Egyptian Journal of Anaesthesia最新文献_第9页

Dexmedetomidine sedation reduces the incidence of atrial fibrillation in mechanically ventilated patients with COVID-19 pneumonia: A randomized controlled trial 右美托咪定镇静降低COVID-19肺炎机械通气患者房颤发生率:一项随机对照试验

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Egyptian Journal of Anaesthesia Pub Date : 2023-05-01 DOI: 10.1080/11101849.2023.2205210

A. M. Fetouh, Motaz Amr Abu Sabaa, A. Aboelezz, A. Elbadry

{"title":"Dexmedetomidine sedation reduces the incidence of atrial fibrillation in mechanically ventilated patients with COVID-19 pneumonia: A randomized controlled trial","authors":"A. M. Fetouh, Motaz Amr Abu Sabaa, A. Aboelezz, A. Elbadry","doi":"10.1080/11101849.2023.2205210","DOIUrl":"https://doi.org/10.1080/11101849.2023.2205210","url":null,"abstract":"Background: Atrial fibrillation (AF) is a cardiac complication commonly associated with COVID-19 infection, especially in severe cases. The sedative agent dexmedetomidine is known to cause bradycardia. In this study, we are testing whether dexmedetomidine could reduce the occurrence of AF in mechanically ventilated COVID-19 patients. Method(s): This prospective trial included 144 patients who were randomly allocated to one of two groups: Group C patients were sedated with propofol and fentanyl. Group D patients were sedated with the same medications in addition to dexmedetomidine infusion. Result(s): Demographic, clinical, and cardiac characteristics of all patients did not significantly differ between the two groups. The duration of intensive care unit (ICU) stay was comparable between the two groups. However, both propofol and fentanyl consumption significantly declined in Group D. The number of AF attacks showed a significant decline in association with dexmedetomidine administration (mean = 12.5% in Group D vs. 29.2% in Group C). Dexmedetomidine also reduced the amount of required electrical cardioversion episodes. Additionally, antiarrhythmic medication needed reduced significantly in Group D. Mortality rates did not differ between the two study groups (58.3% and 63.8% in Groups D and C, respectively). Conclusion(s): Dexmedetomidine is associated with a significant reduction in the burden of AF in patients with severe COVID-19 infection, manifested by fewer AF attacks, the need for electrical cardioversion shocks, and the consumption of antiarrhythmic medication without impact on mortality.Copyright © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42846410","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}

引用次数: 0

Echocardiographic assessment of right ventricular dysfunction and outcome in patients with severe Covid-19 Pneumonia 超声心动图评价重症新冠肺炎肺炎患者右心室功能障碍及预后

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Egyptian Journal of Anaesthesia Pub Date : 2023-04-24 DOI: 10.1080/11101849.2023.2204576

Ali Salam, T. Zaytoun, T. Abdallah, D. Zidan

{"title":"Echocardiographic assessment of right ventricular dysfunction and outcome in patients with severe Covid-19 Pneumonia","authors":"Ali Salam, T. Zaytoun, T. Abdallah, D. Zidan","doi":"10.1080/11101849.2023.2204576","DOIUrl":"https://doi.org/10.1080/11101849.2023.2204576","url":null,"abstract":"Background: Fatal cardiovascular complications and acute respiratory distress syndrome (ARDS) account for the majority of SARS-CoV-2-associated deaths. The objective of this research was to find transthoracic echocardiography (TTE) of right ventricular (RV) dysfunction parameters that can be utilized to predict outcomes in individuals with severe COVID-19 pneumonia;Methods: This observational research included 90 cases with severe COVID-19 pneumonia subjected to TTE on the day of admission and 3rd day to determine the relationship between severity, mortality in severe COVID-19 pneumonia and RV function parameters;Results: TAPSE, SPAP, RVD, RV-WT, and RV-FAC had significant differences among the two groups. PaO2/FiO2 and average MAP were significantly correlated with all RV parameters. Adjusted multivariate regression analysis on day 1 showed that TAPSE and SPAP followed by RVFAC were significantly related to mortality. While on day 3, it was revealed that RVFAC then SPAP were significantly related to mortality. SPAP, with a cutoff point >46 mmHg, was the most sensitive parameter, while the most specific to predict mortality was TAPSE, with a cutoff point ≤15 mm. Conclusions: In cases with severe COVID-19 pneumonia, prediction of mortality can be performed by measuring RV parameters by TTE with high sensitivity and specificity. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49038329","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}

