Background and Objectives: Propofol remains the most common drug for induction of general anaesthesia, although it causes considerable pain on injection. None of the commonly used methods completely attenuate this discomfort. We aimed to investigate the effect of i.v. paracetamol pretreatment on the propofol injection pain. Materials and Methods: A prospective randomized double-blind study was conducted on 180 patients, ASA I or II status, scheduled to undergo elective surgery. They were randomly assigned to one of the three groups of 60 each. Groups I, II, III were pretreated with 40 mg of lidocaine in saline, 100 mg of paracetamol and 10 ml of saline, respectively. All patients had an 18-gauge catheter inserted into a superficial radial vein. After 2 min of venous occlusion, one-fourth of the total propofol dose was injected into the vein over a period of 20 seconds. During the injection of both pretreatment solution and propofol, a blinded researcher assessed the patient's pain level using a four-point verbal rating scale (VRS) (none = 0, mild = 1, moderate = 2, and severe = 3). X 2 test and Kruskal-Wallis tests were used for the statistical analysis. For all analyses, differences were considered to be significant at P < 0.05. Results: The three groups were comparable in respect to patient's characteristics. The incidence of pain on injection of propofol in placebo, i.v. paracetamol and lidocaïne groups were 85%, 36%, 21% respectively (p < 0.05). Intensity and severity of propofol induced pain were comparable between paracetamol and lidocaine groups. Conclusion: Pretreatment using i.v. paracetamol was found to be effective in reducing propofol injection-induced pain.

Introduction: Severe postpartum hemorrhage (PPH) is the main cause of death in Tunisia. Its management is multidisciplinary and requires perfect knowledge of a regularly updated protocol and consistent with available resources. We propose an evaluation of the impact of different therapeutic attitudes, in particular the combination of tranexamic acid and fibrinogen concentrates in the management of this hemorrhage. Material and Methods: This was a retrospective, descriptive and analytical study, conducted in the departments of Gynecology-Obstetrics and Surgical Resuscitation anesthesia of the

Bilateral retinal detachments and cortical blindness are rare complications of preeclampsia and the association of the two pathologies is exceptional. We report the case of a preeclamptic patient who presented with an acute bilateral vision loss. Besides, her ocular ultrasound revealed bilateral retinal detachments and an elevated optic nerve sheath diameter. The patient underwent an urgent cesarean section. Subsequently, magnetic resonance imaging and ocular fundus examination confirmed the diagnosis.

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review

No abstract

Purpose: Subcutaneous implantable venous access devices are of great importance for the administration of chemotherapy in cancer patients. They are routinely implanted under local anesthesia. However, patients complain of pain during the injection of local anesthesia. Alleviating pain for cancer patients is of high importance. Our aim was to evaluate the effectiveness of sodium bicarbonate-buffered lidocaine with epinephrine on reducing pain and patients’ satisfaction during subcutaneous implantable venous access devices insertion.Methods: A prospective double-blind study was conducted over a period of 6 months (January 2017 to June 2017) in a department of anesthesiology in Tunisia. Cancer patients were randomized to receive either buffered (PH= 7.33) or plane lidocaine (PH= 3.50). Pain and satisfaction were evaluated on a VAS score (0-100 mm). Results: One hundred twenty patients were enrolled in this study with sixty patients in each group. Mean pain scores during local anesthesia infiltration were 15.7 ± 7.6 mm vs.46.9 ± 12.3 mm respectively in the study and control group (p<0.001). Mean VAS satisfaction was 95.75±8 mm in the intervention group and 70.2±20.1 mm in the control group (p<0.001). Conclusion: Adjusting the pH of anesthetic agents could minimize pain during PortACath insertion and improve satisfaction of cancer patients.

No abstract

No abstract