Medicine and Health Sciences Commons^™

Comparative Clinical Study Of Intrathecal Low Dose Ketamine Combined With Midazolam Versus Fentanyl As Adjuvants To Bupivacaine For Cesarean Section, Mohamed Mohamed Abo Elenain, Shaimaa Mohammed El-Mahdy, Osama Helal Ahmed, Medhat Helaly Allam

Al-Azhar International Medical Journal

Background: General sedation is related with higher death rate in contrast with spinal sedation. Passings in provincial sedation are principally connected with unnecessary high territorial blocks and harmfulness of nearby sedatives. Spinal sedation is the favored means for cesarean area, being easy to perform, affordable and produces quick beginning of sedation and complete muscle unwinding. Aim: To look at the hemodynamic impacts, beginning, level, term of the intrathecal block and occurrence of intricacies on adding combination of low-portion ketamine and low-portion midazolam to bupivacaine, and on adding fentanyl to bupivacaine during intrathecal infusion for cesarean area. Patients and Methods: In …

Comparative Study Between Intrathecal Hyperbaric Prilocaine Versus Hyperbaric Bupivacaine In Anorectal Surgery, Saeed Mohammed Ali Fayed, Ahmed Mahmoud Mohammed El-Garhy, Mohammed Zakaria Gad El-Karem Abd El-Aziz

Al-Azhar International Medical Journal

Background: The prevalence of ambulatory anorectal surgeries has been increasing, these procedures are deemed appropriate for day case surgery with the use of spinal anaesthesia. This study aims to compare the anaesthetic characteristics of intrathecal hyperbaric bupivacaine 0.5% and intrathecal hyperbaric prilocaine 2% in the context of elective anorectal surgery. Patients and Methodology: The research methodology used in this study is a prospective, double-blinded randomized approach. A total of eighty-eight patients were divided into two similar-sized groups, and randomly allocated to the trial. Group A, got intrathecal administration of 15 mg hyperbaric bupivacaine 0.5%, whereas group B, received intrathecal administration …

Evaluation Of The Prognostic Value Of Rectus Abdominis Muscle Thickness And Rectus Femoris Muscle Thickness Guided By Ultrasound In Intensive Care Patients. Observational Study, Essam Ibrahim Saber Ibrahim, Ali Abdallah Alkumity, Ahmed Mohamed El-Deeb, Ali Abd Elhamed Gharabawy

Al-Azhar International Medical Journal

Background: Early prediction of prognosis of patients is important in critical care. ICUAW, It has been documented that there is an association between the aforementioned condition and the need for prolonged mechanical breathing as well as a lengthy stay in the intensive care unit (ICU). A potential technique to measure muscle thickness is ultrasound, which is noninvasive, frequently used in intensive care units. Objective: Evaluation of the prognostic value of rectus abdominis and rectus femoris muscles thickness guided by US in ICU patients and which of them undergoes more rapid changes and gives earlier prognosis. Patients and Methods: Seventy (70) …

Comparison Between Ultrasound Guided Axillary Brachial Plexus Block Versus Intravenous Regional Block In Forearm Surgeries, Ayman Sayed Abdelaziz, Maged Shawky Alansary, Mohamed Fadel Nabawy

Al-Azhar International Medical Journal

Comparison between Ultrasound Guided Axillary Brachial plexus Block versus Intravenous Regional Block in Forearm Surgeries

ABSTRACT

Background: Regional anaesthesia is particularly effective because it blocks the transduction, transmission, and modification of afferent nociceptive stimuli, inhibits the activation of neurohormones, and prevents the central nervous system from winding up and becoming sensitised (CNS). Aim: The aim of this study is to compare between brachial plexus block “axillary approach” and regional intravenous block in the forearm surgeries regarding the quality of surgical analgesia and relief of postoperative pain. Patients and Methods: The local ethical committee accepted this prospective, randomised, single-blinded clinical trial, …

