Efficacy of Ultrasound Guided Fascia Iliaca Block for Pain Management Compared to Conventional Pain Killers; A Comparative Study

2021 ◽  
Vol 15 (8) ◽  
pp. 2525-2528
Author(s):  
Muhammad Habib Khan ◽  
Shah Hussain ◽  
Muhammad Gulzar Khan ◽  
Jamal Bahadar ◽  
Muhammad Kashif ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Ultrasound Guided ◽  
Analog Scale ◽  
Patients Satisfaction ◽  
Satisfaction Rate ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Fascia Iliaca Block

Objective: The aim of this study is to determine the efficacy of ultrasound guided fascia iliaca block for pain management compared to conventional pain killers. Study Design: Place and Duration: The study was conducted at the emergency department of Lady Reading Hospital Peshawar for duration of six months i.e June 2019 to December 2019. Methods: Total 80 patients of both genders underwent for arthroplasty were presented in this study. Patients were aged between 40-80 years. Patients detailed demographics age, sex, weight and body mass index were recorded after taking informed written consent. Patients were divided into 2-groups. Group I had 40 patients and received fascia iliaca block while group II received conventional pain killers with 40 patients. Postoperative outcomes reduction in pain score was assessed by visual analog scale (VAS). Postoperatively complications and patients satisfaction was also observed and compared among both groups. Complete data was analyzed by SPSS 26.0version. Results: There were 22 (55%) male and 18 (45%) female patients in group I while in group II male patients were 21 (52.5%) and 19 (47.5%) were females. Mean age in group I was 57.17±10.21 years with mean BMI 26.64±3.54 kg/m2 and in group II mean age was 58.25±9.66 years with mean BMI 26.48±3.45 kg/m2. 25 (62.5%) patients had ASA I and 15 (37.5%) had II in group I but in group II 24 (60%) had ASA I and 16 (40%) had II. Post-operative after 48hrs pain score in group I was 2.03±3.18 lower as compared to group II 4.08±7.81. Frequency of complications was higher in group II 23 (57.5%) as compared to group I 8 (20%). Satisfaction among patients of group I was 34 (85%) higher as compared to group II 19 (47.5%). Conclusion: We concluded in this study that the use of anesthesia fascia iliaca block was effective in terms of pain reduction and fewer complications than conventional pain killers after arthroplasty. Except this satisfaction rate was also higher among patients who received FICB. Keywords: Fascia iliaca block, Pain killer, Arthroplasty, Pain, Complications

Comparison of the Effects of Low Dose Methylprednisolone and Metoclopramide on Nausea and Vomiting and Respiratory Complications after Adenotonsillectomy

2021 ◽  
Vol 15 (9) ◽  
pp. 2753-2756
Author(s):  
Shahid Adalat Chaudhry ◽  
Madiha Zafar ◽  
Usman Zeeshan ◽  
Mubashar Iqbal ◽  
Arooj Fatima ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Score ◽  
Low Dose ◽  
Operative Time ◽  
Oral Intake ◽  
Respiratory Complications ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Mean Time

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake

scholarly journals A Seven-year Follow-up Study of Patient Satisfaction with Three-implant-retained Mandibular Overdentures

2021 ◽  
Vol 9 (D) ◽  
pp. 103-107
Author(s):  
Hisham Samir ElGabry
Keyword(s):  
Long Term Results ◽  
Complete Dentures ◽  
Patients Satisfaction ◽  
Follow Up Study ◽  
Group I ◽  
Significant Difference ◽  
Male Patients ◽  
Group Ii ◽  
Anterior Mandible