引用次数: 0

Influence of ultrasound-guided erector spinae plane block on post-operative pain and diaphragmatic dysfunction in obese patients undergoing repair of Epigastric Hernia 超声引导下竖脊肌平面阻滞对肥胖胃上疝修补术后疼痛和膈肌功能障碍的影响

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Egyptian Journal of Anaesthesia Pub Date : 2023-04-18 DOI: 10.1080/11101849.2023.2203545

Asmaa Ragab Eid, Mona Blough El Mourad, Salah Eldeen Ibrahim Al Sherief, S. Zahra

{"title":"Influence of ultrasound-guided erector spinae plane block on post-operative pain and diaphragmatic dysfunction in obese patients undergoing repair of Epigastric Hernia","authors":"Asmaa Ragab Eid, Mona Blough El Mourad, Salah Eldeen Ibrahim Al Sherief, S. Zahra","doi":"10.1080/11101849.2023.2203545","DOIUrl":"https://doi.org/10.1080/11101849.2023.2203545","url":null,"abstract":"ABSTRACT Background Repair of ventral hernia is associated with pain after operation. We wanted to study the influence of ultrasound-guided (US) erector spine plane (ESP) block on postoperative pain and diaphragmatic dysfunction in obese cases undergoing repair of epigastric hernia. Methods This prospective randomized-controlled double-blinded research was conducted on 50 obese cases with body mass index (30–40), aged (21–65) and scheduled for elective open repair of epigastric hernia. Cases were randomized into two equal groups to receive either general anesthesia alone (Controls) or general anesthesia combined with bilateral ultrasound-guided ESP block. Postoperative pain, 24 h postoperative analgesic dose, and postoperative diaphragmatic excursion were assessed. Results There was a statistically evident decrease in NRS score in the ESP versus controls (30 min, 2 hr, 6 hr, 12 hr)(p < 0.001). There was a statistically evident decrease in the total intraoperative fentanyl (p < 0.001) and total 24 h morphine dose (p < 0.001) in the ESP versus controls. There was a statistically evident decrease in the postoperative diaphragmatic excursion in controls versus the ESP (p = 0.001). Conclusions The ESP block in obese cases undergoing open repair of epigastric hernia provided efficient postoperative analgesia. It decreased postoperative pain, reduced intraoperative and postoperative analgesic dose, and maintained diaphragmatic excursion.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43056416","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}

引用次数: 0

Impact of COVID-19 pandemic on anesthesia resident’s training program in Cairo University Hospital 新冠肺炎疫情对开罗大学医院麻醉住院医师培训的影响

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Egyptian Journal of Anaesthesia Pub Date : 2023-04-18 DOI: 10.1080/11101849.2023.2203546

