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

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.

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Ultrasound Guided Infraclavicular Block for Pain Control After Upper Extremity Surgery

Hospital Practices and Research ◽

10.15171/hpr.2018.24 ◽

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.

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A Comparative Evaluation of Dexamethasone and Tramadol as Adjuvant to Levobupivacaine in Supraclavicular Block

Academia Anesthesiologica International ◽

10.21276/aan.2020.5.1.20 ◽

2020 ◽

Vol 5 (1) ◽

pp. 100-102

Author(s):

Rangit Priyakar Pandey ◽

Richa Chandra

Keyword(s):

Motor Block ◽

Sensory Block ◽

Group I ◽

Significant Difference ◽

The Mean ◽

Group Ii ◽

The Difference ◽

American Society ◽

Supraclavicular Block ◽

Plexus Block

Background: The present study was conducted to evaluate and compare dexamethasone and tramadol as adjuvant to levobupivacaine in supraclavicular block. Subjects and Methods: The present study was conducted on 50 patients of American Society of Anesthesiologists (ASA) grade I and II. Patients were divided in to two groups of 25 each. In group I, 30 ml of 0.5% levobupivacaine hydrochloride plus 2 ml tramadol (100 mg) was used. In group II, 30 ml of 0.5% levobupivacaine hydrochloride plus 2 ml dexamethasone (8 mg) was used. Visual Analogue Scale was used. The onset of sensory and motor block was evaluated.Results: The mean onset of sensory block in group I was 5.41 minutes and in group II was 3.86 minutes, motor onset was 9.12 minutes in group I and 7.25 minutes in group II, duration of sensory block in group I was 12.14 hours and in group II was 15.34 hours, duration of motor block in group I was 14.34 hours and I group II was 16.23 hours, duration of analgesia in group I was 16.1 hour and in group II was 18.4 hours. The difference was significant difference (P<0.05). The mean VAS score in group II was better as compared to group I (P <0.05). Conclusion:Authors found that dexamethasone is a better adjuvant than tramadol when added to levobupivacaine in supraclavicular brachial plexus block.

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The Effects on Sensorial Block, Motor Block, and Haemodynamics of Levobupivacaine at Different Temperatures Applied in the Subarachnoid Space

BioMed Research International ◽

10.1155/2014/132687 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7

Author(s):

Bahittin Nazli ◽

Huseyin Oguzalp ◽

Eyup Horasanli ◽

Mehmet Gamli ◽

Beyazit Dikmen ◽

...

Keyword(s):

Side Effects ◽

Motor Block ◽

Room Temperature ◽

Demographic Data ◽

Sensory Block ◽

Group I ◽

Significant Difference ◽

Different Temperatures ◽

Group Ii ◽

Transurethral Prostate Resection

Aim. To evaluate the effects of 0.5% levobupivacaine at 37°C preheated from room temperature, on sensorial block, motor block, and haemodynamics in patients undergoing transurethral prostate resection (TUR-P).Material and Method. The patients were randomly allocated to two groups: Group I patients were injected with 3 mL 0.5% levobupivacaine solution which had been kept at room temperature for at least 24 hours and Group II patients were injected with 3 mL 0.5% levobupivacaine solution which had been kept at 37°C for at least 24 hours. The patients were examined in terms of sensorial block, motor block, haemodynamic profile, and incidence of side effects.Results. No significant difference was found between the groups in terms of demographic data. The time to reachT10sensory block and the time of starting motor block were found to be significantly shorter in Group II . The duration of sensory block overT10andT6, the duration ofL1regression, the duration of the sensory block, and the regression time of the motor blocks from 3 to 2 were found to be longer in Group II.Conclusion. The use of 0.5% levobupivacaine spinal anaesthesia heated to 37°C accelerated the start of sensory and motor block.

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Perbedaan Respon Hemodinamik terhadap Penambahan Clonidin 1 dan 2 mcg/kgbb pada Scalp Block untuk Operasi Kraniotomi

Jurnal Neuroanestesi Indonesia ◽

10.24244/jni.v10i3.315 ◽

2021 ◽

Vol 10 (3) ◽

pp. 162-171

Author(s):

Syarif Afif ◽

◽

Tri Ardana Arianto ◽

Sugeng Budi Santosa

Keyword(s):