Ultrasound-Guided Lumbar Plexus Block Versus Suprainguinal Facia Iliaca Block For Postoperative Analgesia In Hip Surgeries, Mohamed Aysar Khattab, Abdelwahab Abdelsattar Saleh, Mohamed Amr Abusaba

Al-Azhar International Medical Journal

Introduction:-

SIFIB can anaesthetize the obturator nerve as well as the femoral and lateral femoral cutaneous nerves, unlike traditional facia iliac blocks. SIFIB’s superiority over the sub-inguinal technique is explained by the improved obturator block. SIFIB is regarded to be non-inferior to lumbar plexus block since it may anesthetize lumbar plexus nerves while causing few side effects.The purpose of this trial was to examine the tolerability and analgesic performance of ultrasound-guided SIFIB against LPB in THA patients

Patient and Methods:-

60 patients were enrolled, undergoing THA, with age (40-80) years, ASA (I-III), and BMI (18-35) kg/m². The criteria …

Postoperative Narcotic Sparing Effect Of Ultrasound Guided Quadratus Lumborum Block In Patients Undergoing Percutaneous Nephrolithotomy, Ahmed Refaat Ibrahim Mohammed, Mostafa Ibrahim Mostafa Shalaby, Tamer Mohammed Ahmed Eweda

Al-Azhar International Medical Journal

Background:. Quadratus lumborum block (QLB) technique is strongly recommended as an appropriate adjunctive to systemic intravenous analgesia for pain control. Some modifications of this technique were subsequently introduced.

Aim of the Work: The purpose of this study is to assess the effectiveness of quadrates lumborum plane block as a post-operative analgesic with Percutaneous Nephrolithotomy.

Patients and Methods: A prospective randomized controlled single-blinded clinical research study on 98 patients was conducted at Al-Azhar University hospitals in Cairo. After receiving institutional ethics committee approval, patients were scheduled for Percutaneous Nephrolithotomy. 98 patients were randomly divided into two equal groups: 49 patients given …

Erector Spinae Plane Block Versus Transversalis Fascia Plane Block Guided By Ultrasound For Pain Control Following Unilateral Abdominal Surgeries Under Subarachnoid Anesthesia, Abdelrahman Tarek Abdelnaby Mohammed Osman, Ahmed Mohamed Shawky, Mofeed Abdallah Abdelmaboud

Al-Azhar International Medical Journal

Background: Postoperative complications are increased if postoperative pain is uncontrolled. This can be improved with regional blocks especially in postoperative period. Moreover, complications are reduced by using one analgesia technique. Aim of the Work: Our purpose was to compare Transversalis Fascia plane Block (TFP) and erector Spinae Plane Block (ESP). Patients and Methods: Sixty patients who had unilateral abdominal surgery and fulfilling the inclusion criteria were divided into two equal groups Group I who received ultrasound (US) guided unilateral Transversalis Fascia Plane (TFP) Block and Group II who received US guided unilateral Erector Spinae plane (ESP) block. Primary outcome were …

Correlation Of Inferior Vena Cava Distensibility Index And Pulse Pressure Variation In Prediction Of Fluid Responsiveness In Mechanically Ventilated Hypotensive Patients, Mohamed Ahmed Elfeky, Badr Ismail Fadlallah, Ahmed Mossad Ahmed El Naggar, Murad Zakareya Ibraheem Barakat, Mohammed Farouk Foad Doula

Al-Azhar International Medical Journal

Background; Shocked patients require careful monitoring of intravascular volume and treatment with intravenous fluids. In the intensive care unit (ICU), patients with acute circulatory insufficiency typically benefit from fluid resuscitation. Objectives; to compare the sensitivity of the pulse pressure variation (PPV) and the distensibility index of the Inferior Vena Cava (dIVC) for predicting fluid responsiveness in very ill patients who suffered shock. Patients and Methods: This was an interventional, cross-sectional study, that evaluated mechanically ventilated ICU patients, presented with clinical signs of shock. The study was carried out at al Azhar university hospitals and conducted on 100 individuals. Results; The …

