bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison between Ultrasound Guided Quadratus Lumborum Block and Caudal Block in Children Undergoing Lower Abdominal Surgeries
Authors: Abdel-Naby Ahmed Mohamed , Salama Mohamed R , El-Gendy Hanaa A , Talaat Sahar M 
Published: November 2024

Abstract

Background
Caudal epidural anesthesia is a widely used popular technique for postoperative analgesia. The caudal approach of the epidural space is done through the sacral hiatus. A success rate of 96% was reported, however it can cause complications such as needle trauma, infection, hematoma, inadvertent subarachnoid or intravascular injection of local anesthetic. Quadratus lumborum block (QLB) was found to be an effective method for postoperative analgesia in lower abdominal surgeries. The quadratus lumborum block is also known as the abdominal truncal block. Ultrasound-guided quadratus lumborum block is a technique that was developed to provide visceral and somatic analgesia during abdominal procedures, and it can provide perioperative analgesia for all age groups, including pediatric patients undergoing abdominal surgery.

Aim of the Work
The aim of this study was to compare the postoperative analgesic efficacies of QLB and the caudal block in pediatric patients undergoing lower abdominal surgeries under general anesthesia.

Patients and Methods
This prospective randomized controlled double-blind study was carried out on eighty patients between 6-12 years old and undergoing lower abdominal surgeries. Patients were equally categorized into two groups which are quadratus lumborum block group (40 patients) received general anesthesia followed by ultrasound- guided Quadratus Lumborum block (0.3 ml/Kg of 0.25% Bupivacaine) and caudal block group (40 patients) received general anesthesia followed by caudal block (0.5 ml/Kg of 0.25% Bupivacaine).

Results
VAS score measurements showed no statistically significant difference at baseline, after 1 hr, 18h and 24h postoperative, while VAS score measurements were significantly lower in QLB group than Caudal block group after 2h, 4h, 6h and 12h postoperative. Intraoperative HR and MAP measurements were insignificantly different between both groups. Postoperative HR and MAP measurements were insignificantly different at baseline, after 18h and 24h. Postoperative HR2 measurements were significantly lower in QLB group than Caudal block group after 1h, 2h, 4h, 6h, 12h, 18h and 24h. Time to first analgesic request was significantly higher in QLB group than caudal block group. Total paracetamol consumption was significantly lower in QLB group than caudal block group. Hospital stay was insignificantly different between both groups, also hypotension was reported to be significantly lower in QLB group than caudal block group. There were few cases that experienced postoperative nausea and vomiting in both groups but there was no statistically significant difference in PONV between the two groups.

Conclusion
Performing QLB (anterior approach) is recommended for pediatric analgesia in lower abdominal surgeries as it is more effective in decreasing total paracetamol consumption, pain scores, and prolonging postoperative analgesia time more than caudal block.
Evaluation of Leg Wrapping for Prevention of Postspinal Hypotension in Cesarean Section under Spinal Anesthesia
Authors: Hasan Alaa Eid Mohamed , Taha Sameh Salem Hefni , Eldin Abdel Aziz Farouk Kamal , Abdel salam Aya Fathy 
Published: November 2024

Abstract

Background
Hypotension is one the most common intra-operative complications associated with spinal anesthesia. Its incidence in cesarean section has been estimated to be as high as 50-60 %.

Objective
To evaluate the efficiency of leg wrapping with crepe bandage for the prevention or attenuation of post-spinal hypotension and it’s adverse effects in cesarean section patients.

Patients and Methods
A total of 60 women scheduled for cesarean section under spinal anesthesia were included in the study, divided into 30 patients in each group.

Results
The preemptive use of leg wrapping significantly reduced the incidence of post spinal hypotension in obstetric patients. The minimum Heart Rate throughout the operation was significantly higher in wrapped leg group. Nausea and vomiting were significantly less frequent in wrapped leg group. No statistical significant difference between the study groups regarding birth weight, APGAR1, APGAR-5 and NICU admission. Furthermore, this method reduced vasopressor consumption.

