scholarly journals Evaluation of the Effectiveness of Modified Pectoral Nerve Blocks Type II (PECS II) for Vascular Access Port Implantation Using Cephalic Vein Venesection

2021 ◽  
Vol 10 (24) ◽  
pp. 5759
Author(s):  
Jarosław Janc ◽  
Marek Szamborski ◽  
Artur Milnerowicz ◽  
Lidia Łysenko ◽  
Patrycja Leśnik
Keyword(s):  
Pain Intensity ◽  
Vascular Access ◽  
Cephalic Vein ◽  
Block Type ◽  
Type Ii ◽  
Access Port ◽  
Pectoral Nerve ◽  
Port Implantation ◽  
Significant Difference ◽  
The Mean

The vascular access port implantation procedure can be performed using the venesection method by inserting a catheter into the cephalic vein in the region of the deltopectoral groove. This method eliminates the need for catheter tunneling. An alternative method to infiltration anaesthesia for port implantation may be a modified pectoral nerve block type II (PECS II). This study aimed to evaluate the effectiveness of modified PECS II for vascular access port implantation using cephalic vein venesection. This retrospective observational study was conducted at the 4th Military Clinical Hospital in Wroclaw, Poland. A group of 114 patients underwent the modified PECS II block and additional cutaneous infiltration anesthesia at the incision line. Pain intensity was assessed on the NRS scale measured intraoperatively at four points. The QoR-15 questionnaire was used to assess patient satisfaction during the first 24 h after surgery. The operator’s condition assessment score was used to assess surgical conditions and operator comfort. The analysis showed that the median pain intensity during vascular port implantation was 0. A statistically significant difference in pain intensity was demonstrated between the specialist’s group and the resident’s group at the second and third measurement points (p < 0.008; p < 0.012). The mean value on the QoR-15 scale was 132. There was a significant difference between the pain scores of the groups. The mean score in the pain position in the specialist’s group was 18 points and in the resident’s group, it was 19 points (p < 0.029). In conclusion, the present study revealed that the modified PECS II block is an effective and safe method of anesthesia for Port-A-Cath implantation.

scholarly journals Efficacy of Pectoral Nerve Block Type II for Breast-Conserving Surgery and Sentinel Lymph Node Biopsy: A Prospective Randomized Controlled Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Doo-Hwan Kim ◽  
Sooyoung Kim ◽  
Chan Sik Kim ◽  
Sukyung Lee ◽  
In-Gyu Lee ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Control Group ◽  
Block Type ◽  
Type Ii ◽  
Node Biopsy ◽  
Pectoral Nerve

Objectives. The pectoral nerve block type II (PECS II block) is widely used for postoperative analgesia after breast surgery. This study evaluated the analgesic efficacy of PECS II block in patients undergoing breast-conserving surgery (BCS) and sentinel lymph node biopsy (SNB). Methods. Patients were randomized to the control group (n=40) and the PECS II group (n=40). An ultrasound-guided PECS II block was performed after induction of anesthesia. The primary outcome measure was opioid consumption, and the secondary outcome was pain at the breast and axillary measured using the Numerical Rating Scale (NRS) 24 hours after surgery. Opioid requirement was assessed according to tumor location. Results. Opioid requirement was lower in the PECS II than in the control group (43.8 ± 28.5 µg versus 77.0 ± 41.9 µg, p<0.001). However, the frequency of rescue analgesics did not differ between these groups. Opioid consumption in the PECS II group was significantly lower in patients with tumors in the outer area than that in patients with tumors in the inner area (32.5 ± 23.0 µg versus 58.0 ± 29.3 µg, p=0.007). The axillary NRS was consistently lower through 24 hr in the PECS II group. Conclusion. Although the PECS II block seemed to reduce pain intensity and opioid requirements for 24 h after BCS and SNB, these reductions may not be clinically significant. This trial is registered with Clinical Research Information Service KCT0002509.

scholarly journals Type 2 Myocardial Infarction in Acute Medical Care

2016 ◽  
Vol 01 (04) ◽  
pp. 021-024
Author(s):  
K. Sateesh ◽  
Stitha Pragna ◽  
Y Raju
Keyword(s):  
Myocardial Infarction ◽  
Medical Care ◽  
Oxygen Demand ◽  
Type Ii ◽  
Men And Women ◽  
Upper Limit ◽  
Significant Difference ◽  
The Mean ◽  
Acute Medical Care

