scholarly journals Bilateral ultrasound-guided abdominal peripheral block in tap plane, tap - block

2020 ◽  
Vol 18 (4) ◽  
pp. 344-349
Author(s):  
M. Sekulovski ◽  
B. Simonska ◽  
G. Mutafov ◽  
V. Alexandrov ◽  
L. Spassov
Keyword(s):  
General Anesthesia ◽  
Analgesic Efficacy ◽  
Opioid Analgesics ◽  
Abdominal Muscle ◽  
Control Group ◽  
Tap Block ◽  
Ultrasound Guided ◽  
Group I ◽  
Group Ii ◽  
Peripheral Block

INTRODUCTION: Bilateral ultrasound-guided peripheral block (TAP - block) in the plane between the inner oblique abdominal muscle and the transversal abdominal muscle – TAP plane, is a regional anesthesia technique by infiltration of a local anesthetic, provides analgesia for operations involving the anterior abdominal wall. The analgesic effectiveness of the block decreases the consumption of opioid analgesics and non-steroidal anti-inflammatory drugs. AIM: In this study, we evaluated the intraoperative analgesic efficacy of bilateral TAP - block and the consumption of opioid analgesics in patients undergoing bilateral laparoscopic inguinal hernia repair. METHODS: The study was conducted with 35 patients, who were randomized into two groups. In the control group (group I), there are patients who received general anesthesia (GA), and experimental group (group II), were patients who have received general anesthesia and a bilateral tap block (GA + TAP). RESULTS: Patients with TAP-block (group II) have significantly lower fentanyl consumption compared to group I. CONCLUSION: Multimodal approach for the simultaneous administration of general anesthesia with a TAP block provides effective intraoperative analgesia and significantly reduces the perioperative consumption of opioid analgesics.

To Compare Frequency of Sore Throat in Early Postop period in General Anesthesia and Endotracheal Intubation for Abdominal Surgeries who are given Dexamethasone and Normal Saline

2021 ◽  
Vol 15 (6) ◽  
pp. 1227-1229
Author(s):  
R. Farooqi ◽  
T. Iqbal ◽  
M. S. Mehmood ◽  
Z. Y. Bhatti ◽  
F. Liaquat
Keyword(s):  
General Anesthesia ◽  
Sore Throat ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Controlled Study ◽  
Control Group ◽  
Chi Square ◽  
Group I ◽  
Chi Square Test ◽  
Group Ii

Aim: To Compare frequency of sore throat in early post operative period among patients undergoing general anaesthesia and endotracheal intubation for abdominal surgeries who are given dexamethasone and normal saline. Study Design: Randomized controlled study Setting: Department of Anesthesia/ ICU, Sheikh Zayed Hospital, Lahore Duration of study: Six months i.e. 25-09-2009 to 25-03-2010. Methodology: 120 patients undergoing elective general surgery on abdomen were selected. They were divided into two groups. Group I received dexamethasone 8mg (2ml) I/V pre-operatively and group II received 2ml normal saline I/V pre-operatively. Chi square test was used. Visual analogue (VAS) scale was used for recording sore throat. The VAS score ≤4 was considered as no sore throat and VAS scores>4 were considered as the sore throat. Results: Frequency of post-operative sore throat after the first 24 hours following GA and endotracheal intubation was lower in group (I) as compared to the control group (II). Eleven (20%) patients with dexamethasone had post-operative sore throat compared to thirty one (56.3%) patients in control group. (p<0.01). Conclusion: Pre-operative use of dexamethasone was associated with decreased incidence of post-operative sore throat. Keywords: Visual analogue scale (VAS), Post-operative sore throat, general anesthesia

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 Comparative Study between Ultrasound-Guided Fascia Iliaca Block Versus Adductor Canal Block for Postoperative Analgesia in Patients undergoing Knee Surgeries

