Pub Date : 2022-07-01DOI: 10.4103/roaic.roaic_89_21
{"title":"Coronavirus disease 2019 acute respiratory-distress syndrome in patients having dextrocardia: a rare presentation","authors":"","doi":"10.4103/roaic.roaic_89_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_89_21","url":null,"abstract":"","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128873626","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 : 2022-07-01DOI: 10.4103/roaic.roaic_71_21
{"title":"The neutrophil-to-lymphocyte ratio as a prognostic index for short-term outcome in the ICU admitted COVID-19 adult patients: a prospective cohort study","authors":"","doi":"10.4103/roaic.roaic_71_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_71_21","url":null,"abstract":"","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122069119","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 : 2022-07-01DOI: 10.4103/roaic.roaic_70_21
{"title":"Comparison between low-dose intravenous and caudal dexamethasone as adjuvants to caudal bupivacaine in children undergoing lower abdominal surgeries","authors":"","doi":"10.4103/roaic.roaic_70_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_70_21","url":null,"abstract":"","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121673129","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 : 2022-07-01DOI: 10.4103/roaic.roaic_64_21
{"title":"Erector spinae plane block versus thoracic epidural block as analgesic techniques for chest trauma: a randomized controlled trial","authors":"","doi":"10.4103/roaic.roaic_64_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_64_21","url":null,"abstract":"","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131025057","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 : 2022-07-01DOI: 10.4103/roaic.roaic_82_21
{"title":"Bilateral ultrasound-guided upper cervical erector spinae-plane block in posterior atlantoaxial fusion surgery: a case report","authors":"","doi":"10.4103/roaic.roaic_82_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_82_21","url":null,"abstract":"","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114120798","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 : 2022-07-01DOI: 10.4103/roaic.roaic_67_21
{"title":"Validation of lung sonography in the implementation of open lung strategy as a recruitment maneuver versus traditional sustained inflation in acute respiratory distress syndrome patients","authors":"","doi":"10.4103/roaic.roaic_67_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_67_21","url":null,"abstract":"","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116008906","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 : 2022-01-01DOI: 10.4103/roaic.roaic_78_20
A. Maaly, A. Abdelhady, Rehab Abdelaziz
Background Medical thoracoscopy has become the gold standard for evaluation of intrapleural space. Thoracic paravertebral block is instillation of local anesthetic drug in the thoracic paravertebral space and can be used in several procedures such as medical thoracoscopy. Dexmedetomidine is a potent α-2 agonist with a higher potency and short duration of action. It has a rapid onset and offset. It produces an ‘interactive’ form of sedation and does not induce respiratory depression. This study was conducted to evaluate the efficacy of paravertebral block with intravenous (i.v.) infusion of dexmedetomidine compared with standardized general anesthesia method in medical thoracoscopy. Patients and methods A randomized controlled trial was conducted in the Department of Chest Diseases at Alexandria Main University Hospital, on patients indicated for medical thoracoscopy. Patients were randomized into two groups (30 patients each). Group A received general anesthesia. Group B received paravertebral block at the level of medical thoracotomy covering three levels: at, above, and below thoracotomy level plus i.v. dexmedetomidine. Demographic data, hemodynamics, patient-rated procedural pain, and operator-rated overall procedure satisfaction scores were recorded. Results A significantly lower means of heart rate and blood pressure were found in group B after thoracotomy and immediately postoperative. Patient-rated procedural pain score in group A ranged from 2 to 5 with a mean of 3.90±0.85, while in group B, it ranged from 0 to 3 with a mean of 1.40±0.68. This difference was statistically significant (P<0.001). A significantly higher operator-rated overall procedure satisfaction score was found in group B (95.77±1.74) compared with group A (90.03±2.33) (P<0.001). Conclusion Use of thoracic paravertebral block plus use of i.v. dexmedetomidine in medical thoracoscopy is comparable to general anesthesia as it is comfortable to the patient and the operator without dealing with airway and its difficulties.
