Problem statement: The purpose of this study was to evaluate the onset and duration of sensory and motor block as well as operative analgesia and adverse effects of Dex Metedo Midine (DXM) or fentanyl given intrathecally with plain 0.5% bupivacaine for spinal anesthesia. Approach: seventy six patients classified as American Society of Anesthesiologists (ASA) status I, II and III scheduled for vaginal hysterectomy, vaginal wall repair and tension free vaginal tape were prospectively studied. Patients were randomly allocated to receive intrathecally either 10 mg isobaric bupivacaine plus 5 µg dexmetedomidine (group D n = 38) or 10 mg isobaric bupivacaine plus 25 mg fentanyl (group F n = 38), the onset time to reach peak sensory and motor level, the regression time for sensory and motor block, hemodynamic changes, and side effects were recorded. Results: Patients in group D had significant longer sensory and motor block times than patients in group F. the mean time of sensory regression to S1 was 274±73 min in group D and 179±47 min in group F (P < 0.001). The regression time of motor block to reach modified Bromage 0 was 240±60 min in group D and 155±46 min in group F (P< 0.001). The onset times to reach T10 dermatome and to reach peak sensory level as well as onset time to reach modified Bromage 3 motor block were not significantly different between the two groups. Conclusion: In women undergoing vaginal reconstructive surgery under spinal analgesia, 10 mg plain bupivacaine supplemented with 5 µg dexmetedomidine produces prolonged motor and sensory block compared with 25 µg fentanyl.

Intravenous administration of dexmedetomidine intraoperatively during hypospadius repair in children reduces intraoperative and postoperative analgesic requirements and lowers heart rate and blood pressure.

Background: Jordan implemented a nationwide lockdown and recommended self-quarantine in response to the COVID-19 pandemic. Such measures are expected to have consequences on mental health. Aims: In this study, we aimed to estimate the prevalence of quarantine-related anxiety and its socioeconomic correlates. Methods: An online questionnaire was utilized to collect information about quarantine-related anxiety and related factors from a non-representative sample of Jordanian population in March 2020. The Beck Anxiety Inventory (BAI) was used to ascertain the level of stress. Using STATA 16, multivariable ordinal logistic regression was done to estimate beta-coefficient (β) and corresponding 95% CI of the anxiety level. Results: Overall, 5274 participants returned the survey. The prevalence of mild, moderate, and severe anxiety was 21.5%, 10.9%, and 6%, respectively. Female gender (β= 0.47, 95% CI: 0.34 to 0.59) and more members of the household (β= 0.04, 95% CI: 0.00 to 0.07) were correlated with a higher degree of anxiety, while older age (β=-0.27, 95% CI:-0.33 to-0.20), having larger social network (β=-0.17, 95% CI-0.22 to-0.13), social support (β=-0.28, 95% CI:-0.32 to-0.23), and higher income (>2000 Jordanian Dinars vs reference, β=-0.52, 95% CI:-0.71 to-0.33) were correlated with lower BAI scores. Conclusion: Our findings showed that approximately four out of every ten participants experienced quarantine-related anxiety. Younger participants, women, and people with poor social support were more likely to experience quarantine-related anxiety. These findings highlight the importance of targeting these groups to mitigate the consequence of home quarantine on public health.

Ondansetron or dexamethasone added to collective anesthetic antiemetic measures does not further decrease the incidence of PONV after laparoscopic cholycestectomy.