PURPOSE: This study aimed to compare patients’ satisfaction with mandibular overdentures retained by three-splinted implants versus conventional complete denture wearers during a 7-year follow-up study period. MATERIALS AND METHODS: Thirty edentulous male patients (mean age: 60 years) were carefully selected and divided into two equal groups. All patients received a new set of complete dentures. Group I patients received three implants in the anterior mandible and were connected after 3 months with bars, clips, and loaded. Group II patients received conventional complete dentures. Patients’ satisfaction was recorded for both groups at 3 weeks (baseline) and after 1, 3, 5, and 7 years. Patients were then asked to grade their overdentures/dentures on a visual analog scale and written questionnaire to evaluate their overall satisfaction. RESULTS: Satisfaction scores of Group I patients were found to be statistically significantly higher than that of Group II patients (p < 0.05) at 3, 5, and 7 years follow-up, meanwhile, no statistically significant difference was found at baseline or after 12 months. CONCLUSION: The long-term results suggest that three-implant-retained mandibular overdenture with a clip-bar attachment appears to be a successful rehabilitation strategy which is superior to conventional dentures for patients with advanced ridge resorption.

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 Lidocaine spray administration in transrectal ultrasound-guided prostate biopsy: Five years of experience

2014 ◽  
Vol 86 (4) ◽  
pp. 340 ◽  
Author(s):  
Lucio Dell’Atti
Keyword(s):  
Pain Score ◽  
Prostate Biopsy ◽  
Low Cost ◽  
Prostate Gland ◽  
Transrectal Ultrasound ◽  
Pain Scale ◽  
Patient Comfort ◽  
Ultrasound Guided ◽  
Male Patients ◽  
Lidocaine Spray

Objectives: We report in this singlecenter study our results of a five-year experience in the administration of lidocaine spray (LS) during ultrasound-guided prostate biopsy (TPB). Material and Methods: Between August 2008 and July 2013 a total of 1022 consecutive male patients scheduled for TPB with elevate PSA (≥ 4 ng/ml) and (or) abnormal digital rectal and (or) suspect TRUS were considered eligible for the study. Each patient was treated under local anaesthesia with LS (10 gr/100 ml), applied two minutes before the procedure. TPB was performed with the patient in the left lateral decubitus using multi-frequency convex probe “end-fire”. Two experienced urologists performed a 14-core biopsy, as first intention. After the procedure each patient was given a verbal numeric pain scale (VNS). The evaluation was differentiated in two scales VNS: VNS 1 for the insertion of the probe and the manoeuvres associated, while VNS 2 only for the pain during needle’s insertion. Results: Pain scores were not statistically significant different with regard to the values of PSA and prostate gland volume. Pain score levels during probe insertion and biopsy were significantly different: the mean pain score according to VNS was 3.3 (2-8) in the first questionnaire (VNS1) (p &lt; 0.001) and 2.1 (1-7) in the second one (VNS2) (p &lt; 0.125). The 8.2% of cases referred severe or unbearable pain (score ≥ 7), 74% of patients referred no pain at all. Only 21 patients would not ever repeat the biopsy or would request a different type of anaesthesia, while 82% of them would repeat it in the same way. In only eight patients we have not been able to insert TRUS probe. Conclusions: Our pain score data suggest that LS provides efficient patient comfort during TPB reducing pain both during insertion of the probe and the needle. This non-infiltrative anaesthesia is safe, easy to administer, psychologically well accepted by patients and of low cost.

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.

scholarly journals Efficacy of ultrasound-guided rectus sheath block, butorphanol for single-incision laparoscopic cholecystectomy: A prospective, randomized, clinical trial

2020 ◽  
Author(s):  
Huimin Fu ◽  
Chaochao Zhong ◽  
Yongtao Gao ◽  
Xingguo Xu
Keyword(s):  
Visceral Pain ◽  
Rectus Sheath ◽  
Group Iv ◽  
Ultrasound Guided ◽  
Group Iii ◽  
Group I ◽  
Rectus Sheath Block ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Group Ii ◽  
Incisional Pain

