Background:Pain associated with laparoscopic cholecystectomy is most severe during the first 24 h and the port sites are the most painful. Recent multimodal approaches target incisional pain instead of visceral pain which has led to the emergence of abdominal fascial plane blocks. This study embraces a novel combination of two independently effective fascial plane blocks, namely rectus sheath block and subcostal transversus abdominis plane (TAP) block to alleviate postoperative pain.Study Objective:The aim is to evaluate the effectiveness of the combination of rectus sheath block and subcostal TAP block, to compare its efficacy with that of subcostal TAP block alone and with conventional port site infiltration (PSI) in alleviating postoperative pain in patients undergoing laparoscopic cholecystectomy.Methodology:This prospective, randomized control, pilot study included 61 patients scheduled for elective laparoscopic cholecystectomy and distributed among three groups, namely Group 1: Combined subcostal TAP block with rectus sheath block (n = 20); Group 2: Oblique subcostal TAP block alone (n = 21); and Group 3: PSI group as an active control (n = 20).Results:Combined group had significantly lower pain scores, higher satisfaction scores, and reduced rescue analgesia both in early and late postoperative periods than the conventional PSI group.Conclusion:Ultrasound-guided combined fascial plane blocks is a novel intervention in pain management of patients undergoing laparoscopic cholecystectomy and should become the standard of care.
Background: One of the common indications for upper gastrointestinal (GI) endoscopy is dysphagia. Dysphagia is usually associated with serious underlying disorder that requires immediate attention. The current study aimed to determine the frequency of common endoscopic findings in patients presenting with dysphagia.Methods: This retrospective study was conducted at the S.S Institute of Medical Science and Research center Davangere from January 2015 to June 2019. Patients admitted with complaints of dysphagia, OPD patients and references with complaints of dysphagia underwent upper GI endoscope by different endoscopist were included in the study. Register in endoscopic room was referred for different endoscopic findings in dysphagia patients.Results: A total of 158 patients presenting with dysphagia were studied, 83 (52.53%) were males and 74 (47.46%) were females. The mean age was 55years. Normal study present in 63 (39.87). Malignant oesophageal stricture was the next common finding noted in 47 (29.74%) patients. Among these patients 25 (53.19%) males and 22 (46.80%) females patients. It was followed by reflux esophagitis in 31 (19.62%) patients. Benign oesophageal strictures in 9 (5.69%) patients while achalasia was noted in 1 (0.63%) patients, 7 (4.46%) patients had findings other than the ones mentioned above. Malignant lesions commonly present in elderly patients with age. Benign lesions present commonly in younger age group.Conclusions: Malignancies, reflux esophagitis, benign oesophageal strictures are a more common cause of dysphagia in our population. Early diagnosis of can result in proper treatment of many of these cases.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.