bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Ultrasound Guided Bilateral Rectus Sheath Block versus Local Wound Infiltration for Post Operative Analgesia in Patients undergoing Laparotomy with Midline Incision
Authors: Kamal Karim Youssef , Hazem Ashraf Mahmoud , Nassif George Maher , Kamal Mohy Merna Mohamed 
Published: November 2024

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
The aim of this study is to assess the postoperative analgesic efficacy of Rectus Sheath Block (RSB) compared local wound infiltration after midline incision regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received.

Patients and Methods
The study was conducted on 56 randomly chosen patients aged 20 to 60 years, American Society of Anesthesiologists (ASA) class I or II scheduled for elective midline expolaratory surgery. in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 28 patients each:

Results
Patients receiving RSB block had significantly lower pain scores at rest for 24 hr after operation and decrease total need of analgesic in first 24 h post operative compared with patients who received wound infiltration of local anaesthetic.

Conclusion
U/S-guided rectus sheath block is more effective analgesic technique than local infiltration of the surgical wound, with longer duration of action and pethidine -sparing effect during the postoperative period after midline exploratory surgeries.
Validation of a Proposed Equation for Calculation of the Optimal Depth of Central Venous Catheter Inserted via the Right Internal Jugular Vein using the Middle Approach in Adult Patients
Authors: Hakim Sameh Michel , Elgouhary Mohamed Osama , Akhnokh Mina Reda Noaman 
Published: November 2024

Abstract

Background
A central venous catheter (CVC) is utilized for the monitoring of central venous pressure (CVP) and the administration of vasoactive drugs and fluids.

Aim of the Work
The aim of this study was to validate a proposed equation for evaluation of the optimal depth of central venous catheter inserted via the right internal jugular (IJV) vein using the middle approach in adult patients.

Patients and Methods
40 adult patients scheduled for open cardiac surgery were enrolled in whom TEE monitoring is indicated or preferred.

Results
Postoperative CXR showed that none of the patients in whom CVC placement was guided by TEE had their CVC tip placed below the level of the carina. The hypothetical position of the CVC tip as guided with surface landmark-based formula would have been below the carina in 6 (15%) of patients. The corresponding percentages for the C-length method and Pere’s formula would have been 45% and 100% respectively.

Conclusion
The central venous catheter tip was evaluated with the TEE and we were able to verify the accuracy of the proposed equation that was introduced by regression analysis of the results they got by placing the CVC tips in the mid SVC based on surface landmarks.
Red Cell Distribution Width as a Predictor for Post-Operative Atrial Fibrillation after Open Heart Surgeries
Authors: Mohamed Abdelaal Wael Ahmed , Saleh Ashraf Nabil , Ahmed Mohamed Ahmed Abdou Khaled Mohamed , Youssef Mohamed Ali 
Published: November 2024

Abstract

Background
Post operative Atrial Fibrillation is the most common type of arrythemia after open heart surgeries with incidence 30- 50%, in this study we investigated the relationship between RDW and the prediction of post operative atrial fibrillation, the eligiable patients were 76 patients, the duration of study was 2 months of data collection, patients were included according to the inclusion criteria mentioned earlier.

Objective
To evaluate the effectiveness of RDW preoperatively as predictor of incidence of post operative atrial fibrillation (POAF) in patients undergoing open heart surgeries.

Patients and Methods
Type of Study: Prospective observational study. Study Setting: To be conducted in Ain Shams University Hospitals cardiothoracic ICU unit on a postoperative patients with open heart surgeries after applying exclusion criteria.

