Pub Date : 2023-04-18DOI: 10.1080/11101849.2023.2203545
Asmaa Ragab Eid, Mona Blough El Mourad, Salah Eldeen Ibrahim Al Sherief, S. Zahra
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.
{"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}
Pub Date : 2023-04-17DOI: 10.1080/11101849.2023.2197784
S. Soaida, Safinaz H. Osman, Abeer Ahmed, D. Saad, Mohamed A Selim
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.
{"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}
Pub Date : 2023-04-14DOI: 10.1080/11101849.2023.2200320
Rehab Abdelfattah Abdelraziq, S. Ayoub, Hagar Mahmoud El-Sherief, Mohammed Sayed Shorbagy
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.
{"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}
Pub Date : 2023-04-04DOI: 10.1080/11101849.2023.2196112
A. Abdou, Waleed Abdalla, M. Ammar
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.
{"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}
Pub Date : 2023-03-30DOI: 10.1080/11101849.2023.2196806
E. S. Ibrahim, S. Elkhadry
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.
{"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}
Pub Date : 2023-03-30DOI: 10.1080/11101849.2023.2196809
Ebraheem Albazee, R. J. Alhubail, M. Alsakka, Khaled Ahmad Al Sadder, Sabri M. Hammoud, Abdulrazzaq Alshakhri
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.
{"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}
Pub Date : 2023-03-29DOI: 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
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.
{"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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