bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of U/S Guided Erector Spinea Plane Block for Post-Operative Pain Control in Breast Surgeries
Authors: Din Abdel Wahab Qara'ah Alaa El , Malek Fady Adib Abdel , Fahim Hani Magdy , Abo AlMagd Mohamed Sayed 
Published: November 2024

Abstract

Background
Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related mortality among females in more than 100 countries. The traditional therapeutic approaches for breast cancer include surgery, radiation therapy, chemotherapy, Immunotherapy and endocrine therapy, surgical resection is still considered to be the primary and most effective therapy.

Objective
To evaluate the analgesic effect of ultrasound-guided erector spinae plane (ESP) block in breast surgery postoperatively

Methods
This was randomized controlled clinical trial that was held in major operating theaters in el demerdash hospital, Ain Shams University, Cairo, Egypt for 6 months on females undergoing breast surgeries aged between 21 - 45 years.

Results
Our results reported that there was highly statistically significant difference found between Group I and Group II regarding Postoperative pain scores Immediately, Postoperative pain scores After 5min, Postoperative pain scores After 10 min, and there was no highly statistically significant difference found between Group I and Group II regarding Postoperative pain scores After 15min, Postoperative pain scores After 20min, Postoperative pain scores After 25min and Postoperative pain scores After 30min. There was highly statistically significant difference found between Group I and Group II regarding Total morphine consumption (mg) and Number of patients requiring morphine. Also, there was highly statistically significant difference found between Group I and Group II regarding Mean arterial blood pressure (mmHg) Immediately, and there was no highly statistically significant difference found between Group I and Group II regarding Mean arterial blood pressure (mmHg) After 5min, Mean arterial blood pressure (mmHg) After 10 min, Mean arterial blood pressure (mmHg) After 15 min, Mean arterial blood pressure (mmHg) After 20 min, Mean arterial blood pressure (mmHg) After 25 min and Mean arterial blood pressure (mmHg) After 30 min. Regarding Patients satisfaction, there was statistically significant difference found between Group I and Group II

Conclusion
Ultrasound-guided ESP block with general an aesthesia offers superior post-operativeanalgesia compared to general an aesthesia alone in patients undergoing unilateral non-reconstructive breast cancer surgeries and is associated with better patient satisfaction scores at discharge. There was no significant difference in intraoperative morphine consumption. The ultrasound-guided ESP block appears to be an effective block for postoperative analgesia in breast cancer surgery.
Ultrasound Guided Quadratus Lumborum Block versus Transversus Abdominis Plane Block in Post-Operative Pain Management after Laparoscopic Sleeve Gastrectomy
Authors: Elsaid Amr M , Hussien Rania M , Mahrose Ramy A , Abd Elraziq Mohamed Y 
Published: November 2024

Abstract

Background
ultrasound-guided quadratus Lumborum block (QLB) performed as one of the postoperative pain management procedures for patients undergoing abdominal surgeries.

Objective
The aim of this study is to compare the effect of ultrasound guided bilateral QLB versus bilateral ultrasound guided Transversus abdominis plane (TAP) block on postoperative analgesia in patients undergoing laparoscopic sleeve gastrectomy (LSG) under general anesthesia.

Patients and Methods
Setting and design: pilot exploratory study conducted on 45 patients scheduled for elective LSG. All patients received general anesthesia using IV fentanyl (1-2 Mg/kg). QLB Group (15 patients): received ultrasound-guided QLB after induction of general anesthesia using 0.2 mL/kg of 0.25% bupivacaine per side. TAP Group (15 patients): received ultrasound-guided TAP block after induction of general anesthesia using 0.2 mL/kg of 0.25% bupivacaine per side. Control Group (15 patients): received general anesthesia and then 1gm IV paracetamol and 30mg IV ketorolac 1 hour and 8 hour postoperative.

Results
there was statistically significant difference between the three groups as regards the VAS score, total dose of pethidine used postoperatively, number of patients needed rescue analgesia and postoperative hemodynamics; indicating that TAP block was more effective than intravenous drug analgesia, while QLB was more effective than TAP block.