Results
In our study of the risk factors for prediction of Atrial fibrillation, we found that COPD patients carry higher risk for POAF in comparison to non COPD patients with a p value

Conclusion
POAF remains one of the most challenging post operative complications after cardiac surgeries. Pre operative identification and classifications of high risk patients can contribute in decreasing the post operative morbidity and mortality after cardiac surgeries. The interpretation of CBC findings including RDW value along with the results of our study augment the valuable use of RDW as a novel biomarker for prediction of POAF. Other Inflammatory markers needs to be investigated to detect it’s reliability for prediction of POAF after cardiac surgeries and the interventions that can be taken to decrease the incidence of POAF after cardiac surgeries which includes the usage of anti –oxidants which needs further investigations and research.
Comparative Study between the Effect of Ultrasound Guided Erector Spinae Plane Block (ESPB) versus Serratus Anterior Plane Block (SAPB) for Postoperative Analgesia in Modified Radical Mastectomy Patients
Authors: Megeed Mohamed Al-Taher Waleed Abdel , Hussein Ahmed Noha Sayed , Khamis Mohamed Ibrahim , Ahmed Mohamed Ashraf 
Published: November 2024

Abstract

Background
Breast cancer is the most common cancer in women both in the developed and less developed world. In 2012, it represented about 12 percent of all new cancer cases and 25 percent of all cancers in women.

Aim of the Work
The aim of this work is to evaluate the effectiveness of ultrasound guided erector spinae plane block (ESPB) versus Serratus Anterior plane block (SAPB) as a postoperative Analgesia in Modified Radical Mastectomy.

Patients and Methods
After obtaining approval from the medical ethical committee in Ain Shams University, this study was conducted in the operating theatres of Ain Shams University Hospitals. It included 64 female patients undergoing modified radical mastectomy were divided randomly into two groups, each group consisted of 32 patients group I in which patients received ESPB and group II in which patients received SAPB.

Results
The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the numeric rating score system, besides, recording time for first for analgesic need and total consumption of opioid and analgesic in the 1st 24 postoperative hours. Demographic data and post operative hemodynamics were also assessed.

Conclusion
Both Erector spinae plane block and serratus anterior plane block provide good analgesic control after modified radical mastectomy but the ESPB is more superior compared to SAPB in postoperative hemodynamics and pain score.
Postoperative Pulmonary Functions Evaluation for Recently Recovered Covid-19 Positive Patients Posted for Surgeries under General Anaesthesia
Authors: Mohamed Basiony El-Ansary Samir El-Ansary , El Hakim Ashraf Mahmoud Hazem , Sayed Amr Gaber , Shokry Abdel Aziz Mohamed Raafat 
Published: November 2024

Abstract

Introduction
Since COVID-19 can impact virtually all major organ systems, the timing of surgery after a Covid-19 diagnosis is important when considering the risk of postoperative complications.

Objective
Evaluation of the pulmonary functions of recently recovered COVID positive patients after general anesthesia.

Methods
During this study, 30 recently recovered COVID positive patients, 4-8 weeks after the end of symptoms with a history of mild to moderate Covid-19 infection. Post-operative spirometry was performed after 8 hours and compared with the pre-operative one. Patients were divided into two groups, mild and moderate regarding severity of symptoms. Each group was further divided into two subgroups; first subgroup included 4 weeks post-Covid patients and second subgroup included 5 to 8 weeks post-Covid patients.

Results
There were no significant differences between study groups as regard postoperative pulmonary functions, intra operative hemodynamic instability, post-operative hypoxemia PSO2 &lt; 90, post-operative nausea and vomiting.

Conclusions
Patients should avoid elective surgery shortly after infection, unless the benefits of doing so exceed the risk of waiting. Individualised multidisciplinary risk assessment for patients requiring elective surgery after SARS-CoV-2 infection is recommended.
Hypophosphatemia as a Prognostic Value in Acute Exacerbation of COPD: Prospective Study
Authors: Mohammed Abdelhakem Ali Mohammed Mohsen , Elhamid Hatem Said Abd , Labib Heba Abdel Azim , Mohamed EL Naggar Dalia Ibrahim 
Published: November 2024

Abstract

Background
Acute exacerbation of chronic obstructive disease leads to repeated hospital admissions and is associated with a high mortality rate, making it a leading cause of disability and morbidity. Phosphorus is an important and essential electrolyte that plays a significant role in various physiological and cellular biochemical processes, including adenosine triphosphate high energy bonds, which affect muscle contractility, cellular integrity, and other biological functions.