Conclusion
the leg wrapping technique was a reliable method in decreasing the incidence of the commonest complications occurring after spinal anesthesia in obstetric patients: hypotension, bradycardia, nausea and vomiting. Recommendations: further studies with larger samples and more advanced leg compression equipments should be considered
Comparison of Ultrasound Guided Transversus Abdominis Plane Block versus Intravenous Patient Controlled Analgesia for Post-Operative Analgesia in Patients Undergoing Lower Abdominal Surgeries under Spinal Anesthesia
Authors: Mohammed Kamel Baheya Hesham , Ibrahim Sherif Farouk , Kamal Abo Seif Eman Mohamed , Hassan Hala Said 
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 postoperative 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.

Aim of the Work
to compare the efficacy of TAP block versus PCA with IV morphine to provide prolonged post-operative analgesia; secondary objective is to identify the side effects of both techniques as post-operative analgesia

Patients and Methods
The study was conducted on 40 randomly chosen patients aged 21 to 70 years in both sexes, American Society of Anesthesiologists (ASA) class I or II scheduled for elective lower abdominal surgeries under spinal anesthesia in Ain Shams University Hospitals after approval of the medical ethical committee.

Results
TAP block is given in the volume of 20 mL bilaterally, it is as effective as intravenous Morphine PCA in pain treatment, but with less systemic side effect Also TAP block delay using of postoperative additional analgesia, however PCA analgesic effect last longer, less invasive technique and easier to be used while TAP require hand skills and limited to 24 hours analgesia only.

Conclusion
In lower abdominal surgery, when TAP block is given in the volume of 40 mL, it is as effective as intravenous PCA in pain treatment. Compared with intravenous PCA, TAP block can be considered as a more preferable method because it can avoid the systemic actions of morphine.
Effect of Intravenous Infusion of Ketamine versus Fentanyl on Intraoperative and Postoperative Analgesia in Patients Undergoing Posterior Lumbar Fusion Surgery: A Blind Randomized Study
Authors: Refai Ahmed Essam Alaa , Abdellatif Ayman Ahmad , Mohamed Mohamed Abdelwareth 
Published: November 2024

Abstract

Background
Use of opioids for perioperative analgesia is associated with sedation, respiratory depression and postoperative nausea and vomiting. N-methyl-D-aspartate receptor antagonist such as ketamine has both analgesic and antihyperalgesic properties.

Objective
Comparison between intravenous infusion of ketamine and fentanyl in patients undergoing posterior lumbar fusion surgery on postoperative analgesia.

Patients and Methods
A total of 60 patients who underwent elective posterior lumbar fusion were enrolled and divided into two equal groups; ketamine and fentanyl groups, with the same inclusion and exclusion criteria. Baseline vital parameters, adequacy of ventilation, surgical time from skin incision to skin closure, heart rate, mean arterial pressure, and pulse oximetry, total consumption of isoflurane, Visual Analogue Scale, total morphine consumption and sedation score (Ramsay sedation score) and occurrence of any complication were recorded.

Results
Postoperative VAS score was statistically significant higher in fentanyl compared to ketamine group, however, we reported statistically significant higher median of sedation score in fentanyl group. Our study showed statistically significant higher frequency of propofol 100mg and morphine 5mg consumption in fentanyl comparing to ketamine group.

Conclusion
Patients undergoing posterior lumbar fusion surgery, ketamine has potent postoperative analgesic effect with less opioid consumption and need for rescue sedation compared with fentanyl.
Role of Interleukin 6 and C-Reactive Protein Levels in Predicting the Need for Mechanical Ventilation in COVID 19 Patients
Authors: Mahmoud Mohamed Sidky , Anis Sherif George , Amer Akram Mohamed , Hamed Abdelhak Hadeer Ashraf 
Published: November 2024

Abstract

Background
COVID-19 is caused by coronavirus; first discovered in China 2019, COVID-19 infection shows symptoms ranging from influenza like symptoms; fever, sore throat, headache, cough and dyspnea to marked respiratory distress manifestations like dyspnea, hypoxia, tachypnea and disturbed conscious level lastly to death

Objective
As severe symptoms are related to increased inflammatory markers. So the aim is to assess the correlation between levels of IL6, CRP and other inflammatory markers as predictors and the need for mechanical ventilation.