Comparative Study Of Prilocaine-Dexmedetomidine Versus Bupivacaine-Dexmedetomidine In Spinal Anaesthesia For Inguinal Hernia Repair Operation, Fetouh Ahmed Fetouh Amr, Abdelazim Abdulhalim Taha Hegazy, Othman Saadeldien Yahia Mousa

Al-Azhar International Medical Journal

Background; fast track surgery necessitates the use of short-acting anaesthetics with minimum adverse effects. The purpose of this study is to assess the onset, offset time, and duration of motor and sensory block after spinal anaesthesia with hyperbaric prilocaine 2% or bupivacaine 0.5% added to dexmedetomidine during elective inguinal hernia repair surgery. Methods; Participants were randomly allocated using a computer-generated randomisation sequence. The study was carried out on 60 patients and were randomly allocated into one of two groups: Group A: 30 patients received 20 mg 0.5% bupivacaine plus 2.5 μg dexmedetomidine with total volume 4.5 cm. Group B: 30 …

Comparative Study Between Uses Of Levosimendan Versus Intra-Aortic Balloon Pump In High Risk Patients Undergoing Beating Heart Coronary Artery Bypass Surgery, Ahmed Mohamed Shawki Ragheb, Abdel-Hafez Mohamed El-Husseiny, Mofeed Abdalla Abdelmaboud, Ahmed Fathy Abdel-Aziz, Ahmed Abdel Hamid Bakry Ahmed

Al-Azhar International Medical Journal

Background: Patients undergoing coronary artery bypass surgery (CABG), preoperative left ventricular insufficiency has been linked to increase mortality and morbidity. Intra-aortic ballon pump (IABP) helped high-risk cardiac patients during surgery to stabilize the hemodynamics. However, there are some drawbacks to balloon installation. Levosimendan, a newly developed medication, is now frequently utilised as an inotropic support without increasing the myocardium oxygen demand. Objective: Our study compared the effectiveness of levosimendan against intra-aortic balloon pump in candidates having beating heart CABG and whom had reduced left ventricular function and ejection fraction below 35 percent. Subjects and Methods: A prospective randomized clinical trial …

Evaluation Of Midazolam As An Adjuvant To Rectus Sheath Block For Postoperative Analgesia In Patients Undergoing Umbilical Hernia Repair, Ahmed Younes, Ahmed Mahmoud M.M. Elgarhy, Emad Shaban

Al-Azhar International Medical Journal

There is no abstract

Prevention Of Pre-Operative Anxiety In Pediatric Tonsillectomy Using Intranasal Dexmedetomidine Versus Intranasal Midazolam, Ahmed Mahmoud Mohammed Abdelnaby, Hamed Ahmed Sanad Al Ezza, Ali Abdallah Al Kumity

Al-Azhar International Medical Journal

Background; The pre-operative stage is an important frustrating process for almost all patients who need operations, especially children. As a consequence, an anesthesiologist's first concern involves reducing patient stress prior to surgery, Aim and objectives; the aim of this study was to make a comparison between the impact of intranasal dexmedetomidine versus intranasal midazolam in prevention of pre-operative anxiety in children group undergoing tonsillectomy. Subjects and methods: The current study is a randomized clinical trial carried out at department of Anesthesia and Intensive Care and pain management, Al-Azhar faculty of medicine. Seventy-five children aged 5-10 years, of either sex, BMI …

Comparative Study Between The Effect Of Ultrasound Guided Interscalene Block Versus Patient-Controlled Intravenous Analgesia On Postoperative Analgesia After Shoulder Surgery, Sohair Farag Moahammed, Ahmed Saied Abdelrahman, Abdelrahman Waheed Ahmed Ali

Al-Azhar International Medical Journal

Background: The gold standard for evaluating the efficacy of acute postoperative pain treatment is PCA. PCIVA is used more often in conjunction with opioids, however potent opioids might have undesirable side effects, such as nausea and pruritus. Brachial plexus block has important advantages for upper extremity surgery over general anaesthesia. With the ISB, any surgery on the upper extremities is possible. In contrast to single-shot ISB with a long-acting local anaesthetic, parenteral opioids are less effective, but the effect is only temporary. Parenteral opioids or single-shot ISB are less effective at relieving pain than continuous ISB. Aim: to contrast intravenous …

