Our service evaluation demonstrated that enhanced recovery benefits both types of renal transplant (living and deceased grafts) procedures, with excellent patient satisfaction and reduction of hospital length of stay.
Background: Thyroidectomy is the most common endocrine surgical procedure, and many challenges are encountered during the preoperative, intraoperative, and postoperative periods. After thyroidectomy, bilateral superficial cervical block is the most successful option reducing postoperative pain, analgesic needs and postoperative complications such as vomiting. Objective: Our study aimed to evaluate the analgesic effect, onset time of sensory block, duration time, postoperative visual analogue score (VAS) and complications of adding dexmedetomidine versus dexamethasone to levobupivacaine for cervical plexus block. Patients and Methods: A prospective-randomized clinical trial study that was conducted at Sohag University between April 2018 and March 2020. The study included fifty patients with (ASA) Class I or II, aged 30 to 60 years were scheduled for euthyroid surgeries (including thyroid adenoma, Hashimoto's goiter, and nodosity thyroiditis) Results: The addition of dexmedetomidine to levobupivacaine (group D) shortened the sensory block onset time compared to dexamethasone added to the levobupivacaine group (group S) (p < 0.05). The duration of analgesia of cervical plexus block in group (D) was significantly longer than that in group (S) (232.34 versus 303.55 min; p < 0.05). HR level in group (D) was significantly lower than that in group (S) (p < 0.05).
Conclusion:The addition of 1 μg kg−1 dexmedetomidine to levobupivacaine for cervical plexus block (BSCPB) shortened the sensory block onset time and extended the duration of analgesia and increased the quality of analgesia more superior than the addition of dexamethasone.
Background the aim of this study is to compare between ketamine and dexamethasone when added to bupivacaine in ultrasound guided infraclavicular brachial plexus block for upper limb surgeries. Methods: The patients were randomly allocated to two groups, 25 patients each: Group K (ketamine group) Patient received 30 ml of 0.375% bupivacaine plus 0.5 mg/kg ketamine in 2 ml saline Group D (dexamethasone group) Patient received 30 ml of 0.375 bupivacaine plus 8 mg dexamethasone in 2 ml. Results: Onset time of sensory and motor blocks was significantly decreased in dexamethasone group in comparison with the ketamine group. The visual analogue scale was significantly lower in patients who received dexamethasone versus patients who received local anesthetics and ketamine. The duration of analgesia and resolution of motor block were significantly prolonged in dexamethasone group as compared to ketamine group. Postoperative analgesic consumption was reduced significantly in dexamethasone group as compared with ketamine group. Conclusion: The addition of dexamethasone to bupivacaine resulted in significant reduction in onset time of sensory and motor blocks, prolonged duration of post-operative analgesia, lower analgesic consumption and lower incidence of complications.
Background: Regional anesthesia techniques as a caudal epidural block (CEB) are commonly used to help with pain control during pediatric surgeries, decrease parenteral analgesics requirement, and improve the quality of postoperative pain control and general satisfaction of patient parents. Transversus abdominis plane (TAP) block is an evolving modality of regional anesthetic techniques for the abdominal wall. Objective: The aim of the current study was to compare the analgesic effect of CEB versus TAP block in pediatrics undergoing infraumblical surgeries. Patients and methods: A total of 120 kids between the ages of 4 and 7 years old who needed infraumbilical procedures were divided into two groups of 60 patients. Group (1) received caudal epidural block using Plain bupivacaine 0.25 % 1 ml/kg, and Group (2) received ultrasound-guided TAP block using plain bupivacaine 0.25% 1 ml/kg. Follow up postoperative pain using Faces Pain Scale-Revised, vital signs, first rescue analgesia, the total dose of paracetamol needed, and complications. Results: At 8 and 18 hours postoperatively, Group (1) had substantially lower pain scores on the Faces pain scale-revised, reduced heart rate and mean arterial pressure compared to Group (2). Group (1) had a considerably later time to first rescue analgesia with less paracetamol use than Group (2). There was no discernible difference in postoperative complications between groups (1) and (2). Conclusion: At 6-24 hours after block placement, caudal block provides superior analgesia compared to TAP block in children undergoing lower abdominal surgeries. Caudal block is an effective, feasible, and safe option for postoperative analgesia, especially when compared to TAP block.
Background: This study is done in Sohag University Hospitals, Faculty of medicine,sohag university as a collaboration between maxillofacial, head, and neck surgery unit in the general surgery department and anesthesia department.Fiberoptic intubation is the magic technique for difficult airway management in patients of difficult intubation especially in cases of temporomandibular joint ankylosis.Objective: This study aimed to compare the clinical efficacy and safety of premedication with (dexmedetomidine versus fentanyl ) added to propofol infusion for fiberoptic intubation. Patients and Methods: 60 adult patients aged from 20 to 50 years with temporomandibular joint ankylosis, allocated for gap arthroplasty operation. They were enrolled for this prospective randomized clinical trial with two equal groups with 30 patients in each group. Group (D) patients received dexmedetomidine (1μg/kg infused over 10 min ) followed by sedative propofol infusion and Group (F) patients were given fentanyl (2 mcg/kg over 10 min) infused followed by propofol infusion to achieve sedation. Condition achieved endoscopy, intubating conditions, and Stress response including (hemodynamic changes and cortisol level) postoperative complications were evaluated. Results: The fiberoptic intubation was successful with good satisfaction with endoscopy and intubating conditions in both groups. Dexmedetomidine as premedication has provided satisfactory conditions for fiberoptic intubation more than fentanyl group and hemodynamic stability response of fiberoptic intubation than the fentanyl group. Conclusion: Fiberoptic intubation was found to be easier with dexmedetomidine as premedication with a sedative infusion of propofol with complete amnesia of the procedure, with hemodynamic stability and good control of the patent airway.
Background: Supraclavicular block provides alternative way to general anesthesia for upper limb surgeries. They produce complete muscular relaxation, maintaining hemodynamic stability intraoperatively and avoidance of the risks with general anesthesia. The most important target of anesthesia is to manage the patient's pain, as we can do the surgical procedures with no discomfort, and controlling of intraoperative and postoperative pain. Objective: Our study aimed to detect how adding Mg sulphate or dexmedetomidine can improve the effect of local anesthetic in regional block (supra clavicular block). Patient and Methods: 90 patients aged between 20-75 years old with ASA I-II who were scheduled for forearm surgeries under supraclavicular block anesthesia were enrolled in our study. This Study was conducted in Sohag University Hospitals from May 2019 to April 2020. Patients were divided into 3 equal groups. Results: Magnesium sulphate had a more rapid onset of both sensory and motor block onset than dexmedetomedine and control groups. Dexmedetomidine had a longer duration of both motor and sensory block than magnesium sulphate group and control groups. Dexmedetomidine had a longer analgesic effect than magnesium sulphate group and control group. As regards rate of complications, there was no significant difference between the three groups.
Conclusion:The addition of 1 ml (100 μg) dexmedetomedine or 200 mg magnesium sulphate to supraclavicularyinjected levobupivacaine improved the onset, duration and postoperative analgesia of levobupivacaine.
Aim: This work aims to compare the postoperative analgesic effects and side effects of Dexamethasone or Magnesium sulfate (Mg) that added to bupivacaine.
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