Aim of the Work
to evaluate the prognostic effects of hypophosphatemia in acute exacerbation of COPD patients and evaluate the correlation between phosphorus levels and the severity of acute exacerbation of COPD.

Patients and Methods
a prospective comparative study that was conducted on patients admitted to ER previously diagnosed as COPD with Gold score (moderate IIA to very severe IV) suffering from acute exacerbation of COPD at Ain Shams University Hospital throughout 6 months.

Results
The study found a male predominance (85%) among the included COPD patients with acute exacerbation. COPD patients with hypophosphatemia were significantly associated with a need for mechanical ventilation and failed weaning. Blood gas analysis is an important method in ICU departments which can evaluate the condition and progress of patients with acute exacerbation of COPD.

Conclusion
Hypophosphatemia was found to be a predictor of failure in weaning from mechanical ventilation among patients with acute exacerbation of COPD. Treatment with phosphorus improves outcomes and reduces the duration of mechanical ventilation.
The use of End Expiratory Occlusion Test vs. Inferior Vena Cava Respiratory Variation for the prediction of volume responsiveness in mechanically ventilated patients with sepsis
Authors: ElSayed Abd El Maksoud Nevein Fawzy , Elewa Gamal Eldin Mohammad Ahmad , Sayed Ahmed El Sers Mayar Hassan , Emam Ali Nawar Dalia Fahmy , Ahmad Youssef, Eldemerdash Dr Ahmad Moneer 
Published: November 2024

Abstract
Sepsis being a chief prominent fatal condition in critically ill patients. In septic shocked patients, the first-line therapeutic intervention is fluid resuscitation in an attempt to improve their cardiac output (COP). However, fluids must be given only if the chance of improving COP exists. So, assessing fluid responsiveness is crucial. To our knowledge, yet no studies comparing the End- expiratory-occlusion (EEO) test and the variation of the inferior-vena-cava diameter with respiration (ΔIVC) in hypovolemic cases. So, our aim is to use both tests as indices for responsiveness to fluid in septic mechanically ventilated (MV) patients. The Patients and Method: Thirty four MV septic patients were enrolled and baseline COP assessment was performed followed by an EEO test applied to each patient, after which, COP was measured to detect the probable responders (defined as an increased COP by ≥ 15%) and non-responders. Then, ΔIVC was assessed for the same patients to predict the probable responders (with ΔIVC &gt;12%) and non-responders. Finally, fluid therapy was initiated as per the guidelines of surviving sepsis campaign (2021) followed by COP re-assessment to determine actual fluid responders\non-responders.

Results
Sixty-seven% of the cases were responding to fluid. Receiver operating characteristic showed areas under curve for EEO and ΔIVC in predicting responsiveness to fluid were 0.597 and 0.925, respectively. EEO (32.4%) was predictive with 47.8% sensitivity and 100% specificity. The ΔIVC (64.7%) was predictive with 91.3% sensitivity and 100% specificity.

Conclusion
IVC-respiratory-variation showed better values in prediction of response to fluid in MV patients with sepsis than EEO test.
Efficacy of Pericapsular Nerve Group Block (PENG BLOCK) in the Perioperative Period for Patients Undergoing Hip Surgery
Authors: Mahmoud Ahmed Sherif Khairy , Ibrahim Ahmed Saeed , Ismail Wafaa Elsayed , Fouly Mohamed Abdelmoneim 
Published: November 2024

Abstract

Background
Proximal femur fractures are common fractures especially in elderly population and produce routine problems for trauma. It is common that they lead to immobility or hindrance in daily life. In addition, elderly people can have surgical problems as well as multiple medical complications (Schuetze et al., 2019).

Aim of the Work
The study aimed to Studying the effect of the pericapsular nerve group (PENG) block on providing perioperative analgesia and improving functional recovery following total hip arthroplasty.

