EFFICACY OF ANALGESIA PROVIDED BY ULTRASOUND GUIDED FASCIA ILIACA COMPARTMENT BLOCK WITH AND WITHOUT PARACETAMOL (I.V) IN FACILITATING POSITION FOR CENTRAL NEURAXIAL PROCEDURE

Introduction: The use of ultrasound reduces the onset time, improves the quality of sensory block, and minimizes the risks associated with the block. There are few studies supporting the efficacy of ultrasound guided fascia iliaca block Methodology: 60 patients posted for femur surgeries admitted in Orthopaedics Department, were assessed for the inclusion and exclusion criteria and were included in the study after obtaining written informed consent. Results: Among the patients undergoing spinal anaesthesia in fracture femur surgery, 3.3% of patients of both the groups had not satisfactory positioning, 36.7% of Group A and 33.3% of Group B had satisfactory positioning, 50% of Group A and 53.4% of Group B patients had good positioning, 10% of patients of both groups had optimal positioning. Conclusion: Therefore the positioning of the patients for spinal anaesthesia is comparable and is no significant difference is seen among both the groups.

Download Full-text

Comparative study of intrathecal fentanyl with bupivacaine and fentanyl midazolam with bupivacaine in spinal anaesthesia

Indian Journal of Clinical Anaesthesia ◽

10.18231/j.ijca.2021.056 ◽

2021 ◽

Vol 8 (2) ◽

pp. 302-309

Author(s):

Vishruti R Shah ◽

Shweta Mehta ◽

Danish A Khan

Keyword(s):

Spinal Anaesthesia ◽

Local Anaesthetic ◽

Perioperative Complications ◽

Sensory Block ◽

Hyperbaric Bupivacaine ◽

Rescue Analgesia ◽

Significant Difference ◽

Block Time ◽

Group B

Spinal anaesthesia is preferred for lower abdominal and lower limb surgeries. Bupivacaine is the most popular local anaesthetic for subarachnoid blockade because of less neurotoxicity. Intrathecal bupivacaine alone may be insufficient to provide prolonged post-operative analgesia, even with high sensory block. So, various adjuvants are used like ketamine, midazolam, clonidine, opioids, neostigmine etc. to prolong the effect of local anaesthetic.To compare the effect of intrathecal fentanyl and fentanyl-midazolam combination with hyperbaric bupivacaine for quality of anaesthesia and post-operative analgesia.Study was conducted on 60 patients aged 20-60 years and were randomly divided into two groups of 30 patients each. Group A received 0.5% bupivacaine heavy 3 ml (15mg) + fentanyl 0.5 ml (25µg) and Group B 0.5% bupivacaine heavy 2.8 ml (14mg) +fentanyl 0.5 ml (25 µg) + midazolam 0.2 ml (1mg). Total volume is 3.5 ml in both groups. They were assessed for quality of block, post-operative analgesia and perioperative complications.Data were compared using t- test(unpaired). The level of significance used was p<0.05. There was a significant difference in onset and duration of sensory and motor block, time to administer first rescue analgesia in group B. Addition of midazolam (1mg) to fentanyl with bupivacaine intrathecally gives better onset & duration of sensory & motor blockade and longer duration of post-operative analgesia.

Download Full-text

COMPARISON BETWEEN THERAPEUTIC ULTRASOUND AND SCAR MOBILIZATION OVER PERSISTENT POSTNATAL DYSPAREUNIA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i9.18757 ◽

2017 ◽

Vol 10 (9) ◽

pp. 48

Author(s):

Mariyam Farzana Sf ◽

Ponmathi P ◽

Sivakumar Pvr

Keyword(s):

Quality Of Life ◽

Analogue Scale ◽

Therapeutic Ultrasound ◽

Ultrasound Therapy ◽

Age Group ◽

Functional Index ◽

Significant Difference ◽

Group A ◽

Group B

Objective: Dyspareunia is known as the painful sexual intercourse. This study was conducted to compare the effectiveness between therapeutic ultrasound and scar mobilization in persistent postnatal dyspareunia.Methods: This is an experimental study. 30 subjects with superficial dyspareunia, age group between 25 and 35 years are taken in this study and 15 subjects in Group A were treated with ultrasound therapy, 15 subjects in Group B were treated with scar mobilization. Female sexual functional index questionnaire (FSFI) and visual analogue scale (VAS) were used as the outcome measure.Results: Results showed a significant difference in FSFI and VAS measurements in both the groups, but clinically Group A showed better improvement in pain and quality of life than Group B.Conclusion: There is no significant difference between ultrasound therapy and scar mobilization over the pain and quality of life in patients with persistent postnatal dyspareunia.