AbstractBackground: Type 2 myocardial infarction (MI) is defined as MI secondary to ischemia due to either increased oxygen demand or decreased supply. It is seen in conditions other than coronary artery disease (CAD) contributes to an imbalance between myocardial oxygen supply and/or demand. Little is known about patient characteristics and clinical outcomes.Methods: A retrospective analysis was performed in patients who were admitted in acute medical care with symptoms suggestive of myocardial ischemia and enzymatic elevation from January 2015 to December 2015. Patients with slight elevation (above the upper limit of normal) of CK-MB were included in the study and compared the clinical and laboratory profile between men and women.Results: This survey includes a total of 54 patients, Out of which complete details were available in 41 patients (M:23; F:18). The mean age was 42.61. The common causes of type-II MI were Infectious (M:9 (39.1%), F:10 (55.6%) followed by haematological disorders (M:3 (13%), F:5 (27.7%). The mean CK-MB was 28.00. The mean CPK was 122.5. There was no hypotension, renal failure at the time of admission. One patient had in-hospital mortality out of all patients, whose primary diagnosis was septicaemia with shock who had normal CPK, elevated CK-MB and elevated NT pro BNP levels. Patients with type-II MI were not referred for coronary interventions and managed conservatively.Conclusions: There is no significant difference in the risk for type 2 MI between men and women. Clinical suspicion and diagnosis of type 2 MI is crucial in acute medical care setting, as the mortality can be reduced with adequate management of underlying condition. The threshold of biomarker levels should be low (above the upper limit of normal in symptomatic ischemia) to label type 2 MI contrary to the third universal definition of MI.

scholarly journals Oxidative stress in chronic periodontitis patients with type II diabetes mellitus

2018 ◽  
Vol 12 (02) ◽  
pp. 225-231 ◽  
Author(s):  
Ruby Ramya Vincent ◽  
Devapriya Appukuttan ◽  
Dhayanand John Victor ◽  
Aruna Balasundaram
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Periodontal Disease ◽  
Diabetic Patients ◽  
Clinical Parameters ◽  
Type Ii ◽  
Chronic Periodontal Disease ◽  
Significant Difference ◽  
The Mean ◽  
Group 1

ABSTRACT Objective: Oxidative stress (OS) refers to the disequilibrium between free radicals and antioxidant defense mechanisms and is significantly implicated in the pathogenesis of chronic degenerative and inflammatory diseases such as chronic periodontal disease (CP) and diabetes mellitus (DM). This study aimed to evaluate the total antioxidants capacity (TAOC) and total oxidants status (TOS) in the gingival crevicular fluid (GCF) in CP participants with type II DM. Materials and Methods: A total of 80 participants were allotted into four groups as follows: Group 1: Generalized CP (GCP) without type II DM (n = 20); Group 2: GCP with type II DM (n = 20); Group 3: Type II DM without CP (n = 20); and Group 4: Systemically and periodontally healthy (PH) (n = 20). Clinical parameters such as plaque index, gingival index, probing pocket depth, and clinical attachment level were recorded. Pooled GCF was collected followed by the estimation of TAOC, TOS, and OS index (OSI) using Erel O Colorimetric analysis. Results: The clinical parameters recorded showed the statistically significant difference (P < 0.001) between the groups. The mean TAOC value was the highest in PH group. The mean TOS and OSI were higher in Group 1, 2, and 3 participants when compared to the PH participants. All the biochemical parameters evaluated showed a statistically significant difference (P < 0.001) between groups. Conclusions: The study further validates the use of OSI as a marker for periodontal disease activity and emphasizes the role of OS in the pathogenesis of Type II diabetic patients with the chronic periodontal disease.

scholarly journals Management of mal-united Pilon fractures with joint-sparing osteotomy

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0052
Author(s):  
Guang-rong Yu
Keyword(s):  
Type Ii ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Vas Score ◽  
Articular Surfaces ◽  
Significant Difference ◽  
The Mean ◽  
American Orthopaedic ◽  
Time From Injury ◽  
Pilon Fractures

