Pub Date : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3a.413
Zinb Twfik Ragab, Shaimaa F. Mostafa, Nagat Sayed El Shamaa, Hesham Mohamed Maruf, A. M. El-Sheikh
{"title":"The effect of two different doses of Dexmedetomidine infusion on oxygenation, lung mechanics and quality of recovery in morbidly obese patients: A prospective randomized study","authors":"Zinb Twfik Ragab, Shaimaa F. Mostafa, Nagat Sayed El Shamaa, Hesham Mohamed Maruf, A. M. El-Sheikh","doi":"10.33545/26643766.2023.v6.i3a.413","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3a.413","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79782369","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 : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3b.420
Vishal V Lanjewar, Vivek Manohar Chawali
From thounds of years, electricity used for treatment of pain such as Ancient Egyptians and later the Greeks and Romans recognized that electrical fishes are capable of generating electric shocks for relief of pain. The modern era of neuromodulation began in the early 1960s, first with deep brain stimulation which was soon followed (in 1967) by spinal cord stimulation, both for otherwise intractable pain. Dry needling is one of the common intervention used for low back pain of different origine. Electric current can be used in addition to dry needling in treatment of neuropathic and nociceptive type of pain by using percutaneous needles. Sixty years old female patient came with complaint of severe low back pain since two years on and off, which become persistent since last 1 month with increased pain intensity. Pain was diffuse, aching, stabbing type with numerical rating scale (NRS) score of 8/10 and score on pain detect tool was 18. Low back pain used to aggravate on prolonged sitting, standing in one place, and repetitive lifting and bending activities. MRI lumber spine suggestive of L5-S1 disc prolapsed posterocentral non compressing nerve roots with normal lumber canal. Based on these findings our provisional diagnosis L5-S1 disc prolapsed posterocentral with myofascial trigger points over gluteal region. For that tablet baclofen and etodolac for 2 weeks was prescribed but there was no significant relief i.e. patient reported NRS score 7/10 on follow up after 2 weeks. Subsequently intervention was planned. Dry needling with electric stimulation done for 60 minutes on bilateral gluteal region. On follow up visit after onemonth patient reported excellent pain relief with NRS sore of 1/10. Patient had good pain relief by the followup of nine months. Dry needling with electric stimulation increases duration of pain relief and cause some neuromodulation effect in low back pain.
{"title":"Case report: Electric dry needling for treatment of low back pain","authors":"Vishal V Lanjewar, Vivek Manohar Chawali","doi":"10.33545/26643766.2023.v6.i3b.420","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3b.420","url":null,"abstract":"From thounds of years, electricity used for treatment of pain such as Ancient Egyptians and later the Greeks and Romans recognized that electrical fishes are capable of generating electric shocks for relief of pain. The modern era of neuromodulation began in the early 1960s, first with deep brain stimulation which was soon followed (in 1967) by spinal cord stimulation, both for otherwise intractable pain. Dry needling is one of the common intervention used for low back pain of different origine. Electric current can be used in addition to dry needling in treatment of neuropathic and nociceptive type of pain by using percutaneous needles. Sixty years old female patient came with complaint of severe low back pain since two years on and off, which become persistent since last 1 month with increased pain intensity. Pain was diffuse, aching, stabbing type with numerical rating scale (NRS) score of 8/10 and score on pain detect tool was 18. Low back pain used to aggravate on prolonged sitting, standing in one place, and repetitive lifting and bending activities. MRI lumber spine suggestive of L5-S1 disc prolapsed posterocentral non compressing nerve roots with normal lumber canal. Based on these findings our provisional diagnosis L5-S1 disc prolapsed posterocentral with myofascial trigger points over gluteal region. For that tablet baclofen and etodolac for 2 weeks was prescribed but there was no significant relief i.e. patient reported NRS score 7/10 on follow up after 2 weeks. Subsequently intervention was planned. Dry needling with electric stimulation done for 60 minutes on bilateral gluteal region. On follow up visit after onemonth patient reported excellent pain relief with NRS sore of 1/10. Patient had good pain relief by the followup of nine months. Dry needling with electric stimulation increases duration of pain relief and cause some neuromodulation effect in low back pain.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135804632","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 : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3a.408
Dr. Arjun Joshi, D. S. Raghu, Dr. Hakam Singh, Dr. Rajat Jain, Mitesh Garg
{"title":"to study the hemodynamic variation to laryngoscopy and endotracheal intubation while comparing the effectiveness of nebulised VS intra-venous form of 2% lidocaine to attenuate the sympathetic response to laryngoscopy in Indian population","authors":"Dr. Arjun Joshi, D. S. Raghu, Dr. Hakam Singh, Dr. Rajat Jain, Mitesh Garg","doi":"10.33545/26643766.2023.v6.i3a.408","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3a.408","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80757945","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 : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3b.422
