Background Total thyroidectomy is a common procedure, we wish to examine the effects of utilizing a harmonic scalpel with traditional procedures on parathyroid hormone levels. Patients and methods 100 patients who underwent total thyroidectomy at the Department of General Surgery, were enrolled in this prospective randomized study, were randomly allocated into two equal groups: Group I: total thyroidectomy using a harmonic scalpel (HS) and Group II: total thyroidectomy using conventional technique. Results There is a significant association between the technique of surgery and the decrease in Postoperative PTH, Mean Difference, Pre and Postoperative and the change Pre PTH (p-value <0.001). Conclusion The postoperative serum level of parathyroid hormone declined significantly after thyroidectomy if the conventional method was used. Using HS during thyroidectomy is safe and effective with low rates of hypoparathyroidism.

Article informationBackground: Despite laparoscopic cholecystectomy being less invasive, patients report significant pain within the first 24 h following surgery. To minimize post-operative pain, a number of preoperative, intraoperative, and postoperative pain management techniques are available. These include lowpressure pneumoperitoneum, use of opioids, local anesthetic infiltration, intraperitoneal instillation, thoracic paravertebral or epidural blocks, and intraperitoneal infiltration of local anesthesia. Aim of the work:This research aimed to evaluate rectus sheath block versus local infiltration with regard to efficacy at the port sites with an intraperitoneal injection of bupivacaine for pain control following a laparoscopic cholecystectomy. Patients and Methods:This prospective comparison research involved 80 patients including both genders who were set for laparoscopic cholecystectomy. Two groups of patients were determined: Group I: Received 30 ml of 0.25 % bupivacaine 15 ml for intraperitoneal instillation and 15 ml for local infiltration at the port sites. Group R: Bupivacaine 0.25% in 30 ml was administered bilaterally [RSB] [15 ml on each side]. Results: Regarding postoperative [VAS], there was statistically significant variation among the two groups at 16 and 24 hours postoperatively [p= 0.013]. As for postoperative request analgesia, the intraperitoneal instillation group [11.8 ± 0.34 hour] and the RSB group [17.16 ±4.83 hour] as needed their first dose of rescue analgesic. Statistical analysis revealed clear group distinction [p = 0.002]. Regarding patient satisfaction. No significant variations were observed between the groups. Conclusion:Bupivacaine intraperitoneal infused with local infiltration at the port sites an effective analgesic approach, as is ultrasound-guided rectus sheath block, but [RSB] was better due to longer postoperative pain relief and less opioid consumption. Both methods are easy, risk-free, and without adverse effects.