2021 ◽  
pp. 214-224
Author(s):  
Soliman Ramadan Naser ◽  
Sameh Mohammed Refaat ◽  
Nagat Sayed El Shmaa ◽  
Sabry Mohammed Amin
Keyword(s):  
Spinal Anesthesia ◽  
Postoperative Analgesia ◽  
Control Group ◽  
Ultrasound Guided ◽  
Adductor Canal Block ◽  
Group Iii ◽  
Adductor Canal ◽  
Group I ◽  
Group Ii ◽  
Fascia Iliaca Block

Background: Peripheral nerve block may provide effective unilateral postoperative analgesia following knee and hip surgeries with a lower incidence of opioid-related and autonomic side-effects, less motor block. Fascia iliaca block (FIB) and adductor canal block (ACB) have been shown to be a successful technique for postoperative pain relief after knee surgeries. The aim of our study was to compare the effect of ultrasound guided FIB versus ultrasound guided ACB for postoperative analgesia in patients undergoing knee surgeries. Methods: Our randomized controlled trial was conducted over 105 patients aged between 18 and 65 years, (ASA) class I and II undergoing knee surgeries. Patients divided into three groups: Group I control (C): Patients received spinal anesthesia alone. Group II (FIB): Patients received spinal anesthesia with postoperative ultrasound guided FIB. Group III (ACB): Patients received spinal anesthesia with postoperative ultrasound guided ACB. Results: Both FIB and ACB provided better pain control compared to control group. The need for first dose of supplemental analgesic was earlier in the control group than FIB and ACB groups postoperatively. Additionally, the total 24-h pethidine consumption was highest in the control group compared to fascia FIB and ACB groups. FIB was shown to reduce the strength of the quadriceps muscle, which resulted in delayed early postoperative mobilization and influencing patient satisfaction. There was statistically significant increase in heart rate and mean arterial blood pressure in group I as compared to group II and group III at 6hrs and 12hrs postoperatively. Conclusions: Both FIB and ACB provide excellent postoperative analgesia after knee surgeries, however the ACB is superior to FIB because it has no prolonged muscle weakness and FIB did.

scholarly journals The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair

PRILOZI ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 135-142 ◽  
Author(s):  
Andrijan Kartalov ◽  
Nikola Jankulovski ◽  
Biljana Kuzmanovska ◽  
Milka Zdravkovska ◽  
Mirjana Shosholcheva ◽  
...  
Keyword(s):  
Hernia Repair ◽  
General Anesthesia ◽  
Umbilical Hernia ◽  
Rectus Sheath ◽  
Morphine Consumption ◽  
Ultrasound Guided ◽  
Group I ◽  
Umbilical Hernia Repair ◽  
Rectus Sheath Block ◽  
Group Ii

Abstract Background: Ultrasound guided rectus sheath block can block the ventral rami of the 7th to 12th thoracolumbar nerves by injection of local anesthetic into the space between the rectus muscle and posterior rectus sheath. The aim of this randomized double-blind study was to evaluate the analgesic effect of the bilateral ultrasound guided rectus sheath block as supplement of general anesthesia on patents undergoing elective umbilical hernia repair. Methods: After the hospital ethics committee approval, 60 (ASA I–II) adult patients scheduled for umbilical hernia repair were included in this study. The group I (n=30) patents received only general anesthesia. In the group II (n = 30) patents after induction of general anesthesia received a bilateral ultrasound guided rectus sheath block with 40 ml of 0.25% bupivacaine. In this study we assessed demographic and clinical characteristics, pain score - VAS at rest at 2, 4, 6, 12 and 24 hours after operation and total analgesic consumption of morphine dose over 24-hours. Results: There were statistically significant differences in VAS scores between the groups I and II at all postoperative time points - 2hr, 4 hr, 6 hr, 12 hr and 24 hr. (P < 0.00001). The cumulative 24 hours morphine consumption after the operation was significantly lower in the group II (mean = 3.73 ± 1. 41) than the group I (mean = 8.76 ± 2.41). This difference was statistically significant (p = 0.00076). Conclusion: The ultrasound guided rectus sheath block used for umbilical hernia repair could reduce postoperative pain scores and the amount of morphine consumption in 24 hours postoperative period.

