scholarly journals Addition of Dexmedetomidine to Low Dose Solution of Lidocaine for Intravenous Regional Anesthesia A Randomized Study

JMS SKIMS ◽  
2016 ◽  
Vol 19 (1) ◽  
pp. 21-25
Author(s):  
Ghulam Mohammed Mir ◽  
Firdose Shafi Shiekh ◽  
Arif Nazir
Keyword(s):  
Local Anesthesia ◽  
Regional Anesthesia ◽  
Postoperative Analgesia ◽  
Low Dose ◽  
Tourniquet Pain ◽  
Intravenous Regional Anesthesia ◽  
Group I ◽  
Significant Difference ◽  
Recovery Times

Background and Aims: Intravenous Regional Anesthesia (IVRA) provides analgesia of distal part of limb by intravenous injection of local anesthesia in to the vein of the same limb, while the circulation to the limb is occluded by application of tourniquet. However, IVRAis limited by local anesthesia toxicity, tourniquet pain and absence of postoperative analgesia. Various additives to local anesthetics such as ketamine, clonidine, opiods, NSAIDs are used to address these issues. The aim of our study was to evaluate the effectiveness of Dexmedetomidine to low dose Lidocaine solution for IVRA.Patients and Methods: A prospective, randomized double blind study was conducted on 60 patients divided in to two groups of thirty each; Group I patients received 40 ml of Lidocaine 0.25% while Group II patients received 40 ml of 0.25% of lidocaine mixed with I mcg/kg of dexmedetomidine. The motor and sensory block onset and recovery times were assessed. Tourniquet pain and sedation score were assessed intraoperatively and postoperatively.Results: Sensory and motor block onset times were shorter and recovery times were prolonged in Dexmedetomidine group. The quality of anesthesia was better in the Dexmedetomidine group and the fentanyl dose required was also lower in the dexmedetomidine group. There was a significant difference in the postoperative analgesia time which was demonstrated by less use of intramuscular diclofenac in dexmedetomidine group.Conclusions: A safe intravenous dose of lidocaine can be used for IVRA for superficial hand surgery, and the addition of I mcg /kg dexmedetomidine shortened the onset times for both sensory and motor blockade and improved the quality of anesthesia, with prolonged postoperative analgesia time. By adding dexmedetomidine we were able to reduce the dose of lidocaine to 0.25% concentration without compromising analgesia. JMS 2016; 19(1):21-25

Premedication with Gabapentin: The Effect on Tourniquet Pain and Quality of Intravenous Regional Anesthesia

2007 ◽  
Vol 104 (1) ◽  
pp. 97-101 ◽  
Author(s):  
Alparslan Turan ◽  
Paul F. White ◽  
Beyhan Karamanlio??lu ◽  
Zafer Pamuk??u
Keyword(s):  
Regional Anesthesia ◽  
Tourniquet Pain ◽  
Intravenous Regional Anesthesia

A Comparative Study between Dexamethasone versus Paracetamol Added to Xylocaine in Local Intravenous Anesthesia in Upper Limb Minor Surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Reem Hamdy Elkabarity ◽  
Heba Abdel Azim Labib ◽  
Marwa Mamdouh Elfar ◽  
Mostafa Mohamed Mohamed Ibrahim Sharaf
Keyword(s):  
Regional Anesthesia ◽  
Motor Block ◽  
Intravenous Anesthesia ◽  
Full Stomach ◽  
Opioid Dose ◽  
Intravenous Regional Anesthesia ◽  
Significant Difference ◽  
Block Time ◽  
Recovery Times ◽  
Group D

Abstract Background Intravenous regional anesthesia (IVRA) is a technically simple, reliable and costeffective method of regional anesthesia for short operative procedures of the extremities. It is easy to be administered, of lower cost compared with general anesthesia, no need for deep sedation and can be used for emergency operations on extremities for patients with full stomach. Objective Comparison between the anesthetic and analgesic parameters in local intravenous anesthesia by adding Paracetamol and Dexamethasone to xylocaine. Patients and methods This study was carried out in Ain Shams University hospitals for six months (from August 2018 to February 2019) on 45 patients of both sexes aged 20-50 years belonging to ASA I & II undergoing forearm and hand surgeries using IVRA. Results There was no significant difference between group (P), Group (C) as regard sensory, motor recovery times, both had a shorter sensory and motor block time need to an opioid dose as an analgesic dose. Group (D) had the fastest sensory and motor block time and more prolonged recovery time than group (P) and group (C) need less opioid dose as analgesia for controlling pain. As regard postoperative analgesic requirements. Group (D) and group (P) needed less analgesic doses than group (C) but there was no significant difference between group (P) and group (C). Conclusion Addition of 8 mg Dexamethasone as adjuvant to xylocaine for intravenous regional anesthesia led to: Reduction the dose of xylocaine used for IVRA, Shortening the sensory and motor block onset times, Prolong the sensory and motor block recovery times, and Reduction the postoperative analgesic requirement with satisfaction for patient and surgeon.