D. M. Mohamed, Hagar Hassanein, Fahima M ElSharkawy, Sahar Elshal, A. Hussam

{"title":"Impact of COVID-19 pandemic on anesthesia resident’s training program in Cairo University Hospital","authors":"D. M. Mohamed, Hagar Hassanein, Fahima M ElSharkawy, Sahar Elshal, A. Hussam","doi":"10.1080/11101849.2023.2203546","DOIUrl":"https://doi.org/10.1080/11101849.2023.2203546","url":null,"abstract":"Background: The purpose of this study was to evaluate the impact of COVID-19 pandemic on the training process of anesthesia residents in Cairo University Hospital regarding technical skills, operative, and critical care experience. Method(s): This cross-sectional survey study included two groups of anesthesia residents according to the time of their residency in relation to the pandemic (before-pandemic group [N = 44] and during-pandemic group [N = 42]). The participants were asked to fill out a questionnaire regarding their training. The questionnaire included technical skills experience (regional anesthesia, vascular access, and advanced airway techniques, soft tissue ultrasound), operative and critical care experience, and duration of intensive care unit (ICU) rotation. The quality of training was graded as adequate, moderate, or deficient training according to the number of performed procedure/managed cases. Comparisons of continuous data were done using the Mann-Whitney test, and qualitative categorical was analyzed using the chi-square test. Result(s): All the participants completed the questionnaire. The training in the during-pandemic group was lesser than that in the before-pandemic group for most of the technical skills except for soft tissue ultrasound which was more in the during-pandemic group. The operative experience was less in the during-pandemic group than that in the before-pandemic group. On the other hand, the ICU experience was more in the during-pandemic group than that in the before-pandemic group. Conclusion(s): The COVID-19 pandemic disrupted the training program of anesthesiology residents with regard to elective procedures and produced over-training in critical care subspeciality.Copyright © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59761925","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}

引用次数: 1

Evaluation of Ambu-Aura-i laryngeal mask as a conduit for endotracheal intubation. A comparison with Air-Q intubating laryngeal airway in adult surgical patients Ambu-Ura-i喉罩作为气管插管导管的评价。Air-Q与成人外科患者喉气道插管的比较

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Egyptian Journal of Anaesthesia Pub Date : 2023-04-17 DOI: 10.1080/11101849.2023.2197784

S. Soaida, Safinaz H. Osman, Abeer Ahmed, D. Saad, Mohamed A Selim

{"title":"Evaluation of Ambu-Aura-i laryngeal mask as a conduit for endotracheal intubation. A comparison with Air-Q intubating laryngeal airway in adult surgical patients","authors":"S. Soaida, Safinaz H. Osman, Abeer Ahmed, D. Saad, Mohamed A Selim","doi":"10.1080/11101849.2023.2197784","DOIUrl":"https://doi.org/10.1080/11101849.2023.2197784","url":null,"abstract":"ABSTRACT Background Supraglottic airway devices (SGA) are used as primary devices or conduits for endotracheal intubation with normal or difficult airway. The purpose of this study was to assess how the Ambu-Aura-i laryngeal mask would act as a conduit for endotracheal intubation compared to the Air-Q Intubating Laryngeal airway in adult patients in operating room. Methods Fifty-four adult patients scheduled for elective procedures under general anaesthesia were divided into air-Q and Aura-i groups. The ease and time of insertion, the number of insertion attempts, the airway leak pressure, the duration of fiberoptic endotracheal intubation, the grade of the fibre-optic laryngoscopic view, and the time to remove the device were noted. Results Comparing the Aura-i group to the Air-Q group, the Aura-i group had a considerably shorter insertion time and a longer time to remove the device (28.1 ± 3.5 vs 32.7 ± 6.9 sec P-value = 00.4 and 40.7 ± 5.1 vs 32.0 ± 5.4 sec, P-value = 0.001; respectively). Both devices were comparable regarding the number of insertion attempts and the time to insert an endotracheal tube. Compared to the Air-Q group, the Aura-i group’s airway leak pressure was considerably greater (25.9 ± 3.9 vs 23.4 ± 4 CmH2O, respectively, P-value = 0.03). Both groups had comparable fibre-optic laryngoscopic view grades. Conclusion The Ambu-Aura-i laryngeal mask and the Air-Q intubating laryngeal airway are efficient conduits for fibre-optic endotracheal intubation in adults with Ambu-Aura-i Laryngeal mask exhibiting advantages in terms of device insertion time and use during mechanical ventilation.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46547956","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}

引用次数: 0

Pre-emptive epinephrine nebulization prior to nasotracheal intubation for mandibular fracture fixation surgeries: Does it really differ? A randomised controlled clinical trial 下颌骨折固定手术鼻气管插管前预先雾化吸入肾上腺素：真的有区别吗？一项随机对照临床试验

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Egyptian Journal of Anaesthesia Pub Date : 2023-04-14 DOI: 10.1080/11101849.2023.2200320

Rehab Abdelfattah Abdelraziq, S. Ayoub, Hagar Mahmoud El-Sherief, Mohammed Sayed Shorbagy

