Background & Aims: Sedation and analgesia are important elements of endoscopic examinations; sedation for colonoscopy aims to relieve patient discomfort and anxiety, improve the outcome of the examination, diminish the patient’s memory of the event and achieve comfortable and technically successful endoscopic procedure. Methods: Our prospective study was carried out on 150 patients who were referred for colonoscopy; they were divided into two groups based on the pre-endoscopic sedation given for them: propofol fentanyl or propofol ketamine. Detailed histories, thorough physical examinations, and routine laboratory investigations were performed for all patients, along with monitoring of their vital signs and oxygen saturation levels (before, during and after colonoscopy), to assess safety, efficacy, recovery times, complications of the sedative drugs, comfort of the patients and endoscopists. Results: There was no statistically significant difference between the two groups in terms of age, sex and Body Mass Indexes (BMI). With respect to their Mean Arterial Blood Pressures (MAPs) and heart rates, there was high hemodynamic stability in the propofol ketamine group, and both the groups were efficacious, although the propofol fentanyl group had shorter recovery times than the propofol ketamine group (3±1.7 minutes and 4±2.8 minutes, respectively). However, nausea, vomiting and hypoxia were common in the propofol fentanyl group, while hallucinations were common in the propofol ketamine group. In propofol fentanyl group; there was a significant decrease in the heart rate more common in females (with age range 39-58 years) during and after colonoscopy [p value 0.01]. Conclusion: Sedation with propofol ketamine during colonoscopy was found to be safe and efficacious to achieve hemodynamic stability with fewer complications than propofol fentanyl.

Background and aim: Regional anesthesia is one of the best options anesthetic technique, it was very difficult to be used in pediatrics anesthesia, now a days it becomes more easier and safer with the era of high-quality ultrasound. This study aimed to assess the effectiveness of ultrasound-guided nerve block (ilioinguinal/iliohypogastric; II/IH) in pediatric unilateral inguinal herniorraphy, time for first analgesic dose, parents, surgeon satisfaction and complication.Patients and methods: The study was done in Zagazig university hospital after approval of the ethical committee. Induction of anesthesia using sevoflorane MAC (Minimal Alveolar Concentration) 4%-6% then Laryngeal Mask Airway was inserted (LMA). Ultrasound-guided (ilioinguinal/iliohypogastric) nerve block was performed on 20 male pediatric patients their age ranged from 4 to 10 years old with ASA status I and II, with unilateral inguinal hernia. hemodynamics as heart rate (HR) blood pressure systolic/diastolic (SBP/DBP) was reported also Children Infants Postoperative Pain (CHIPPS) score was recorded every 2 h until 12 h and time for first analgesic dose also reported. Results: Our result showed no significant changes in heart rate (HR) and blood pressure (BP) at skin incision; HR (95 ± 8), BP (97.6±/50 ± 5) and intraoperative HR (93.5 ± 6), BP (99.6 ± 9/51 ± 4) compared with the basal readings; HR (113 ± 10), BP (104 ± 12/53 ± 6). Pain score was evaluated using (ChIPPS), it started to increase after 4 to 5 h and reported by first analgesic dose (5.2 ± 1.5) that managed by paracetamol (15 mg/kg/day). Surgeon and parents were satisfied. Early ambulation and less hospital stay. Less complications (no motor block or urine retention). Conclusion: Ultrasound-guided (ilioinguinal and iliohypogastric) nerve block was found to be an ideal intraoperative anesthetic and postoperative analgesic for unilateral inguinal herniorrhaphy in children with no complications.

Background: Trigeminal neuralgia (TN) is a painful condition characterized by sudden onset, severe unilateral, brief, stabbing recurrent episodes electric shock like pain in the distribution of one or more branches of the trigeminal nerve. Many approaches were used for treatment of TN as balloon decompression, thermocoagulation radiofrequency (TRF), and pulsed radiofrequency (PRF). Objectives: This study evaluated the effectiveness of combined PRF and TRF for long-term therapy of patients with idiopathic TN. Patient and methods: Our prospective study was carried out after the approval of ethical committee of Zagazig University Hospital Pain Management Unit from June 2017 to May2019. Overall, 20 adult patients suffering from idiopathic TN who treated with combining PRF and TRF for the gasserian ganglion. PRF (continuous for 20 min, at 42°C) followed by TRF (for 60 s at 70°C, then for 60 s, at 75°C) was performed to the gasserian ganglion. The post-operative pain relief and complications were evaluated at first day, 1, 3, 6, 12, 18, and 24 months after treatment. Results: There were significant improvements of pain relief as regards Visual Analog Scale showed baseline VAS [8.65 ± 0.59] and first day, 1, 3, 6, 12, 18, 24 months [3.60 ± 1.09, 2.55 ± 0.69, 1.7 ± 0.65, 1.05 ± 0.68, 0.85 ± 0.67, 0.80 ± 0.69, 0.9 ± 0.69], respectively, facial numbness and postoperative masseter muscle weakness recovered more rapidly in patients receiving combined PRF and TRF therapy. Conclusion: Combination of PRF followed by TRF is effective in treating TN pain with minimal postoperative complications.