Patients and Methods
This prospective randomized controlled trial study was conducted in Ain Shams University Hospitals. Thirty six adult patients scheduled for proximal femur fracture fixation under spinal anaesthesia were included in this study. The patients' age was above 18 years old and with the American Society of Anaesthesiologists (ASA) Class I, II and III. At the the beginning of the surgery, patients were randomized using a random number table and the use of a closed envelopes technique were used to receive either ultrasound guided pericapsular nerve group block (PENG) block, or normal saline (no PENG block), each group constitutes 18 patients.

Results
As regarding time of 1st rescue analgesia our study revealed that there was significant shorter duration to first rescue analgesia in control group as mean time in control group was 13 hours compared to 19 hours in PENG group. As regarding to total morphine consumption our study revealed marked decrease in morphine consumption in the 1st 24 hours post operatively with mean 3mg in PENG group and 6mg in control group. As regarding the mobility after surgery we found that 17 patients out of 18 who received PENG block could stand at 24 hours post operatively in comparison to only 6 patients in control group.

Conclusion
The other aspect that should be discussed is that the PENG block provides only anterior hip capsule analgesia. Although the anterior capsule innervation is responsible for the majority of hip-related pain, it omits the posterior capsule, which is innervated by the nerve to the quadratus femoris and from the superior gluteal nerve, both from the sacral plexus.
A Comparative Controlled Study of Preoperative Skin Infiltration with Bupivacaine-Dexmedetomidine versus Bupivacaine-Magnesium for Pain Control Analgesia in Para Umbilical Hernia regarding Their Perioperative Analgesic Effect
Authors: Ali Naglaa Mohamed , Mohammed Ammar Mona Ahmed , Mawla Saleh Mohamed Abdel , Abdel Razek Ahmed Tasneem Fathy 
Published: November 2024

Abstract

Background
Postoperative pain and opioid-related adverse drug events are still among the principal factors affecting the rapid recovery and discharge of patients undergoing surgery. Wound pain at rest and on movement is one of the main sources of postoperative pain. In addition, skin traction stimulation, which can be caused by respiratory movement and the daily activities of patients after surgery, further aggravates the severity of wound pain, resulting in restlessness and insomnia and even inducing serious symptoms such as wound tear and infection. The analgesic regimen needs to meet the goals of providing safe, effective analgesia, with minimal side effects for the patient, together with inhibition of trauma –induced nociceptive impulses. The technique of wound infiltration analgesia has been shown to play an active role in relieving postoperative pain and reducing opioid consumption.

Aim of the Work
Comparing the effectiveness of pre-incision skin infiltration with bupivacaine- dexmedetomidine mixture versus bupivacaine-magnesium mixture for elective para umbilical hernia repair.

Patients and Methods
A Prospective randomized, double blinded controlled study was conducted in Ain Shams university hospital on 75 adult patients undergoing para umbilical hernia or infra umbilical incisional hernia repair. They will be randomly divided into three groups. Method of randomization using computer generated number list using opaque sealed envelopes. Patients will be enrolled in group B for bupivacaine alone, group D for bupivacaine-dexmedetomidine and group M for bupivacaine-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 pain conduction 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.

Conclusion
Dexmedetomidine is found to be an effective adjuvant to bupivacaine for local wound infiltration analgesia in terms of effective analgesic duration, need for rescue analgesic and better pain scores in the immediate postoperative period, and provides better sedation than bupivacaine–magnesium sulfate mixture or bupivacaine alone in patients undergoing surgeries for hernia repair.
The Efficacy of Ultrasound-Guided Bilateral Quadratus Lumborum Block versus Bilateral Transversus Abdominis Plane Block in Patients Undergoing Total Abdominal Hysterectomy
Authors: Mohammed Yasmeen Khaled , EL- Said Kamel Amr Mohamed , Said Alfred Maurice , Abdelgawad Ahmed Tarek 
Published: November 2024

