scholarly journals Retrospective Analysis of Ultrasound-Guided Infraclavicular Block: Effect of Experience of Anesthesiologists on Volume of Local Anesthetic Administered

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Tugce Yeniocak ◽  
Nur Canbolat
Keyword(s):  
Success Rate ◽  
Failure Rate ◽  
Local Anesthetic ◽  
Initial Period ◽  
High Dose ◽  
Ultrasound Guided ◽  
Group Iii ◽  
Sonographic Guidance ◽  
Group I ◽  
American Society

Performing a block under ultrasound guidance effectively requires skill; however, inexperienced anesthesiologists often use high-dose LA to ensure success. We aimed to share our experience with the ultrasound-guided infraclavicular brachial plexus block (USGICB) for upper extremity surgeries and to determine changes in failure rate and local anesthetic dose administered with gaining adequate experience. With approval from the local ethics committee, a retrospective review of records of 2953 patients who underwent USGICB between November 2011 and March 2015 was performed for evaluating the following data: age, sex, height, weight, operation type, American Society of Anesthesiologists physical status score, local anesthetic volume, complications, and success of USGICB. The patients were divided into 4 groups of 10 months each from November 2011 to March 2015: first 10-month period, 628 cases (group I); second 10-month period, 672 (group II); third 10-month period, 720 (group III); and the fourth 10-month period, 933 cases (group IV). Nine anesthesiologists with the same baseline experience in USG performed the blocks. During the initial period, when anesthesiologists had insufficient experience, local anesthetic (LA) dose, success rate, failed blocks, and complications were investigated. The LA volume administered in group I (33.7 ± 4.2 ml) was significantly higher than that in groups II, III, and IV (p<0.05). Although a reduction in LA volume administered with increasing anesthesiologist experience was not statistically significant, a volume reduction of over 30 ml was observed in groups II, III, and IV compared with group I. Furthermore, in group I, failure rate (3.2%) was higher than that in groups II, III, and IV (p<0.05). We concluded that sonographic guidance ensures a high success rate and that increased experience of anesthesiologists is associated with reduced complications and failure rate of blocks, in addition to prevention of LA overdose.

Effect of Silver Nitrate Application on the Success of Endoscopic Dacryocystorhinostomy

2021 ◽  
pp. 194589242110427
Author(s):  
Yaser S. Çetin ◽  
Ramazan Akın ◽  
Ufuk Düzenli ◽  
Mahfuz Turan ◽  
Nazım Bozan
Keyword(s):  
Silver Nitrate ◽  
Success Rate ◽  
Postoperative Period ◽  
Revision Surgery ◽  
Granuloma Formation ◽  
Stent Insertion ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Silicone Stent

Objectives To compare the clinical outcomes of patients undergoing additional procedures in endoscopic endonasal dacryocystorhinostomy (End-DCR) surgery and discuss the factors affecting the success of End-DCR surgery in light of relevant literature. Methods The study included 155 patients who underwent End-DCR surgery in our clinic due to epiphora. This was a prospective randomized, single-blind, controlled trial. Group I (control) included 54 patients who did not undergo silicone stent insertion or silver nitrate application, group II included 51 patients who underwent silicone stent insertion only, and group III included 50 patients who underwent silver nitrate application only. Statistical analysis was performed on follow-up data regarding anatomic and functional success rates. Results Revision surgery was performed in 16 patients who developed persistent epiphora in the postoperative period, including 6 in group I, 7 in group II, and 3 in group III ( P = .4). The most common reason for revision surgery was stenosis of the neo-ostium ( n = 8), followed by granulation tissue formation ( n = 5) and synechia formation ( n = 3). Granuloma formation was the most common postoperative complication, and a significant difference was found among the groups with regard to granuloma formation ( P = .04). At postoperative month 12, the functional success rate was estimated to be 88%, 86%, and 94%, and the anatomic success rate was estimated to be 94%, 92%, and 96% in groups I, II, and III, respectively, with no significant difference, found among the 3 groups with regard to both rates ( P = .79 and P = .76, respectively). Conclusion The results indicated that stenting and silver nitrate application did not affect surgical success. Our preliminary results on silver nitrate cauterization showed that it is an effective, inexpensive, and practical method to reduce granulation formation in the postoperative period.

scholarly journals Prospective Study: The Analgesic Efficacy of Ultrasound-Guided Erector Spinae Plane Block versus Serratus Plane Block in Patients Undergoing Modified Radical Mastectomy