Blood Pressure ◽

Pulse Rate ◽

Skin Incision ◽

Control Group ◽

Hemodynamic Responses ◽

Nerve Blocks ◽

Anesthetic Agents ◽

Group I ◽

Significant Difference ◽

Scalp Block

Bacground and Objective: The addition of a levobupivacaine scalp block is effective in reducing hemodynamic responses such as blood pressure, mean arterial pressure (MAP) and pulse rate, especially when pinning, skin incisions, and durameter incisions in craniotomy. Adjuvants are often added to local anesthetics to enhance and prolong the analgesic effect of peripheral nerve blocks. Clonidine has a synergistic action with local anesthetic agents. Clonidine increases sensory and motor blocks in both peripheral and neuraxial blocks. The common dose is 2 mcg/kgbw. The aim of this study was to determine the effectiveness of adding clonidine 2 mcg/kg and 1 mcg/kg on scalp block as craniotomy analgesic. Subjects and Methods: Study on 30 patients met the inclusion criteria. Subjects were divided into three groups, group I: scalp block with levobupivacain 0.25%, group II: scalp block plus clonidine 1 mcg/kg, group III: scalp block plus clonidine 2mcg/kg. All patients were treated with general anesthesia according to the standard then assessed their blood pressure, MAP, pulse rate before intubation, pinning, skin incision and duramater incision. Results: There was a significant difference in the addition of clonidine with the control group, especially in the pulse and diastolic rates. Clonidine 2 mcg/kg at several times showed a significant difference compared to 1 mcg/kgbb dose. Conclusion: The clonidine addition to scalp block of levobupivacaine was effective in maintening hemodynamic responses, especially pulse rate and diastolic blood pressure.

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Addition of dexmedetomidine to bupivacaine in supraclavicular brachial plexus block

Clinical & Investigative Medicine ◽

10.25011/cim.v40i3.28390 ◽

2017 ◽

pp. E111-E116 ◽

Cited By ~ 4

Author(s):

Recep Aksu ◽

Cihangir Bicer

Keyword(s):

Brachial Plexus ◽

Motor Block ◽

Brachial Plexus Block ◽

Onset Time ◽

Sensory Block ◽

Ultrasound Guided ◽

Block Success ◽

Supraclavicular Brachial Plexus Block ◽

Group B ◽

Plexus Block

Purpose: Research is ongoing to determine the lowest dose of local anesthetics in brachial plexus block that provides adequate anesthesia and postoperative analgesia and reduces complications related to local anesthetics. Methods: Patients 18-65 years of age who underwent upper limb surgery and who received ultrasound-guided supraclavicular brachial plexus block at the Erciyes University Faculty of Medicine Hospital between February 2014 and January 2015 were included in the study (n=50). Supraclavicular brachial plexus blocks were performed on Group B cases by adding 30 ml 0.33% bupivacaine and on Group BD cases by adding 15 ml 0.33% bupivacaine and 1 µg / kg dexmedetomidine. Block success was evaluated by the onset and block duration of motor and sensory block and the duration of analgesia. Results: The block success of Group B and Group BD was 92.6% and 89.3%, respectively (P = 1.000). Onset time of sensory block, degree of sensory block, duration of sensory block, onset time of motor block, degree of motor block and duration of motor block were similar in both groups in the intergroup comparison (P > 0.05). Duration of analgesia and the operative conditions of groups were similar (P > 0.05). Conclusions: In the implementation of ultrasound-guided supraclavicular brachial plexus block, block success, sensory and motor block and analgesia duration were similar for patients anaesthetized with 30 ml of bupivacaine in comparison with dexmedetomidine+bupivacaine (when the bupivacaine dose was reduced by 50% by the addition of the adjuvant).

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Regenerative Therapy Modality for Treatment of True Combined Endodontic-Periodontal Lesions: A Randomized Controlled Clinical Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126220 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6220

Author(s):

Reham AlJasser ◽

Sundus Bukhary ◽

Mohammed AlSarhan ◽

Dalal Alotaibi ◽

Saleh AlOraini ◽

...

Keyword(s):