A Comparative Study between Ultrasound Guided Trans-muscular Quadratus Lumborum Block Versus Ultrasound Guided Transversus Abdominis Plane Block as postoperative analgesia in Laparoscopic Bariatric Surgery

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Peter N Youwakiem ◽  
Moustafa K Reyad ◽  
Abd El Aziz A Abo Zeid ◽  
Mariam K Basta
Keyword(s):  
Bariatric Surgery ◽  
General Anesthesia ◽  
Analgesic Efficacy ◽  
Visual Analog Score ◽  
Laparoscopic Bariatric Surgery ◽  
Tap Block ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Pain Scores ◽  
Analgesic Technique

Abstract Background A variety of unwanted post-operative consequences, including patient suffering, respiratory distress complications, delirium, myocardial ischemia, prolonged hospital stay and an increased likelihood of chronic pain are due to poorly controlled acute pain after laparoscopic abdominal surgery. Aim of the Work is to compare the analgesic efficacy of ultrasound-guided TQL with TAP block during laparoscopic bariatric surgery and to improve the outcome of the patients undergoing laparoscopic bariatric surgery under general anesthesia who suffer from postoperative pain and also in the early postoperative period regarding pain relief, decreasing postoperative opioid requirements, provision of comfort, early mobilization and improved respiratory functions. Patients and Methods The study was conducted on 40 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 20 patients each: Group TQL (n = 20): received combined general anesthesia with TQL block. Group TAP (n = 20): received combined general anesthesia with TAP block. Results TQL block has more analgesic efficacy than TAP block. The first call for rescue analgesia (Meperidine), total meperidine consumption and pain scores (visual analog score at rest and movement) indicated the superiority of the analgesic technique TQL block. Conclusion TQL with general anesthesia was more effective technique in providing analgesia after laparoscopic bariatric surgery without associated hemodynamic instability in comparison to TAP block with general anesthesia and also the first call for rescue analgesia (Meperidine), total meperidine consumption and pain scores (visual analog score at rest and movement) indicated the superiority of the analgesic technique TQL block.

scholarly journals Effect of Adding Dexamethasone as a Ropivacaine Adjuvant in Ultrasound-Guided Transversus Abdominis Plane Block for Inguinal Hernia Repair

PRILOZI ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 35-41 ◽  
Author(s):  
Andrijan Kartalov ◽  
Nikola Jankulovski ◽  
Biljana Kuzmanovska ◽  
Milka Zdravkovska ◽  
Mirjana Shosholcheva ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
General Anesthesia ◽  
Inguinal Hernia Repair ◽  
Morphine Consumption ◽  
Tap Block ◽  
Group Iii ◽  
Group I ◽  
Open Inguinal Hernia Repair ◽  
Group Ii

Abstract Background: The transverses abdominals plane block (TAP) is a regional anesthesia technique that provided analgesia to the parietal peritoneum, skin and muscles of the anterior abdominal wall. The aim of this randomized double-blind study was to evaluate postoperative analgesia on patients undergoing open inguinal hernia repair under general anesthesia (GA), (GA + TAP) block preformed with ropivacaine and (GA + TAP-D) block preformed with ropivacaine and 4 mg dexamethasone. Methods: 90 (ASA I-II) adult patients for unilateral open inguinal hernia repair were included in this study. In group I (n = 30) patents received only general anesthesia (GA). Patients in group II (n = 30) received GA and unilateral TAP block with 25 ml of 0.5% ropivacaine and the patients in group III (n = 30) received GA and unilateral TAP-D block with 25 ml of 0.5% ropivacaine + 4 mg Dexamethadsone. In this study we assessed the pain score - VAS at rest at 2, 4, 6, 12 and 24 hours after the operation and the total analgesic consumption of morphine over 24 hours. Results: There were statistically significant differences in the VAS scores between group I, group II and group III at all postoperative time points - 2hr, 4hr, 6hr, 12hr and 24hr. (p < 0.00001). The cumulative 24 hours morphine consumption after the operation was significantly lower in group III (5.53 1.21 mg) than in group II (6.16 2.41 mg) and group I (9.26 2.41 mg). This difference is statistically significant (p < 0.00001). Conclusion: Concerning the inguinal hernia repair we found better postoperative pain scores and 24 hours reduction of the morphine consumption in group III (GA and TAP-D block) compared with group I (GA) and group II (GA + TAP block).

