bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study Between Bupivacaine 0.5% Versus Bupivacaine 0.5% with Fentanyl in TAP Block for Post-Operative Analgesia After Appendectomy
Authors: Seleem Hussein Hamdy Gomaa , Fawzy Hazem Mohammed Abdelrahman , Ahmed Mohammed Saleh , Fahim Hany Magdy 
Published: October 2021

Abstract

Background
Post operative pain and stress is a very known complication of many surgical procedures which represents a burden for the patient and associated with many complications including stress, myocardial ischemia, prolonged hospital stay and the need of extensive post operative analgesia.

Objective
to compare the effectiveness of US guided TAP block using 0.5% bupivacaine versus 0.5% bupivacaine with Fentanyl for postoperative analgesia in patients undergoing appendectomy.

Patients and Methods
After ethical committee approval and informed consent from the patients, this prospective randomized control study, randomization done by closed envelope method & was performed on total 60 patients who underwent surgical appendectomy in Ain Shams University hospitals for 3 months from January to March 2019.

Results
In our study, 60 patients were randomly divided into 2 equal groups. Control group received bupivacaine only while the fentanyl group in which 50 ug of fentanyl were added to bupivacaine. All patients received equal volumes. Our study showed that addition of a 50 microgram of fentanyl to bupivacaine in ultrasound-guided TAP block has statistically significant effect on the onset of sensory block and prolonged the duration of the sensory block. In addition, fentanyl prolonged the duration of analgesia significantly, as proved by the time of request of first analgesia. Moreover, in fentanyl group, postoperative analgesic requirements were greatly lesser than that of bupivacaine groups. Addition of fentanyl also did not affect the hemodynamics to a significant level. This makes fentanyl with bupivacaine more superior than the use of bupivacaine alone.

Conclusion
Fentanyl as an adjuvant to bupivacaine in Ultra-sound guided TAP block reduced post-operative pain scores, porolonged the duration of analgesia and decreased demand for rescue analgesics.
Validation of the Modified Integrative Weaning Index as a Predictor of Weaning from Mechanical Ventilation in Comparison to Conventional Weaning Indices in Adult Critically Ill Patients
Authors: Barakat Hythem Mohamed Mamdouh Abdelmeguid , El-Kady Galal Adel , El-Ansary Adel Mohammed , El-Gendy Mohammed Abd El-Salam 
Published: October 2021

Abstract

Introduction
Timely recognition of the return to spontaneous ventilation is essential for reducing costs, morbidity, and mortality. Delays in both removing invasive ventilatory support and excessively early removal are correlated with complications that vary according to the severity of the underlying disease. Several weaning indices and predictors were studied in an attempt to evaluate the outcome of removing ventilatory support. However, none of them have yet presented good results in discriminating the outcome of extubation, even those most used in clinical practices.

Aim
The aim of this study is to validate the modified integrative weaning index (mIWI) as a reliable weaning index in comparison to the conventional weaning indices in the weaning of critically ill patients from invasive mechanical ventilation.

Patients
Four hundred patients, above the age of 18 years, on mechanical ventilation for more than 48 hours through an endotracheal tube for any cause were randomly assigned to this study.

Methods
patients ready to be weaned were assessed using mIWI and conventional indices and monitored for 48 hours. The performance of the indices were assessed in both successful and unsuccessful groups.

Results
The performance of the mIWI was not significantly superior to the conventional weaning indices in predicting weaning success or failure than the traditional weaning indices. The cut-off value for the predicting successful weaning from mechanical ventilation for the mIWI was higher than suggested by the original study and yet in agreement with some other studies. The cut-off value for the mIWI is higher in patients above the age of 60 years.

