Addition of an to local anesthetics improves the quality of nerve block and reduces the need for postoperative intake. The study was aimed to compare the efficiency of versus as to local mixture in plexus block. The study included 45 patients scheduled for ambulatory upper extremities operations under the plexus block. The patients were allocated to three equal groups (n=15): (i) Group C: patients received 30 of local anesthetics ( 0.5% + 2% 1:1 mixture) + 2 ml normal saline. (ii) Group D: patients received 30 volume of local anesthetics ( 0.5% + 2% 1:1 mixture) + 8 mg 0.4% (2 ). (iii) Group N: patients received 30 of ( 0.5% + 2% 1:1 mixture) +10 mg (completed to 2 with normal saline). We compared the duration of postoperative analgesia, total consumption, and complications in the first 24 hours. Statistically significant prolongation in the duration of analgesia was noticed in group D and group N with the least consumption in group N. Addition of or to / mixture can prolong the duration of analgesia and reduce consumption after plexus block.
Background
Ultrasound (US) guidance for central venous catheter (CVC) placement is considered gold standard in localization and cannulation, making the procedure safer with less complications.
Objective
To compare the short-axis/out-of-plane (SAX) with the long-axis/in-plane (LAX) technique for US-guided CVC insertion in internal jugular vein in intensive care practice regarding safety and efficacy.
Patients and methods
A prospective randomized trial was conducted in Zagazig University Hospitals, from October 2017 to October 2018. All were randomized into one of two groups according to US guidance technique: SAX technique (group S), including 116 patients, and the LAX technique (group L), including 116 patients, for US-guided CVC insertion in internal jugular vein. The primary outcome was first-attempt success rate of both the SAX and LAX approaches for US-guided vascular catheterization. The secondary outcomes were total success rate, which was defined as successful venous cannulation without complication; cannulation times calculated in seconds; the number of attempts; and complications (hematoma and arterial puncture).
Results
US-guided venous cannulation was successful without complications in 115 (99.14%) patients. Venous access time, catheterization time, and US imaging time were significantly lower in the group S than in the group L (P<0.05). Complications in both groups had no significant difference. Hematoma formation was evident in one patient in group L. Multiple puncture was more in LAX group, with no significant difference.
This paper presents a novel application of watercycle algorithm (WCA) for optimal distribution network reconfiguration (DNR) and distributed generation (DG) allocation in radial distribution network (RDN). WCA is proposed to simultaneously have the optimal topology of RDN and get the optimal DG size and placement. The objective is to minimize power losses and the voltage profile index. in addition, study the variation in both voltage magnitude and voltage stability profiles. Loss sensitivity factor index is utilized to crop the candidate buses for DG allocation aiming to narrow the search space for DG sizing. Moreover, the graph theory is presented to get the fundamental loops that used to reduce the search space for DNR by limiting the infeasible configurations during the optimization process, where the connection matrix of the radial network is used to check the radial constraint of each configuration. The proposed method has been applied on two different RDN with different scenarios. The obtained results verify the effectiveness of the proposed algorithm in comparison with previous works in literature.
After complete hyparthroplasty, postoperative discomfort is a significant issue. In these patients, many methods are often utilised in postoperative analgesia, including neuraxial analgesia, intravenous analgesia and peripheral neuron blocks. The benefit of peripheral nerveblocks is phytosanitary treatment, reduced engine impairment and fewer systemic effects. Common peripheral blocks of nerve for hip operations include suprainguinal fasciailiacablock(FIB) and lumbar plexusblock. The Quadratus lumborum block (QL) is a newly designed lower abdominal and hip chirurgical block with high performance. Seventy patients between 8-70 years of age with ASA physical status I-III were enrolled in the research and were scheduled for dynamic hip screw surgery under subarachnoid block (SAB) hip. Patients were randomly assigned in one of two groups using the hidden closed envelope method: group of FICBs (n=35): this group receives a suprainguinal iliac fascia block, the end of the injection is deep to the fascia iliaca and the lateral portion of the iliacus muscle above the iliacus. 30 mL of 0.25 percent of Bupivacaine is injected gradually beneath the fascial plane and each 5 ml is absorbed after negative aspiration. QLB Group (n=35): the group got ultrasonically-guided lumborum block transmuscular quadratus; (QLB anterior or QLB III) a needle tip between the main muscle of the psoas and the lumborum muscles of the quadratus is inserted. After negative aspiration, 30 mL of 0.25% bupivacaine is gradually administered into the fascial plane, each 5 ml aspiration. Both FIB and transmuscular QLB performed in the first 24 hour postopérative and comparable analgesic duration following hip arthroplasty operations with similar static and dynamic VAS. Both single shot blocks FIB and QLBT offer excellent postoperative analgesia afterTHA. FIB demonstrated a little reduced intake of morphine over 24 hours.
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