Dr. Chenal Shah, Dr. Rahul Gupta
This case study presents the management of a 54-year-old British male patient suffering from rerosternal goiter with a BMI of 46.11, who was scheduled for lipoma excision and biopsy with adjacent tissue transfer or rearrangement on the back. The patient had a complex medical history, including type 2 diabetes mellitus, hypertension, hyperlipidemia, and obstructive sleep apnea. Preoperative assessments revealed difficulties in mask ventilation, intubation, and ventilation due to anatomical factors, such as a thyromental distance of less than 6 cm and a large retrosternal goiter causing compressive symptoms and wheezy breathing. A multidisciplinary team implemented a dual-plan approach utilizing a laryngeal mask airway (LMA) as the primary airway management strategy, with an endotracheal tube as the backup plan. The patient underwent successful surgery with stable vital signs and optimal oxygenation. This case emphasizes the significance of comprehensive preoperative assessments, multidisciplinary collaboration, and adaptable airway management strategies in challenging surgical cases.
{"title":"Successful airway management in a comorbid patient with retrosternal goiter: A case study on lipoma excision and biopsy","authors":"Dr. Chenal Shah, Dr. Rahul Gupta","doi":"10.33545/26643766.2023.v6.i3b.422","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3b.422","url":null,"abstract":"This case study presents the management of a 54-year-old British male patient suffering from rerosternal goiter with a BMI of 46.11, who was scheduled for lipoma excision and biopsy with adjacent tissue transfer or rearrangement on the back. The patient had a complex medical history, including type 2 diabetes mellitus, hypertension, hyperlipidemia, and obstructive sleep apnea. Preoperative assessments revealed difficulties in mask ventilation, intubation, and ventilation due to anatomical factors, such as a thyromental distance of less than 6 cm and a large retrosternal goiter causing compressive symptoms and wheezy breathing. A multidisciplinary team implemented a dual-plan approach utilizing a laryngeal mask airway (LMA) as the primary airway management strategy, with an endotracheal tube as the backup plan. The patient underwent successful surgery with stable vital signs and optimal oxygenation. This case emphasizes the significance of comprehensive preoperative assessments, multidisciplinary collaboration, and adaptable airway management strategies in challenging surgical cases.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806106","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 : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3a.409
Reham Zaki Zaki El-mazawy, Ahmed Ali Al-daba, Mohammed Mohy Eldin Abu Elyazed, Sameh Mohamed Refaat El shehdawy
{"title":"Perioperative management of the antiplatelet therapy in patients with ischemic heart disease undergoing noncardiac surgery","authors":"Reham Zaki Zaki El-mazawy, Ahmed Ali Al-daba, Mohammed Mohy Eldin Abu Elyazed, Sameh Mohamed Refaat El shehdawy","doi":"10.33545/26643766.2023.v6.i3a.409","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3a.409","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81834896","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 : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3a.415
Eman Hamdy Abu-Shanab, Mohamed Lotfy, Ahmed Said El-Gebaly, N. Yousef
{"title":"Comparison of conventional caudal block, ultrasound guided caudal block and ultrasound guided erector spinae block for pediatric hip surgery: A randomized double blinded study","authors":"Eman Hamdy Abu-Shanab, Mohamed Lotfy, Ahmed Said El-Gebaly, N. Yousef","doi":"10.33545/26643766.2023.v6.i3a.415","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3a.415","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90194308","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 : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3b.425
Mohamed Shaaban Shehataa
Background: Fluid overload is commonly detected in critically ill cases with AKI and is accompanied by serious outcome. Lung US (LUS) is an efficiently used tool to assess volume noninvasively. We assessed the importance of these measurements in combination, for estimation of the PaO2/FiO2 ratio in critical patients with AKI.The aim of the study: To evaluate the value of B-lines on chest ultrasound in predicting respiratory dysfunction in AKI and to assess the relation between the B lines on chest ultrasound and po2/fio2 ratio in acute kidney injury patients.Patients and methods: This was a prospective observational study in which 40 cases who were presented on admission or developed at any time during ICU stay acute kidney injury determined based on the KDIGO criteria and according to RIFLE classification. Cases were studied at baseline as well as following 48 hrs using lung US, in addition to measuring the arterial blood gases.Results: The PaO2/FiO2 ratio showed negative correlation with the B-lines score, and this correlation was kept even following adjustment. A cut of value of 15 for the B-lines score has a sensetivity of 94% and a specificity of 77.3% in detecting cases with PaO2/ FiO2 of less than 300.Conclusion: It can be concluded that B-lines on chest US can predict volume overload and respiratory dysfunction in cases with AKI.