2021 ◽  
pp. 9-18
Author(s):  
Martina Farag Wahba Mekhaeil ◽  
Ayman Abd Elmaksod Yousef ◽  
Hesham Mohammed Marof ◽  
Shaimaa Farouk Abdelkader
Keyword(s):  
Radical Mastectomy ◽  
Analgesic Efficacy ◽  
Erector Spinae ◽  
Control Group ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Group Iii ◽  
Erector Spinae Plane Block ◽  
Group I

Background: Breast Cancer is the most commonly occurring cancer affecting ‎women undergoing modified radical mastectomy, causing acute pain, and in ‎high percentage of patients it progresses to chronic pain syndromes. The Erector Spinae Plane Block (ESPB) ‎and Serratus Anterior Plane Block (SAPB) are options of regional anesthesia that can produce reliable ‎analgesia. In this study we aimed to evaluate the analgesic efficacy of ‎ultrasound guided ESPB and SAPB in patients underwent modified radical ‎mastectomy operation. Patients and Methods: Patients were randomly classified using computer generated numbers ‎concealed in ‎ sealed opaque envelopes into three equal groups; 30 patients ‎were enrolled in each group. ‎Group I: Control Group (C): Patients received intravenous (IV) systemic analgesia only, Group II: ESPB group: Patients received ‎ipsilateral ultrasound guided ESPB using 20 ml bupivacaine 0.25% at the ‎level of the 4th thoracic segment (T4). and Group III: SPB group: Patients received ipsilateral ‎serratus plane block using 30 ml bupivacaine 0.25% at the level of the 5th rib.‎ Results: In this study, 113 patients were assessed for eligibility, 16 patients ‎did not meet the criteria and 7 patients refused to participate in the study. ‎The remaining 90 patients were randomly allocated into three groups (30 ‎patients in each). All patients (90) were followed-up and analyzed ‎statistically‎. Conclusion: Ultrasound-guided SAPB and ESPB provided effective post-‎operative analgesia in patients undergoing modified radical mastectomy with ‎lower pain scores, less peri operative analgesic consumption and longer ‎duration of analgesia in SAPB.

scholarly journals Concentration of hepatic vitamins A and E in rats exposed to chlorpyrifos and/or enrofloxacin

2016 ◽  
Vol 19 (2) ◽  
pp. 371-378 ◽  
Author(s):  
A. Spodniewska ◽  
D. Barski
Keyword(s):  
Lipid Peroxidation ◽  
Free Radicals ◽  
Gastric Tube ◽  
Initial Period ◽  
Hplc Method ◽  
Antioxidant Vitamin ◽  
Exposure Group ◽  
Group Iii ◽  
Group I

Abstract The aim of the study was to determine the level of antioxidant vitamins A and E in the liver of rats exposed to chlorpyrifos and/or enrofloxacin. Chlorpyrifos (Group I) was administered at a dose of 0.04 LD50 (6 mg/kg b.w.) for 28 days, and enrofloxacin (Group II) at a dose of 5 mg/kg b.w. for 5 consecutive days. The animals of group III were given both of the mentioned above compounds at the same manner as groups I and II, but enrofloxacin was applied to rats for the last 5 days of chlorpyrifos exposure (i.e. on day 24, 25, 26, 27 and 28). Chlorpyrifos and enrofloxacin were administered to rats intragastrically via a gastric tube. The quantitative determination of vitamins was made by the HPLC method. The results of this study indicated a reduction in the hepatic concentrations of vitamins A and E, compared to the control, which sustained for the entire period of the experiment. The four-week administration of chlorpyrifos to rats resulted in a significant decrease of vitamins in the initial period of the experiment, i.e. up to 24 hours after exposure. For vitamin A the maximum drop was observed after 24 hours (19.24%) and for vitamin E after 6 hours (23.19%). Enrofloxacin caused a slight (3-9%) reduction in the level of the analysed vitamins. In the chlorpyrifos-enrofloxacin co-exposure group reduced vitamins A and E levels were also noted, but changes in this group were less pronounced in comparison to the animals intoxicated with chlorpyrifos only. The decrease in the antioxidant vitamin levels, particularly noticeable in the chlorpyrifos- and the chlorpyrifos combined with enrofloxacin-treated groups, may result not only from the increase in the concentration of free radicals, but also from the intensification of the secondary stages of lipid peroxidation.

scholarly journals Screening of anticonvulsant effect of carvedilol on electrically induced convulsions in Wistar albino rats

2020 ◽  
Vol 9 (12) ◽  
pp. 1803
Author(s):  
Biacin Babu ◽  
Madhavrao Chavan
Keyword(s):  
Albino Rats ◽  
High Dose ◽  
Anticonvulsant Effect ◽  
Low Doses ◽  
Test Drug ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Wistar Albino Rats