Comparison Between Ultrasound Guided The Genicular Nerve Block And Infiltration Between The Popliteal Artery And The Capsule Of The Posterior Knee (Ipack) Block For Post-Operative Pain Relief In Total Knee Replacement Surgery, Mohamed Hussein, Mohamed Hamada, Othman Saad-Eldien Yahia Mousa, Salah Mohamed Salah Bazina

Al-Azhar International Medical Journal

Background; Total knee replacement (TKR) is the optimal option for individuals with advanced knee joint disease, it has the advantages of both pain relief and improved joint function, but still faces some difficulties. The most challenging factor after TKR is pain control, so the invention of an ultrasound-guided nerve block is optimal option.

Aim and objectives: In the study, the effectiveness of genicular nerve block and IPACK block was compared with regard to postoperative pain levels, the necessity of rescue analgesics, ROM, and walking distance in cases of TKR.

Subjects and Methods: This prospective, randomised, double-blinded study was carried out …

Oxycodone Versus Morphine For Post-Operative Analgesia In Patients Undergoing Laparoscopic Cholecystectomy, Mostafa Mohamed Sabra, Wael Mohamed Elmahdy Ibrahim, Abd El Rahman Mohamed Abd El Aziz Ali

Al-Azhar International Medical Journal

Background: one of common causes studied cases that seek medical attention after laparoscopic surgery is visceral pain. Opioids are commonly used analgesics for postoperative visceral pain because they can be utilized either before & after surgery in a patient-controlled analgesia pump.

Aim of the Work: Intravenous oxycodone versus morphine after laparoscopic cholecystectomy on postoperative pain: the primary result is to compare the impacts of the severity of postoperative pain using VAS score. The secondary outcomes are to compare occurrence of postoperative nausea, & vomiting, impact on HR, & length of hospital stay.

Patients & Techniques: This study was prospective, single-blinded, …

Comparative Study Between Sitting And Left Lateral Position For Spinal Anesthesia In Elective Cesarean Section, Mahmoud Farouk Mahmoud Gadallah, Ahmed Sayed Mahmoud Sayed, Osama Helal Ahmed, Mohammed Mohammed Abo Elenain, Medhat Helaly Allam

Al-Azhar International Medical Journal

Background: Both spinal anesthesia and general anesthesia have risk-benefit profiles that strongly favor spinal anesthesia for the majority of pregnant women. Consider the potential for clinically significant maternal haemodynamic derangements, difficult airway management, stroke, and adverse neonatal outcomes.

Aim: to compare the sensory and motor blockade, hemodynamic changes, nausea and vomiting, duration of the technique, and patient satisfaction of two distinct positions used to induce spinal anesthesia during a caesarean section.

Patients and Methods: In a prospective randomized uncontrolled trial conducted at Al-Azhar University Hospitals (Assiut) on 80 pregnant women scheduled for an elective cesarean section under spinal anesthesia from …

Use Of Pulse Oximeter Perfusion Index During Ultrasound Guided Supraclavicular Brachial Plexus Block With Or Without Epinephrine In Upper Extremity Surgery. A Randomized Comparative Study, Gamal Lotfy Gad, Ayman Said Abd El Aziz, Mohamed Abd El Aziz Nasr El Dien Metwalli

Al-Azhar International Medical Journal

Background: Ultrasound (US) guided supraclavicular block (SCB) has the benefit of the widest sensory blocking of all of the brachial plexus techniques, including the single puncture method, due to the concentration of the plexus components at this site. Objectives: to assess the use of pulse oximeter perfusion index (PI) changes in assessment of success SCB in upper extremity surgery and to evaluate impact of adrenaline on pulse oximeter perfusion index changes. Patients and methods: A prospective, randomized, double-blind, comparative research was done on 90 cases between June 2022 to January 2023, at Al- Faculty of Medicine , Al-Al-Azhar University.

Results: …