{"title":"Value of B lines score on lung ultrasound as a direct measure of respiratory dysfunction and volume overload in critical care patients with acute kidney injury","authors":"Mohamed Shaaban Shehataa","doi":"10.33545/26643766.2023.v6.i3b.425","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3b.425","url":null,"abstract":"Background: Fluid overload is commonly detected in critically ill cases with AKI and is accompanied by serious outcome. Lung US (LUS) is an efficiently used tool to assess volume noninvasively. We assessed the importance of these measurements in combination, for estimation of the PaO2/FiO2 ratio in critical patients with AKI.The aim of the study: To evaluate the value of B-lines on chest ultrasound in predicting respiratory dysfunction in AKI and to assess the relation between the B lines on chest ultrasound and po2/fio2 ratio in acute kidney injury patients.Patients and methods: This was a prospective observational study in which 40 cases who were presented on admission or developed at any time during ICU stay acute kidney injury determined based on the KDIGO criteria and according to RIFLE classification. Cases were studied at baseline as well as following 48 hrs using lung US, in addition to measuring the arterial blood gases.Results: The PaO2/FiO2 ratio showed negative correlation with the B-lines score, and this correlation was kept even following adjustment. A cut of value of 15 for the B-lines score has a sensetivity of 94% and a specificity of 77.3% in detecting cases with PaO2/ FiO2 of less than 300.Conclusion: It can be concluded that B-lines on chest US can predict volume overload and respiratory dysfunction in cases with AKI.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807430","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 : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3b.419
Dr. Anuradha Sen, Dr. Mukta Jitendra, Dr. Rajesh Mahajan, Dr. Jyoti Raina
Background: Traditionally, endotracheal intubation has been the standard practice for administering general anaesthesia for most of the surgeries. Now a number of supraglottic airway devices (SAD) have been introduced in the clinical practice offering a simple and effective alternative to the endotracheal intubation, avoiding the use of laryngoscope to put the ETT (endotracheal tube) which is associated with exaggerated hemodynamic response. Method: The present prospective comparative study was conducted in the Department of anaesthesiology and Intensive Care, Government Medical College, Jammu. After attaining approval of the Ethical committee of the Institute, present study included 90 patients of either gender ranging from 18 – 70 years, belonging to ASA grade I and II scheduled for elective surgery of less than 2 hours duration under general anaesthesia. Patients were randomly allocated into Group P (PLMA) &Group B (Baska mask) of 45patients in each group. Result: Mean oropharyngeal leak pressure for Group P and Group B was almost equal (30.1 ± 3.08 cm H 2 O vs 30.7 ± 2.59 cm H 2 O after 5 minutes and 30.4 ± 3.09 cm H 2 O vs 31.6 ± 2.55 cm H 2 O after 30 minutes of device placement respectively). Conclusion: Oropharyngeal seal provided by the Baska mask is comparable with that of Proseal LMA with no difference in postoperative oropharyngeal morbidity.
