Background: In the realm of thoracic surgery, video-assisted thoracoscopic surgery (VATS) is a well-established minimally invasive approach. The objective of the current study is to compare the analgesic effects of erector spinae plane blocks guided by ultrasound vs serratus anterior plane blocks guided by ultrasound in patients undergoing thoracoscopic sympathectomy for palmer hyperhidrosis. Patients and methods: A total of 110 patients, aged between 21 and 40 years old planed for sympathectomy, were randomly allocated into 55 patients who were subjected to erector spinae plane block (ESPB) and 55 patients who were subjected to serratus anterior plane block (SAPB). All patients with VAS more than 30 were received i.v. ketorolac 30 mg every 8 hours. Up to the end of the first 24 hours following surgery, the total amount of fentanyl and paracetamol used was tracked, along with the length of analgesia, the occurrence of side effects during the first 24 hours following surgery, and the patient satisfaction score after 12 and 24 hours. Result: The total analgesic (fentanyl) consumption in 24 h was significantly lower in ESPB group compared with SAPB group. Significantly lower VAS was observed with ESPB. Significantly longer time for the first request to rescue analgesia was recorded with ESPB. Significantly longer time of block performance was observed in ESPB group. Significantly delayed onset of sensory block and less number of fentanyle doses were recorded in ESPB group. No significant difference between ESPB and SAPB as regards to patient satisfaction score and side effects. Conclusion: ESPB shows superior analgesic effect to SAPB in sympathectomy surgeries

Background: A reflex sympathoadrenal response could be elicited by laryngoscopy and intubation in the form of tachycardia and hypertension. These responses could be attenuated to decrease cardiac work and oxygen demands. This study was conducted to assess the role of oral gabapentin in decreasing the stress response associated with intubation. Objective: This study was conducted to assess the role of oral gabapentin in decreasing the stress response associated with intubation. Patients and methods: A total of 70 cases who underwent intracranial surgery in Mansoura University Hospitals were included. They were divided into two groups; group C who received placebo, and group G who received gabapentin 1000 mg orally. Heart rate, blood pressure, and catecholamine levels were measured prior to intubation, then after 1, 5, 10, and 15 minutes. Results there is no correction: When given 1 hr prior to surgery, gabapentin effectively attenuated blood pressure, heart rate, and catecholamine levels compared to the placebo after intubation, although no statistical differences were detected statistically before intubation. Conclusion: Pre-treatment with 1000 mg oral gabapentin before induction of anesthesia is both safe and effective in reducing the stress response to laryngoscopy and intubation.