Methods
A retrospective analytical cohort study was performed on twenty-five patients admitted to critical care department with COVID-19 positive reverse transcription polymerase chain reaction (PCR) over last 3 years. Patients’ data collected from the critical care department port- Fouad hospital and Ain Shams University Hospital. Labs and vital signs were collected at day 0 and day 3 of admission and patients were divided into two groups.

Results
The higher the levels of IL6 and CRP the more severe are the symptoms. The study showed higher IL6 levels in group II with (mean 238±169.79) as compared to group I (mean 49.18 ± 56.18) with significant p value 0.001. CRP in mechanically ventilated patients (group II) showed higher values (mean 176.54±51.69) than other patients who didn’t need mechanical ventilation (mean 69.42±23.56). with significant p value &lt; 0.001. Variables found to be statistically significant related to outcome. The values correlate well with the need to mechanical ventilation, as the higher the CRP and IL-6 value the increased need to mechanical ventilation. It also correlates with longer length of stay in intensive care unit and increasing mortality of high-risk group.

Conclusion
Through studying the levels of IL-6 and CRP in patients admitted to ICU due to COVID-19 infection; who were classified to 2 groups the first needed mechanical ventilation and the other group did not, it was noticed that higher levels of IL-6 and CRP are strong predictors for the need of mechanical ventilation with cut off value 120 for CRP and 151 for IL-6. They also were a strong predictor for mortality and increased ICU -LOS, as the higher levels of circulating inflammatory markers and cytokine (cytokine storm) was associated with a higher risk of mortality and increase LOS in ICU.
Predictors of Weaning Failure from Mechanical Ventilation in Post Cardiac Surgery Patients
Authors: Elkhalek Mohamed Ali Mohamed Abd , Kamar Mohamed ELsharnouby Noha Mohamed , Elgendy Hanaa Mohamed , Shalaby Mohamed Diaa Eldin , Sayed AbdelRasol Hatem Mahmoud 
Published: November 2024

Abstract

Background
Cardiac surgery disrupts homeostasis, putting the patient in danger. Weaning from a ventilator requires clinical judgement and multiple signs. Patients recovering from anaesthesia can restart spontaneous ventilation. Cardiopulmonary bypass recovers during breathing. Weaning patients from mechanical ventilation after heart surgery involves vital capacity, tidal volume, respiratory rate, and minute ventilation. Others have related advanced age, comorbidities, protracted extracorporeal circulation, cardiac dysfunction, and low cardiac output to unsuccessful weaning of cardiac patients from mechanical ventilation and postoperative hemodynamics and neurological alterations to long-term ventilation.

Aim
To determine predictors of unsuccessful weaning from mechanical ventilation after cardiac surgery, and therefore avoid the potentially hazardous long stay in ICU.

Subjects and Methods
This study was conducted at Ain Shams University Hospital, post cardiac surgery ICU including 80 patients undergo cardiac surgery and receiving mechanical ventilation after operation.

Results
Most of our included patients were successfully extubated. Most of our included patients developed intraoperative complications; the commonest complications were pacemaker wire followed by VF. Most of our included patients have CABG followed by MVR. Most of our included patients have mild tracheal secretion followed by moderate secretion. Charlson Comorbidity Index, COPD and CVS were statistically significant higher in failed extubation than weaned group while MBP and PO2/FIO2were statistically significant lower in failed than weaned patients.

Conclusion
From findings of this study we can conclude that SOFA (≥ 6), Comorbidity index (&gt;3), sever tracheal Secretion, RR/TV (≥57), MV (≥ 13.5) are independent predictors of failed weaning from mechanical ventilation.
Effect of Intravenous versus Intrathecal Dexmedetomidine on Potentiation of Spinal Anesthesia in Lower Abdominal Surgeries in Pediatric Patients
Authors: El Kersh Kareem Mohammad , El Kady Galal Adel , Khairy Elbeialy Marwa Ahmad , Amer Akram Mohamed 
Published: November 2024

Abstract

Background
regional anesthesia in children was first studied by August Bier in 1899. Since then, spinal anesthesia was practiced for years, and several cases were published in 1909- 1910. After some years, it fell into disuse owing to the introduction of various muscle relaxants and inhalational agents.