背景:传统上，气管内插管一直是大多数手术中给予全身麻醉的标准做法。目前，许多声门上气道装置(SAD)已被引入临床实践，为气管插管提供了一种简单有效的替代方法，避免了使用喉镜置入气管内插管时血流动力学反应过大的问题。方法:前瞻性比较研究在查谟政府医学院麻醉与重症监护科进行。经研究所伦理委员会批准，本研究纳入90例患者，男女不限，年龄在18 - 70岁之间，属于ASA I级和II级，计划在全身麻醉下进行持续时间少于2小时的择期手术。将患者随机分为P组(PLMA)和B组(Baska mask)，每组45例。结果:P组和B组的平均口咽漏压基本相等(放置5min后分别为30.1±3.08 cm h2o vs 30.7±2.59 cm h2o，放置30min后分别为30.4±3.09 cm h2o vs 31.6±2.55 cm h2o)。结论:Baska面罩提供的口咽密封与Proseal LMA相当，术后口咽发病率无差异。
{"title":"Comparative study of safety of Baska mask and Proseal LMA with respect to the oropharyngeal seal in a tertiary centre","authors":"Dr. Anuradha Sen, Dr. Mukta Jitendra, Dr. Rajesh Mahajan, Dr. Jyoti Raina","doi":"10.33545/26643766.2023.v6.i3b.419","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3b.419","url":null,"abstract":"Background: Traditionally, endotracheal intubation has been the standard practice for administering general anaesthesia for most of the surgeries. Now a number of supraglottic airway devices (SAD) have been introduced in the clinical practice offering a simple and effective alternative to the endotracheal intubation, avoiding the use of laryngoscope to put the ETT (endotracheal tube) which is associated with exaggerated hemodynamic response. Method: The present prospective comparative study was conducted in the Department of anaesthesiology and Intensive Care, Government Medical College, Jammu. After attaining approval of the Ethical committee of the Institute, present study included 90 patients of either gender ranging from 18 – 70 years, belonging to ASA grade I and II scheduled for elective surgery of less than 2 hours duration under general anaesthesia. Patients were randomly allocated into Group P (PLMA) &Group B (Baska mask) of 45patients in each group. Result: Mean oropharyngeal leak pressure for Group P and Group B was almost equal (30.1 ± 3.08 cm H 2 O vs 30.7 ± 2.59 cm H 2 O after 5 minutes and 30.4 ± 3.09 cm H 2 O vs 31.6 ± 2.55 cm H 2 O after 30 minutes of device placement respectively). Conclusion: Oropharyngeal seal provided by the Baska mask is comparable with that of Proseal LMA with no difference in postoperative oropharyngeal morbidity.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79315016","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 : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3b.421
Dr. Jaya Batra, Dr. Himanshu Chauhan, Dr. Praveen Kesav, Dr. Ashootosh Batra
We present a case of local anesthesia toxicity resulting in generalized tonic-clonic convulsions following an occipital nerve block procedure. A 42-year-old female patient underwent an occipital nerve block procedure for her persistent daily headaches. Shortly after the injection, she experienced an episode of generalized tonic-clonic seizure. Prompt recognition and management led to the resolution of the attack without any residual neurological sequelae. This case highlights the importance of vigilance during occipital nerve blocks, early identification of potential adverse events including seizures albeit rare and appropriate management of local anesthesia toxicity accordingly
{"title":"Local anesthesia toxicity in occipital nerve block: A case of generalized tonic-clonic convulsions","authors":"Dr. Jaya Batra, Dr. Himanshu Chauhan, Dr. Praveen Kesav, Dr. Ashootosh Batra","doi":"10.33545/26643766.2023.v6.i3b.421","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3b.421","url":null,"abstract":"We present a case of local anesthesia toxicity resulting in generalized tonic-clonic convulsions following an occipital nerve block procedure. A 42-year-old female patient underwent an occipital nerve block procedure for her persistent daily headaches. Shortly after the injection, she experienced an episode of generalized tonic-clonic seizure. Prompt recognition and management led to the resolution of the attack without any residual neurological sequelae. This case highlights the importance of vigilance during occipital nerve blocks, early identification of potential adverse events including seizures albeit rare and appropriate management of local anesthesia toxicity accordingly","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805340","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 : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3a.426
Fatma Alzahraa Ibrahim Alsamahy, Sabry Mohammad Amin, Mohammad Ali Mohammad Abdullah, Mohammad Elsayed Afandy
