scholarly journals Ultrasound Guided Infraclavicular Block for Pain Control After Upper Extremity Surgery

2018 ◽  
Vol 3 (4) ◽  
pp. 108-112
Author(s):  
Derya Yalçın ◽  
Dilek Erdoğan Arı ◽  
Ceren Köksal ◽  
Cansu Akın ◽  
Sinan Karaca ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Recovery Room ◽  
Motor Block ◽  
Double Blind Study ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Double Blind ◽  
Significant Difference ◽  
Infraclavicular Block ◽  
Group 2

Background: Opioids added to local anesthetics for peripheral nerve blocks may intensify analgesia and prolong analgesic and sensorial block duration. These agents may also cause potentiation and prolongation of motor block. Objective: This study compared the postoperative effects of 30 mL of 0.25% bupivacaine +50 mcg fentanyl and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl solutions for the ultrasound-guided infraclavicular block in patients undergoing elbow and forearm surgery. Methods: In this randomized double-blind study, thirty-six patients with risk of ASA class I-III were randomly allocated into 2 randomized groups. Ultrasound-guided infraclavicular blocks with 30 mL of 0.25% bupivacaine + 50 mcg fentanyl for group 1 and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl for group 2 were performed before patients emerged from general anesthesia. After surgery, pain levels at rest and during movement were evaluated using the 10-cm visual analog scale (VAS) at recovery room admission, at the 15th and 30th minutes in the recovery room, and at the 2nd, 6th, 12th and 24th hours postoperatively. Both morphine and rescue analgesic requirements were recorded. Sensorial and motor block durations, patient satisfaction, and complications related to the infraclavicular block were recorded. Results: In both groups, no significant difference in VAS pain scores, total morphine and total rescue analgesic requirements, duration of sensorial and motor block, or patient satisfaction were observed. None of the patients experienced any complications. Conclusion: The mixtures of 0.25% bupivacaine + 50 mcg fentanyl and 0.25% bupivacaine + 100 mcg fentanyl showed similar postoperative effects.

scholarly journals Pull vs. wet: rendimiento diagnóstico y calidad de las muestras de las PAAF guiadas por USE en las masas sólidas del páncreas

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Cecilia Curvale ◽  
Ignacio Málaga ◽  
Paloma Rojas Saunero ◽  
Viviana Tassi ◽  
Enrique Martins ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Double Blind Study ◽  
Cell Block ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Fine Needle ◽  
Significant Difference

Differential diagnosis of pancreatic masses is challenging. The endoscopic ultrasound-guided fine-needle aspiration method with the highest diagnostic yield has not been established. It was realized a prospective, randomized, double-blind study of the endoscopic ultrasound-guided fine-needle aspiration in solid lesions of the pancreas to compare and evaluate diagnostic yield and aspirate quality between wet and pull technique. Forty-one patients were enrolled. The wet technique presented a sensitivity, a specificity, a positive and negative predictive value, and a diagnostic accuracy of 58.3%, 100%, 100%, 25% and 63.4%, respectively. In the capillary technique they were: 75%, 100%, 100%, 35.7% and 78.1%, respectively. Comparing the diagnostic yield between both techniques, there was no statistically significant difference (McNemar’s test p = 0.388). Regarding the cellularity of the specimen, both in cytology and the cell block samples, no significant difference was observed between the techniques (p = 0.84 and 0.61, respectively). With respect to contaminating blood in the specimen, there was no difference in cytology samples (p = 0.89) and no difference in cell block samples (p = 0.08). The suitability of cytology samples for diagnosis was similar in both techniques (wet = 57.5% and capillary = 56.7%, p = 0.94) and there was no difference in cell block samples (wet = 75% and capillary = 66.1%, p = 0.38). In this study we did not observe differences in diagnostic yield or sample quality. Since both techniques are effective, we suggest the simultaneous and alternate use of both methods.

scholarly journals Comparison of Ondansetron with Gabapentin for prevention of intrathecal morphine induced pruritus

2019 ◽  
Vol 2 (3) ◽  
pp. 142-148
Author(s):  
Rohini Sigdel ◽  
Anil Shrestha ◽  
Roshana Amatya
Keyword(s):  
Single Dose ◽  
Intrathecal Morphine ◽  
Double Blind Study ◽  
Physical Status ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Subarachnoid Block ◽  
Significant Difference ◽  
Group 2 ◽  
To Receive