Download Full-text

Efficacy of perineural versus systemic dexamethasone in prolonging analgesia after ultrasound guided femoral and sciatic nerve block for patients undergoing below knee surgeries

QJM ◽

10.1093/qjmed/hcaa039.010 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A A Abdelaziz ◽

H M Elzahaby ◽

A A Elshebeiny ◽

D M Heiba

Keyword(s):

Sciatic Nerve ◽

Nerve Block ◽

Onset Time ◽

Analgesic Efficacy ◽

Sensory Block ◽

Postoperative Pain Management ◽

Sciatic Nerve Block ◽

Dexamethasone Group ◽

Significant Difference ◽

Group B

Abstract Background Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stay and increase of chronic pain. Neuroaxial block is used for postoperative pain management and decrease analgesic use. Objective to compare the analgesic efficacy of both, intravenous and perineural administration of dexamethasone during femoral and sciatic nerve block using bupivacaine in patients undergoing below knee surgeries. Patients and Methods In our study, 50 patients were randomly divided into two equal groups: Group A (Perineural Dexamethasone group) [n = 25]: Those cases received 2ml volume of dexamethasone (8mg) combined with the 20 ml of bupivacaine of 0.5% concentration in each block, followed by injecting 5 ml saline intravenous. Group B (Systemic Dexamethasone group) [n = 25]: Those cases received 2 ml of dexamethasone (8mg) diluted over 3 cm saline in a 5 ml syringe following injection of the perineural 20 ml bupivacaine (0.5%) combined with 2 ml saline to have the same syringe volume for each block. Results Our study showed that onset time for sensory block was (25.39 ± 3.79) mins for systemic group and (18.85 ± 4.11) mins in perineural group with a significant statistical difference (P < 0.001) between both groups as the onset of sensory block in perineural group was significantly shorter than the systemic group and the duration of sensory block was (650.00 ± 62.8) mins in systemic group and (718.52 ± 62.06) mins in perineural group. The duration of sensory block was significantly shorter in systemic group than in perineural group with statistically high significant difference between groups (P < 0.001). Onset time for motor block was (30.61 ± 4.89) mins in systemic group and (27.59 ± 3.31) mins in perineural group. Perineural group had shorter time of onset than systemic dexamethasone group with a significant difference between groups (P = 0.013). The duration of analgesia was significantly longer in perineural group than systemic group (P < 0.001) Conclusion Dexamethasone was seen to be a potent adjunct to local anesthetic to prolong post operative analgesia with negligible side effects & better outcome to the perineural route.

Download Full-text

The Effect on Performance Time and Quality of the Knots after Mono or Bimanual Training of Laparoscopic Intracorporeal Knot Tying according to the Gladiator Rule Technique

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0038-1649494 ◽

2018 ◽

Vol 40 (05) ◽

pp. 266-274

Author(s):

Fernanda Asencio ◽

Helizabet Ribeiro ◽

Armando Romeo ◽

Arnauld Wattiez ◽

Paulo Ribeiro

Keyword(s):

Dominant Hand ◽

Resident Students ◽

Performance Time ◽

Laparoscopic Suture ◽

Significant Difference ◽

Bimanual Training ◽

Group A ◽

Group B ◽

Intracorporeal Knot Tying

Objective To assess whether the monomanual or bimanual training of laparoscopic suture following the same technique may interfere with the knots' performance time and/or quality. Methods A prospective observational study involving 41 resident students of gynecology/obstetrics and general surgery who attended a laparoscopic suture training for 2 days. The participants were divided into two groups. Group A performed the training using exclusively their dominant hand, and group B performed the training using both hands to tie the intracorporeal knot. All participants followed the same technique, called Romeo Gladiator Rule. At the end of the course, the participants were asked to perform three exercises to assess the time it took them to tie the knots, as well as the quality of the knots. Results A comparative analysis of the groups showed that there was no statistically significant difference (p = 0.334) between them regarding the length of time to tie one knot. However, when the time to tie 10 consecutive knots was compared, group A was faster than group B (p = 0.020). A comparison of the knot loosening average, in millimeters, revealed that the knots made by group B loosened less than those made by group A, but there was no statistically significant difference regarding the number of knots that became untied. Conclusion This study demonstrated that the knots from group B showed better quality than those from group A, with lower loosening measures and more strength necessary to untie the knots. The study also demonstrated that group A was faster than B when the time to tie ten consecutive knots was compared.