Methods: The current study was a prospective randomized controlled double blinded study was conducted at Tanta University Hospitals for patients admitted to undergo elective thyroid surgeries for a period of 9 months. Inclusion criteria were patients aged 21 -65 y and ASA physical status I or II, prepared for elective thyroid operation were encouraged to contribute to the study cases were divided to 2 equal groups (50 cases each) in a random manner: Group I (Control group): Sham Technique: the cases received general anaesthesia plus US guided Bilateral SCPB with 10 ml NaCl 0.9% were injected on both sides. Group II (Study group): cases received general anaesthesia plus US guided Bilateral SCPB with a total volume of 10 ml containing Bupivacaine 0.25% was injected (5 ml Bupivacaine 0.5%- and 5-ml NaCl 0.9% bilaterally).Results: Postoperative QOR-15 score was significantly elevated in group II in comparison with group I; P value less than 0.001. Time to 1st rescue analgesia was significantly higher in group II in comparison with group I; P value < 0.001. VAS was significantly elevated in group I at 30min, 2hrs, 4hrs and 6 hrs in comparison with Group II: P value less than 0.001. nevertheless, no statistically significant differences were found between both groups at 8hr, 10hr, 12hr, 18hr and 24hr; P value < 0.005. Postoperative opioid consumption was significantly reduced in group II in comparison with group I: P value less than 0.001.Pre and post-operative values of diaphragmatic excursion revealed that there was no statistically significant differences either in the same group or between the 2 groups. Conclusions: Patients undergoing thyroid surgery showed improved global quality of recovery after preoperative US guided BSCPB. It decreased POP score, diminished intraoperative analgesic consumption, reduced postoperative morphine consumption, and maintained diaphragmatic excursion.
{"title":"Role of Bilateral ultrasound guided superficial cervical plexus block as a part of enhanced recovery after thyroid surgery","authors":"Fatma Alzahraa Ibrahim Alsamahy, Sabry Mohammad Amin, Mohammad Ali Mohammad Abdullah, Mohammad Elsayed Afandy","doi":"10.33545/26643766.2023.v6.i3a.426","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3a.426","url":null,"abstract":"Methods: The current study was a prospective randomized controlled double blinded study was conducted at Tanta University Hospitals for patients admitted to undergo elective thyroid surgeries for a period of 9 months. Inclusion criteria were patients aged 21 -65 y and ASA physical status I or II, prepared for elective thyroid operation were encouraged to contribute to the study cases were divided to 2 equal groups (50 cases each) in a random manner: Group I (Control group): Sham Technique: the cases received general anaesthesia plus US guided Bilateral SCPB with 10 ml NaCl 0.9% were injected on both sides. Group II (Study group): cases received general anaesthesia plus US guided Bilateral SCPB with a total volume of 10 ml containing Bupivacaine 0.25% was injected (5 ml Bupivacaine 0.5%- and 5-ml NaCl 0.9% bilaterally).Results: Postoperative QOR-15 score was significantly elevated in group II in comparison with group I; P value less than 0.001. Time to 1st rescue analgesia was significantly higher in group II in comparison with group I; P value < 0.001. VAS was significantly elevated in group I at 30min, 2hrs, 4hrs and 6 hrs in comparison with Group II: P value less than 0.001. nevertheless, no statistically significant differences were found between both groups at 8hr, 10hr, 12hr, 18hr and 24hr; P value < 0.005. Postoperative opioid consumption was significantly reduced in group II in comparison with group I: P value less than 0.001.Pre and post-operative values of diaphragmatic excursion revealed that there was no statistically significant differences either in the same group or between the 2 groups. Conclusions: Patients undergoing thyroid surgery showed improved global quality of recovery after preoperative US guided BSCPB. It decreased POP score, diminished intraoperative analgesic consumption, reduced postoperative morphine consumption, and maintained diaphragmatic excursion.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806172","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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