Anaesthesia, Pain & Intensive Care最新文献

{"title":"Ketodex versus opioid based anesthesia in cleft palate","authors":"Marwa Mamdouh Mohamed, Ahmed Fayez Abdelraof, Mohamed Abdallah Noser","doi":"10.35975/apic.v28i1.2239","DOIUrl":"https://doi.org/10.35975/apic.v28i1.2239","url":null,"abstract":"Background & objective: Cleft palate is a congenital anomaly of the palate of the infants, and it may or may not be associated with cleft lip. The only remedy is surgical repair under general anesthesia. Postoperative pain relief in cleft palate repair surgery is very important to keep the infant or child calm and pain-free. It can only be achieved by use of analgesic drugs. We compared ketodex - a combination of ketamine and dexmedetomidine, versus opioid based anesthesia in cleft palate surgery as regards postoperative respiratory depression, need for oxygenation, and the emergence agitation. \u0000Methodology: Fifty children, aged 6 months to 5 y, undergoing cleft palate surgery under general anesthesia, were randomly assigned to either ketodex group (Group KD) or opioids group (Group OP). Group KD received ketamine 1mg/kg loading dose followed by infusion @ 0.1 mg/kg/h, and dexmedetomidine loading dose 1 µg/kg followed by infusion @ 0.2 µg/kg/h], isoflurane anesthesia. Group OP received fentanyl in a loading dose of 2 µg/kg followed by infusion @ 0.5 µg/kg/h, followed by isoflurane anesthesia. Heart rate, mean blood pressure, emergence agitation, extubation time, FLACC score for pain, surgeons’ satisfaction, and the adverse effects were noted. \u0000Results: Emergence agitation score was significantly lower in Group KD compared to Group OP. FLACC score showed insignificant difference between the two groups. There was no need for opioid administration in the PACU. Three patients in Group OP desaturated and needed oxygen supply. Incidence of vomiting was significantly higher in Group OP compared to Group KD (P = 0.022). \u0000Conclusion: Ketodex used in opioid free anesthesia for cleft palate repair surgery in children provides adequate pain relief without respiratory depression, and is a good alternative of routine opioid based general anesthesia. \u0000Key words: Ketamine; Dexmedetomidine; Opioids; Anesthesia; Recovery; Cleft Palate Surgery; Pediatrics \u0000Citation: Mohamed MM, Abdelraof AF, Noser MA. Ketodex versus opioid based anesthesia in cleft palate. Anaesth. pain intensive care 2024;28(1):74-80; DOI: 10.35975/apic.v28i1.2239 \u0000Received: May 31, 2023; Reviewed: June 06, 2023; Accepted: January 02, 2024","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"10 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventive analgesia with oral tramadol and pregabalin for post-operative pain in breast surgical patients","authors":"Ali Usman, Syed Raza Mehdi, Asma Ashraf Khan","doi":"10.35975/apic.v28i1.2374","DOIUrl":"https://doi.org/10.35975/apic.v28i1.2374","url":null,"abstract":"Background & objective: Preventive analgesia is implied before the actual surgical insult occurs and it is aimed to reduce the neuro-humoral changes associated with surgical induced pain. Different methods have been used by the anesthesiologists for this purpose. We studied the effect of pre-emptive oral tramadol 50 mg and pregabalin 100 mg on post-operative pain, the requirement of rescue analgesics and the stay in post-anesthesia care unit (PACU) in breast cancer surgery patients. \u0000Methodology: A randomized double blinded, placebo-controlled trial, was conducted in the Department of Anesthesia, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore (Pakistan) after ethical approval by the hospital Scientific Review Committee and Institutional Review Board. Atotal of 30 patients, undergoing breast cancer surgery, were enrolled and randomly divided into two groups. Group A (study group) patients were given tramadol 50 mg and pregabalin 100 mg orally, and Group B (control group) received two soda mint tablets orally 30 min prior to induction of anesthesia. Standard monitoring was done and routine general anesthesia was administered with intubation. After recovery, Visual Analog Scale (VAS) scores and time to rescue analgesia, total morphine consumption, were recorded. Data was analyzed using SPSS v.20. P < 0.05 was considered significant. \u0000Results: The mean ages in Group A and B were 36.67 ± 9.50 y and 41.80 ± 12.43 y (P = 0.236). The differences in intra-operative morphine and rescue morphine use in both groups were not significant (P = 0.139 and 0.293, The rescue analgesic use and VAS scores in PACU were significantly different in both groups (P = 0.005 and P = 0.022, respectively). Total PACU stay in Group A was 79.33 ± 26.31 min and in Group B was 96.67 ± 34.98 min (P = 0.281). Tramadol use in the ward was not statistically equivalent (P = 0.300). Mean post-operative rescue morphine was 0.2 ± 0.775 mg/kg in control group as compared to placebo group was 1.4 ± 1.682 mg/kg, which was statistically significant (P = 0.02). VAS scores in PACU in both groups showed statistically differences, e.g., 1.33 ± 1.1 vs 2.70 ± 1.60 (P = 0.01). PACU stay time was also higher in the control group. \u0000Conclusion: The use of pre-emptive analgesia with oral tramadol 50 mg and pregabalin 100 mg 30 min before the surgery can reduce the requirement of peri operative opioid use, achieve better pain control and early recovery. \u0000Abbreviations: BMI- Basal Metabolic Rate; PACU- Post-Anesthesia Care Unit; PONV- Postoperative Nausea and Vomiting; VAS- Visual Analog Scale \u0000Key words: Analgesia, Preventive; Cancer Surgery; Opioids; Post-Anesthesia Care Unit; Pregabalin; Tramadol \u0000Citation: Usman A, Mehdi SR, Khan AA. Preventive analgesia with oral tramadol and pregabalin for post-operative pain in breast surgical patients. Anaesth. pain intensive care 2024;28(1):81−84; DOI: 10.35975/apic.v28i1.2374 \u0000Received: November 17, 2021; Reviewed: September 24, 2022; Accept","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain &amp; Intensive Care","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139806490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sphenopalatine ganglion block vs greater occipital nerve block in the management of post dural puncture headache in obstetric patients: a randomized clinical trial","authors":"Rehab A. Abdelrazik, H. Toulan, Sabah Naguib Barsoom Ayoub","doi":"10.35975/apic.v28i1.2143","DOIUrl":"https://doi.org/10.35975/apic.v28i1.2143","url":null,"abstract":"Background: With the increased popularity of spinal anesthesia for a variety of surgeries, the anesthesiologists have to face the increased incidence of post dural puncture headache (PDPH). It is especially cumbersome to the obstetric patients. A variety of management techniques have been used. We compared the efficacy of sphenopalatine ganglion block (SPGB) versus greater occipital nerve block (GONB) for the management of PDPH in obstetric cases. \u0000Methodology: This prospective, randomized trial, enrolled 120 PDPH cases into two groups. The SPGB group received bilateral SPGB with a 3 ml mixture of 2% lidocaine and 4 mg dexamethasone (in each nostril). In the GONB group, the greater occipital nerves were blocked utilizing a solution of 3 ml mixture of 2% lidocaine and 4 mg dexamethasone on each side. Prior to the procedure, a pain score on numerical pain scale (NPS) was reported. Pain scores were noted at 15 and 30 min, then at 2, 4, 8, 16, and 24 h after the intervention. Need for and cumulative dose of analgesics used were recorded. Complications, patient satisfaction, hospital stay for epidural blood patch (EBP), and hospital discharges were also recorded. \u0000Results: Pain perception in upright position at 30 min and at 2, 16, and 24 h, the need for rescue analgesia and the cumulative analgesic dose within 24 h were significantly lower in SPGB group. Bitter taste was significantly more frequently complained by the patients of SPGB group. In the SPGB group, the EBP was not significantly less prevalent. In the SPGB group, patient satisfaction was noticeably greater. \u0000Conclusion: The sphenopalatine ganglion block is more effective in relieving PDPH and its associated symptoms than the greater occipital nerve block. Both procedures are easy, safe, more conservative than EBP, and without serious adverse effects. The sphenopalatine ganglion block can be recommended as a first line treatment for PDPH. \u0000Abbreviations: ASA: American Association of Anesthesiologists; CI: Confidence Interval; CSF: Cerebral Spinal Fluid; EBP: Epidural Blood Patch; GON: Greater Occipital Nerve; GONB: Greater Occipital Nerve Block; PDPH: Post-Dural Puncture Headache; RR: Relative Risk; SPGB: Sphenopalatine Ganglion Block; NPS: Numerical Pain Scale \u0000Key words: Nerve Block; Obstetrical Analgesia; Post-Dural Puncture Headache; Sphenopalatine Ganglion Block \u0000Citation: Abdelrazik RA, Toulan HF, Ayoub SNB, Sphenopalatine ganglion block vs greater occipital nerve block in the management of post dural puncture headache in obstetric patients: a randomized clinical trial. Anaesth. pain intensive care 2024;28(1):68-73; DOI: 10.35975/apic.v28i1.2143 \u0000Received: January 27, 2023; Reviewed: March 02, 2023; Accepted: March 02, 2023","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain &amp; Intensive Care","volume":"15 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139866434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided continuous erector spinae plane block versus thoracic epidural analgesia in open nephrectomy for renal malignancy: a randomized controlled study","authors":"Mohamed A. Wadood, Mahmoud Abdelgalil Abdelrahman, Mamdouh Mahmoud Mostafe, E. Abdelghafar, R. M. Gamal","doi":"10.35975/apic.v28i1.2377","DOIUrl":"https://doi.org/10.35975/apic.v28i1.2377","url":null,"abstract":"Background & objective: Pain during nephrectomy has been reported to be extremely intense and may trigger complex biochemical and physiological stress response if managed inadequately. Erector spinae plane block (ESPB) and thoracic epidural analgesia (TEA) both have been advocated for pain management in adult patients undergoing open nephrectomy under general anesthesia. We compared the efficacy and the dynamics of both of these procedures. \u0000Methodology: This was a randomized, double-blinded, controlled trial involving 54 patients were undergoing open nephrectomy for malignant kidney tumors. All patients were ASA class II, had a BMI 20-40 kg/m2, and were between the ages of 18-65 y. Through random assignment, people were divided into two identical, equivalent groups: Group A (n = 27) received TEA, whereas Group B (n = 27) received US-guided continuous ESPB. Mean arterial pressure (MAP) and intraoperative heart rate (HR) were recorded before and after incision, and at 30 min, 1 h, and 1.5 h. Postoperative HR, MAP were recorded at 6 h and 12 h, both at rest and when moving. Numerical rating scale (NRS) score was used to compare the intensity of postoperative pain. \u0000Results: Postoperative HR, MAP, at 6 h and 12 h, at rest and when moving, were substantially reduced in the TEA group than those in the ESPB group. The NRS score of the ESPB group was substantially greater than that of the TEA group. In contrast to the TEA group, much more total amount of morphine was consumed in the ESPB group. The time to first rescue analgesia was substantially shorter in ESPB group than that of the TEA group. \u0000Conclusions: The results of our study prove that US guided erector spinae plane block is effective in providing postoperative analgesia, decreasing use of intraoperative and postoperative opioids in patients having open nephrectomy. However, it is still inferior to thoracic epidural analgesia in terms of pain control after 6 h postoperatively. Otherwise, erector spinae plane block has fewer side effects compared to thoracic epidural analgesia. So, it may be used as an alternative to thoracic epidural analgesia. \u0000Key words: Erector Spinae Plane Block; Epidural Analgesia; Open Nephrectomy; Pain, Postoperative; Ultrasound \u0000Citation: Wadood MA, Abdelrahman MA, Mostafe MM, Abdelghafar EM. Ultrasound-guided continuous erector spinae plane block versus thoracic epidural analgesia in open nephrectomy for renal malignancy: a randomized controlled study, Anaesth. pain intensive care 2024;28(1):26-32; DOI: 10.35975/apic.v28i1.2377 \u0000Received July 24, 2023; Revised: September 08, 2023; Accepted: October 03, 2023","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain &amp; Intensive Care","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139866502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Nursing Care Pain Management Program’ for children with cancer: novel views by a qualitative study","authors":"Nayereh Naseri, Alireza Irajpour, Atefeh Shamsi","doi":"10.35975/apic.v28i1.2375","DOIUrl":"https://doi.org/10.35975/apic.v28i1.2375","url":null,"abstract":"Background & objective: Pain management is always a practical challenging issue in pediatric oncology. Nurses should be fortified with essential knowledge, attitude, and skills according to required standard. \u0000This study aimed to develop a nursing care pain management program in children with cancer. \u0000Methodology: This qualitative study will be conducted through two phases of interviewing and modified Delphi to develop a pain management nursing care program in children with cancer. \u0000Results: Three main categories (nursing, pediatrics’ parents, and health care organizations related factors) were achieved in qualitative phase as the base of initial pain management nursing care needs and Delphi technique revealed the contents in 13 pain management items. \u0000Conclusion: The development of a pain management nursing care program provides professional educational opportunities for optimal pain management in children with cancer. \u0000Key words: Children; Cancer; Nursing Care; Pain; Pain Management Program; Qualitative Study \u0000Citation: Naseri N, Irajpour A, Shamsi A. ‘Nursing Care Pain Management Program’ for children with cancer: novel views by a qualitative study. Anaesth. pain intensive care 2024;28(1):10−19; DOI: 10.35975/apic.v28i1.2375 \u0000Received: July 03, 2022; Reviewed: February 10, 2023; Accepted: April 04, 2023","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain &amp; Intensive Care","volume":"14 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lavender aromatherapy: Its effect on preoperative anxiety and propofol requirement for anesthesia","authors":"R. Rahman, Menaga M. Vasu Dewan, Syarifah Noor Nazihah Sayed Masri, Mohammad Nizam Mokhtar, Farah Hanim Abdullah, N. M. Nor","doi":"10.35975/apic.v28i1.2376","DOIUrl":"https://doi.org/10.35975/apic.v28i1.2376","url":null,"abstract":"Background & objective: Preoperative anxiety is a natural human psychology, and the physicians usually prescribe tranquillizers to allay the anxiety of their anxiety. Various other means have also been employed for this purpose. We aimed to investigate the impact of lavender aromatherapy on preoperative anxiety and propofol requirement at induction of anesthesia. \u0000Methodology: A total of 108 female patients were enrolled in the study, and their anxiety levels were evaluated using the Visual Analogue Scale (VAS) at three different time points. Patients were randomly divided into two groups. Group A (Lavender Group) patients were given lavender aromatherapy via a cotton strip infused with two drops of 100% pure lavender essential oil, while the patients in Group B (Control Group) had no aromatherapy. \u0000Results: The results showed that the lavender aromatherapy significantly reduced anxiety in Group A (P < 0.001) compared to Group B, and the mean differences of VAS scores for all anxiety assessments were also significantly reduced in Group A (P < 0.000). In addition, the mean total amount of propofol required was significantly less in Group A than in Group B (118.46 ± 40.01 vs 140.38 ± 35.29 mg; P = 0.003), while the mean duration to reach loss of consciousness was similar in both groups. \u0000Conclusion: The findings of our study suggest that lavender aromatherapy can be a simple, safe, and cost-effective way to reduce preoperative anxiety and decrease the amount of propofol required for the induction of anesthesia. Therefore, the use of lavender aromatherapy may be a valuable addition to the preoperative care of patients undergoing elective surgeries. \u0000Abbreviations: APAIS-  Amsterdam Preoperative and Information Scale; LOC- Loss of Consciousness; OT- Operation Theatre; OR- Operating Room; STAI- State-Trait Anxiety Inventory; VAS- Visual Analogue Scale \u0000Key words: Aromatherapy; Benzodiazepines; Lavender; Anxiety, Preoperative; Propofol; Anxiety / therapy; Anxiety Disorders \u0000Citation: Rahman RA, Vasu Dewan MM, Sayed Masri SNN, Mokhtar MN, Abdullah FH, Md Nor N. Lavender aromatherapy: Its effect on preoperative anxiety and propofol requirement for anesthesia. Anaesth. pain intensive care 2024;28(1):20−25; DOI: 10.35975/apic.v28i1.2376 \u0000Received: April 26, 2023; Reviewed: November 22, 2023; Accepted: November 22, 2023","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain &amp; Intensive Care","volume":"9 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxytocin infusion is a safe uterine bleeding controller alternative to blood transfusion in patients undergoing abdominal myomectomy","authors":"Hisham Nasief, Amber Hassan, Nashwa Aldardeir, Khalid Khadawardi, Ahmad B. Alwazzan, Haneen Alothmani, Ziyad Hammad","doi":"10.35975/apic.v28i1.2298","DOIUrl":"https://doi.org/10.35975/apic.v28i1.2298","url":null,"abstract":"Background & objective: Uterine bleeding is a notable complication that can occur after the surgical removal of uterine fibroids, and oxytocin infusion has been a commonly used method to control blood loss in such cases. The objective of this study was to evaluate the effectiveness of oxytocin infusion in managing surgical bleeding following abdominal myomectomy, as an alternative to immediate blood transfusion. \u0000Methodology: The study population consisted of 120 patients who experienced acute blood loss following abdominal myomectomy. These patients were divided into two groups: Group A, which included 50 patients who received an oxytocin infusion, and Group B, which included 60 patients who received a placebo. All myomectomies were conducted according to department protocols, and various variables related to the study were recorded. Postoperative hemoglobin levels were checked in every patient. \u0000Results: In Group A, the average blood loss was 470.02 ± 81.65 ml, while in Group B, it was 721.42 ml ± 63.55 ml (P < 0.0001). The need for urgent blood transfusion was significantly lower in Group A (3.3%) compared to Group B (20.0%), (P = 0.044). Postoperative hemoglobin levels also showed a significant difference between the two groups, with Group A demonstrating better results than Group B. \u0000Conclusion: Oxytocin infusion can be safely used for managing blood loss in patients undergoing abdominal myomectomy. However, in cases where oxytocin is unable to effectively control the bleeding, blood transfusion may be needed as a means to compensate for the blood loss. \u0000Key Words: Uterine leiomyomas; Myomectomy; Surgical blood loss; Oxytocin \u0000Citation: Nasief H, Hassan A, AlDardeir N, Khadawardi K, Alwazzan AB, Alothmani H, Hammad Z. Oxytocin infusion is a safe uterine bleeding controller alternative to blood transfusion in patients undergoing abdominal myomectomy. Anaesth. pain intensive care 2024;28(1):05−09; DOI: 10.35975/apic.v28i1.2298 \u0000Received: October 05, 2023; Reviewed: October 17, 2023; Accepted: November 19, 2023","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain &amp; Intensive Care","volume":"12 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study between rocuronium and magnesium sulfate as adjuvants to local anesthetics for peribulbar block","authors":"Mohamed Nagy Mohamed Alafifi, Sahar Abo El-Ella, Mohamed Anwar El-Shafey, Amr Mohamed Helal, Milad Zekry Ragaei","doi":"10.35975/apic.v28i1.2157","DOIUrl":"https://doi.org/10.35975/apic.v28i1.2157","url":null,"abstract":"Background & Objective: Peribulbar anesthesia is frequently used in cataract surgeries. Compared to retrobulbar anesthesia, this approach is associated with less significant consequences. However, the prolonged onset of orbital akinesia and the frequent need for block replenishment are considered drawbacks. We aimed to investigate the impact of adding rocuronium and magnesium sulfate to a commonly used local anesthetic combination on the onset of corneal anesthesia and the degree of lid and globe akinesia during peribulbar block in ocular surgeries. \u0000Patients and Methods: This prospective double-blinded randomized study was conducted in the ophthalmic surgery operating theater, Ain Shams University Hospital from January 2019 to April 2020. We enrolled 75 patients from both sexes, with American Society of Anesthesiology (ASA) physical status I–III, ages 40-80 y, and an axial globe length less than or equal to 26 mm planned for cataract surgery under peribulbar block in the study following institutional ethical board approval and written informed patient consents. Patients were randomly divided into three groups, 25 patients per group, based on the drugs they received: Group O (control group): received local anesthetic + 0.9% normal saline (1 ml). Group