Restaging of patients with lymphoma

2008 ◽  
Vol 47 (01) ◽  
pp. 37-42 ◽  
Author(s):  
T. Pfluger ◽  
V. Schneider ◽  
M. Hacker ◽  
N. Bröckel ◽  
D. Morhard ◽  
...  
Keyword(s):  
Low Dose ◽  
Non Hodgkin Lymphoma ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Significant Difference ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

SummaryAim: Assessment of the clinical benefit of i.v. contrast enhanced diagnostic CT (CE-CT) compared to low dose CT with 20 mAs (LD-CT) without contrast medium in combined [18F]-FDG PET/CT examinations in restaging of patients with lymphoma. Patients, methods: 45 patients with non-Hodgkin lymphoma (n = 35) and Hodgkin's disease (n = 10) were included into this study. PET, LD-CT and CECT were analyzed separately as well as side-by-side. Lymphoma involvement was evaluated separately for seven regions. Indeterminate diagnoses were accepted whenever there was a discrepancy between PET and CT findings. Results for combined reading were calculated by rating indeterminate diagnoses according the suggestions of either CT or PET. Each patient had a clinical follow-up evaluation for >6 months. Results: Region-based evaluation suggested a sensitivity/specificity of 66/93% for LD-CT, 87%/91% for CE-CT, 95%/96% for PET, 94%/99% for PET/LD-CT and 96%/99% for PET/CE-CT. The data for PET/CT were obtained by rating indeterminate results according to the suggestions of PET, which turned out to be superior to CT. Lymphoma staging was changed in two patients using PET/ CE-CT as compared to PET/LD-CT. Conclusion: Overall, there was no significant difference between PET/LD-CT and PET/CE-CT. However, PET/CE-CT yielded a more precise lesion delineation than PET/LD-CT. This was due to the improved image quality of CE-CT and might lead to a more accurate investigation of lymphoma.

scholarly journals Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: a pre-post analysis

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Um-e-Kalsoom ◽  
Sabiha Khan ◽  
Israr Ahmad
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Perceived Social Support ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
The Impact

Abstract Background Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD). Result A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS. Conclusion The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.

Effectiveness analysis of the new method of antireflux surgery in patients with hiatal hernia

2020 ◽  
Vol 26 (4) ◽  
pp. 50-55
Author(s):  
A.R. Stasyshyn ◽  
◽  
A.A. Hurayevskyy ◽  
Yu.Y. Holyk ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Los Angeles ◽  
Hiatal Hernia ◽  
Antireflux Surgery ◽  
New Method ◽  
Life Questionnaire ◽  
Post Surgery ◽  
Group I ◽  
Significant Difference

Aim. To analyze the effectiveness of a new method of antireflux surgery in patients with hiatal hernia. Materials and Methods. The results of treatment of 157 patients with hiatal hernia from 2016 to 2020 are analyzed. The patients were divided into 3 groups: group I, N=59, underwent laparoscopic antireflux operation modified by the authors (Patent of Ukraine № 59772); group II (N=77), underwent laparoscopic Nissen fundoplication; and group III (N=21) - laparoscopic Toupet fundoplication. Results and Discussion. At 36 months post-surgery follow-up, there was a statistically significant difference in favor of group I on the average scores of the visual analog scale for reflux symptoms, dysphagia and extraesophageal symptoms; the average quality of life questionnaire scores; the average DeMeester index; distribution of the patients by satisfaction; distribution of the patients by degree of reflux esophagitis according to the Los Angeles classification; and distribution by gas-bloat syndrome. Conclusions. Clinical application of the developed new method of laparoscopic surgery for hiatal hernia reduces the number of relapses and complications after surgery, and improves the quality of life of patients. Key words: hiatal hernia, antireflux surgery, new methods of treatment

scholarly journals Comparative Analysis of Acid-base Status Parameters in Newborn with Congenital Surgical Malformations During Perioperative Care Based on Types of Anesthesia