{"title":"Pre-emptive epinephrine nebulization prior to nasotracheal intubation for mandibular fracture fixation surgeries: Does it really differ? A randomised controlled clinical trial","authors":"Rehab Abdelfattah Abdelraziq, S. Ayoub, Hagar Mahmoud El-Sherief, Mohammed Sayed Shorbagy","doi":"10.1080/11101849.2023.2200320","DOIUrl":"https://doi.org/10.1080/11101849.2023.2200320","url":null,"abstract":"ABSTRACT Introduction Isolated mandibular fractures as any other fracture are associated with pain and inflammation which possess difficulty for both laryngoscopy and intubation. Nasotracheal intubation is relatively more efficient in individuals with isolated mandibular injuries. Epistaxis is the most common complication of nasal intubation. This study aimed to highlight the role of preoperative usage of epinephrine 1:1000 combined with lidocaine as a nebulization session before induction of anaesthesia as a method to spread vasoconstriction and analgesia. Methods The patients were randomly assigned to one of two equal groups; nasal Lidocaine drops followed by Oxymetazoline nasal drops (OL as control group) or Epinephrine mixed with Lidocaine as nebulization session (EL as the study group). Our primary measures were to estimate the degree of epistaxis and its effect on intubation time. Results Lidocaine with epinephrine as a nebulization session prior to NTI has statistically significant less intubation time (37.8 ± 6.32) versus (42.16 ± 5.1) in the control group with p- value (0.000028). This correlates with higher incidence of moderate nasal bleeding in OL group (7/60 = 11.66%) versus (4/60 = 6.66%) in EL group and P- value = 0.01. EL mixture has a higher priority of decreasing surgical blood loss. Mean± SD measures were (406.86 ± 89.6) and (468.6 ± 139), p-value = 0.00026*in EL and OL groups respectively. Conclusion Despite being time consuming measure. Yet, lidocaine epinephrine nebulization session can be considered as an efficient method for prophylaxis against nasotracheal intubation induced epistaxis, to control intraoperative field bleeding, acts as an adjuvant to control intraoperative pain and protects against postextubation nasal complications.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42739367","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}

引用次数: 0

Effect of mannitol on postreperfusion syndrome during living donor liver transplant: A randomized clinical trial 甘露醇对活体肝移植再灌注后综合征的影响：一项随机临床试验

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Egyptian Journal of Anaesthesia Pub Date : 2023-04-04 DOI: 10.1080/11101849.2023.2196112

A. Abdou, Waleed Abdalla, M. Ammar

{"title":"Effect of mannitol on postreperfusion syndrome during living donor liver transplant: A randomized clinical trial","authors":"A. Abdou, Waleed Abdalla, M. Ammar","doi":"10.1080/11101849.2023.2196112","DOIUrl":"https://doi.org/10.1080/11101849.2023.2196112","url":null,"abstract":"ABSTRACT Background and aims Hemodynamic instability during postreperfusion syndrome remains the most significant concern for transplantation teams. Various strategies have been investigated in an attempt to reduce the occurrence of postreperfusion in liver transplantation, including the use of mannitol as a scavenger of free radicals and inflammatory mediators. The study examined mannitol intraoperative antioxidant effect on reperfusion hemodynamic events during living donor liver transplantation (LDLT). Methodology This prospective randomized controlled trial divided 60 participants with end-stage liver disease into two groups of 30 participants each. The mannitol group was administered 1 g/kg of mannitol (20%) in a 500-mL labeled bottle (solution A); the control group received the same amount of normal saline (0.9%) in a 500-mL labeled bottle (solution B). The primary outcome was mean arterial pressure (MAP) postreperfusion. Secondary outcomes were recorded after reperfusion: cardiac output (COP), systemic vascular resistance (SVR), the amount of vasopressor administered, central venous pressure (CVP), and urine output (UOP). This study received ethics committee approval (R 42/2022) and was registered at clinicaltrials.gov (NCT05277623). Results The MAP parameters were significantly lower in the control group, with MAP<60 mm Hg in 93.3% of the control group versus 40% of the mannitol group (p ˂ 0.001). There was a statistically significant difference regarding SVR (p ˂ 0.001). Norepinephrine levels were lower for the mannitol group compared with controls (p = 0.003). As regards COP, CVP, and UOP there was no statistically significant difference between the two groups. Conclusion Mannitol attenuates the postreperfusion syndrome during LDLT.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44038590","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}