Download Full-text

Quinolone Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy: An Eight-Year Single Center Experience

The Scientific World JOURNAL ◽

10.1155/2013/452107 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Bing-Juin Chiang ◽

Yeong Shiau Pu ◽

Shiu-Dong Chung ◽

Shih-Ping Liu ◽

Hong-Jeng Yu ◽

...

Keyword(s):

Prostate Biopsy ◽

Transrectal Ultrasound ◽

Infectious Complications ◽

Pipemidic Acid ◽

Ultrasound Guided ◽

E Coli ◽

Single Center Experience ◽

Significant Difference ◽

Group A ◽

Group B

We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx). From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI) rates. Patients’ characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5%) patients belonged to group A, while 2381 (64.5%) patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%,P<0.001). The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens (P<0.001).E. coliwas the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.

Download Full-text

Comparison of Intrathecal Fentanyl and Butorphanol as an Adjuvant to Intrathecal Bupivacaine 0.5% in Infraumbilical Surgeries- A Randomised Double Blind Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44242.13949 ◽

2020 ◽

Author(s):

Sandip Roy Basunia ◽

Prosenjit Mukherjee ◽

Md Bakir Hossain Munshi

Keyword(s):

Spinal Anaesthesia ◽

Motor Block ◽

Controlled Trial ◽

Sensory Block ◽

P Value ◽

Double Blind Study ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Group A ◽

Group B

Introduction: Neuraxial opioids are widely used as adjuvants to local anaesthetic as they improve quality and duration of block. Neuraxial opioids like Butorphanol and Fentanyl allow prolonged analgesia in the postoperative period and faster recovery from spinal anaesthesia. Aim: To compare the safety and efficacy of Butorphanol and Fentanyl combined with bupivacaine for spinal anaesthesia in infraumbilical surgeries. Materials and Methods: The present study was a randomised controlled trial in which 110, ASA I and II patients of either sex who underwent elective infraumbilical surgeries under spinal anaesthesia were selected. Patients were allocated randomly into two groups A (n=55) and B (n=55). Group A (F) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with fentanyl 25 microgram (0.5 mL) to make it total 3.5 mL. Group B (B) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with butorphanol 250 microgram (0.25 mL) and Normal Saline (NS) 0.25 mL to make it total 3.5 mL. Heart Rate (HR), Systolic and Diastolic Blood Pressure (SBP, DBP), two segment regression time of sensory block, motor block were assessed at preset intervals. Chi-square test or Fischer’s-exact test were used and a p-value ≤0.05 was considered as statistically significant. Results: Mean of two segment sensory regression time of Group A was 41.94±1.73 minutes and Group B was 50.56±4.43 minutes (p<0.0001). Time to onset of motor block in Group A was 5.28±.32 minutes and Group B was 5.27±.32 minutes (p=0.96). Mean duration of motor block in Group A was 81.23±4.87 minutes and Group B was 109.83±2.61 minutes (p<0.0001). Time to rescue analgesic was 289.27±7.37 minutes in Group A and 378.41±10.25 minutes in Group B (p<0.0001). HR, SBP and DBP were comparable among the groups. Conclusion: Intrathecal bupivacaine-butorphanol mixture was clinically better as it provided longer duration of analgesia with lesser incidences of pruritus and nausea/vomiting compared to intrathecal fentanyl-bupivacaine mixture.