M: received local anesthetic + magnesium sulphate 50 mg in normal saline. Group R: received local anesthetic + rocuronium at a dose of 0.06 mg/kg (maximum 5 mg) in normal saline. \u0000Results: Our study found statistically significant more rapid onset of action (mean time to start surgery) in rocuronium group (7.00 ± 1.22 min) than control group and magnesium sulfate group (9.00 ± 1.47 and 9.00 ± 1.15 min) respectively, (P < 0.001); Moreover, no significant difference was noted between control group and magnesium sulfate group. In addition, no relevant difference was reported regarding duration of surgery between the groups. \u0000Conclusion: During cataract surgery, the addition of rocuronium to the local anesthetic mixture in the peribulbar nerve block has been found to enhance ocular akinesia and corneal anesthesia. Furthermore, the use of rocuronium demonstrated a significantly faster onset and shorter time needed to achieve the appropriate conditions to initiate the surgical procedure compared to the use of magnesium sulfate. Addition of magnesium sulfate showed good results regarding akinesia, corneal anesthesia and need for supplementary injections but it did not significantly fasten the onset of block and hence the time to start surgery. \u0000Key words: Cataract; Magnesium Sulfate; Peribulbar Block; Rocuronium \u0000Citation: Nagy M, Abo El-Ella S, El-Shafey MA, Helal AM, Zekry MR. Comparative study between rocuronium and magnesium sulfate as adjuvants to local anesthetics for peribulbar block. Anaesth. pain intensive care 2024;28(1):55−61; DOI: 10.35975/apic.v28i1.2157 \u0000Received: February 18, 2023; Reviewed: July 30, 2023; Accepted: December 23, 2023","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain &amp; Intensive Care","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139806552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of platelet rich plasma (PRP) treatment and its comparison with pregabalin in painful diabetic polyneuropathy: A randomized controlled clinical trial","authors":"Shahzad Anwar, Muhammad Waseem Hassan, G. Shaukat, Fatima Tirmzi, Muhammad Umer Saeed, Mudassar Aslam","doi":"10.35975/apic.v28i1.2280","DOIUrl":"https://doi.org/10.35975/apic.v28i1.2280","url":null,"abstract":"Background & objective: The most common consequence of diabetes mellitus (DM) is diabetic peripheral neuropathy (DPN), and it has serious clinical implications that can affect patients' quality of life. There is an urgent need to to discover new methods of treatment, as the medications currently in use for prevention and treatment of DPN are only partially effective and have frequent adverse effects. We aimed to determine and compare the effect of platelet rich plasma (PRP) injection on acupuncture points and pregabalin in painful DPN. \u0000Methodology: A randomized controlled trial was conducted at Iffat Anwar Medical Complex. All the clinically diagnosed patients having neuropathic sign and symptoms of DPN, with type 2 DM diagnosed having an HbA1c level greater than 7.5, both genders aged between 40-70 y were enrolled in the study. After the written informed consent, a total of 60 patients were randomly divided into two groups in a 1:1 ratio. Group I received PRP injections on acupuncture points and Group II received 75 mg pregabalin PO twice daily. The PRP injection treatment was given once a month for three months. Follow up of all patients was conducted every month till three months and after one year for final assessment. All the data was entered and analyzed by SPSS 25.0. The difference among pain, SF-36, sleep quality scale among groups was compared by independent sample t test and before and after difference was observed by paired sample t-test. P < 0.05 was considered as significant. \u0000Results: The VAS scores were significantly decreased in Group I (from 7.47 ± 1.27 to 3.67 ± 1.09; P < 0.05) as compared to Group II (7.30 ± 1.59 to 5.20 ± 1.58, P < 0.05). The neuropathic symptoms scale also showed significant improvement (Group I: 13.50 ± 50 to 8.50 ± 2.30 vs. Group II: 14.93 ± 2.55 to 9.83 ± 2.17, P < 0.05), as well as the quality of life (Group I: 67.77 to 31.50 ± 9.24 vs. Group II:69.37 ± 11.7to 41.20 ± 12.16, P < 0.05) and sleep quality scale (Group I:49.53 ± 12.4 to 27.30 ± 8.03 vs. Group II: 