{"title":"Efficacy of combined thoracic paravertebral block and intravenous dexmedetomidine in medical thoracoscopy: a randomized controlled trial","authors":"A. Maaly, A. Abdelhady, Rehab Abdelaziz","doi":"10.4103/roaic.roaic_78_20","DOIUrl":"https://doi.org/10.4103/roaic.roaic_78_20","url":null,"abstract":"Background Medical thoracoscopy has become the gold standard for evaluation of intrapleural space. Thoracic paravertebral block is instillation of local anesthetic drug in the thoracic paravertebral space and can be used in several procedures such as medical thoracoscopy. Dexmedetomidine is a potent α-2 agonist with a higher potency and short duration of action. It has a rapid onset and offset. It produces an ‘interactive’ form of sedation and does not induce respiratory depression. This study was conducted to evaluate the efficacy of paravertebral block with intravenous (i.v.) infusion of dexmedetomidine compared with standardized general anesthesia method in medical thoracoscopy. Patients and methods A randomized controlled trial was conducted in the Department of Chest Diseases at Alexandria Main University Hospital, on patients indicated for medical thoracoscopy. Patients were randomized into two groups (30 patients each). Group A received general anesthesia. Group B received paravertebral block at the level of medical thoracotomy covering three levels: at, above, and below thoracotomy level plus i.v. dexmedetomidine. Demographic data, hemodynamics, patient-rated procedural pain, and operator-rated overall procedure satisfaction scores were recorded. Results A significantly lower means of heart rate and blood pressure were found in group B after thoracotomy and immediately postoperative. Patient-rated procedural pain score in group A ranged from 2 to 5 with a mean of 3.90±0.85, while in group B, it ranged from 0 to 3 with a mean of 1.40±0.68. This difference was statistically significant (P<0.001). A significantly higher operator-rated overall procedure satisfaction score was found in group B (95.77±1.74) compared with group A (90.03±2.33) (P<0.001). Conclusion Use of thoracic paravertebral block plus use of i.v. dexmedetomidine in medical thoracoscopy is comparable to general anesthesia as it is comfortable to the patient and the operator without dealing with airway and its difficulties.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123481792","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 : 2022-01-01DOI: 10.4103/roaic.roaic_88_20
Z. Naja, S. Kanawati, A. Naja, F. Ziade
Background Submucous resection (SMR) is performed under general anesthesia, local anesthesia, or a combination of both. The combination was associated with less postoperative pain and shorter hospital stay. The purpose of this clinical trial was to compare the effectiveness of two versus five bilateral local anesthetic injections in terms of postoperative pain relief at 24 h postoperatively. Patients and methods This was a prospective, randomized, double-blind clinical trial conducted at a tertiary care center between May 2015 and December 2016. Patients aged between 15 and 63 years scheduled for elective SMR of the nasal septum were included. Eligible patients received general anesthesia and were randomly assigned to receive either two or five bilateral local anesthetic injections. The primary outcome was pain assessed by the Numeric Rating Scale. Other outcomes were hemodynamic stability, analgesic consumption, nausea and vomiting, as well as patient’s and surgeon’s satisfaction. Results A total of 120 patients were included in the study and were divided equally into the two groups. Both groups were similar in terms of age, height, weight, surgery duration, and hemodynamic characteristics. There was no significant difference for both groups in pain scores at 24 h (1.53±1.25 vs. 2.07±1.82, P=0.069 for two vs. five injections, respectively) and over the 10 postoperative days. Similarly, the number of patients who consumed analgesics was similar between the two groups. Conclusion The present study revealed that two bilateral local anesthetic injections at the suprazygomatic and infraorbital areas could be an alternative to five injections in patients undergoing SMR.