Download Full-text

A randomised prospective comparative study of evaluation of dexmedetomidine an adjuvant to ropivacaine for ultrasound guided supraclavicular block

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20182060 ◽

2018 ◽

Vol 5 (3) ◽

pp. 127

Author(s):

V. S. S. N. Murthy ◽

N. Hari Kiran Verma ◽

Anand Acharya

Keyword(s):

Motor Block ◽

Sensory Block ◽

Study Patient ◽

P Value ◽

Ultrasound Guided ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

Supraclavicular Block ◽

Other Regarding

Background: There are clinical evidences for efficacy of dexmedetomidine as an adjuvant to local anaesthetic for peripheral nerve block, but very few published study are available on continuation of dexmedetomidine, with ropivacaine for ultrasound guided supraclavicular block. The present study has been designed to elucidate the effect of dexmedetomidine, in combination ropivacaine on various parameters.Methods: During period of 2 year and 3 months 84 patients were enrolled for this study. Patient in Group A were received 15 ml of 0.5% ropivacaine with 100 microgram one ml dexmedetomidine and Group B were received 15ml of 0.5% of ropivacaine with 1 ml of normal saline. Drug solution was prepared by same individual and was not part of study.Results: Both the group were comparable to each other regarding demography profile. The duration of sensory block 644.96±72.4 min in group A and the duration of sensory block in Group B was 731.53±131.54 min with p value 0.00354. The duration of motor block was 661.5±29.25 in group A and 559.77±29.25 in Group B with P value 0.0001. Duration of analgesia in Group A was 457.06±34.47 min and it was 345.70±38.032 min in Group B. The supplementation of intravenous opioid was required in 3 patients in Group A and 10 patients in group B with P value 0.037.Conclusions: When 100 microgram of dexmedetomidine was added as an adjuvant to ropivacaine is associated with early onset of sensory and motor block, prolongation of sensory and motor block and duration of analgesia in comparison with ropivacaine alone.

Download Full-text

Compare the Analgesic Efficacy of Dexmedetomidineand Fentanyl as an Adjuvant to Bupivacaine for Lower Limb Surgery

10.53350/pjmhs211562153 ◽

2021 ◽

Vol 15 (6) ◽

pp. 2153-2155

Author(s):

Arshi Naz ◽

Mirza Shahzad Baig ◽

Vijai Kumar ◽

Samita S Khan ◽

Sidra Javed ◽

...

Keyword(s):

Spinal Anaesthesia ◽

Lower Limb ◽

P Value ◽

Hyperbaric Bupivacaine ◽

Rescue Analgesia ◽

Sensory Blockade ◽

Significant Difference ◽

Lower Limb Surgery ◽

Group A ◽

Group B

Objective: To compare the analgesic effectiveness of Dexmedetomidine and Fentanyl as an adjuvant to 0.5% Bupivacaine in spinal anaesthesia for patients undergoing lower limb surgery. Study Design: Randomized controlled trial. Place & Duration:The study was conducted at department of Anesthesia, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi for duration from 15thJuly2020 to 15thFebruary 2021. Methods: In this study 52 patients of both genders undergoing lower limb surgeries were included. Patient’s ages were ranging from 20 to 70 years. All the patients were divided into two Groups. Group A included 26 patients and received Inj. Dexmedetomidine 10 μg in 0.5ml normal saline with 12.5mg of 0.5% hyperbaric bupivacaine, Group B had 26 patients and received 25mg fentanyl with 12.5mg of 0.5% hyperbaric bupivacaine. Time to achieve T10 blockade, time to first rescue analgesia were examined and compare between both groups. All the statistical data was analyzed by SPSS 24.0. P-Value <0.05 was significantly considered. Results: Mean age of group A was 40.52±12.28 years and in group B it was 40.14±13.34 years. There were 18 (69.23%) male patients and 8 (30.77%) females in group A while in Group B 19 (73.08%) patients were male and 7 (26.92%) were females. No significant difference was observed between both groups regarding time to T10 blockade with p-value >0.05. A significant difference was found regarding time to rescue analgesia, in Group A it was 426.58±92.44 minutes and in Group B, it was 206.44±48.47 minutes (p-value <0.0001). Patients’ satisfaction was high in dexemedetomidine group as compared to fentanyl group. Conclusion: Dexmedetomidine 10 μg with 0.5% bupvicaine showed better effectiveness regarding time to first rescue analgesia as compared to fentanyl. No significant difference was observed regarding time to sensory blockade between both medications. Keywords: Dexmedetomidine, Fentanyl, Spinal Anaesthesia, Lower Limb Surgery, Sensory Block, Analgesia