52.13 ± 10.9to 32.60 ± 7.103, P < 0.05). \u0000Conclusion: We conclude that the treatment of diabetic peripheral neuropathy with platelet rich plasma injections at acupuncture points significantly improves the pain scores, quality of sleep and neuropathic symptoms as compared to conventional treatment with 75 mg pregabalin PO twice daily. \u0000Abbreviations: DM- Diabetes Mellitus; DPN- Diabetic Polyneuropathy; LANSS- Leeds Assessment of Neuropathic Symptoms and Signs; PRP- Platelet Rich Plasma; QoL- Quality of Life; SQS- Sleep Quality Scale \u0000Key words: Acupuncture; Diabetic Poly Neuropathy; Pain; PRP injections; Quality of Life \u0000Citation: Anwar S, Hassan MW, Shaukat GR, Tirmzi F, Saeed MU, Aslam M. Effectiveness of platelet rich plasma (PRP) treatment and its comparison with pregabalin in painful diabetic polyneuropathy: A randomized controlled clinical trial. Anaesth. pain intensive care 2024;28(1):44-49; DOI: 10.35975/apic.v28i1.2280 \u0000Received: August 07, ","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain &amp; Intensive Care","volume":"2015 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139807153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of some cytokines in patients with brucellosis in Najaf province","authors":"Khitam F. Abbas, L. S. Abdul-Hassan, O. Hadi, Abbas F. Almulla, Zahraa Yosif Kathair","doi":"10.35975/apic.v28i1.2379","DOIUrl":"https://doi.org/10.35975/apic.v28i1.2379","url":null,"abstract":"Background: To evaluate the levels of pro-inflammatory cytokines for ‘Th1/Th2 brucellosis’ patients serum to determine ‘antimicrobial susceptibilities’ of Brucella strains. \u0000Methodology: The study comprised 35 individuals with acute brucellosis, and 21 patients with chronic brucellosis, identified clinically. A group of 20 healthy adult persons was also enrolled in the study. For all of the participants, blood cultures and standard tube agglutination tests for Brucella were performed. ELISA was used to detect cytokine levels in serum samples collected following the treatment period and detect Brucella strains celebrated from different sites of infection, and in order to find-out the susceptibilities against antibiotics including rifampicin (RIF), streptomycin (STR), doxycycline (DOX), and ciprofloxacin (CIP) via the gradient strip (E test). \u0000Results: The patients included 22 (39.29 percent) males and 34 (60.71 percent) females based on their gender and age. Fever was the most common clinical feature (92%), sweating came in second place (75%), followed by back pain with 18%. Patients with brucellosis had substantially higher blood levels of interleukin-6 (IL-6), interferon (IFN), and tumor necrosis factor-alpha (TNF-alpha) analogous to the control group (P = 0.05). IL-4 and IL-2 levels between the sick and control groups did not vary significantly. The amounts of these cytokines were found to be identical in acute and chronic individuals. Rendering to \"minimum inhibitory concentrations (MIC) 90 levels,\" CIP was determined to be the most effective antibiotic. Then followed DOX and then STR, correspondingly. All of the samples were CIP and DOX susceptible; 18 (23.2%) strains were discovered to be only mildly sensitive to RIF, with MIC50 and MIC90 maximal values. \u0000Conclusions: Our findings point to an important role for IFN and proinflammatory cytokines in brucellosis pathogenesis. However, these changes were shown to be unrelated to the severity or activity of the illness. Furthermore, all strains were identified as Brucella strains. ciprofloxacin, doxycycline, rifampicin and streptomycin were found to be effective for the treatment of brucellosis. \u0000Key words: Antimicrobial Susceptibilities; Brucellosis; Cytokines; Interferon; Pro-Inflammatory Cytokines \u0000Citation: Abbas KF, Abdul-Hassan LS, Hadi OM, Almulla AF, Kathair  ZY. Study of some cytokines in patients with brucellosis in Najaf province. Anaesth. pain intensive care 2024;28(1):39-43; DOI: 10.35975/apic.v28i1.2379 \u0000Received: September 15, 2023; Reviewed: November 03, 2023; Accepted: December 23, 2023","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain &amp; Intensive Care","volume":"115 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139806169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}