Background: Ondansetron has been used successfully for prophylaxis and treatment of intrathecal morphine induced pruritus. Gabapentin has anxiolytic, antiemetic, antipruritic effects and has also been shown to potentiate the analgesic effect of intrathecally or epidurally administered opioids. Materials and method: We compared the effectiveness of oral gabapentin with intravenous ondansetron to prevent incidence of intrathecal morphine induced pruritus. In a prospective, double-blind study, sixty patients aged 18-65 years with ASA physical status I and II undergoing surgery under subarachnoid block were randomized to receive placebo tablets (ondansetron group) or gabapentin 1200 mg (gabapentin group) 2 hours before surgery. Patients receiving placebo tablets received 8 mg of intravenous ondansetron and those receiving gabapentin received 4 ml of intravenous normal saline just prior to subarachnoid block with 3 ml of 0.5% hyperbaric bupivacaine plus 0.2 mg morphine. The incidence, onset, severity, location of pruritus and incidence of side effects were studied for next 24 hours. Results: The overall incidence of pruritus was 48.3%. The incidence, severity, location of pruritus was comparable between the two groups. There was significant difference between the onset of pruritus between groups (p=0.009). The incidence and grade of nausea vomiting, requirement of intraoperative sedation was comparable between groups. The incidence of urinary retention was significantly high in gabapentin group (p=0.020). Respiratory depression was observed in one patient. Conclusion: A single dose of 1200 mg oral gabapentin 2 hours before, is as effective as prophylactic intravenous ondansetron 8 mg for prevention of intrathecal morphine induced pruritus.

Effect of Dexamethasone on The Duration of Analgesia for Supraclavicular Brachial Plexus Block

KYAMC Journal ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 199-203
Author(s):  
Md Rafiqul Islam ◽  
Laila Yesmin ◽  
Md Pervez Rahman ◽  
ABM Shafiul Anam Khan ◽  
Md Miraj Hossain ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Group B ◽  
Plexus Block

Background: Brachial plexus block with Bupivacaine provides effective intraoperative anesthesia and analgesia. The use of dexamethasone along with local anesthetic has been shown to improve the duration of analgesia. Objective: To observe the effect of Dexamethasone on the duration of analgesia for Supraclavicular Brachial plexus block. Materials and Methods: A prospective, double-blind study was undertaken in patients scheduled for upper limb surgeries under supraclavicular brachial plexus block. patients were randomly divided into two groups, Group (BD) and B. Group B received 28 ml of 0.25% bupivacaine with 2 ml normal saline while Group BD received 28 ml of 0.25% bupivacain with 2ml (8mg) dexamethasone for supraclavicular brachial plexus block. The groups were compared regarding quality of sensory and motor blockade. All the information was recorded in data collection sheet. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Results: There was no significant difference between groups in respect of demographic and American Society of Anaesthesiologist (ASA) status. Mean age was found to 34.7±8.53 years. In Group (BD) , 63.3% were ASA I and 36.6% were ASA II. In Group B, 60% were ASA I and 40% were ASA II. It has become evident that satisfactory anaesthesia can be made possible by addition of adjuvant to local anaesthetic in brachial plexus block (in Group-BD). onset of sensory block was faster in Group BD (8.17 ± 1.4 min) than Group B (9.12 ± 1.68 min). Similarly mean onset time of motor block in group A was 12.26 ± 3.96 min, and 11.58 ± 3.68 min in group B. Our study shows that duration of motor block was 408.68±26.96 min and 380.26 ± 24.11 min in group BD and Group B respectively. Conclusion: There was significantly prolonged duration of analgesia in addition of Dexamethasone without any unwanted effects. KYAMC Journal Vol. 11, No.-4, January 2021, Page 199-203

scholarly journals Comparison of Two Different Techniques in Ultrasound Guided Infraclavicular Block: Jedi and Classic Grip

2021 ◽  
Author(s):  
SÜLEYMAN CAMGÖZ ◽  
Serap DİKER ◽  
Betül GÜVEN AYTAÇ ◽  
İsmail Aytaç
Keyword(s):  
Motor Block ◽  
Classical Method ◽  
Sensory Block ◽  
Control Group ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Group I ◽  
Block Success ◽  
Significant Difference ◽  
Classical Technique