Features of the cervix uteri in women of reproductive age with endometrial polyps and micropolyps

2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  
Keyword(s):  
Reproductive Age ◽  
Cervix Uteri ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Endometrial Polyps ◽  
Group Iii ◽  
Aggressive Form ◽  
Group I ◽  
Group Ii ◽  
Control Group Group

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.

scholarly journals Transversus abdominis Plane Block for Improved Early Postoperative Pain Management after Periacetabular Osteotomy: A Randomized Clinical Trial

2021 ◽  
Vol 10 (3) ◽  
pp. 394
Author(s):  
Jannis Löchel ◽  
Viktor Janz ◽  
Vincent Justus Leopold ◽  
Michael Krämer ◽  
Georgi I. Wassilew
Keyword(s):  
Postoperative Pain ◽  
Periacetabular Osteotomy ◽  
Opioid Consumption ◽  
Transversus Abdominis ◽  
Control Group ◽  
Block Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Pain Scores

Background: Patients undergoing periacetabular osteotomy (PAO) may experience significant postoperative pain due to the extensive approach and multiple osteotomies. The aim of this study was to assess the efficacy of the transversus abdominis plane (TAP) block on reducing opioid consumption and improving clinical outcome in PAO patients. Patients and Methods: We conducted a two-group randomized-controlled trial in 42 consecutive patients undergoing a PAO for symptomatic developmental dysplasia of the hip (DDH). The study group received an ultrasound-guided TAP block with 20 mL of 0.75% ropivacaine prior to surgery. The control group did not receive a TAP block. All patients received a multimodal analgesia with nonsteroidal anti-inflammatory drugs (NSAID) (etoricoxib and metamizole) and an intravenous patient-controlled analgesia (PCA) with piritramide (1.5 mg bolus, 10 min lockout-time). The primary endpoint was opioid consumption within 48 h after surgery. Secondary endpoints were pain scores, assessment of postoperative nausea and vomiting (PONV), measurement of the quality of recovery using patient-reported outcome measure and length of hospital stay. Forty-one patients (n = 21 TAP block group, n = 20 control group) completed the study, per protocol. One patient was lost to follow-up. Thirty-three were women (88.5%) and eight men (19.5%). The mean age at the time of surgery was 28 years (18–43, SD ± 7.4). All TAP blocks were performed by an experienced senior anaesthesiologist and all operations were performed by a single, high volume surgeon. Results: The opioid consumption in the TAP block group was significantly lower compared to the control group at 6 (3 mg ± 2.8 vs. 10.8 mg ± 5.6, p < 0.0001), 24 (18.4 ± 16.2 vs. 30.8 ± 16.4, p = 0.01) and 48 h (29.1 mg ± 30.7 vs. 54.7 ± 29.6, p = 0.04) after surgery. Pain scores were significantly reduced in the TAP block group at 24 h after surgery. There were no other differences in secondary outcome parameters. No perioperative complication occurred in either group. Conclusion: Ultrasound-guided TAP block significantly reduces the perioperative opioid consumption in patients undergoing PAO.