Abstract Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incisional pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, and butorphanol for postoperative analgesia in patients undergoing SILC.Methods: All patients who met the criteria were randomly divided into four groups: group I, (n=29) patient-controlled intravenous analgesia (PCIA) (sufentanil 1 µg/ml); group II, (n=29) PCIA (butorphanol 0. 08 µg/ml); group III, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (sufentanil 1 µg/ml); and group IV, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (butorphanol 0.08 µg/ml). General anesthesia in all groups, It's noteworthy that we only use general anesthesia, not ultrasound-guided RSB in group I and II. The primary outcome were numeric rating scale (NRS) scores (0-10) of incisional pain and visceral pain. Secondary outcomes were the dose of butorphanol and sufentanil, the number of PCIA presses, the length of hospital stay and the incidence of postoperative adverse events. Results: Both the rest and cough incisional pain scores were lower during the first 2, 6 and 12 h in group Ⅲ than in group Ⅰ (P＜0.05). Similarly, scores in group Ⅳ were significantly lower than those in group II (P＜0.05). The NRS scores for visceral pain were lower in group II at 2, 6 and 12 h after surgery than in group I (P＜0.05) and lower in group IV than in group Ⅲ (P＜0.05). Patients in group I needed more butorphanol as a rescue analgesic for pain relief than did those in group III, and patients in group IV needed less butorphanol as a rescue analgesic for pain relief than did those in group II. From the above pairwise comparisons, it is clear that groups III and IV had lower NRS scores. Overall, ultrasound-guided RSB combined with PCIA (butorphanol 0. 08 µg/ml) performed the best. Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC than can general anaesthesia combined with sufentanil.

scholarly journals EVALUATION OF PUNCTURE DRAINING INTERVENTIONS EFFICACY IN PATIENTS WITH PANCREATIC FLUID COLLECTIONS

2020 ◽  
Vol 24 (3-4) ◽  
pp. 3-5
Author(s):  
Ohanezian Aikanush
Keyword(s):  
Ultrasound Guidance ◽  
Minimal Invasive ◽  
Ultrasound Guided ◽  
Septic Complications ◽  
Surgical Interventions ◽  
Group I ◽  
Specific Sign ◽  
Group Ii ◽  
Ultrasound Guided Puncture ◽  
Guided Puncture

The aim of the research is to evaluate the effectiveness of ultrasound guided punctures and drainage for FCs in AP. The results of the examination and treatment of 72 patients with FCs in AP who have been treated using step up approach in the period from 2010 till 2018 are analyzed. Patients were divided on two groups: The first group included 40 patients, who underwent draining of FCs under ultrasound guidance as a first stage of treatment. The second group included 32 patients, who underwent puncture of FCs under ultrasound guidance as the first stage of treatment. In the majority of patients in Group I (65.0%) we observed acute post-necrotic FCs. In 30 (75.0%) patients draining under ultrasound guidance was final in treatment. 10 (25.0%) patients with infected acute postnecrotic FCs, after drainage and aspiration underwent necrectomy. In most of patients of group II (62.5%) were noted acute postnecrotic FCs too. 17 patients underwent ultrasound guided puncture and aspiration of FCs. 15 patients of group II underwent drainage of acute post-necrotic FCs under the ultrasound guidance. In 11 (73.3%) of them the drainage of FCs was definitive in treatment, 4 (26.7%) - required the necrosectomy. In group II, in 81.2% patients minimal invasive surgical interventions were effective. SIRS was noted as in patients with aseptic FCs so in patients with infected FCs. In patients with acute pancreatitis, the duration of the disease up to 4 weeks, as well as the presence of SIRS, is not a specific sign of infection only. Ultrasound-guided diagnostic puncture of FCs is a safe method that facilitates early diagnosis of infected FCs. Ultrasound guided puncture with aspiration can reduce the incidence of purulent-septic complications and be definitive in treatment for aseptic acute parapancreatic FCs and aseptic acute post-necrotic FCs. Infected FCs without suppuration do not require routine drainage. Drainage is absolutely indicated in case of purulent content and persistent SIRS in patients after primary puncture of infected FCs.

scholarly journals CLINICAL EFFICACY OF RECOMBINANT FACTOR VIII FC FUSION PROTEIN IN HAEMOPHILIA A PATIENT RECEIVING ON DEMAND TREATMENT ONLY