Background: The widespread use of ultrasonography in peripheral nerve blocks requires an assistant. Pappin et al. described the “Jedi grip” technique in which the practitioner works alone by controlling the ultrasound prob with one hand and the needle and injector with the other. In this study, we aimed to compare the block characteristics of the “Jedi grip” technique with the classical technique that performed with an assistant. Methods: 78 patients were included in our study. They were randomly divided into two groups (Group I: Jedi grip and Group II: Classical grip technique). Local anesthetic was applied to both groups from 10 ml of 0.5% bupivacaine +10 ml of 2% prilocaine mixture. The block characteristics were evaluated and recorded every 5 minutes for the first 30 minutes after each block. When the sensory block score was 7 and the total score was 14 or above, the block was considered successful, and the patient was ready for surgery. Results: There was no significant difference between the groups in terms of block characteristics such as block pain, number of attempts, arterial puncture, sensory and motor block onset and regression times, time to be ready for surgery, tourniquet pain, use of additional anesthesia method, use of postoperative analgesia. The duration of block application was 158±47 sec in the Jedi group and 121±83 sec in the control group. Conclusion: The Jedi grip technique has been found to be applicable with the same confidence compared to the classical method in terms of block success and complications.

Clonidine as an Adjuvant to Bupivacaine for Suprazygomatic Maxillary Nerve Blocks in Cleft lip and Palate Repair: A Randomized, Prospective, Double-Blind Study

2020 ◽  
pp. 105566562096414
Author(s):  
Gaston Echaniz Barbero ◽  
Marcos de Miguel ◽  
Plinio Sierra ◽  
Glenn Merritt ◽  
Pranjal Bora ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Blind Study ◽  
Double Blind Study ◽  
Emergence Agitation ◽  
Nerve Blocks ◽  
Double Blind ◽  
Maxillary Nerve ◽  
Significant Difference

Objectives: Does clonidine, as adjuvant to bupivacaine for suprazygomatic maxillary nerve blocks, reduce emergence agitation in patients undergoing cleft lip and cleft palate surgery? Design: Randomized, controlled, and double-blind study. Setting: Guwahati Comprehensive Cleft Care Center, Guwahati (Assam, India). Participants: A total of 124 patients; with a median age of 5 years in the clonidine group (CLG) and 7 years in the control group (CG), who underwent cleft lip or cleft palate surgery were included. Exclusion criteria included lack of consent from patients or their guardians, allergy to local anesthetics, coagulation disorders, local infection at the puncture site before performing the block, and language difficulties or cognitive disorders. Interventions: Patients were randomized into 2 groups to receive bilateral suprazygomatic maxillary nerve blocks with either a bupivacaine/clonidine mixture for the CLG or bupivacaine alone in the CG. Main Outcome Measure: The primary end point was the incidence of emergence agitation. Results: There was a statistically significant difference in the incidence of emergence agitation (30.2% in the CG compared to 15.2% in the CLG; difference of incidences: 15%, 95% CI: 0.1-30.1). The percentage of patients requiring intraoperative Fentanyl was lower in the CLG (10.6% compared to 26.4%; difference of incidences: 15.8%, 95% CI: 1.8-29). No other differences were observed. Further research in a more typically aged children population undergoing cleft surgery is needed. Conclusions: The use of clonidine as an adjuvant to bupivacaine in maxillary nerve block reduces the incidence of emergence agitation and intraoperative opioid consumption without hemodynamic or sedative side effects in patients undergoing cleft lip and palate surgery.

scholarly journals Comparison of ropivacaine and bupivacaine in ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing elective lower abdominal surgeries - A randomized double-blind trial

2021 ◽  
Vol 8 (2) ◽  
pp. 191-198
Author(s):  
Nidhi Sharma ◽  
Arnab Banerjee ◽  
Jyothi Jain ◽  
Pradeep Kumar Goyal
Keyword(s):  
Rating Scale ◽  
Transversus Abdominis ◽  
Double Blind Study ◽  
Tap Block ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Patient Satisfaction Score ◽  
Significant Difference ◽  
Group A ◽  
Group B