2021 ◽  
Vol 2 ◽  
pp. 14-22
Author(s):  
Oleksii Vlasov
Keyword(s):  
Regional Anesthesia ◽  
Oxygen Mixture ◽  
Acid Base ◽  
Group Iii ◽  
Group I ◽  
Anesthesia Group ◽  
Significant Difference ◽  
Combined Anesthesia ◽  
Acid Base Status ◽  
Group Ii

Introduction: Congenital malformations (CM) are most common in newborns and infants in the first year of life and require surgical correction in the first hours, days, months of life. Surgical interventions in severely ill babies with malformations can lead to catabolic stress, circulatory and respiratory disorders, metabolism shifts, water-electrolyte, protein, and acid-base status disorders. This study aimed to compare acid-base status in newborns and infants with congenital surgical pathology under different types of combined anesthesia.  Materials and methods: This retrospective study included 150 newborns and infants with CM who required surgery. The patients were divided into three groups based on types of provided anesthesia: inhalation by Sevoran (sevoflurane) and regional anesthesia (group I); inhalation of Sevoran and intravenous anesthesia by Fentanyl (group II); and intravenous combination of Fentanyl and 20% Sodium Oxybutyrate (group III). The analysis included: acid-base status, peripheral oximetry, and the need for an oxygen mixture inhaled by the patient. Results In group I, there was a significant reduction in partial tension of CO2 and increased pH from the pre-surgical status, at the time of induction of anesthesia, during the most painful, traumatic stage, and after surgery compared to group II and III. Peripheral O2 saturation was not critically reduced at all stages of observation except in babies of group I compared to group III at the stage of induction of anesthesia (97.79 ± 2.45 vs. 98.79 ± 1.63, p = 0.0194) and at the most painful period of surgery (96.29 ± 3.47 vs. 98.10 ± 2.47, p = 0.0368). In group I, newborns and infants required higher oxygen concentrations in the inhalation mixture. There was a significant difference in FiO2 between groups I and III during the most painful stage of surgery (0.47 ± 0.29 and 0.33 ± 0.2, p = 0.0071), and immediately after surgery (0.34 ± 0, 19 and 0.26 ± 0.13, p = 0.0246). Conclusion: Among the newborns and infants with CM requiring surgical intervention and combined anesthesia, the most substantial acid-base status changes were observed in the group where anesthesia was provided by Sevoran (sevoflurane) and regional anesthesia (Group I).

scholarly journals Comparitive evaluation of different concentrations of alcohol in ultrasound guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies

2021 ◽  
Vol 8 (4) ◽  
pp. 492-500
Author(s):  
Manish Kumar Singh ◽  
Pragya Verma ◽  
Sarita Singh ◽  
Gyan P Singh ◽  
Hemlata Verma
Keyword(s):  
Quality Of Life ◽  
Morphine Consumption ◽  
Rescue Analgesia ◽  
Vas Score ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Upper Abdominal

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.

scholarly journals A clinical comparison of high dose and low dose of Suxamethonium

2014 ◽  
Vol 9 (2) ◽  
pp. 1-8
Author(s):  
RK Yadav ◽  
PC Majhi ◽  
D Tiwari
Keyword(s):  
Intraocular Pressure ◽  
Dose Group ◽  
Low Dose ◽  
Cardiovascular Responses ◽  
High Dose ◽  
Clinical Effects ◽  
Duration Of Action ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background: Suxamethonium having its rapid onset and short duration of action makes this drug unique amongst the neuromuscular blocking drugs described so far. However, use of suxamethonium is associated with a large number of undesirable side effects. Objective: To evaluate clinical effects of high and low dose of suxamethonium and to determine whether lower dose of suxamethonium can be used for any beneficial effects in terms of its various adverse effects e.g. cardiovascular responses, post-operative muscle pains and intraocular pressure. Methods: A total of 100 patients were included in this prospective study. All these patients on preoperative clinical evaluation were assessed to have adequate airway. All the patients were divided in two groups, low dose group (group I) and High dose group (group II) with 50 patients in each at random. A standard anesthetic technique was adhered to all the patients and following parameters were observed on comparative basis: a. Fasciculation and post operative myalgia. b. Cardiovascular effects, c. Intraocular pressure. Observation: The incidence of post Suxamethonium pain was significantly greater in group II. Increase in heart rate from baseline was significant in both groups. There was no significant difference between the two groups in the diastolic pressure but rise in systolic blood pressure was significant at all assessment times in both groups. This rise from control was statistically significant. Conclusion: Suxamethonium can be used in lower doses (0.5 mg/kg) in elective cases without airway compromise. It gives benefits of reduced muscle pains, cardiovascular responses and intraocular hypertension. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 1-8 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9677

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