Bone Graft ◽

Bone Grafting ◽

Endodontic Treatment ◽

Control Group ◽

Controlled Clinical Trial ◽

Bony Defect ◽

Keratinized Tissue ◽

Group I ◽

Significant Difference ◽

Grafting Procedure

The aim of this in-vivo study was to evaluate/compare the clinical periodontal parameters in patients with true combined endo-perio lesions (EPL), treated with gutta-percha (GP) and mineral trioxide (MTA) as an obturation material alone and with addition of bone grafting in such lesions. 120 Saudi patients (mean age = 41yrs) diagnosed with true combined EPL participated in this study. Group I (control group, n = 30) was treated with conventional endodontic treatment using GP for obturation. Group II (n = 30) was treated with conventional endodontic treatment using MTA for obturation. Group III (n = 30) was treated with conventional endodontic treatment using GP for obturation + grafting procedure to fill the bony defect. Group IV (n = 30) was treated with conventional endodontic treatment using MTA for obturation + grafting procedure to fill the bony defect. Clinical parameters (Pocket depth (PD); Clinical attachment loss (CAL); keratinized tissue width (KTW); gingival phenotype (G.Ph.) and Cone Beam Computed Tomography Periapical Index (CBCTPAI)) were recorded and compared at baseline, 3, 6, 12 months’ interval. For the groups III and IV, CBCTPAI showed significant difference (p < 0.0001) with the other groups at 6 months and 1-year interval. The group with MTA + bone graft showed 76% and 90% patients with 0 score at 6 months and 1-year follow-up, respectively. Comparison of mean values of PD among study groups at 3 months, 6 months and 1 year showed significant difference at 3 months, whereas the mean PD values of subjects in GP + bone graft showed significantly higher PD values than other 3 groups (p = 0.025). Use of GP and MTA for root canal obturation along with periodontal therapy and bone augmentation helps in resolving complex endo-perio lesions. Bone grafting in addition to obturation with MTA was found to be the best treatment strategy in management of EPL cases and is recommended for clinicians who are treating EPL patients.

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Comparative Evaluation of Fracture Resistance of Endodontically Treated Teeth Restored with Resin Fiber Post and Stainless Steel Post: An In Vitro Study

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672019 ◽

2015 ◽

Vol 03 (02) ◽

pp. 080-084

Author(s):

Vijay Singh ◽

Poonam Bogra ◽

Saurabh Gupta ◽

Navneet Kukreja ◽

Neha Gupta

Keyword(s):

Stainless Steel ◽

Fracture Resistance ◽

Testing Machine ◽

Compressive Force ◽

Control Group ◽

Fiber Post ◽

Endodontically Treated Teeth ◽

Group I ◽

Significant Difference

AbstractFracture resistance of endodontically treated teeth restored with post. Aims: This study aims to compare the fracture resistance of endodontically treated teeth restored with resin fiber and stainless steel post. Commercially available prefabricated resin fiber post(Dentsply Maillefer Easy Post), prefabricated stainless steel post(Coltene/Whaledent Parapost) were used. Methods and Material: Forty five maxillary central incisors were obturated and divided into 3 groups: Control Group (Group I) without any post (n = 15), Resin Fiber Post Group (Group II) (n = 15) and Stainless Steel Post Group (Group III) (n = 15). In all Groups except control group, post space was prepared; a post was cemented, and a core build-up was provided. All the specimens were subjected to compressive force under a universal testing machine until fracture. Statistical analysis used: The results were analyzed using the variable analysis test (ANOVA). Results: One-way analysis of variance revealed significant difference among test groups. The control group demonstrated highest fracture resistance (925.2183 N), followed by the resin fiber post group (486.7265 N) and stainless steel post group (423.539N). Conclusions: Teeth restored with resin fiber post showed higher fracture resistance values than prefabricated stainless steel post.

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Histological Study On Using Ileal Submucosa In Repairing Urinary Bladder Defect In Adult Albino Rat

QJM ◽

10.1093/qjmed/hcab099.004 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Eman Gomaa El Saeed ◽

Manal H Moussa ◽

Gehad A Hammouda ◽

Sahar M. M Omar

Keyword(s):