Conclusion
The results of the study revealed that the mIWI is a good predictor of weaning from mechanical ventilation and assessment of pulmonary mechanics and is not significantly superior to the traditional weaning indices, yet is not a good predictor for extubation success.
A comparative study between Bupivacaine volumes on diaphragmatic mobility in Ultrasound guided Supraclavicular Block
Authors: Abdelaziz Israa Tarek Mohamed , El shaer Ahmed Nagah , Elie Tamer Yousef , Mohamed Wael Abd Elaziz 
Published: October 2021

Abstract

Background
Brachial plexus is a complex network of nerves supplying the whole upper limb, with both motor and sensory supply. It arises from the neck and passes through the axilla to the upper limb. It is composed of 5 roots, 3 trunks, 6 divisions, 3 cords, and terminal branches.

Objective
To compare the effect of two different volumes of bupivacaine (20 ml and 25 ml) on diaphragmatic mobility within 15 and 30 minutes from ultrasound guided supraclavicular brachial plexus block in upper limb orthopedic surgeries.

Patients and Methods
In our study, 40 patients were randomly divided into 2 equal groups. Group A received 20 ml of bupivacaine (0.5%) and group B in which patients received 25 ml of bupivacaibe (0.5%). Diaphragmatic excursion measured in both groups after 15 and 30 mins sequentially.

Results
Our study showed that the use of low volume of bupivacine has much lower incidence of phrenic nerve affection, and in turn affection of mobility of the diaphragm measured by diaphragmatic excursion.

Conclusion
Assessment of diaphragmatic excursion is the best indication of phernic nerve injury after supraclavicular block. The use of the ultrasonography is the fastes, easiest and safest method for this assessment. The use of ultrasonography in performing the supraclavicular nerve block decreased significantly the incidence of complications such as pneumothorax or intravascular injection and hence, lowered the incidence of systemic toxicity of local anesthetics.
Continuous Femoral Nerve Blockade versus Continuous Epidural Analgesia for Postoperative Pain Relief in Knee Surgeries
Authors: Salama Hala Gomaa , El- Shebiny Ahmed Ali , Aziz Abd Al Aziz Abdullah Abd Al , Shehata Mariam Mahmoud Ahmed Ali 
Published: October 2021

Abstract

Background
The progression of osteoarthritis is characteristically slow, occurring over several years or decades. Over this period, the patient can become less and less active and thus more susceptible to morbidities related to decreasing physical activity (including potential weight gain). Early in the disease process, the joints may appear normal. However, the patient’s gait may be antalgic if weight-bearing joints are involved.

Objective
Compare the benefits of continuous femoral nerve block (CFNB) with those of continuous epidural analgesia CEPA for postoperative pain management after Knee surgeries.

Methods
This study is a randomized controlled clinical trial was conducted in Ain Shams University Hospitals after obtaining approval from the Research Ethical Committee of Ain Shams University during a period of three months. Patients undergoing primary unilateral TKA for osteoarthritis, were recruited at least one day prior to the scheduled surgery, male and female patients.

Results
There was significant difference in terms of pain scoring between continuous femoral nerve block (CFNB) and continuous epidural analgesia (CEA) in the first 6 hours, 12 hours, 24 hours, 48 hours, 72 hours but non significant difference in incidence of side effects

Conclusion
Our study showed that CEA had optimal analgesia and pain control than CFNB in management of post operative pain after total knee replacement.
Tranversus Abdominus Plane Block with or without Magnesium Sulphate on Postoperative Pain Control after Open Appendectomy Operation
Authors: Elzyat Menna A , Kaschef Nevine A , Hussien Rania M , Armanios Simon H 
Published: October 2021

Abstract

Background
Patients undergoing Open Appendectomy experience pain postoperatively, requiring a multimodal approach to analgesia. The transversus abdominis plane (TAP) block seems to be an ideal approach. This block may be achieved using bupivacaine with adjuvants such as magnesium sulfate, which we were used in this study.

Aim of the Work
to detect the efficacy and safety of magnesium sulphate as an adjuvant to the analgesia offered by local anesthetic in ultrasound guided TAP block in patients undergoing open appendectomy.

Patients and Methods
A prospective double blinded randomized controlled trial was conducted on 60 patients undergoing open appendectomy at Ain Shams University Hospital, Cairo, Egypt.

