No abstract

Our study was designed to evaluate the efficacy of Ropivacaine 0.75% plus Lidocaine 2% versus Bupivacaine 0.5 % plus lidocaine 2 % to provide peribulbar anaesthesia for cataract surgery .Time to adequate block for surgery, ocular eyelid movement scores at 8 min after block and quality for postoperative analgesia were recorded. Sixty patients are randomly divided into two groups of 30, to receive a peribulbar block with 8 -10 ml of either Ropivacaine -Lidocaine or Bupivacainelidocaine,and 15U Hyaluridase per ml with each combination .There was no difference between the two groups in clinical endpoint , Median time at which the block was adequate to start surgery was 8 min. ( 4-10 min ) in each group . Median eyelid movement scores were similar in both groups, yet the lower potential for systemic toxicity of ropivacaine compared with bupivacaine enables it to be used for surgical anesthesia in higher concentration which may facilitate diffusion of local anesthetic molecules into peripheral nervous tissue, improving the onset of nerve blockade.

Background Invasive mechanical ventilation (IMV) for management of chronic obstructive pulmonary disease (COPD) associated respiratory failure is increasing in Intensive Care Units. The bridging process from IMV to extubation is called weaning in which mechanical ventilation is gradually withdrawn and the patient resumes spontaneous breathing. Many objective parameters have been defined for weaning success. The following review focuses on the different weaning methods in patients chronic obstructive pulmonary disease with respiratory failure. Objective To compare among the different methods of weaning in chronic obstructive pulmonary disease patients with respiratory failure weaned with different method ie BIPAP, CPAP and T-Piece. Patients and Methods Cross sectional descriptive study. 60 patients diagnosed as COPD with respiratory failure on MV, will be recruited from ICU Department Zefta general hospital. This study included 60 patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) with age more than18 years old admitted in adult ICU Department in Zefta general hospital that are on mechanical ventilation. These patients fulfilled the inclusion criteria of the study. Patients were classified randomly into 3 groups. Results In this study I try to overcome these challenges by studying the effect of using of NIPPV both CPAP or BIPAP immediately after extubation or using T piece for 1 hour followed by extubation and using oxygen therapy that BIPAP improves patient gas exchange, hemodynamics and associated with shortest ICU stay which reflects on utilization of resources. Conclusion We suggest that BIPAP improves patient gas exchange specially in hypercapnic patients, hemodynamics and associated with shortest duration of ICU stay and decrease rate of reintuabtion.

Background Cesarean section rate increased those days and postoperative pain control. The goal of postoperative pain management is provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using multimodal analgesic therapy, preference for regional techniques, avoidance of sedatives, non-invasive ventilation with supplemental oxygen and early mobilization. Objectives The aim of this study was to assess the analgesic efficacy of ultrasound-guided trans-muscular QLB compared with TAP block after cesarean section surgeryperiod regarding pain relief, provision of comfort, and improved respiratory functions. Patients and Methods After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, female patients were included in the study, and were divided into three groups (n = 20; each); group QLB and group TAP. Group QLB: Patients (n = 20) of this group received bilateral ultrasound-guided QLB after induction of general anesthesia using 0.2 ml/kg bupivacaine 0.125%, Group TAP: Patients (n = 20) of this group received bilateral ultrasound-guided TAP block after induction of general anesthesia using 0.2 ml/kg bupivacaine 0.125%. Results The current study also measured and compared postoperative VAS score and firs time to rescue analgesia and the total amount of opioid (pethidine) given in the first 24 hours with the standard deviation for each of the two groups studied we found that TAP patients had the highest values compared to the QLB group. This is mainly due to the extension of the local anesthetic agent beyond the transverse abdominal plane to the thoracic paravertebral space, which then results in more analgesia, even somatic and visceral pain control. Conclusion Quadratus lumborum block was the most effective technique in providing analgesia after cesarean section without associated hemodynamic instability in comparison to transversus abdominis plane block and even more time covering to rescue opioid.