Urinary Bladder ◽

Histological Study ◽

Squamous Metaplasia ◽

Muscle Layer ◽

Control Group ◽

Albino Rats ◽

Adult Rats ◽

Group I ◽

Significant Difference ◽

Graft Area

Abstract Background Repairing urinary bladder (UB) defect by enterocystoplasty remains the gold standard surgical bladder reconstruction procedure to increase the capacity and compliance of dysfunctional bladders. However, many complications were recorded. Aim of the work This work aimed to compare the consequences of reconstruction of urinary bladder defect using untreated small intestinal submucosal (SIS) matrix versus seeded and unseeded decellularized SIS matrix. Material and Methods Fifty female albino rats were used in this study. The animals were divided into three groups: Group I (Control) included ten adult rats from which ileal tissue was obtained. Group II included ten adult rats in which their UB defect was repaired by untreated cellular SIS. Group III included twenty adult rats that were subdivided into two subgroups, 10 rats each; Subgroup IIIA where rats had their UB defect repaired by acellular SIS and subgroup IIIb where rats had their UB defect repaired by acellular SIS seeded with adipose mesenchymal stem cells (AMSCs).Ten young rats were used for preparation of AMSCs. Morphometric and statistical analysis were also performed. Results In rats where UB defect was repaired by untreated cellular SIS, the graft area showed loss of epithelial polarity, presence of intraepithelial cysts and occasional extension of urothelium to the outer surface forming fistula. There were areas of metaplasia with the appearance PAS positive cells. In the lamina propria, there was areas of lymphocytic infiltration together with significant increase in the collagen fiber deposition (p < 0.05). There was a significant decrease thickness of muscle layer as compared to control (p < 0.05). In rats where UB defect was repaired by acellular SIS, urothelium in the graft area showed occasional squamous metaplasia and often the urothelium extended to the deeper layers forming Brunn's nest. There was minimal muscle regeneration in the graft area. However, in rats where UB defect was repaired by acellular SIS seeded with AMSCs, the urothelium in the graft area was nearly similar to control group with uniform urothelium thickness, minimal collagen fibers deposition and thick muscle layer that showed no significant difference from the control (p > 0.05). Conclusion Acellular SIS seeded with AMSCs showed better results compared to non-seeded and cellular SIS in reconstructing urinary bladder defects.

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Impact of supplementing commercial rabbit pellets with fresh Moringa oleifera leaves on semen characteristics in rabbit bucks under tropical climate in Trinidad

Caribbean Medical Journal ◽

10.48107/cmj.2021.04.001 ◽

2021 ◽

Author(s):

Krishna Mohan Kumar

Keyword(s):

Sperm Motility ◽

Moringa Oleifera ◽

Sperm Count ◽

Control Group ◽

Computer Assisted ◽

Group Iii ◽

Group I ◽

Significant Difference ◽

Moringa Oleifera Leaves ◽

The Impact

Objective This study aimed to evaluate the impact of the dietary supplement of Moringa oleifera leaves (MOL) on semen quality and characteristics in rabbits. Methods Eighteen (n=18) breeding bucks of New Zealand white, of similar age group, were used for the study. Three feeding regimes, (i) 100% commercial rabbit pellets (CRP)-Group I (ii) 90% CRP + 10% fresh MOL on a dry matter (DM) basis – Group II and (iii) 80% CRP + 20% fresh MOL on a DM basis – Group III, were adopted and the trial continued for 21 days. After adaptation to the diet, semen was collected from each buck and subjected to evaluation using a computer-assisted semen analyser. Results In Group III, the sperm count, normal sperm morphology, and sperm motility increased (52.0%) in comparison with the control (Group I; 50.1%). The inclusion of 20% Moringa oliefera in the diet (Group III) caused a significant increase (P<0.05) in semen concentration (Control =136.2 M/mL; Group III=297.2 M/mL). There was no significant difference (P>0.05) in sperm motility and semen volume among the groups. Conclusion The results suggest that supplementing commercial rabbit pellets with 20% fresh Moringa oliefera leaves on a DM basis can improve the quality and characteristics of semen in breeding bucks.

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Assessment of in Obsessive Compulsive Disorder

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1030915 ◽

2021 ◽

pp. 105-114

Author(s):

Sarah Alaa Mohsen ◽

Fatma Ahmed El Deeb ◽

Ehab Sayed Ramadan ◽

Mai Abd El-Raouf Eissa

Keyword(s):

Obsessive Compulsive Disorder ◽

Test Performance ◽

Age Of Onset ◽

Neuropsychological Test ◽

Control Group ◽

Obsessive Compulsive ◽

Cross Sectional ◽

Compulsive Disorder ◽

Group I ◽

Significant Difference

Background: Obsessive compulsive disorder (OCD) is a common and potentially debilitating disorder. Neuropsychological assessment provides unique complementary information that is critical for evaluating higher cortical abilities. This study aimed to assess the neuropsychological functions in OCD patients which can then point to the brain structures or pathways and to study the correlation between these assessments and different clinical variables. Methods: This cross-sectional case control study had included sixty patients who were divided into two groups, Group I: thirty OCD patients diagnosed by DSM-IV and Group II: thirty healthy controls who were recruited from the community, matched with patients’ age, gender, and education. Results: The age of onset in our study was 19.13 ± 0.35 years, the mean duration was 7.44 ± 3.88 years, 40% of the studied cases had severe OCD symptoms and 33.3% of them were compulsive cleaners. There was a high significant difference between the two groups regarding WCST in favor of the control group. There was a high significant difference between the two groups regarding ROCF where the control group showed better results than the OCD patients. Conclusions: Neuropsychological test performance remains an informative and objective means of investigation, especially when applied to psychiatric disorders. The executive functions in OCD patients were impaired in comparison to the normal study subjects.

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