Aim of the Work
to compare the effectiveness and feasibility of dexmedetomidine intravenously and intra-thecally in potentiation and prolongation of spinal anesthesia in pediatric population undergoing lower abdominal surgeries.

Patients and Methods
this study is a prospective randomized single-blind Clinical trial. study setting pediatric surgery operating theatre, Ain Shams University Hospitals, Cairo, Egypt. Study Period 6 months. This study was carried out on children aging from 1year till 7 years of age who were undergo elective lower abdominal surgeries.

Results
the major obstacle for routine use of spinal anesthesia in pediatric patients is the short block duration provided with the plain SAB hence the use of adjuvants to overcome this defect were considered. The current clinical trial attempts to synthesize the evidence regarding the safety and efficacy of dexmedetomidine as an adjuvant with the most common spinal anesthetic, bupivacaine. The intrathecal route appear more effective in prolongation of duration of motor block and maintaining an adequate sensory level with slower two segment regression course which can be explained by the previously speculated anti-nociceptive effects of the intrathecal route of dexmedetomidine and its action at the level of spinal cord. Intravenous route seems to provide deeper level of sedation when compared to intrathecal route which can be explained by its higher level and bioavailability in the blood which provides a more satisfactory centrally inhibiting action.

Conclusion
dexmedetomidine as an adjunct to spinal anesthesia in pediatric lower abdominal surgeries either intravenous or intrathecal can potentiate the motor and sensory block and provide good postoperative analgesia without exerting hemodynamic compromise or significant adverse events. While intrathecal route provide better prolongation of the motor and sensory blockade and also provide longer postoperative analgesia than intravenous route.
Ultrasound Guided Transversus Abdominis Nerve Block versus Bilateral Ultrasound Guided Ilioinguinal-Iliohhypogastric Nerve Block in Elective Cesarean Section in El-Demerdash Hospital. A Randomized Controlled Trial
Authors: Kamal Hakim Kareem Youssef , Youssef Osama Ramzy , Mohamed Shimaa Ahmed , Soliman Kholoud Usama 
Published: November 2024

Abstract

Background
Pain after CS is a primary concern of women and the provision of effective analgesics is an essential duty for the obstetric anaesthetist. After the application of ultrasound in anesthetic practice, we can now choose between a landmark- or ultrasound-guided TAP block, Ilio- inguinal nerve block (alone or in combination with an Iliohypogastric nerve block) among others.

Objective
To compare the effect of bilateral ultrasound guided TAP block versus ultrasound guided Ilioinguinal and Iliohypogastric nerve block on post-operative analgesia in patients undergoing elective Cesarean section under spinal anesthesia.

Patients and Methods
The study was conducted on 64 random patients per each group who were scheduled to undergo elective cesarean section under spinal anesthesia, the two groups were as following;

Results
As for the comparison between effect of TAP block and ilioinguinal-iliohypogastric block as regard post-operative pain in elective cesarean section under spinal anesthesia, it showed that there is significance regarding the numeric version of the VAS score and its intensity. These findings the TAP block more effective than the ilioinguinal-iliohypogastric block. These findings with our primary and secondary outcomes showed that TAP block has more analgesic effect with respect to ilioinguinal-iliohypogastric block regarding pain assessment but with no significant difference regarding the time till first analgesia postoperative and total analgesics consumption over 24-hour period post-operative.