Results
Our study concluded that co administration of 500mg MgSo4 to 0.5 % bupivacaine in US guided TAP block lead to: Significant decrease in VAS pain score especially at 4hrs, 6hrs and 12hrs,1st rescue dose of nalbuphine was delayed. And number of patients require rescue doses of nalbuphine in 1st 4 hrs, while only 2 patients require rescue doses of nalbuphine between 4&6 hrs.4 patients require rescue doses of nalbuphine between 6&12 hrs, while 26 patients require rescue doses of nalubuphine between 12&24hrs. we also cocluded that there were a significant decrease in HR and MABP especially at 4hrs and 6 hrs postoperative,.

Conclusion
MgSO4 as an adjuvant to bupivacaine in Ultra-sounded guided TAP block reduces post-operative pain scores, prolong the duration of analgesia and decreases demand for rescue analgesics.
Comparative Study between Opioid-Free General Anesthesia by Dexmedetomidine and Opioid-Based General Anesthesia in Rhinoplasty Surgeries
Authors: Rashad Mohamed Nagdy , Akl Diaa Abdel khalek , Ammar Mona Ahmed , ElGharabawy Wael Sayed 
Published: October 2021

Abstract

Background
The use of opioid-free analgesic technique have the propensity to decrease and even avoid many of these side effects and lead to early oral intake, early ambulation, earlier hospital discharge, and lesser readmission rates to the hospital in the post-operative period.

Aim of the Work
to compare the effect of opioid-free using Dexmedetomidine and opioid-based using Fentanyl on hemodynamics (inducing deliberate hypotension and providing a better surgical field exposure), post-operative pain intensity and the incidence of side effects in patients scheduled for rhinoplasty surgeries.

Patients and Methods
This study included Fifty adult patients undergoing rhinoplasty surgery. Patients were randomly divided into two equal groups. Group D received Dexmedetomidine and Group F received Fentanyl. Patients are ASA physical status I, age group ranged from 18 to 45 years.

Results
The study revealed a statistically significant decrease mean of group D compared to group F according to intraoperative mean arterial blood pressure. statistically significant decrease mean of group D compared to group F according to intraoperative heart rate (beat/min).

Conclusion
We found that dexmedetomidine is better than fentanyl for patients who undergo rhinoplasty surgeries to achieve controlled hypotension, decrease dosages of postoperative analgesics, prolong the duration of postoperative analgesia and decrease postoperative nausea and vomiting.
Comparison of Analgesic Efficacy between Bupivacaine with Dexamethasone and Bupivacaine Alone in Caudal Block for Pediatric Patients Undergoing Open Inguinal Hernia Repair
Authors: Mohammed Mohammed A , Kamaly Ayman M , Nasr Thabet A , Azim Heba A 
Published: October 2021

Abstract

Background
Open inguinal hernial repair surgeries are one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provide safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Regional anesthetic techniques are commonly used to facilitate pain control in pediatric surgical procedures. The most used techniques in pediatrics is caudal block.

Objective
To evaluate the analgesic effect of dexamethasone when given caudally as an adjuvant to caudal block vs bupivacaine alone in caudal block for children undergoing open inguinal hernial repair surgeries.

Methods
The study is a prospective double – blinded randomized controlled trial conducted on 50 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups; each group consisted of 25 patients. After preoperative assessment and obtaining baseline vital data, all patients received general anesthesia. Group BD who would receive caudal dexamethasone added to Bupivacaine and Group B who would receive caudal block with Bupivacaine.

Results
Dexamethasone addition shows statistically significance difference between two groups according to FLACC scale at 4h, 8h and 12h. The duration of adequate analgesia (FLACC pain score 4 or less) was significantly higher in group BD compared to group B.

