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: 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.

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