Download Full-text

COMPARISON OF THE ONSET OF SENSORY BLOCK USING LIDOCAINE 1.5% WITH ADRENALINE OR LIDOCAINE 1.5% WITH ADRENALINE AND DEXAMETHASONE IN ULTRASOUND GUIDED AXILLARY NERVE BLOCK FOR BELOW ELBOW SURGERIES

Wiadomości Lekarskie ◽

10.36740/wlek202109214 ◽

2021 ◽

Vol 74 (9) ◽

pp. 2337-2339

Author(s):

Nabaa Adnan Ahmed ◽

Alaa Hussein Altaei ◽

Mohammed Adel Jasim

Keyword(s):

Peripheral Nerve ◽

Nerve Block ◽

Peripheral Nerve Block ◽

Onset Time ◽

Sensory Block ◽

Axillary Nerve ◽

P Value ◽

Group A ◽

Group 2 ◽

Group B

The aim: To demonstrate the onset of dexamethasone when added to lidocaine in ultrasound regional axillary brachial block. Materials and methods: 30 patients participated in this study in Al-wasity hospital from June 1st to December 1st 2019; all were of ASA I-II type, aged 18-65 years old. All patients were scheduled for upper limb below elbow surgery with peripheral nerve block. They were divided randomly in to 2 groups: Group A: received 20 ml of lidocaine 1.5% with adrenaline 1:200000; Group 2 : received 20 ml of lidocaine with adrenaline and dexamethasone 8 mg. There was no significant differences among the groups regarding the change in pulse rate, MAP and Oxygen saturation. The group B was faster than group A (p value < 0.001) in both the time of cold sensory block onset and pinprick sensory block onset at all dermatome (C5,C6,C7,C8,T1). Results: A variety of adjuvants have been used with peripheral nerve block to decrease the onset time, improve block quality, and prolong analgesia. Steroids have been shown to be beneficial in improving block onset. Conclusions: Adding dexamethasone to lidocaine enhanced the onset time of the block with no hemodynamic effect.

Download Full-text

Septoplasty Improves Life Quality Related to Allergy in Patients with Septal Deviation and Allergic Rhinitis

Otolaryngology ◽

10.1177/0194599811424119 ◽

2011 ◽

Vol 145 (6) ◽

pp. 910-914 ◽

Cited By ~ 10

Author(s):

Young Hyo Kim ◽

Beom Joon Kim ◽

Kang Hyun Bang ◽

Yoonseok Hwang ◽

Tae Young Jang

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Clinical Course ◽

Septal Deviation ◽

Vas Score ◽

Medication Score ◽

Significant Difference ◽

Group A ◽

Group B

Objective. Evaluate the effect of septoplasty on the clinical course of allergic rhinitis by comparing (1) symptom change using the Visual Analogue Scale (VAS), (2) change of the medication score, and (3) improvement of the quality of life using a questionnaire. Study Design. Prospective pilot. Setting. Academic tertiary rhinological practice. Subjects and Methods. Sixty-two patients who had undergone septoplasty and turbinoplasty for septal deviation and allergic rhinitis were enrolled in group A. Twenty-six patients who had undergone only turbinoplasty for allergic rhinitis were enrolled in group B. The VAS score, the Average Rescue Medication Score (ARMS), and the Rhinasthma Questionnaire for the quality of life were all obtained from each patient. These parameters were compared before and after the surgery and between the groups. Results. Both groups showed significant improvement of the VAS score ( P < .001). When the change of VAS was compared between groups, there was a significant difference in group A only for nasal obstruction ( P = .047). Comparison of the ARMS between groups showed significant improvement in both groups after the surgery ( P < .01). However, there were no differences between the groups. The Rhinasthma score of group A was significantly lowered after the surgery (56.4 ± 13.2 to 34.1 ± 12.3, P < .001). The Rhinasthma score of group A was significantly lower than that of group B after the surgery ( P = .004). Conclusions. This is the first research about the potential effect of septoplasty on the clinical course of allergic rhinitis. Further studies are needed to elucidate the mechanisms underlying these effects.

Download Full-text