引用次数: 0

Effects of automatic gas control on sevoflurane gas monitor and recovery during pancreatico-duodenectomy operation: prospective randomized study 自动气体控制对胰十二指肠切除术中七氟烷气体监测和恢复的影响:前瞻性随机研究

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Egyptian Journal of Anaesthesia Pub Date : 2023-03-30 DOI: 10.1080/11101849.2023.2196806

E. S. Ibrahim, S. Elkhadry

{"title":"Effects of automatic gas control on sevoflurane gas monitor and recovery during pancreatico-duodenectomy operation: prospective randomized study","authors":"E. S. Ibrahim, S. Elkhadry","doi":"10.1080/11101849.2023.2196806","DOIUrl":"https://doi.org/10.1080/11101849.2023.2196806","url":null,"abstract":"ABSTRACT Background The aim of the study was to evaluate the effect of automatic gas control (AGC) on sevoflurane gas monitoring, safety, and recovery of patients during pancreatico-duodenectomy operation. Methods Forty patients scheduled for the pancreatico-duodenectomy operation were allocated into group I manual gas control group (MGC, n = 20) and group II AGC (n = 20) group. In (the MGC group): The vaporizer set ranged from 3 to 5% Sevoflurane until reaching 1 MAC, fresh gas flow (FGF) 1–2 L/min, and FiO2 of 0.4 was set. In (the AGC group): Set target FiO2 of 0.4, end-tidal anesthetic agent (EtSev was set to 1.5–2%) with safely ventilate the patient with an FGF down to 0.3 liters per minute. Hemodynamics, anesthesia gas analysis (FiSev, EtSev, FiO2, and EtO2), total gas consumption, extubation time, incidence of perioperative hypercapnia, hypoxia, and accidental awareness were recorded. Results The volume of sevoflurane administered in the MGC group was in a mean ± standard deviation of 81.20 ± 16.47 ml which was statistically significantly greater than that administered in the AGC group (58.80 ± 10.54), P ≤ 0.001. ETSevo, FISevo, and the EtO2 were significantly larger in the MGC group than in the AGC group. The extubation time was statistically prolonged in the MGC group than in the AGC group (14.10 ± 4.75 versus 7.70 ± 1.59 min, P < 0.001). No patient developed hypoxia, hypercapnia, or awareness in both groups. Conclusion AGC maintained the targeted end-tidal sevoflurane concentration with the least sevoflurane consumption. It reduced the manual adjustment of delivered sevoflurane and oxygen. General anesthesia with manual and AGC is safe and maintains hemodynamic stability.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48451232","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}

引用次数: 0

Analgesic efficacy of local anesthesia during thyroid fine-needle aspiration biopsy: A PRISMA-compliant systematic review and meta-analysis of randomized controlled trials 甲状腺细针穿刺活检局部麻醉的镇痛效果：符合PRISMA的随机对照试验系统综述和荟萃分析

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Egyptian Journal of Anaesthesia Pub Date : 2023-03-30 DOI: 10.1080/11101849.2023.2196809

Ebraheem Albazee, R. J. Alhubail, M. Alsakka, Khaled Ahmad Al Sadder, Sabri M. Hammoud, Abdulrazzaq Alshakhri