Conclusion
Dexamethasone 0.1 mg/kg, when used as an adjuvant to caudal anesthesia, can significantly prolong the duration of postoperative analgesia. It is better than bupivacaine alone in caudal block at similar doses in controlling postoperative pain.
A Comparative Study between Caudal and Penile Blockade in Pediatric Patients Undergoing Hypospadias Repair
Authors: Eldemirdash Mona Ismail Mohammed Fadl , Gadalla Raouf Ramzy , Fahmy Neveen Gerges , Maky Yahia Mamdouh Hassan 
Published: October 2021

Abstract

Background
Regional anesthesia, in combination with general anesthesia, is frequently used for children undergoing surgical procedures.

Aim of the Work
to compare postoperative analgesia between caudal block and penile block with bupivacaine in elective hypospadias repair cases in pediatric patients.

Patients and Methods
This study is a randomized clinical study conducted in the operating theaters of pediatric surgery unit in Ain shams university hospitals. The study was performed after ethical committee approval and informed consent from the parents after full explanation of the procedure, possible side effects and complications. This study was done in the period between March 2019 and August 2019.it included sixty male children undergoing hypospadias repair.

Results
Postoperative pain was evaluated by FLACC pain score at PACU, 2, 4 and 8, 12, 16 and 24 hrs. There was a significant increase in the pain score in group C starting from the fourth hour postoperativly and thereafter every hour, while the lowest pain scores were recorded in group P (P &lt; 0.05). Also, the time to first need for rescue analgesia was significantly shorter in group C (240 +/-105 min) compared with group P (720 +/-301) (P&gt;0.01).The total rescue analgesic requirement was significantly lower in group P (168.26 +/22.69) than group C (573.8+/- 124.1) (P &lt; 0.01).Postoperative time of ambulation was significantly lower in group C (6.95+/- 3.22) compared with group P (5.28+/-1.99) (P &lt; 0.01).

Conclusion
Dorsal penile nerve block in children undergoing penile surgery provides effective and a longer duration of postoperative analgesia and decreased postoperative analgesic requirements with more hemodynamic stability both intraoperatively and postoperatively, as it is safer and easier to perform, with higher success rates than caudal epidural block, which is invasive and shows some difficulty in practice.
A Comparative Study between Dexamethasone versus Paracetamol Added to Xylocaine in Local Intravenous Anesthesia in Upper Limb Minor Surgeries
Authors: Elkabarity Reem Hamdy , Labib Heba Abdel Azim , Elfar Marwa Mamdouh , Sharaf Mostafa Mohamed Mohamed Ibrahim 
Published: October 2021

Abstract

Background
Intravenous regional anesthesia (IVRA) is a technically simple, reliable and costeffective method of regional anesthesia for short operative procedures of the extremities. It is easy to be administered, of lower cost compared with general anesthesia, no need for deep sedation and can be used for emergency operations on extremities for patients with full stomach.

Objective
Comparison between the anesthetic and analgesic parameters in local intravenous anesthesia by adding Paracetamol and Dexamethasone to xylocaine.

Patients and methods
This study was carried out in Ain Shams University hospitals for six months (from August 2018 to February 2019) on 45 patients of both sexes aged 20-50 years belonging to ASA I & II undergoing forearm and hand surgeries using IVRA.

Results
There was no significant difference between group (P), Group (C) as regard sensory, motor recovery times, both had a shorter sensory and motor block time need to an opioid dose as an analgesic dose. Group (D) had the fastest sensory and motor block time and more prolonged recovery time than group (P) and group (C) need less opioid dose as analgesia for controlling pain. As regard postoperative analgesic requirements. Group (D) and group (P) needed less analgesic doses than group (C) but there was no significant difference between group (P) and group (C).