scholarly journals Irisin levels in relation to metabolic and liver functions in Egyptian patients with metabolic syndrome

2016 ◽  
Vol 94 (4) ◽  
pp. 359-362 ◽  
Author(s):  
Fatma H. Rizk ◽  
Samah A. Elshweikh ◽  
Amira Y. Abd El-Naby
Keyword(s):  
Metabolic Syndrome ◽  
Liver Enzymes ◽  
Resistance Index ◽  
Control Group ◽  
Model Assessment ◽  
Group Iii ◽  
Group I ◽  
Elevated Liver Enzymes ◽  
Liver Functions ◽  
Group Ii

Irisin is a new myokine that is suspected to influence metabolic syndrome (MetS). However, there is a great controversy with respect to its level in cases of MetS and its correlation with different metabolic parameters. The present study assesses irisin levels in MetS patients and studies its relationship to metabolic and liver functions to evaluate the possible role of the liver in regulation of this level. Sixty subjects were included in this experiment, who were divided into 3 groups: group I (normal control), group II (MetS patients with normal liver enzymes), and group III (MetS with elevated liver enzymes and fatty liver disease). Serum irisin levels showed significant increases in groups II and III compared with group I, and significant increases in group III compared with group II. Also, irisin levels were positively correlated with body mass index, serum triglycerides, homeostatic model assessment of insulin resistance index (HOMA-IR), and liver enzymes. We concluded that serum irisin levels increased in patients with MetS, especially those with elevated liver enzymes, and had a positive correlation with parameters of lipid metabolism and glucose homeostasis with the possibility of hepatic clearance to irisin.

Comparison of the parameters of retinal sensitivity after vitrectomy due to rhegmatogenous retinal detachment

2021 ◽  
pp. 349-354
Author(s):  
R.R. Fayzrakhmanov ◽  
◽  
A.V. Sukhanova ◽  
O.A. Pavlovsky ◽  
E.D. Bosov ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Light Sensitivity ◽  
Control Group ◽  
Strong Positive Correlation ◽  
Gas Tamponade ◽  
Group I ◽  
Silicone Oil Tamponade ◽  
Group Ii

Purpose. To compare the parameters of a light sensitivity (LS) of the central zone of a retina after vitrectomy due to reghmatogenous retinal detachment (RRD) with a silicone oil tamponade (SOT) and gas tamponade (GT). Material and methods. The study included 20 eyes after pars plana vitrectomy due to macula-off rhegmatogenous retinal detachment (RRD) by 25G. All patients were divided in 2 groups depending on the choice of the tamponade. The group I (10 eyes) included cases with the silicone oil tamponade (SOT) (1300 cSt), in the group II (10 eyes) – the gas tamponade (GT) (C2F6). The control group included contralateral eyes without ophthalmic pathology. All patients underwent standard ophthalmological examination and fundus- microperimetry (FMP) on the 30th day after removal of the SOT for the group I, or on the 30th day after the C2F6 tamponade for the group II. Results. According to FMP data, the parameter of average light sensitivity (LS) in the group I was significantly reduced, both in comparison with the group II (p=0.007) and the control group (p=0.003). Differentiation by zones in the group I revealed a decrease in each analyzed parameter in comparison with the control group (p<0.05) and a decrease in the 2nd zone (p=0.031) and the 4th zone (p=0.038) in comparison with the group II. In the 1st zone of the group I the formation of a relative scotoma was revealed in 4 cases out of 10 (40%). The parameters of light sensitivity (LS) in comparison with the control in the group II were significantly reduced when analyzed in each zone (p<0.05). A strong positive correlation was found between the Best Corrected Visual Acuity (BCVA) and the average LS in the group II (r=0.87). Conclusion. There is a decrease in the functional parameters of the retina with SOT compared with GT in the form of a decrease in the LS parameter in the 10° zone according to FMP data. Key words: retinal detachment, photosensitivity, microperimetry, silicone tamponade.

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