Background: Epilepsy is one of the major central nervous system disorders. The parent study aimed to screen the anticonvulsant effect of carvedilol on electrically induced convulsions in Wistar albino rats.Methods: This study was done in Wistar albino rats. A total of 30 rats were divided into 6 groups each of six rats. group-I (0.9% normal saline), group-II diphenylhydantoin (10 mg/kg/BW/ip), group-III carvedilol (1mg/kg/BW/PO), group-IV carvedilol (2 mg/kg/BW/PO) and group-V carvedilol (4 mg/kg/BW/PO). All the groups were administered drugs and subjected to electric shock. Scores of seizures and percentage of protection were recorded to compare between the groups. One was ANOVA (post hoc) followed by Dunnet t test applied to find the statistically significant between the groups.Results: Group-I showed significant difference compared to other groups. Group-II showed significant difference with group-III and IV not with V. High dose of test drug and standard drug showed similar results in percentage of seizures prevention. Control and low doses of test drugs showed significant difference compared to standard and high dose of test drug in seizures prevention.Conclusions: High of carvedilol showed significant seizures prevention compared to low doses and control group.

scholarly journals Efficacy of ultrasound-guided rectus sheath block, butorphanol for single-incision laparoscopic cholecystectomy: A prospective, randomized, clinical trial

2020 ◽  
Author(s):  
Huimin Fu ◽  
Chaochao Zhong ◽  
Yongtao Gao ◽  
Xingguo Xu
Keyword(s):  
Visceral Pain ◽  
Rectus Sheath ◽  
Group Iv ◽  
Ultrasound Guided ◽  
Group Iii ◽  
Group I ◽  
Rectus Sheath Block ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Group Ii ◽  
Incisional Pain

Abstract Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incisional pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, and butorphanol for postoperative analgesia in patients undergoing SILC.Methods: All patients who met the criteria were randomly divided into four groups: group I, (n=29) patient-controlled intravenous analgesia (PCIA) (sufentanil 1 µg/ml); group II, (n=29) PCIA (butorphanol 0. 08 µg/ml); group III, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (sufentanil 1 µg/ml); and group IV, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (butorphanol 0.08 µg/ml). General anesthesia in all groups, It's noteworthy that we only use general anesthesia, not ultrasound-guided RSB in group I and II. The primary outcome were numeric rating scale (NRS) scores (0-10) of incisional pain and visceral pain. Secondary outcomes were the dose of butorphanol and sufentanil, the number of PCIA presses, the length of hospital stay and the incidence of postoperative adverse events. Results: Both the rest and cough incisional pain scores were lower during the first 2, 6 and 12 h in group Ⅲ than in group Ⅰ (P＜0.05). Similarly, scores in group Ⅳ were significantly lower than those in group II (P＜0.05). The NRS scores for visceral pain were lower in group II at 2, 6 and 12 h after surgery than in group I (P＜0.05) and lower in group IV than in group Ⅲ (P＜0.05). Patients in group I needed more butorphanol as a rescue analgesic for pain relief than did those in group III, and patients in group IV needed less butorphanol as a rescue analgesic for pain relief than did those in group II. From the above pairwise comparisons, it is clear that groups III and IV had lower NRS scores. Overall, ultrasound-guided RSB combined with PCIA (butorphanol 0. 08 µg/ml) performed the best. Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC than can general anaesthesia combined with sufentanil.

scholarly journals Comparison of various regimens of itraconazole in treatment of acute vulvovaginal candidiasis

2021 ◽  
Vol 8 (2) ◽  
pp. 244-249
Author(s):  
Dhiraj Dhoot ◽  
Piyush Prabhat ◽  
Lalita Mayadeo ◽  
Harshal Mahajan
Keyword(s):  
Signs And Symptoms ◽  
Vulvovaginal Candidiasis ◽  
High Dose ◽  
Group Iii ◽  
Group I ◽  
Comparative Clinical Study ◽  
Current Scenario ◽  
Striking Change ◽  
Group Ii ◽  
Cure Rates

