Ghandour (2021) Bilateral quadratus lumborum block versus epidural morphine in aortobifemoral bypass graft surgery under general anaesthesia: A prospective randomized controlled study,

Background: This study is a controlled prospective randomized blinded study. Our aim was to evaluate the effect of wound installation with bupivacanie through surgical drains to control postoperative pain and decrease the use of systemic analgesics after mastectomy.Methods: This study was conducted on 168 female patients candidates for modified radical mastectomy admitted to the Surgical Oncology Unit, Faculty of Medicine, University of Alexandria. Patients were randomly divided into two equal groups. Group A Bupivacaine was installed through axillary and chest wall drains by the end of surgery. While, group B was installed by equal amount of normal saline as placebo. We assessed the visual analogue score (VAS), need and timing for systemic analgesics during the first 24 hours.Results: The mean values for VAS were always lower in group A. This was reflected on the timing and need for additional analgesia.Conclusions: We concluded from this study that using bupivacaine instillation through surgical drains is an effective and easy method to control post mastectomy pain and enhance patients' recovery in the first 24 hours postoperative.

Background: The aim of the present study was for comparison of stroke volume versus stroke volume variations as guidance for fluid management under guide directions of electrical cardiometry, during major abdominal surgeries. The primary outcome was to compare between two fluid infusion protocols, regarding the haemodynamic changes, whereas secondary outcomes were to evaluate the impact of each protocol on extravascular lung water and oxygenation changes in the post-operative periods, study the effect of each of the adopted method on postoperative complications, incidence of acute kidney injury and intensive care unit staying duration. Settings and Design: This study was a prospective randomized controlled clinical trial. Methods: The study was carried out on 60 patients scheduled for major abdominal surgery. 30 patients, whose intraoperative fluid administration was managed by stroke volume optimization, were compared with 30 patients who received intraoperative fluid therapy guided by stroke volume variation optimization. Results: There was no difference regarding haemodynamic changes in terms of mean heart rate, mean blood pressure, stroke volume, stroke volume variation, and cardiac index. The first group showed a significant incidence of postoperative pulmonary edema which affected oxygentation process till 24 hours postoperatively.