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: For both children and their caregivers, postoperative pain is an irritating experience. Several approaches have been used to treat postoperative pain in pediatric patients improving sleep quality, and extending sedation time. Objectives: This work aimed to compare the postoperative analgesic effect and any complications of addition of one of these drugs nalbuphine versus fentanyl versus dexamethasone to levobupivacaine in caudal block (CB) in pediatric patients undergoing hypospadias repair. Patient and Methods: 90 ASA status I and II patients aged 2 to 9 years underwent hypospadias repair were prospectively involved in this study. Patients were randomized into three equal groups (Group N, Group F and Group D). Result: There was no statistically significant difference between three groups as regards systolic blood pressure (SBP) except after 60 and 70 minutes after caudal block as there was a significant difference as SBP decreased in the group (N) more than in both groups (F and D). Also there was a significant deference between the three groups in SBP at 1, 1.5, 2 and 4 hours postoperatively. FLACC pain score between three groups showed a significant difference between three groups at 2, 6 and 8 hours postoperatively otherwise no significant difference Conclusion: Adding a nalbuphine to levobupivacaine in caudal block had longer duration for postoperative analgesia and showed more sedation time than that of fentanyl and dexamethasone with more stability in hemodynamics.
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.
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