2021 ◽  
Vol 71 (1) ◽  
pp. 62-66
Author(s):  
Saima Zahir ◽  
Tahira Zafar ◽  
Altaf Hussain ◽  
Hamid Saeed Malik ◽  
Pervez Ahmed ◽  
...  
Keyword(s):  
Fusion Protein ◽  
Factor Viii ◽  
Armed Forces ◽  
Recombinant Factor Viii ◽  
Haemophilia A ◽  
On Demand ◽  
Group I ◽  
Fc Fusion Protein ◽  
Male Patients ◽  
Group Ii

Objective: To evaluate the efficacy of recombinant factor VIII FC fusion protein in haemophilia A patientreceiving on demand treatment only. Study Design: Comparative cross sectional study. Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology and PakistanHemophilia Welfare Society, Rawalpindi, from Jun to Dec 2017. Methodology: Eighty-nine male patients of Hemophilia A already receiving recombinant factor VIII (20-30 Units/kg) on demand, with no history of inhibitors were included in study. Patients were divided as per age into paediatric and adult group and also on the basis of their basal factor VIII levels into severe, moderate and mild groups. Same patients were switched to recombinant factor VIII FC fusion protein (20-30 Units/kg) and its efficacy was measured and compared with recombinant Factor VIII in terms of dose requirement, injections, bleeds in six month period, presence of inhibitors and side effects. Results: Eighty nine male patients were studied. There was significant reduction in dose from median value of5750 units for group I to 4000 units for group II. Number of bleed in six month period were reduced from 5.3 ingroup I to 4.5 in group II. Number of injections were reduced on average to 1-2 injection per bleed in group II. No inhibitors were detected in group II. Conclusion: rFVIII Fc fusion protein has prolong activity and results in reduction of total dose, number of bleed,dose per bleed and has reduced antigenecity.

scholarly journals AGGRAVATING EFFECT OF ARTERIAL HYPERTENSION ON THE COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN PATIENTS WITH COMORBID PATHOLOGY

2021 ◽  
Vol 74 (4) ◽  
pp. 973-976
Author(s):  
Viktoriia V. Rodionova ◽  
Olha O. Boiko
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Arterial Hypertension ◽  
Middle Age ◽  
Clinical Manifestations ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Group I ◽  
Male Patients ◽  
Group Ii

The aim: To study the effect of arterial hypertension on the course of chronic obstructive pulmonary disease in patients with comorbid pathology. Materials and methods: The prospective study included 61 patients with COPD: 32 stable male patients with COPD with comorbid arterial hypertension of stage II 1-3 degrees and 29 stable outpatients of men with COPD of clinical groups A-D with impaired respiratory function II-IV according to GOLD. All patients, in accordance with the goals and objectives of the study, were divided into 2 groups: group I consisted of men with isolated COPD, middle age – 56.0 (8.5) years, average duration of the disease – 16.2 (1.3) years, Group II consisted of male patients with COPD and arterial hypertension (AH), middle age – 59.5 (7.5). The patients underwent a general clinical examination, which included an assessment of complaints, anamnestic data, and a physical examination. The severity of COPD was determined on the basis of the frequency of exacerbations during the year, assessment of dyspnea using the mMRS scale, spirographic data. Statistical materials were processed using the STATISTICA 10.0 program. Results: In group I, 20 patients (69%) complained of dyspnea during exercise, in group II – 25 patients (78%) (p = 0.4), 28 patients (96.5%) complained of cough with vague sputum. group and 30 patients in group II (93.8%) (p = 0.09). When assessing the number of exacerbations over the past year, it was determined that patients with isolated COPD had an average of 1.0 (1.0; 2.0) exacerbations, and patients with COPD and AH – 2.0 (1.0; 3.0 ) (p = 0.06). According to the CAT questionnaire, the following data were obtained: in group I – 9.0 (8.0; 11.0) points, and in group II – 17.5 (10.0; 20.0) points (p = 0.02). When conducting spirographic studies, a statistically significant more expressive bronchial obstruction was found in patients with COPD and comorbid hypertension. Conclusions: The presence of comorbid arterial hypertension leads to the intermittent effect of diseases: according to the results of mMRC and SAT test, ailments for COPD were examined, they have a more severe course of underlying seizure in the presence of concomitant arterial hypertension. Clinical manifestations in patients with COPD and H are more severe compared to clinical manifestations in patients without aggravated diseases of the cardiovascular system. Concomitant arterial hypertension enhances the manifestations of bronchial obstruction, in the same way as with patients with isolated COPD.