Ultrasound-guided Transversus Abdominal Plane (TAP) block is an effective and safe regional anaesthesia technique. Our study is aimed to draw a comparison between the analgesic efficacy of Ropivacaine and Bupivacaine using ultrasound-guided TAP block. After approval from our Institutional Ethical Committee, 100 ASA I and II patients were recruited. Patients of either sex in age group of 18–65 years, undergoing elective lower abdominal surgeries were included in this prospective double-blind study. Patients were randomized into two groups, A and B. Group A (n=50) patients received ultrasound-guided TAP block with 20 ml 0.5% Ropivacaine and those in group B (n =50) received 20 ml 0.25% Bupivacaine at the end of surgery. The postoperative pain score (Numeric Rating Scale, NRS), patient satisfaction score, total requirement of analgesics in the first 24 hours, and the side effects were observed. Statistical tests were conducted using student's t-test, chi-square test, or fisher's exact test whichever was applicable. P < 0.05 was considered statistically significant. Statistically significant difference in the pain scores were observed between the two groups at different time intervals. The mean NRS score was higher for group B at 2, 4, 6 and 14 hour following the block. The duration of analgesia was longer and the total requirement of analgesic was lesser in group A as compared to group B.(p<0.001)Ultrasound-guided TAP block with 0.5% Ropivacaine provides effective analgesia for longer duration and decreases the total analgesic consumption as compared to 0.25% Bupivacaine in lower abdominal surgeries.

scholarly journals COMPARISON OF CLONIDINE AND DEXMEDETOMIDINE AS AN ADJUVANT TO 0.5% BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMISED PROSPECTIVE DOUBLE-BLIND STUDY

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Kushal Jethani ◽  
Preeti Sahu ◽  
Seethal Ann
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Double Blind Study ◽  
Nerve Blocks ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block ◽  
Group D

Background and Objectives: Alpha-2 agonists are used as adjuvant with local anaesthetic agents to prolong the duration of spinal, epidural and peripheral nerve blocks as well as to prolong the duration of post operative analgesia. We performed a study to compare clonidine(1ug/kg) and dexmedetomidine (1ug/kg) as an adjuvant to 0.5% bupivacaine in supraclavicular brachial plexus block. Methods: Eighty ASA I and II patients scheduled for elective upper limb orthopaedic surgeries under supraclavicular brachial plexus block were divided into two  groups(n=25 each) in a randomized, double-blinded fashion. Group C received clonidine 1 μg/kg and Group D received dexmedetomidine 1 μg/kg added to bupivacaine 0.5% (30 cc). Onset and recovery time of sensory and motor block, as well as duration of analgesia were studied in both the groups. Results: Duration of sensory block and motor block was 220.12 ±50.3 and 280.1± 20.12 min respectively in group C, while it was 410.34± 60.12 and 460.4 ± 50.56 min respectively in group D and hence both were significantly prolonged in group D.  No statistically significant difference was seen in onset of sensory and motor block between the two groups. The duration of analgesia i.e. time to requirement of rescue analgesia was 270.4± 56.7 mins and 452.7 ±64.23 mins in group C and D respectively and  this difference was statistically significant (P=0.001). Conclusion: Addition of dexmedetomidine to bupivacaine 0.5% in supraclavicular brachial plexus block prolonged the duration of sensory and motor block as well as the duration of analgesia when compared with clonidine. Keywords: Clonidine, dexmedetomidine, supraclavicular block

Sulphadiazine/Trimethoprim Once Daily in Maxillary Sinusitis: A Randomized Double-Blind Comparison with Sulphamethoxazole/Trimethoprim B.I.D.

1981 ◽  
Vol 9 (6) ◽  
pp. 478-481 ◽  
Author(s):  
Pierre Federspil ◽  
Peter Bamberg
Keyword(s):  
Maxillary Sinusitis ◽  
Favourable Result ◽  
Double Blind Study ◽  
Double Blind ◽  
Once Daily ◽  
Days Of Therapy ◽  
Significant Difference ◽  
Blind Comparison ◽  
Cure Rates

In a randomized double-blind study fifty-four patients suffering from acute maxillary sinusitis were treated for 10 days with daily doses of sulphadiazine/trimethopim (1 g) and sulphamethoxazole/trimethoprim (1.92 g), respectively. The efficacy was evaluated clinically at two follow-up visits. X-ray investigations were performed at admission and after the therapy. Of thirty-nine patients finally evaluated, thirty-seven showed a favourable result. After 6–8 days of therapy there was significant difference in cure rates in favour of sulphadiazine/trimethoprim (p < 0.05) while the outcome as evaluated after treatment was similar for both drugs.

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