Conclusion
The comparison between effect of TAP block and ilioinguinal-iliohypogastric block as regard post-operative pain in elective cesarean section under spinal anesthesia showed significant difference regarding the numeric version of the visual analogue scale (VAS) that was used to assess postoperative pain and its intensity. These findings with our study primary and secondary outcomes showed that TAP block has more analgesic effect with respect to ilioinguinal-iliohypogastric block regarding pain assessment and the time till first analgesia postoperative and total analgesics consumption over 24-hour period post-operative.
Nebulized Heparin for Prevention of Acute Lung Injury in Adult Patients Suffering Smoke Inhalation Injury: A Randomized Controlled Trial
Authors: Hakim Sameh Michel , Foad Mariam Nady , Ghaly Safaa Eshak , Saad Mohamed Mahmoud , Habib Mariam Kamal 
Published: November 2024

Abstract

Background
Nebulized heparin (NH) has been used for treatment of inhalation injury- induced acute respiratory distress syndrome (ARDS) but its benefit for prevention of severe ARDS in those patients is not known.

Aim of the Work
The aim of this study was to examine the effect of NH on prevention of severe ARDS and on survival in patients suffering inhalation injury.

Methods
Eighty-eight adults suffering inhalation injury were randomized to receive 5,000 IU of heparin in 3 ml normal saline (n = 44) or to normal saline only (n = 44) by nebulization every 4 hours until successful extubation or death, whichever was earlier, to a maximum of 14 days. Primary outcomes were occurrence of severe ARDS (PaO2/FiO2 ratio &lt;100) and survival to ICU discharge. Secondary outcomes were failed weaning from mechanical ventilation (reintubation in 48 hours after extubation) and occurrence of heparin-related side effects.

Results
There was no statistically significant difference between both groups as regards occurrence of severe ARDS (p-value =.233), mortality (p-value = .354), reintubation within 48 hours (p-value = .419) or thrombocytopenia (p-value = .777). None of the patients developed abnormal prolongation of prothrombin time (PTT). Estimated marginal mean PaO2/FiO2 ratio was significantly higher (p-value &lt; .001) and mean platelet count was significantly lower (p-value = .005) in the nebulized heparin group, with no statistically significant difference in mean PTT (p-value = .074).

Conclusions
Nebulized heparin was associated with improved oxygenation but was did not reduce the incidence of severe ARDS, failed weaning from mechanical ventilation or mortality in patients suffering inhalation injury. Nebulized heparin had no effect on prothrombin time but could be associated with clinically unimportant reduction in platelet count.
Fentanyl-Midazolam versus Ketamine-Midazolam in Anesthesia of Patients with Sepsis undergoing Abdominal Surgery
Authors: Zohdy Marwa Mounir , Abo-Elela Sahar K , Hefny Sameh S , Hafez Amr F 
Published: November 2024

Abstract

Background
Induction of anesthesia in hemodynamically compromised patients is a challenge for every anesthetist. Most of the intravenous induction agents have a negative effect on arterial blood pressure and cardiac output. Theoretically, the ideal emergency induction intravenous anesthetic should achieve rapid hypnosis and maintain the hemodynamic stability.

Aim of the Work
to compare the effect of ketamine midazolam versus fentanyl midazolamin anesthesia of septic patients and find which one of them is more effective to maintain hemodynamic stability in patients with sepsis.

Patients and Methods
A randomized controlled double-blinded study was conducted in Ain Shams University hospital after research ethics board approval during the period from June 2020 to June 2022. Written informed consent was obtained from participants or their surrogates before enrollment. Randomization was achieved using a computer-generated sequence. Concealment was achieved using opaque envelopes.

Results
there was no difference between study groups according to serum lactate. intra operative mean arterial blood pressure was higher in ketamine group than fentanyl group and norepinephrine infusion rate was increased in the two groups over the period from the baseline, but the most increase was in the fentanyl compared with ketamine group; as there was a statistically significant difference between them at 2-5 minutes then from 10 to 90 minutes with 10-minutes intervals. There was no statistically significant difference between study groups according to ICU length of stay and mortality rates. In this study we found that ketamine- based induction of anesthesia maintained hemodynamics better than fentanyl-based induction of anesthesia in patient with abdominal sepsis.

Conclusion
In anesthesia of septic patients ketamine midazolam was more effective than fentanyl midazolam in maintenance of hemodynamic stability.