Conclusion
QLB was the most effective technique in providing analgesia after LSG in comparison to TAP block and intravenous analgesic drugs.
The Effect of Quadratus Lumborum Block vs Erector Spinae Block in Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy
Authors: Abd Elhady Abo Elkassem Mostafa Moharram , Abd Elhamid Hadeel Magdy , Khattab Salwa Omar , Farrag Ossama Mohamed 
Published: November 2024

Abstract

Background
However, the postoperative pain following laparoscopic cholecystectomy consists of both somatic and visceral components with pain originating from port entry wounds, gallbladder resection and abdominal insufflation that leads to peritoneal distention and peritoneal damage.

Aim of the Work
to compare analgesic efficacy of Quadratus lumborum block versus erector spinae block in postoperative analgesia in patients undergoing laparoscopic cholecystectomy.

Study Design
prospective randomized controlled clinical trial

Methods
This prospective randomized controlled clinical trial was conducted at operative theatres, Anesthesiology, Intensive Care and Pain Management Department, Faculty of Medicine, Ain Shams University Hospitals from March until August 2023. During this study, 80 patients electively scheduled for laparoscopic cholecystectomy were enrolled and divided into two equal groups; group A subjected to quadratus lumborum block and group B subjected to erector spinae block. Intraoperative, Post Anaesthesia Care Unit and postoperative haemodynamic, postoperative VAS score, first time of postoperative analgesic request, total amount of postoperative analgesia, time needed for postoperative mobilization and side effects of study procedures were evaluated.

Results
In this study there was no significant difference between the two groups as regards VAS score. In this study there was no significant difference between the two groups according to total amount of analgesia needed post operatively. In this study there was no significant difference between the two groups according to total amount of analgesia needed post operatively. In this study time needed for mobilization was insignificant different between two groups. In this study, no statistically significant disparity was observed between the two groups in terms of side effects. In this study, no significant difference was found between the two groups according to the first time postoperative analgesia.

Conclusion
This study showed comparable effect of both QLB and ESPB in patients undergoing laparoscopic cholecystectomy.
Comparative Study between Ultrasound Guided Pectoral Nerve Block Type-II (PECS II) and Serratus Anterior Plane Block (SAPB) in Postoperative Analgesic Efficacy in Modified Radical Mastectomy
Authors: Nemr Nouran Ehab , Mohsen Abdel Lateef Samia Abdel , Hamawy Tamer Youssef , Abdel Tawab Samar Mohamed 
Published: November 2024

Abstract

Background
Breast cancer has continued to be the most common cancer afflicting women, accounting for 31% of all new cancer cases in the female population. Every year, thousands of patients undergo surgery in the region of the breast and axilla. Surgery is one of the mainstays of treatment, and a procedure called modified radical mastectomy (MRM) is now a standard surgical treatment for early-stage breast cancers.

Aim of the Work
to evaluate the effectiveness of ultrasound guided pectoral nerve block (PECS II) versus serratus anterior plane block (SAPB) for postoperative Analgesia in modified radical mastectomy.

Patients and Methods
After obtaining approval from the medical ethical committee in Ain Shams University and written informed consent. This Double Blind Prospective Randomized Controlled study was conducted in the operating theatres of Ain Shams University Hospitals. It included Sixty Female patients undergoing Modified Radical Mastectomy.

Results
The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling 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
SAPB was effective in reducing postoperative pain scores for 6 -12 hours and lower total 24-h postoperative opioid and analgesic consumption after Modified Radical Mastectomy under general anesthesia, compared to PECS II block.
Comparative study between Inferior Vena Cava Collapsibility Index (IVCCI) and Serum Lactate Level as Weaning Predictors of Vasopressors in Septic Shock Patients
Authors: Mohammed Ali Osama Mohammed , Elazzazi Hesham Mohammed , Zekrey Milad Ragaie , Ahmed Youssef Ahmed Monier 
Published: November 2024

Abstract

Background
Sepsis is a complex disorder that develops as a dysregulated host response to an infection, and is associated with acute organ dysfunction and a high risk of mortality. This syndrome needs urgent treatment, and thus awareness of the presenting characteristics is of great importance. The incidence of sepsis is high, and the condition remains one of the leading causes of death globally. Thus, sepsis is an important public health issue with considerable economic consequences.