{"title":"Two versus five bilateral local anesthetic injections for submucosal resection: a randomized double-blind clinical trial","authors":"Z. Naja, S. Kanawati, A. Naja, F. Ziade","doi":"10.4103/roaic.roaic_88_20","DOIUrl":"https://doi.org/10.4103/roaic.roaic_88_20","url":null,"abstract":"Background Submucous resection (SMR) is performed under general anesthesia, local anesthesia, or a combination of both. The combination was associated with less postoperative pain and shorter hospital stay. The purpose of this clinical trial was to compare the effectiveness of two versus five bilateral local anesthetic injections in terms of postoperative pain relief at 24 h postoperatively. Patients and methods This was a prospective, randomized, double-blind clinical trial conducted at a tertiary care center between May 2015 and December 2016. Patients aged between 15 and 63 years scheduled for elective SMR of the nasal septum were included. Eligible patients received general anesthesia and were randomly assigned to receive either two or five bilateral local anesthetic injections. The primary outcome was pain assessed by the Numeric Rating Scale. Other outcomes were hemodynamic stability, analgesic consumption, nausea and vomiting, as well as patient’s and surgeon’s satisfaction. Results A total of 120 patients were included in the study and were divided equally into the two groups. Both groups were similar in terms of age, height, weight, surgery duration, and hemodynamic characteristics. There was no significant difference for both groups in pain scores at 24 h (1.53±1.25 vs. 2.07±1.82, P=0.069 for two vs. five injections, respectively) and over the 10 postoperative days. Similarly, the number of patients who consumed analgesics was similar between the two groups. Conclusion The present study revealed that two bilateral local anesthetic injections at the suprazygomatic and infraorbital areas could be an alternative to five injections in patients undergoing SMR.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132757061","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 : 2022-01-01DOI: 10.4103/roaic.roaic_54_21
Mohamed Yahia, M. Soliman, M. Fawzy, Hatem Sultan
Background and objective Although acute heart failure (AHF) is a common cause of dyspnea, its diagnosis still represents a challenge. Lung ultrasound is an emerging point-of-care diagnostic tool, but its diagnostic performance for AHF is still under evaluation. We evaluated the accuracy and clinical usefulness of combining lung ultrasound with clinical assessment compared with the use of chest radiography, echocardiography, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in conjunction with clinical evaluation for diagnosing AHF in the emergency department. Patients and methods A total of 47 patients presenting with dyspnea and symptoms suggestive of AHF were evaluated by NT-proBNP, echocardiography, and chest radiography. Lung ultrasound was done to look for the presence of diffuse B-lines. Results Lung ultrasound showed a sensitivity of 91.9% and a specificity of 100% in diagnosing AHF comparable to plasma NT-proBNP, which had a sensitivity of 100% and a specificity of 60%. It was also superior to other methods of diagnosing AHF namely chest radiograph. Lung ultrasound showed a significant correlation with the echocardiography findings (P=0.001). Conclusion The implementation of lung ultrasound with the clinical evaluation improves accuracy of diagnosis of AHF in the emergency department.
{"title":"Diagnostic accuracy of lung ultrasound in acute heart failure","authors":"Mohamed Yahia, M. Soliman, M. Fawzy, Hatem Sultan","doi":"10.4103/roaic.roaic_54_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_54_21","url":null,"abstract":"Background and objective Although acute heart failure (AHF) is a common cause of dyspnea, its diagnosis still represents a challenge. Lung ultrasound is an emerging point-of-care diagnostic tool, but its diagnostic performance for AHF is still under evaluation. We evaluated the accuracy and clinical usefulness of combining lung ultrasound with clinical assessment compared with the use of chest radiography, echocardiography, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in conjunction with clinical evaluation for diagnosing AHF in the emergency department. Patients and methods A total of 47 patients presenting with dyspnea and symptoms suggestive of AHF were evaluated by NT-proBNP, echocardiography, and chest radiography. Lung ultrasound was done to look for the presence of diffuse B-lines. Results Lung ultrasound showed a sensitivity of 91.9% and a specificity of 100% in diagnosing AHF comparable to plasma NT-proBNP, which had a sensitivity of 100% and a specificity of 60%. It was also superior to other methods of diagnosing AHF namely chest radiograph. Lung ultrasound showed a significant correlation with the echocardiography findings (P=0.001). Conclusion The implementation of lung ultrasound with the clinical evaluation improves accuracy of diagnosis of AHF in the emergency department.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117233570","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 : 2022-01-01DOI: 10.4103/roaic.roaic_11_21
