 0.01 respectively). Regarding long-term 6-month results, there was a highly significant decrease in VAS score, plantar fascia thickness, and an increase in FHSQ score in the PRP group (p < 0.01 respectively). Conclusion:Corticosteroid and Ozone injections were effective at shortterm assessment, but PRP was more valuable at long-term assessment regarding pain management in plantar fasciitis patients.
Background: Intravenous regional anesthesia [IVRA] is a simple and effective anesthetic method for providing regional anesthesia of the upper limbs during carpal tunnel release surgery [CTRS]. However, the procedure is associated with significant postoperative pain and adjuvant analgesic agents are recommended. TheAim of The Work: This study aimed to compare the analgesic effects of magnesium sulfate and tramadol when added to lidocaine for IVRA during CTRS. Methods: In this double-blinded, randomized clinical trial, 60 ASA I-II patients eligible for elective CTRS with IVRA were randomly allocated into one of 3 groups. The first group [lidocaine group] received IVRA with 40 ml lidocaine 0.5%. The second group [lidocaine + tramadol group] received IVRA with40 ml 0.5% lidocaine and tramadol 1mg/kg. The third group [lidocaine + magnesium sulphate group] received IVRA with 40 ml 0.5% lidocaine and magnesium sulfate 10 mg/kg and normal saline. Outcome parameters included time to onset of sensory and motor block, time to onset of tourniquet pain, need of intraoperative analgesia, intraoperative consumption of fentanyl, duration of postoperative analgesia and pain intensity were noted in each patient.Results: Comparison between the studied groups regarding the outcome parameters. The Lidocaine + Tramadol and the Lidocaine + Magnesium groups achieved better performance in all the studied parameters in comparison to the Lidocaine group. In addition, Lidocaine + Tramadol groups had significantly better performance in comparison to the Lidocaine + Magnesium group. No significant differences were reported between the studied groups regarding post-operative complications Conclusions: Use of tramadol and magnesium sulphate as adjuvants to lidocaine achieved better performance in all the studied parameters in comparison to the lidocaine only. In addition, tramadol had significantly better performance in comparison to magnesium sulphate without significant side effects.
Background: Extraction is still the primary treatment of choice for impact tooth under IANB or GA or a combination of both. Dexmedetomidine has been noticed to lengthen nerve blocks' range of duration, possibly due to the consequent vasoconstriction if combined with local anaesthetics. Aim of the work: This study investigates the effect of injection of Dexmedetomidine as an additive to Lidocaine in IAN for patients undergoing lower bilateral impacted tooth extraction regarding analgesia's overall quality. Patients and Methods: Sixty patients were randomized; 30 patients were in Group D and the other 30 in Group A. IANP was done bilaterally after GA using Lidocaine with Dexmedetomidine or Adrenaline. The primary outcome was the overall quality of analgesia and the whole demanded amount of analgesia. Hemodynamic parameters, patients and surgeon's satisfaction were recognized as secondary outcomes. Result: The mean duration of local anaesthesia and postoperative analgesia time in Group (D) is (259.0±11.5 min) and (362.3±12.3 min), which is higher than Group (A) (180.7±13.1) and (231.4±13.1). 83.3% of Group (D) received no analgesics, and 16.7% received one dose, while in Group (A), 50% received two doses, 33.3% received one dose, and 16.7% received no doses. VAS score was lower for Group (D) than (A) except for zero. The satisfaction was higher in Group (D) for both the patients and the surgeons. Conclusion: Adding 12.5μ/ml of Dexmedetomidine is an excellent additive to Lidocaine regarding the overall quality of analgesia, patient and surgeon satisfaction postoperatively.
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