{"title":"Analgesic efficacy of local anesthesia during thyroid fine-needle aspiration biopsy: A PRISMA-compliant systematic review and meta-analysis of randomized controlled trials","authors":"Ebraheem Albazee, R. J. Alhubail, M. Alsakka, Khaled Ahmad Al Sadder, Sabri M. Hammoud, Abdulrazzaq Alshakhri","doi":"10.1080/11101849.2023.2196809","DOIUrl":"https://doi.org/10.1080/11101849.2023.2196809","url":null,"abstract":"ABSTRACT Aim The objective of this study is to evaluate the analgesic efficacy of local anesthetic (LA) agents on pain severity among patients undergoing thyroid fine needle aspiration biopsy (FNAB). Design A systematic review and meta-analysis of randomized controlled trials (RCTs). Methods Digital databases, including PubMed, Scopus, Cochrane, Web of Science, and Google Scholar, were systematically screened from inception till December 2022. The Cochrane risk of bias tool (ROB 2) was used to evaluate the quality of each RCT. The primary outcome (pain severity) was gathered as a mean difference (MD) with a 95% confidence interval (Cl), under the random-effect model. Results Overall, 444 patients were enrolled in five RCTs. Regarding pain severity via the visual analogue scale (VAS) assessment tool, the overall effect size showed no substantial difference between LA and control groups (n = 4 RCTs,MD = −8.45, 95% CI [−27.41, 10.52], p = 0.38). Regarding pain severity via the numerical rating scale (NRS) assessment tool, the overall effect size showed no substantial difference between LA and control groups (n = 3 RCTs,MD = −0.85, 95% CI [−3.14, 1.45], p = 0.47). Conclusion We have found that the pain levels between the LA and control-receiving groups were comparable. Hence, we concluded that LA before FNAB provides no benefit, especially for one needle puncture and sampling.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42247755","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}

引用次数: 3

Propofol/dexmedetomidine Versus Desflaurane Effects on Post Hepatectomy Hepatocellular Injury 异丙酚/右美托咪定与地氟醚对肝切除术后肝细胞损伤的影响

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Egyptian Journal of Anaesthesia Pub Date : 2023-03-29 DOI: 10.1080/11101849.2023.2190865

Ola A. Saad Ali Lashin, Hany M. Mohamed Elzahaby, Sahar M. Talaat Taha, Mohamed M. Abd- Elfattah Ghoneim, M. M. Mohamed Awad Rashed

{"title":"Propofol/dexmedetomidine Versus Desflaurane Effects on Post Hepatectomy Hepatocellular Injury","authors":"Ola A. Saad Ali Lashin, Hany M. Mohamed Elzahaby, Sahar M. Talaat Taha, Mohamed M. Abd- Elfattah Ghoneim, M. M. Mohamed Awad Rashed","doi":"10.1080/11101849.2023.2190865","DOIUrl":"https://doi.org/10.1080/11101849.2023.2190865","url":null,"abstract":"ABSTRACT Objective The Pringle maneuver used during hepatectomy causes ischemic reperfusion injury to the liver remnant. In this study, we compared the effect of maintenance of general anesthesia with propofol dexmedetomidine intravenous infusion versus desflurane inhalational anesthesia on post-hepatectomy hepatocellular injury in patients undergoing partial hepatectomy during the first six postoperative days. Methods Group A (15 patients) received total intravenous anesthesia with a combination of propofol and dexmedetomidine for anesthesia maintenance, and group B (15 patients) received desflurane for anesthesia maintenance. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum albumin, serum bilirubin, prothrombin time (PT), and international normalized ratio (INR) were measured before surgery and at 1, 3, and 6 days after surgery. Results Transaminase levels, which were comparable in both groups, peaked between the first and the third postoperative days. The peak ALT was 224.27 ± 29.7 and 318.20 ± 52.5 U/L in group A and group B, respectively (P < 0.001). The peak AST was 265.60 ± 22.3 U/L in group A and 349.27 ± 56.1 U/L in group B (P < 0.001). Albumin levels at day 1 showed no significant differences between both groups, but at days 3 and 6, group A showed significantly higher albumin levels than group B. Other liver function tests including serum albumin, total and direct bilirubin, PT, and INR showed lower values in the propofol/dexmedetomidine group. Conclusion The main finding of this study is that propofol/dexmedetomidine as a technique for the maintenance of anesthesia resulted in less hepatocellular injury and better hepatic functions than desflurane in patients undergoing partial hepatectomy during the first six postoperative days.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44771809","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}

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