Conclusion
Addition of 8 mg Dexamethasone as adjuvant to xylocaine for intravenous regional anesthesia led to: Reduction the dose of xylocaine used for IVRA, Shortening the sensory and motor block onset times, Prolong the sensory and motor block recovery times, and Reduction the postoperative analgesic requirement with satisfaction for patient and surgeon.
Comparative study of the performance of SOFA and qSOFA versus SIRS criteria for predicting mortality among septic patients admitted to the intensive care unit
Authors: Aly Naglaa Mohammad , Hussein Mustafa Mansour , Allah Mohammad Mohammad Kamal Abd , Abd-El Magid Mustafa Youssef 
Published: October 2021

Abstract

Background
Sepsis is considered one of a life-threatening condition among intensive care unit (ICU) patients. Although, there are evidence-based management guidelines, sepsis still remains a leading cause of death with in-hospital mortality ranging from 22.8% to 48.7%. Previously sepsis was defined as systemic inflammatory response to infection, which could be diagnosed by meeting two or more Systemic Inflammatory Response Syndrome (SIRS) criteria, along with a known or suspected infection. Even though the SIRS criteria were sensitive, but they were not specific enough to differentiate between sepsis and other inflammatory conditions.

Objective
To compare between the ability of SOFA score, the quick SOFA (qSOFA) and Systemic Inflammatory Response Syndrome (SIRS) to predict ICU mortality.

Patients and Methods
Randomized prospective comparative study conducted in El Haram Specialized Hospital. The study included 75 patients. We calculated SOFA, SIRS, and qSOFA scores based on physiological and laboratory data that were collected upon admission to the ICU. Standard criteria were applied with a threshold of 2 or more points for each scoring system. The baseline SOFA score was assumed to be zero for patients without a known preexisting organ dysfunction. The baseline total SOFA score was considered to be 4 for patients undergoing chronic dialysis, and 2 or 3 for cirrhotic patients, depending on baseline bilirubin levels.

Results
ROC curve analysis between survival and each of SIRS, qSOFA and SOFA, it shows that SOFA score presented the best discrimination with an AUC of 0.993 (95% CI 0.981–100).

Conclusion
In patients with suspected infection admitted to an ICU, an increase in SOFA score had greater prognostic accuracy for in-hospital mortality than SIRS criteria or qSOFA. These findings suggest that SIRS and qSOFA may have limited use for predicting mortality in an ICU setting.
A comparative study between bupivacaine-dexmedetomidine mixture versus bupivacaine-magnesium mixture in Pre-incision skin infiltration for para-umbilical hernia repair regarding their intraoperative and postoperative analgesic effect
Authors: Kandeel Nahla Y , Bassiony Mohsen A , Soliman Ahmed K , Toulan Heba F 
Published: October 2021

Abstract

Background
Poorly controlled acute pain after abdominal surgery is related to somatic pain signals derived from the abdominal wall and is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay, an increased likelihood of chronic pain, increased consumption of analgesics, delayed bowel function and increase the requirement for rescue analgesics. Appropriate pain treatment protocols to reduce postoperative morbidity, improve the results of the surgery and decrease hospital costs.

Aim of the Work
to compare skin infiltration with bupivacaine-dexmedetomidine mixture versus bupivacainemagnesium mixture for analgesia in patients undergoing para-umbilical hernia repair under general anesthesia. magnesium.

Results
This study demonstrated that the addition of dexmedetomidine to wound infiltration with local anesthetics improves postoperative pain and reduces the need for analgesics which can be explained by different mechanisms: inhibition of painconduction in C -fibers, decreased in the production of inflammatory cytokines, the vasoconstrictive effect of 2 on vascular smooth muscle prolongs the time of analgesia, inhibition of tetrodotoxin-sensitive Na+ channels, and the absorption of dexmedetomidine to systemic circulation resulting in supraspinal analgesia.

Patients and Methods
A prospective randomized clinical trial study was conducted in Ain Shams university hospital on 44 adult patients undergoing para umbilical hernia or infra umbilical incisional hernia repair. The patients were randomly divided into two groups using their computer-generated random numbers will be enrolled in group D for bupivacaine-dexmedetomidine and group M for bupivacaine-

Conclusion
Pre-skin incision wound infiltration with dexmedetomidine–bupivacaine mixture provides prolonged local anesthetic effect, decreases the need for rescue analgesics, and provides better sedation than bupivacaine–magnesium sulfate mixture or bupivacaine alone in patients undergoing surgeries for hernia repair.