Aim of the Work
to elaborate the effectiveness of IVC collapsibility index versus serum lactate level as predictors for weaning from vasopressors in septic shock patients.

Patients and Methods

Results
There were no statistically significant correlations between vasopressor doses, serum lactate or IVCCI at different time- points. To stratify the predictive value of serum lactate and IVCCI in weaning from vasopressors, patients were divided into 2 groups at the end of the 2nd day and at the end of the 3rd day: Weaned group and non- weaned group. Both groups were compared and performance of serum lactate and IVCCI in prediction of weaning from vasopressors at different time- points was assessed using Receiver Operator Characteristics analysis. At different measurements, IVCCI had larger area under curve with better diagnostic performance than serum lactate in prediction weaning from vasopressors.

Conclusion
serum lactate and inferior vena cava collapsibility index decrease significantly with improvement of sepsis and subsequent reduction of vasopressor doses. Changes in serum lactate and inferior vena cava collapsibility could predict changes in vasopressor doses with better performance for inferior vena cava collapsibility index.
Comparative Study of Nebulized Dexmedetomidine and Intramuscular Ketamine for Premedication in Paediatric Patients Undergoing Hernia Repair Surgery
Authors: Shoukry Randa Ali , Naseef John Nader , El Sayed Ahmed El Sherif Ibrahim Mohamed , Hassan Bayoumi Rana Galal 
Published: November 2024

Abstract

Background
Infants and preschool children that require surgery and imaging are often anxious, due to the separation from their parents, fear of doctors, and unfamiliar environments, and it is often difficult to obtain their cooperation.

Aim of the Work
It was to determine the sedative effect of inhaled nebulized dexmedetomidine as a premedication for pediatrics compared to intramuscular ketamine.

Patients and Methods
60 patients, aged 2 to 8 years of both sexes scheduled for hernia repair surgery under general anesthesia, were randomized to two equal groups. Patients in group D received dexmedetomidine (2 µg/kg), and patients in group K received ketamine (5 mg/kg) before the induction of anesthesia.

Results
Sedation scale (RSS) was significantly lower in Dexmedetomidine group than in Ketamine group at minutes-5, 10 and 15. Acceptable sedation was significantly less frequent in Dexmedetomidine group than in Ketamine group at minutes-5, 10 and 15. Dexmedetomidine group significantly had more frequent excellent parental separation anxiety and less frequent fair parental separation anxiety than Ketamine group had. Acceptable parental separation was significantly more frequent in Dexmedetomidine group than in Ketamine group. Dexmedetomidine group significantly had more frequent excellent mask acceptance and less frequent fair mask acceptance than Ketamine group had. Satisfactory mask acceptance was significantly more frequent in Dexmedetomidine group than in Ketamine group. Recovery time was significantly shorter in Dexmedetomidine group than in Ketamine group. Watcha score was higher in Dexmedetomidine group than in Ketamine group beginning from minute-0 until minute-30, but the differences were statistically significant only at minutes-25 and 30. Emergence agitation (Watcha-3/4) started to appear in Dexmedetomidine group at minute-20 and its frequency increased until minute-30, while in Ketamine group Emergence agitation (Watcha-3/4) appeared at minute-30. Emergence agitation (Watcha-3/4) was more frequent in Dexmedetomidine group than in Ketamine group in minutes-20, 25 and 30, but the differences were statistically significant only at minutes-25 and 30. Bradycardia and hypotension were more frequent in Dexmedetomidine group, but the differences were statistically significant only in case of bradycardia.