scholarly journals Bronchoscopy Guided V.S Ultrasound Guided Percutaneous Tracheostomy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M Elazzazi ◽  
E M Aboseif ◽  
R A Abdelrazik ◽  
A K A Elbardan
Keyword(s):  
Percutaneous Tracheostomy ◽  
Percutaneous Dilatational Tracheostomy ◽  
Mean Value ◽  
Tube Placement ◽  
Safe Procedure ◽  
Ultrasound Guided ◽  
Dilatational Tracheostomy ◽  
Group I ◽  
Endotracheal Tube Placement ◽  
Group Ii

Abstract Introduction Percutaneous dilatational tracheostomy (PDT) is a widely utilized technique in the intensive care unit as it is a safe and cost effective technique. Bronchoscopy guided percutaneous dilatational tracheostomy has traditionally been used as a safety adjunctive tool in order to define the appropriate site for the tracheal puncture, to guide the real-time entrance of the needle into the trachea, avoiding tracheal posterior wall injuries, and confirming the endotracheal tube placement. By contrast, bronchoscopy might not precisely identify the cervical anatomical structures. Ultrasound has emerged as potentially useful tool in assisting percutaneous dilatational tracheostomy when factors that increase the technical difficulty of the procedure (morbid obesity, difficult anatomy & cervical spine precautions) are present. Several studies have demonstrated the value of pre-procedure cervical ultrasound in order to improve the safety of percutaneous dilatational tracheostomy. Objectives This review aimed at comparing bronchoscopy guided versus ultrasound guided percutaneous tracheostomy in terms of the detected complications resulting from each procedure. Design A randomized prospective comparative trial. Setting Critical care department, Ain Shams university hospital. Patients Forty adult patients, requiring elective PDT, and need to maintain a secure airway. Methods They were randomly assigned to 2 groups; fiber optic bronchoscopy PDT group I and Ultrasound guided PDT group II. Both groups used Blue Rhino technique for PDT. Post-operative complications were recorded. Results In group I, males were 11(55%) and females were 9(45%) while in group II, males and females were 14(70%) and 6(30%) respectively. Age in group I ranged from 37-67 with mean value of 52.4±10.89 and in group II ranged from 40-71 with mean value of 54.6±9.81. There was one puncture in 19 cases (95%) in group I, while one puncture in 17 cases (85%) in group II. Total time in group I was ranged from 3-9 with mean value 5.3±1.69 and in group II was ranged from 3-9 with mean value 6.2±1.79. Transient hypoxemia occurs in about 3 cases (15%) in the bronchoscopy guided PDT group in comparison to none in the ultrasound guided PCT group. Bleeding occurred in 2 patients (10%) in bronchoscopy guided PDT group versus one patient (5%) in Ultrasound guided PCT group. Misplacement of the tracheostomy tube was encountered in only two cases (10%) in US guided PDT group and non in the other bronchoscopy guided PDT group, which lead subsequently to pneumothorax in one case (5%). Conclusion Percutaneous dilatational tracheostomy is a bedside safe procedure with low rate of complications. US guided PDT and bronchoscopy guided PDT are effective, safe and associated with similar complication rate and clinical outcome. Bronchoscopy guidance during PDT offers the best vision decreasing the need for multiple punctures and the risk of misdirection or false passage of the tube. Ultrasound is a promising less invasive method to guide the percutaneous tracheostomy procedure.

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