One of the most striking change in the current scenario is the increasing occurrence of non-albicans vulvovaginal candidiasis (VVC), which is considered as the major cause of recurrence, relapse and chronic VVC in India. In the present study we evaluated the effectiveness of three different regimens of itraconazole in the treatment of acute VVC.The present randomised, three arm comparative clinical study involved 123 women aged 18 years or above with symptomatic acute VVC. These patients were randomised (41 patients in each group) to receive either itraconazole 200 mg twice daily for 1 day (group I), 200 mg twice daily for 2 days (group II) or 100 mg twice daily for 3 days (group III). Effectiveness was evaluated on the basis of clinical cure (total symptom score), mycological cure (negative KOH test). All the groups were effective in relieving signs and symptoms (p&#60;0.05), but on comparison between all groups, there was statistical difference between Group II and Group I & III (p&#60;0.05) and Group III & I (p&#60;0.05). Complete cure i.e. disappearance of signs and symptoms and negative KOH test was maximum in group II (44%) as compared to groups I (12%) and III (17% of the patients). Relapse was least in seen in 11 patients (27%) in Group I, 3 patients (7%) in Group II and 7 patients (17%) in Group III. All the 3 regimens were well tolerated.In the present study, 2 day high dose itraconazole therapy was found to have better effectiveness compared to conventional regimens. Longer duration of therapy might be required to attain even better cure rates, especially when the incidence of Non Albicans vulvovaginal candidiasis is rising in all parts of the country.

scholarly journals Hepatoprotective efficacy of ethanolic extracts of rhizome Curcuma amada Roxb. In experimental rats

2018 ◽  
Vol 7 (1) ◽  
pp. 1966 ◽  
Author(s):  
Ramnath V. ◽  
Maria Caroline Rebellow M. ◽  
Seethalakshmi S.
Keyword(s):  
Olive Oil ◽  
Treated Group ◽  
Vehicle Group ◽  
Control Group ◽  
High Dose ◽  
Supporting Evidence ◽  
Group Iii ◽  
Curcuma Amada ◽  
Group I ◽  
Appreciable Increase

Thescope of this study is to evaluate the hepatoprotective efficacy of rhizome Curcuma Amada Roxb (CAR) in CCl4 induced hepatotoxicity in rats. Male Albino Wister rats were divided into six groups (n=6). Group I served as the normal control group and received olive oil (i.p. 0.5 mL/kg b.w.) as a vehicle. Group II served as high dose group and received 400mg/kg b.w CAR. Group III served as the carbon tetrachloride (CCl4) group and received CCl4 (i.p., 0.1 mL/kg b.w., 50% CCl4 in olive oil). Groups IV–VI served as the treatment groups, and they received CARdissolved in distilled water orally at dose levels of 100, 200, and 400 mg/kg b.w., respectively, with CCl4 (i.p., 0.1 mL/kg b.w., 50% CCl4 in olive oil). All the groups were given the respective dosages twice a week for 28 days. The result of the marker enzymes AST, ALT, ALP and TBARS in the serum sample revealed an appreciable increase in groups IV, V and VI with respect to CCl4 treated group. This confirmed the hepatoprotective nature of CAR there by deactivating the phase II detoxifying enzymes, preventing the formation of free radical and protecting the cell membrane from degeneration. The nonenzymatic antioxidants pattern of GSH, GPX and GST showed decreased levels with respect to group III. This confirmed that CAR has induced the GSH antioxidant system by increasing cellular defense against reactive free radicals and other oxidative species. The histological architecture of liver sections in Group-IV–VI showed more or less normal lobular pattern with mild degrees of fatty change, necrosis and lymphocyte infiltration almost comparable to those of control group. These results act as a supporting evidence to exhibit the hepatoprotective nature of CAR.

High-Dose Ascorbic Acid Decreases Cholesterolemic Factors of an Atherogenic Diet in Guinea Pigs

2007 ◽  
Vol 77 (2) ◽  
pp. 125-129
Author(s):  
Filis ◽  
Anastassopoulou ◽  
Sigala ◽  
Theodorou ◽  
Manouras ◽  
...  
Keyword(s):  
Ascorbic Acid ◽  
Guinea Pigs ◽  
Low Dose ◽  
Plasma Concentrations ◽  
Atherogenic Diet ◽  
High Dose ◽  
Low Density ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Background: The study evaluates the effect of a high supplemental dose of ascorbic acid (AA) on plasma concentrations of total cholesterol (TC), triglycerides (TG), total lipids (TL), and lipoprotein fractions high-density, very-low-density-, and low-density lipoprotein (HDL, VLDL, LDL) in guinea pigs fed with atherogenic diet. Methods: Group I consisted of 5 normally fed guinea pigs plus a low dose of AA (1 mg/100 g/day), group II consisted of 7 guinea pigs fed with food enriched with 2% cholesterol plus a low dose of AA (1 mg/100 g/day), and group III consisted of 7 guinea pigs fed with food enriched with 2% cholesterol plus a high dose of AA (30 mg/100 g/day). Cholesterolemic factors concentrations were determined after nine weeks. Results: Concentrations of TC, TG, TL, LDL, and VLDL were increased in group II compared to group I (p < 0.01 for all differences). Supplementation with a high dose of AA resulted in decreased concentrations of TC (p < 0.01), TG (p < 0.01), TL (p < 0.01), and LDL (p < 0.01) in group III compared to group II. Additionally, concentration of HDL was increased in group III compared to group II (p < 0.01). Conclusion: High-dose AA supplementation to an atherogenic diet decreases concentrations of TC, TG, TL, and LDL and increases concentration of HDL compared to low-dose AA.

