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Background and aims: we aimed to detect the outcome values of adding fentanyl, dexamethasone and sodium bicarbonate to mixture of local anesthetic in peribulbar block for vitreoretinal surgery. Methods: 120 adult ASA I & II patients, admitted for vitreoretinal surgery under peribulbar block were included in this comparative study. This study included 4 groups: Group I: (30) patients using a mixture of 1 ml normal saline, 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group II: (30) patients using a mixture of 1 ml of sodium bicarbonate (from 1 ml sodium bicarbonate 8.4% diluted in 10 ml normal saline), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group III: (30) patients using a mixture of 1 ml fentanyl 20 μg (from a mixture of fentanyl 100 µg diluted in 5 ml normal saline), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group IV: (30) patients using a mixture of 1 ml of 4 mg dexamethasone (1 ampoule = 8 mg/2 ml), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. We measured the onset and duration of anesthesia, IOP, eyelid and global akinesia, postoperative pain by numerical pain rating scale, first analgesic requirement and postoperative side effects. Results: No significant differences were detected among the four groups as respect to age, sex and the intraocular pressure (IOP) before the anesthesia block. While the intraocular pressure (IOP) after the anesthesia block there was a significant difference, as IOP was markedly decreased postoperatively in group II compared with other groups. As regard to the onset

Background and Objectives: The main benefits of laparoscopic surgery in comparison to open surgery involve the rapid discharge from recovery room, decreased postoperative hospital stays, reduced postoperative discomfort, easier getting back to work and faster return to ordinary daily life as well as cosmetic surgical wounds. The anesthesia type has an essential role in attenuation of the surgical stress and achievement of these advantages. We aimed to determine the outcome of giving general anesthesia in conjunction with thoracic epidural analgesia (TEA) compared to general anesthesia alone on stress response to surgery and anesthesia by investigating cytokine reaction (interleukin 6 and 8 levels), hemodynamic changes (BP, HR, RR, SPO2), and Visual Analogue Scale (VAS) scores postoperatively in patients subjected for laparoscopic cholecystectomy. Methods: This study included 40 patients aged 20-60 years old with American Society of Anesthesiologists physical status (ASA) I and II. They were planned for laparoscopic cholecystectomy at Aswan University Hospital from April 2017 to March 2018. They were randomly allocated into two groups. Group A (n. 20) received general anesthesia only and Group B (n. 20) received general anesthesia in conjunction with thoracic epidural analgesia using fentanyl and bupivacaine in the epidural catheter. Chi-square was applied to differentiate categorical variables, whereas comparison between continuous variables was done by using t-test.

Background: Preoperative use of oral pregabalin was a recommended option for managing acute postoperative pain, a promising way to induce hypotension and reduce postoperative analgesic requirements during dacryocystorhinostomy operation.Objectives: Study was designed to estimate the effect of oral pregabalin on deliberate hypotension, postoperative pain and total postoperative analgesic requirements during dacryocystorhinostomy surgery under local anesthesia. Methods:This double blind randomized clinical study included 80, ASA I-II patients prepared for dacryocystorhinostomy under local anesthesia. The study enrolled two groups, Group I where patients received 300mg pregabalin capsule orally, one hour before surgery. Group II (control group) where patients received placebo capsule orally, one hour before surgery. Mean arterial blood pressure was maintained within no more than 20% to 30% lower than baseline with co-administration of nitroglycerin. We assessed acute postoperative pain using visual analogue scale (VAS) score until 24 hours after surgery. Also, intraoperative bleeding was evaluated by the visibility of the operative field during dacryocystorhinostomy operation by Fromm and Boezaart scale. Duration from the end of surgery till first requirement of analgesia of pethidine and the overall dose of pethidine used in the first 24 hours and side effects were recorded. Total requirement of nitroglycerin administration and undesirable side effects of pregabalin were also recorded. Data were analyzed using Student's t-test and chi-square test. P<0.05 was considered significant.Results: Decreased postoperative pain, minimal Fromm and Boezaart scale of bleeding, lower total dose of nitroglycerin required, low dose of pethidine, less side effects and less number of patients needed analgesia were observed in group I (pregabalin group) than in group II (control group). Conclusion:Pre-emptive oral Pregabalin had the efficacy of reducing the intensity of pain during dacryocystorhinostomy, reducing consumption of opioids with its unwanted side effects after the operation, and minimizing the need for intraoperative uses of hypotensive agents with enhancement of surgical field visibility.