Conclusion
Dexmedetomidine nebulization had better smooth separation from parents and had satisfactory acceptance of face mask for induction of general anesthesia compared to intramuscular ketamine. Sedation was the same between the two groups. Emergence agitation was higher in Dexmedetomidine group.
Intranasal Dexmedetomidine (Precedex) versus Intranasal Midazolam (Dormicum) as a Premedication in Pediatrics Undergoing Upper GI Endoscopy
Authors: Shoukry Randa Ali , Hanafy Amira Fathy , Salem Reem Refaat Muhammed Refaat Marwa Mostafa 
Published: November 2024

Abstract

Background
Upper GI endoscopy is one of the most common surgical procedures performed in pediatric patients. Relieving pre- and post- operative anxiety is an important concern for the pediatric anesthesiologist. Anxiety can produce aggressive reactions, increase distress, and may make the control of postoperative pain difficult. Pre-anesthetic medication in children should aim at relieving this anxiety and psychological trauma and also to facilitate the induction of anesthesia without prolonging the recovery.

Aim of the Work
The aim of this work is to compare the effectiveness of intranasal dexmedetomidine and midazolam as a premedication in sedation of preschool children in GI endoscopy.

Patients and Methods
A prospective, randomized and double blind clinical trial was done after approval of institutional ethics committee in Ain Shams University Hospitals for 6 months and obtaining an informed written consent from parents. It was designed to include 70 pediatric patients, aged 2 to 6 years old of both genders, with physical status ASA I – II.

Results
In the present study, the children were satisfactorily separated from parents in dexmedetomidine group when compared to the midazolam group; p value &lt;0.001 as also documented by Ayushi that Parental separation was successful in 73.3% of patients in Group SD compared with 46.7% of patients in Group SM (P = 0.035). Furthermore, children in dexmedetomidine group achieved significant lower agitation and delirium postoperative after drug in comparison to midazolam group; regarding delirium: p value &lt;0.001, and regarding agitation: p value &lt;0.001.

Conclusion
Premedication with intranasal dexmedetomidine 1 μg/kg attained significant and satisfactory sedation with better parent separation and lower agitation and delirium in the postoperative period as compared to intranasal midazolam 0.2 mg/kg in children undergoing upper GI endoscopy although dexmedetomidine had a delayed onset of action when compared to that of midazolam.
A Comparative Study of Subinguinal Microscopic versus Open Surgical Varicocelectomy in Treatment of Primary Varicocele
Authors: Abdallah Hany Mostafa , El-Sayed Tarek Osman , Radwan Ahmed Ibrahim , Abdel Aziz Aly Abbas Khalaf 
Published: November 2024

Abstract

Purpose
To compare the outcome between microscopic and conventional subinguinal varicocelectomy regarding improvement in semen quality and pain resolution in patients who complain of varicocele-related infertility, pain, or both.

Patients and Methods
A prospective interventional non randomized controlled trial was carried out on 64 patients who met the criteria and allocated to two groups, group A (n = 34) underwent microscopic sub inguinal varicocelectomy, and group B (n = 30) underwent conventional sub inguinal varicocelectomy. A 3-month postoperative semen analysis was compared to the preoperative one, and pain was assessed preoperatively, 1 month and 3 months postoperatively.

Results
Both study groups showed significant improvement in the semen quality. Moreover, improvement in semen parameters was significantly higher in group A when compared to group B. Improvement in sperm concentration was 89.2 % and 41.7%, and in progressive motility was 100% and 50% for group A and B, respectively (P &lt; 0.01). At 1 month and 3 months postoperatively, pain score was significantly lower in group A (Median = 0 & 0, respectively) in contrast to group B (Median = 2 & 0, respectively) (P &lt; 0.01).

Conclusion
In patients who suffer from varicocele-related infertility or pain, microsurgical technique in sub inguinal varicocelectomy gives better results in improvement of semen quality and pain resolution when compared to the conventional technique.
The Effect of General Anesthesia on Liver Function Tests in Patients with Portal Hypertension
Authors: Lotfy Atallah Youstina Magdy , Muselhy ElAnsary Adel Mohamed , Wahba Gobran Ramy Mounir , Zakhary Lydia Edward Aziz 
Published: November 2024

Abstract

Background
Patients with liver disease and portal hypertension usually as a result of advanced fibrosis or cirrhosis, are at increased risk of complications when undergoing surgery.