scholarly journals Gastric pH in patients premedicated with Esomeprazole or Famotidine undergoing routine surgery under general anaesthesia

2013 ◽  
Vol 1 (2) ◽  
pp. 71-76
Author(s):  
BR Shrestha ◽  
S Shrestha ◽  
S Moktan ◽  
OS Shrestha
Keyword(s):  
General Anaesthesia ◽  
Ph Value ◽  
Elective Surgery ◽  
Gastric Ph ◽  
Control Group ◽  
Ph Indicator ◽  
Double Blind ◽  
Group Iii ◽  
Group I ◽  
American Society

Background: Stress and anxiety in patients planned for surgery under anaesthesia may change pH of gastric secretion. Premedication of surgical patients with pH altering drugs may modify the pH favourably. With the advent of newer agents, premedication has been carried out with different agents. Most of the time choice of drug is made by the perioperative physician on his/her own. Objective: To study gastric pH in patients premedicated either with Esomeprazole or Famotidine. Methods: This is a randomized controlled double blind prospective study conducted in 150 patients of American Society of Anesthesiologists grade I and II posted for elective surgery under general anaesthesia. The patients enrolled in the study were randomly assigned to three groups having 50 patients in each. Group I (control group) did not receive any pH altering drug, Group II (Famotidine Group) received 40 mg of Famotidine and Group III (Esomeprazole Group) received 40 mg of Esomeprazole the night before surgery. The observer was totally blind about the groups or drugs given to the patients. On the day of surgery, after induction of anaesthesia gastric juice was obtained via nasogastric tube and was checked for pH using pH indicator paper. Results: The pH raised by Esomeprazole was statistically significant (p<0.001) when compared to that of control group or Famotidine group. The mean pH value in control group was less than 2.5 whereas the pH value was higher than 2.5 in patients premedicated with either Famotidine or Esomeprazole. Conclusions: Gastric pH is raised by Famotidine or Esomeprazole premedication prior to routine surgery, Esomeprazole being superior to Famotidine, p<0.001. Patients (84%) not premedicated with either of the drugs had pH less than 2.5. DOI: http://dx.doi.org/10.3126/jkmc.v1i2.8141 Journal of Kathmandu Medical College, Vol. 1, No. 2, Oct.-Dec., 2012: 71-76

scholarly journals The effect of apple (Malus Domestica) juice on the damage of mice liver cells due to paracetamol treatment

2009 ◽  
Vol 21 (2) ◽  
Author(s):  
Anthony Hartanto ◽  
Murnisari Dardjan ◽  
Silvi Kintawati
Keyword(s):  
Liver Damage ◽  
Malus Domestica ◽  
Apple Juice ◽  
Liver Cells ◽  
High Dose ◽  
Toxic Agent ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Mice Liver

The liver is an important organ for body metabolism process. Liver disease is one of serious health problems in developing countries including Indonesia. Liver damage is caused by viral infection, toxic agent exposure (medications, alcohol), hormonal disturbance, neoplasm and autoimmune diseases. The use of high dose paracetamol to reduce pain also leads to liver damage. Apple (Malus domestica) juice is a natural anti oxidant agent. This laboratory experimental study was performed to discover the effect of giving apple juice on damaged cell regeneration due to the use of paracetamol. The study was performed in 21 male mice from Swiss-Webster strain that were divided into group I, II, and III. Group, I served as control while group II received 1 mg/ml paracetamol dose for 5 days and Group III received 1 mg/ml paracetamol for 5 days and 1 ml of apple juice on the 5th to 10th day. The observation of the mice liver cells was conducted using a light microscope with 400x magnification to get the number of necrotic liver cells per view field. The results of this study showed a difference in the number of necrotic liver cells between Group II and III. ANOVA statistical test ( = 0.05) concluded that apple juice significantly helps regeneration process in damaged liver cells caused by paracetamol.

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