Abstract

Background
Nerve root or myofascial irritation at the abdominal wall is a common cause of pain following surgeries such as cholecystectomy, cesarean section, prostatectomy, hysterectomy and transplant surgery. Spinal or systemic opioid analgesia techniques are often used to manage pain after abdominal surgeries and appropriate pain management is necessary for optimizing clinical outcomes and patients’ satisfaction. However, complications such as nausea, vomiting and respiratory depressions are often associated with opioid use. As a result, investigation of alternative analgesia regimens to enhance effectiveness in postoperative pain management while improving the safety profile has emerged as a significant field of inquire.

Aim of the Work
To study the analgesic efficacy of ultrasound- guided bilateral trans- muscular quadratus lumborum block (QLB) compared with bilateral transversus abdominis plane (TAP) block on postoperative period regarding pain control, total opioid given in the first 24-hour post-operative, VAS score and first time to ask for analgesia in patients undergoing total abdominal hysterectomy under general anesthesia.

Patients and Methods
After approval of anaesthesiology department scientific and ethical committees in Ain Shams University Hospitals, 50 female patients were included in the study, and were divided into two groups, each group consisted 25 patients. Group A (TAP): Patients in this group received bilateral US guided TAP block at the end of surgery. Group B (QLB): Patients in this group received bilateral US guided QLB block at the end of surgery.

Results
As regard the analgesic parameters recorded; in the current study, the VAS was significantly lower in group B QLB block when compared with that of group A TAP block and showed significant difference between both groups at 2,4,8 and 12 hrs postoperatively. Also, time to rescue analgesia, there was clinically and statistically highly significant longer time to 1st rescue analgesic in group B (QLB block) was 8.68±1.14 hours compared to that of group A (TAP block) was 5.24±1.64 hours. Also in the current study, total pethidine consumption ―mg with the mean total consumption in each of Group was 100.80±35.58 mg in the TAP group compared with 78.00±25.33 mg in the QLB group there was highly statistically significant higher mean of total analgesic consumption in group A compared to Group B.

Conclusion
Bilateral ultrasound-guided QL block provides more potent and longer postoperative analgesia with less analgesia consumption than TAP block after total abdominal hysterectomy.
A Comparative Study between Sub-Sartorial Canal Block and Patient Controlled Analgesia for Postoperative Analgesia after Total Knee Replacement Surgery
Authors: Mohamed Elsayed Yomna Emad , Kamal Manal Mohamed , Mohamed Rania Magdy , Al-shahat Ibrahim Ibrahim 
Published: November 2024

Abstract

Background
Knee arthroscopy is a common orthopaedic procedure worldwide, despite its minimally invasive nature compared to the traditional knee surgery, post-arthroscopic pain may be severe, and the patients generally require a significant amount of opioid-based analgesics after such procedures.

Aim of the Work
To compare the analgesic efficacy and functional recovery of Adductor Canal Block and PCA in patients who have undergone total knee replacement surgeries.

Patients and Methods
This study is a prospective randomized controlled clinical trial. After obtaining approval from the Research Ethical Committee of Ain Shams University, this study will be conducted in the operating theatres of Ain Shams University Hospitals. Through a period of six months.

Results
Peripheral nerve blocks offer effective analgesia and decrease the need for opioids, thereby reducing the complications associated with the use of this class of drug. Pain management regimens following knee arthroscopy include oral analgesics, periarticular injection, peripheral nerve blocks (PNBs), and intravenous patient-controlled analgesia (PCA). The use of an adductor canal block (ACB) that offers almost pure sensory block with minimal motor involvement as part of a multimodal approach to pain control after knee arthroscopy

Conclusion
Effective pain management following total knee arthroplasty (TKA) and knee arthroscopy is crucial for achieving early post-operative mobilization, patient satisfaction, and minimizing complications. Opioids have traditionally been used to manage pain, but their potential side effects, such as vomiting and respiratory depression, have led to a search for alternative approaches.