Gajanan Fultambkar, Pradeepa Chavla, Vijayanand Budi, R. Gurram, V. Kukreja, Abhijit S. Nair
Introduction Alpha-2 agonists are popular adjuvants used in neuraxial anesthesia like spinal, epidural, caudal anesthesia, and peripheral nerve blocks. The authors compared the efficacy of clonidine with dexmedetomidine as an adjuvant to ultrasound (US)-guided supraclavicular brachial plexus block in adult patients undergoing elective upper limb surgeries. Materials and methods After obtaining Ethics Committee approval, 60 American Society of Anesthesiologists’- physical status (ASA-PS) I/II patients were randomized into two groups. Group Clonidine-Ropivacaine (CR) received 1 μg/kg clonidine as an adjuvant and group Dexmedetomidine-Ropivacaine (DR) received 1 μg/kg dexmedetomidine. Patients received an ipsilateral US-guided supraclavicular brachial plexus block with 0.75% ropivacaine (total volume of 20 ml). Demographic data, hemodynamics, the onset of block (sensory, motor), the duration of block (sensory, motor), duration of analgesia and surgery, total number of rescue analgesics, numerical rating scores, and Ramsay sedation score were compared between both groups using appropriate statistical tests. Results Heart rates at 30 min, 60 min, 2 h, and 3 h were lower in group DR compared with group CR, which was statistically significant (P=0.0001, 0.0001, 0.021, and 0.026, respectively). The onset of sensory and motor block, duration of sensory and motor block, and duration of analgesia were better in group DR compared with CR, which was statistically significant (P=0.00). The number of rescue analgesics required in group CR in both groups was comparable (P=0.057). Numeric rating scale scores at 12, 18, and 24 h were significantly better in group DR compared with group CR (P=0.0001, 0.039, and 0.036, respectively). Conclusion When added as an adjuvant to 0.75% ropivacaine in the US-guided supraclavicular brachial plexus, dexmedetomidine block produced faster onset of sensory and motor blockade, prolonged the duration of sensory and motor blockade, and also prolonged the duration of analgesia, when compared with clonidine.
{"title":"A prospective randomized comparative study of dexmedetomidine versus clonidine as an adjunct to 0.75% ropivacaine in ultrasound-guided supraclavicular brachial plexus block","authors":"Gajanan Fultambkar, Pradeepa Chavla, Vijayanand Budi, R. Gurram, V. Kukreja, Abhijit S. Nair","doi":"10.4103/roaic.roaic_11_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_11_21","url":null,"abstract":"Introduction Alpha-2 agonists are popular adjuvants used in neuraxial anesthesia like spinal, epidural, caudal anesthesia, and peripheral nerve blocks. The authors compared the efficacy of clonidine with dexmedetomidine as an adjuvant to ultrasound (US)-guided supraclavicular brachial plexus block in adult patients undergoing elective upper limb surgeries. Materials and methods After obtaining Ethics Committee approval, 60 American Society of Anesthesiologists’- physical status (ASA-PS) I/II patients were randomized into two groups. Group Clonidine-Ropivacaine (CR) received 1 μg/kg clonidine as an adjuvant and group Dexmedetomidine-Ropivacaine (DR) received 1 μg/kg dexmedetomidine. Patients received an ipsilateral US-guided supraclavicular brachial plexus block with 0.75% ropivacaine (total volume of 20 ml). Demographic data, hemodynamics, the onset of block (sensory, motor), the duration of block (sensory, motor), duration of analgesia and surgery, total number of rescue analgesics, numerical rating scores, and Ramsay sedation score were compared between both groups using appropriate statistical tests. Results Heart rates at 30 min, 60 min, 2 h, and 3 h were lower in group DR compared with group CR, which was statistically significant (P=0.0001, 0.0001, 0.021, and 0.026, respectively). The onset of sensory and motor block, duration of sensory and motor block, and duration of analgesia were better in group DR compared with CR, which was statistically significant (P=0.00). The number of rescue analgesics required in group CR in both groups was comparable (P=0.057). Numeric rating scale scores at 12, 18, and 24 h were significantly better in group DR compared with group CR (P=0.0001, 0.039, and 0.036, respectively). Conclusion When added as an adjuvant to 0.75% ropivacaine in the US-guided supraclavicular brachial plexus, dexmedetomidine block produced faster onset of sensory and motor blockade, prolonged the duration of sensory and motor blockade, and also prolonged the duration of analgesia, when compared with clonidine.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115722781","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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