Category: Ankle Introduction/Purpose: To explore the effectiveness and operative methods to treat various mal-united Pilon fractures with joint-sparing osteotomy. Methods: Between January 2011 and October 2016, 21 patients with mal-united Pilon fractures were treated with joint-sparing osteotomy. There were 13 males and 8 females with an average age of 38.4 years (range, 22-48 years). 14 were left feet and 7, right. The time from injury to reconstructive operation was 4 months to 10 years. 17 received operative treatment previously, and 4 were treated by plaster fixation. According to Rüedi-Allgöwer classification, 16 were rated as type II (including 6 medial Pilon fractures, 5 anterior, 5 posterior) and 5, type III. All patients received standardized postoperative managements. Results: All patients were followed up for more than 1 year. All the fractures were reunited in an average time of 13.8 weeks (range 9 to 18 weeks). The mean visual analogue scale (VAS) score was 2.42 (range 0 to 5) and the mean ankle and hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS) score was 78.81(range 65 to 92) 6 months after operation. The VAS score was 5.27 (range 2 to 7) and the AOFAS score was 57.26 (range 20 to 81) before. Comparing to preoperative data, statistically significant difference was found postoperatively (P<0.05). Conclusion: Results by joint-sparing osteotomy to realign and reconstruct articular surfaces of ankles are acceptable. Functions and symptoms are improved significantly after operation. Joint-sparing osteotomy can be a considerable option for treating mal-united Pilon fractures.

Assessment of Symptoms and Symptom Burden before and after Engraftment during Allogeneic Blood or Marrow Transplant (BMT).

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1323-1323
Author(s):  
Loretta A. Williams ◽  
Xin S. Wang ◽  
Charles S. Cleeland ◽  
Gary Mobley ◽  
Sergio Giralt
Keyword(s):  
Pain Intensity ◽  
Symptom Burden ◽  
Dry Mouth ◽  
Patient Treatment ◽  
Allogeneic Bmt ◽  
Significant Difference ◽  
Symptom Intensity ◽  
Before And After ◽  
The Mean ◽  
Neutrophil Engraftment

Abstract Symptom burden (SB) is the combined impact of all disease- or therapy-related symptoms on one’s ability to function as one did before onset of disease or therapy. Clinician report of BMT toxicities is well described, but patient report of symptoms is not. Lack of understanding of symptoms and SB may result in failure to address symptoms and return patients to optimum functioning. The purpose of this study was to describe symptoms and SB in AML/MDS patients undergoing allogeneic BMT before and after neutrophil engraftment (first of 3 consecutive days ANC ≥ 500 cells/mm3). Methods: 30 patients with a mean age of 52.9 yrs (SD 9.6) rated 19 symptoms on a 0-10 scale twice weekly from baseline before the start of conditioning to 28 days post-BMT using the M. D. Anderson Symptom Inventory. Results: Patient/treatment characteristics are summarized in Table 1. Table 1: Patient/Treatment Characteristics n % Sex Male 17 56.7 Female 13 43.3 Conditioning Myeloablative 17 56.7 Non-myeloablative 13 43.3 Donor Related 13 43.3 Unrelated 17 56.7 Cell Source BM 13 43.3 PBSCs 17 56.7 Mean global symptom intensity (GSI) peaked at Day +11 post-BMT. The 7 most severe symptoms on Day +11 were pain, drowsiness, lack of appetite, dry mouth, mouth sores, physical weakness, and fatigue. Mean symptom intensity scores and SDs are reported in Table 2. Table 2: Mean Symptom Intensity Scores Symptom Baseline Day +11 Day +15 Day +29 Mean, SD Mean, SD Mean, SD Mean, SD GSI 1.32, 1.38 3.08, 1.74 2.72, 1.91 2.24, 1.59 Pain 1.80, 2.91 5.30, 2.68 3.52, 2.84 2.29, 2.45 Drowsiness 1.87, 2.50 5.20, 2.89 4.48, 3.00 3.75, 3.08 Lack of Appetite 1.10, 2.22 4.57, 3.18 4.14, 3.32 3.18, 2.88 Dry Mouth 0.87, 1.61 4.52, 3.21 3.97, 3.52 2.93, 3.21 Mouth Sores 0.03, 0.18 4.50, 3.95 2.93, 3.21 0.82, 2.06 Physical Weakness 2.03, 2.55 4.37, 2.86 3.83, 2.90 3.96, 2.76 Fatigue 3.00, 2.29 4.20, 2.57 4.41, 2.78 4.46, 2.82 There was a significant difference (t=−4.34, p&lt;.001) between the mean GSI at baseline and Day +11. Neutrophil engraftment occurred on average 13.7 days (SD=3.00) post-BMT. There was no significant difference (t=0.75, p=.455) in mean GSI from Day +11 to Day + 15, the first post-engraftment assessment. Mean GSI declined by Day +29, but the difference between the mean GSI on Day +11 and Day +29 was not significant (t=1.92, p=.060). At Day +15, only mean pain intensity had declined significantly (t=2.48, p=.016) from Day +11. At Day +29, mean pain and mouth sores intensity had declined significantly (t=4.46, p&lt;.001 and t=2.26, p=.031, respectively) from Day+11. Conclusion: Patients report various symptoms post-allogeneic BMT, with the most intense involving the upper GI tract, pain, fatigue, and weakness. After engraftment, pain intensity declines rapidly, GI symptoms decline more slowly, and fatigue and weakness do not decline. Figure Figure Most symptoms have not declined significantly a month post-BMT and patients remain burdened by symptoms. Clinicians should verify with patients the symptoms they are experiencing and intervene to control them. Further research is needed in SB and causative mechanisms of symptoms after BMT to improve treatment outcomes.

