Background Paravertebral block can be performed with the aid of surgical landmarks, ultrasound, or a thoracoscope. This study was designed to compare ultrasound-guided paravertebral block with the thoracoscopic technique. Methods This prospective randomized comparative study included 40 adults scheduled for elective thoracic surgery. Study participants were randomized to an ultrasound group or a thoracoscope group. A catheter for paravertebral block was inserted prior to thoracotomy with real-time ultrasound visualization in the ultrasound group, and under thoracoscopic guidance in the thoracoscope group. Total analgesic consumption, visual analogue pain score, technical difficulties, and complications were compared between the 2 groups. Results Total analgesic consumption in the first 24 hours was less in the ultrasound group than in the thoracoscope group (rescue intravenous fentanyl 121.25 ± 64.01 µg in the ultrasound group vs. 178.75 ± 91.36 µg in the thoracoscope group; p = 0.027). Total paravertebral bupivacaine consumption was 376.00 ± 33.779 mg in the ultrasound group and 471.50 ± 64.341 mg in the thoracoscope group ( p < 0.001). Technical difficulties and complications in terms of time consumed during the maneuver, more than one needle pass, and pleural puncture were significantly lower in the ultrasound group than in the thoracoscope group. Conclusion Ultrasound-guided paravertebral catheter insertion is more effective, technically easier, and safer than the thoracoscope-assisted technique.

Background: Plasmapheresis is a procedure carried out for various life-threatening and debilitating diseases as a principal mode of treatment or as an adjunct with other therapies. It is a process involving extracorporeal removal of plasma from other components of blood, discarding and replacing plasma with physiological fluids. Aim: The present study was conducted to assess needs for the patients undergoing plasmapheresis and develop suggested guidelines. Research design: A descriptive exploratory design.Setting: The study was conducted in hemodialysis unit at urology and nephrology center and hemodialysis unit affiliated to Mansoura university hospitals. Methods: A purposive sample of 108 patients undergoing plasmapheresis that met the following selective criteria, from both genders, adult focal segmental glomerulosclerosis patients prepare for renal transplantation, adult patients after renal transplantation rejection, patients suffer from immunological disorder (systemic lupus) and patients undergoing plasmapheresis and agree to participate in the study. Results: Majority of studied patients had unsatisfactory level of overall knowledge needs of patients undergoing plasmapheresis. More than one third of patients were partially physically dependent and about one third of them were minimally physically dependent. Regarding psychological needs, Most of the patients under the study had anxiety level while the majority of the studied patients suffer from borderline depression. Regarding social needs the current study revealed that about more than one third of studied patients were very socially dependent. Conclusion:The highest dependence needs were anxiety followed by knowledge needs, depression, total physically dependent lastly totally socially dependent. Also, there wasn't a statistically significant relationship between knowledge needs and their educational level and occupation among the studied patients. There was a statistically significant relationship between physical needs and age. Recommendations: Providing of simple booklet written in Arabic language for all plasmapheresis units to improve patients' knowledge level & Psychosocial counseling should be provided by specialist for them to facilitate dealing with anxiety and depression and improve their mental health and social dependance.