Aim of the Work
The aim of the study is to assess the changes in liver functions postoperatively in patients with portal hypertension undergoing abdominal or pelvic surgeries, to assess intra operative complications in patients with portal hypertension undergoing general anesthesia, for abdominal or pelvic surgeries.

Patients and Methods
The type of this study is prospective Observational Study, conducted at Ain Shams University Specialized Hospital on 40 patients in 6 months duration.

Results
In this study, we compared changes in liver functions postoperative in patients with portal hypertension undergoing pelvic surgery or abdominal surgery and there were highly significant difference between pre operative and post operative labs as postoperative Hb, Plts level decreased while INR, liver enzymes, bilirubin level increased than preoperative. There was significant difference between pelvic surgery and abdominal surgery of the studied patients regarding intra-operative blood loss as amount of blood loss intraoperative increased in abdominal surgery more than pelvic surgery. In this study, we compared between pelvic surgery and abdominal surgery regarding laboratory data post operative, and there were highly significant difference in labs postoperative between them as liver enzymes increased, Hb, Plts levels decreased in abdominal surgery more than pelvic surgery. In our study we compared between child B, child C classification patients there was highly significant difference between them regarding total time of surgery as time of surgery increased in child C patients more than child B patients, there were highly significant difference between them postoperative regarding hepatic encephalopathy, Bilirubin as they affected more in child C patients and there were highly significant difference between them regarding blood products transfusion as child C patients received more amounts of PRBCS, FFP, Plts transfusion than child B patients.

Conclusion
Patients with underlying liver disease have an increased surgical risk. Prediction of surgical risk is based on the degree of liver dysfunction, the type of surgery, and the preoperative clinical status of the patient as previously mentioned.
Study of Effects of Amino Acids Infusion on Perioperative Hypothermia and Postoperative Shivering in School-Age Children Scheduled for Abdominal Surgeries
Authors: Mohamed Hegazy Yumna Ahmed , Ali Sultan Sherif Sayed , Shabanna Tarek Samir , Hafez Helmy Amr Fouad 
Published: November 2024

Abstract

Background
Hypothermia is one of the reported side effects of general anesthesia. Deviations from normothermia are associated with numerous complications and adverse outcomes, with infants and small children at the highest risk.

Aim of the Work
to assess the role of perioperative amino acid infusion in the prevention of perioperative hypothermia and postoperative shivering in school-age children.

Patients and Methods: Study
Randomized Controlled Double Blind Study. Study Setting: Ain Shams University Hospitals, Cairo, Egypt. Study Period: 6 months. Study Population: School age children undergoing abdominal surgery.

Results
The present study involved fifty-two patients divided into two groups. Group A consists of twenty-six patients who received IV amino acid infusion, and Group B (control) consists of patients who received an equivalent volume of Ringer’s solution. In addition, the current study analyzed temperature fluctuations between the two distinct groups. Initially, no statistically significant difference was found in temperatures at baseline, during induction, and minute-15 intraoperatively between the Amino Acid and Control groups. This initial parity in the temperature profiles indicates a well-matched starting point for temperature measurements. In addition, the current study revealed a significant difference in the frequency of perioperative hypothermia between the two groups. Importantly, all cases of hypothermia observed in this study were classified as mild. In the Amino Acid group, perioperative hypothermia occurred less frequently when compared to the Control group. This statistically significant difference suggests that the infusion of amino acids may have a protective effect against the development of hypothermia in school-age children undergoing abdominal surgeries.

Conclusion
We conclude that intraoperative hypothermia is relatively frequent complication that can have adverse physiological effects. Maintenance of normothermia during anesthesia and surgery decreases the overall morbidty. Intraoperative hypothermia could be prevented or at least decreased by using one or more of different methods for this purpose.