scholarly journals Conventional Dissection and Bipolar Electrocauterization Methods of Tonsillectomy: A Comparative Study

2022 ◽  
Vol 19 (1) ◽  
pp. 77-80
Author(s):  
Anshu Sharma ◽  
Shama Bhandari ◽  
Dhundi Raj Paudel
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Pain Intensity ◽  
Postoperative Blood Loss ◽  
Intraoperative Blood Loss ◽  
Advantages And Disadvantages ◽  
Post Operative Pain ◽  
Significant Difference ◽  
The Mean ◽  
Dissection Method

Introduction: Tonsillectomy is frequently performed surgical procedure. There are several different methods with varied advantages and disadvantages. In spite of the different techniques available there is no consensus and definite evidence for best method. The most commonly performed are conventional dissection and bipolar electrocauterization methods. Aims: The aim of the study was to compare time required for the completion of surgery, intraoperative and postoperative blood loss along with post operative pain between conventional dissection and bipolar electrocauterization methods. Methods: This comparative study was conducted from August 2019 to March 2021 in total of 30 patients planned for tonsillectomy in department of Otorhinolaryngology, Nepalgunj Medical College Teaching Hospital.In every patient right side tonsillectomy was done with conventional dissection method and left side tonsillectomy was done with bipolar electrocauterization method. Results: The mean age was 27.2±13.08 years. The mean duration of surgery was 16.53 ± 2.43 min and 11.10 ± 1.93 min in conventional dissection method and bipolar electrocauterization method respectively. The difference was statistically significant. Intraoperative blood loss was significantly lower in bipolar electrocauterization method with mean intraoperative blood loss of 19 ±4.62 ml in bipolar electrocauterization group and 81.83 ±36.54 ml in conventional dissection method. The pain intensity was statistically similar in both methods at all-time intervals post operatively. Conclusion: In tonsillectomy, bipolar electrocauterization method has advantage over conventional dissection method in regards to reduced surgical time and intra operative blood loss, without any significant difference in post-operative pain intensity and post-operative hemorrhage.

Pectoral Nerve Block Type II as the Sole Anesthetic for Removal of a Large Axillary Tumor

2020 ◽  
Vol 14 (6) ◽  
pp. e01201
Author(s):  
Peter Van de Putte ◽  
Diederik Blockmans ◽  
Carine De Rop ◽  
Barbara Versyck
Keyword(s):  
Nerve Block ◽  
Block Type ◽  
Type Ii ◽  
Pectoral Nerve

The development of lampbrush chromosome-type transcription in the early diplotene oocytes of Xenopus laevis: an electron-microscope analysis

1980 ◽  
Vol 44 (1) ◽  
pp. 87-101
Author(s):  
R.S. Hill ◽  
H.C. Macgregor
Keyword(s):  
Linear Regression ◽  
Xenopus Laevis ◽  
Linear Regression Analysis ◽  
Transcription Unit ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Significant Difference ◽  
Germinal Vesicles ◽  
The Mean

Oocytes of Xenopus laevis in pachytene and early diplotene of meiosis have been studied using the Miller spreading technique. Transcription first appears in germinal vesicles 25–40 micrometers in diameter, when the oocyte is in early diplotene. Transcription at this stage consists of arrays of short RNP transcripts, irregularly distributed along the DNP axis. Linear regression analysis has shown that many of these arrays are transcription units (Type I) with the transcripts having a common point of origin. The lengths of these early transcription units (mean = 7.06 +/− 5.06 micrometers), calculated from the linear regression data, are comparable to the lengths of transcription units from later stages, including Dumont stage 3. The polymerase granules of Type I transcription units are widely and irregularly spaced, having a mean spacing of 505 +/− 748 nm. More advanced transcription units (Type II, mean length = 8.72 +/− 3.77 micrometer) are usually found in the same chromosome set as the Type I units. Type II transcription units have closer and more regularly spaced polymerase granules than Type I transcription units (mean spacing = 92 +/− 49 nm). Both Type I and II transcription units have comparatively short RNP transcripts, the mean values for the slopes of their regression lines being 0.1336 and 0.1440 respectively. By the time the germinal vesicles are about 50–60 micrometers in diameter the transcription units have a quite different morphology (Type III). The lengths of the Type III transcription units are comparable to the Type I and II units, the mean length being 6.34 +/− 4.03 micrometers. The spacing of the polymerase granules in the Type III units is closer and more regular than the earlier stages (70 +/− 40 nm). Another significant difference between Type III and Types I and II transcription units is a decrease in the foreshortening of the Type III RNP transcripts. The mean slope of the regression lines for Type III transcription units is 0.2439. The morphological appearance of the Type III transcription unit is virtually identical to that of the transcription units from Dumont stage 3 oocytes, both with respect to the length and the spacing of the polymerase granules. However, the transcripts in Type III transcription units are still more foreshortened than those of Dumont stage 3 oocytes, having mean regression slopes of 0.4728. From the data obtained in the present study, it has been concluded that the pattern of lampbrush-type transcription is virtually fully established by the time most germinal vesicles are about 50 micrometers in diameter.

scholarly journals EFFICACY OF PECTORAL NERVE BLOCK TYPE II VERSUS THORACIC PARAVERTEBRAL BLOCK FOR ANALGESIA IN BREAST CANCER SURGERY

2020 ◽  
Vol 73 (7) ◽  
pp. 1470-1475
Author(s):  
Volodymyr V. Martsiniv ◽  
Oleg A. Loskutov ◽  
Andriy M. Strokan ◽  
Mihaylo V. Bondar
Keyword(s):  
Breast Cancer ◽  
Nerve Block ◽  
Cancer Surgery ◽  
Paravertebral Block ◽  
Breast Cancer Surgery ◽  
Block Type ◽  
Type Ii ◽  
Thoracic Paravertebral Block ◽  
Pectoral Nerve ◽  
Block Groups

The aim: to compare the efficacy of pectoral nerve block type II and thoracic paravertebral block for analgesia during and after breast cancer surgery. Materials and methods: Sixty adult women were undergoing unilateral radical mastectomy or quadrantectomy with axillary dissection. Patients were randomized to receive either pectoral nerve block with ropivacaine 0.375% 30 ml or thoracic paravertebral block with ropivacaine 0.5% 20 ml. Evaluated variables included pain intensity at 0, 2, 4, 6, 12, 18 and 24 hours, intraoperative fentanyl, 24-hour postoperative opioid (promedol) and nonopioid (ketoprofen) consumption, the time to first rescue analgesia. Results: There were no statistically significant differences between pectoral block and paravertebral block groups in intraoperative fentanyl consumption 2,2 (1,81-2,81) vs 1,9 (1,63-2,25) mcg/kg/hour (Р>0,05) and in the pain intensity during the first 24 hours after operation. The mean postoperative 24-hour promedol and ketoprofen consumption was 4,0 (±8,14) mg vs 5,0 (±8,85) mg (Р>0,05) and 66,7 (±66,09) mg vs 95,8 (±90,78) mg (Р>0,05) in the pectoral and paravertebral block groups respectively. Time to the first analgesia request was longer in pectoral block group — 540 (455,0-600,0) min vs 515 (265,0-650,0) min (Р>0,05). There were no complications after pectoral blocks and 2 complications after paravertebral blocks. Conclusions: in breast cancer surgery pectoral nerve block type II can provide postoperative analgesia comparable to thoracic paravertebral block with lower complications rate.

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