Objectives We aimed to investigate the safety and efficacy of propofol plus fentanyl versus midazolam plus fentanyl as sedative for patients with advanced liver disease presented for gastrointestinal endoscopy. Methods A total of 100 patients with liver cirrhosis referred for upper endoscopy were enrolled and divided equally in two groups, midazolam plus fentanyl group and propofol plus fentanyl group. All patients were subjected to history taking, estimation of level of sedation, endoscopist rating, and hemodynamic parameters including oxygen saturation, heart rate, mean arterial pressure, incidence of side effect as (bradycardia, hypotension, hypoxia, nausea and vomiting, cough, shivering, or diplopia), time needed for complete recovery, and time needed for discharge. Results There was no statistical significant difference between the studied groups regarding age, sex, weight, Child–Pugh classification score, type and duration of endoscopic intervention, time needed for complete recovery, or time needed for discharge. Complication rates were similar in both groups except for mean arterial blood pressure which was significantly lower in group of patients receiving propofol and fentanyl (P = 0.001). Conclusion The use of either propofol or midazolam in combination to fentanyl is effective in sedation of patients with advanced liver diseases presented for upper GIT endoscope. The trial is registered with ClinicalTrials.gov Identifier: NCT03063866.

No abstract

No abstract

BackgroundPreoperative oral pregabalin could improve postoperative analgesia and prevent chronic pain development. The aim of this study is to evaluate the effect of oral pregabalin on the duration and quality of postoperative analgesia in spinal anesthesia.MethodsSixty adult patients presented for internal fixation of femoral fracture under spinal anesthesia were included in the study. They were randomly distributed to a placebo group and a pregabalin group receiving 150 mg pregabalin capsules 1 hr before surgery. The onset, duration, and regression of sensory and motor block were recorded. Rescue analgesia consumption, postoperative pain score, and quality of sleep were also assessed.ResultsOral pregabalin significantly prolonged the time to two-segment regression of sensory block, reaching 86.67±17.88 mins, the time required to regression of spinal block to L2, reaching 155.33± 34.71 mins, and the duration of motor block, reaching 138 ± 23.5 mins, with no effect on the onset of sensory or motor block (P = 0.60 and 0.62). It significantly decreased the VAS score 4 hrs, 6 hrs, and 12 hrs postoperatively, prolonged the duration of postoperative analgesia, reaching 392.00±47.23 mins, and decreased morphine consumption to 7.67±3.65 mg. It also improved the quality of sleep in the first night after surgery.ConclusionPreemptive oral pregabalin prolonged the time to the first request for postoperative analgesics and improved sleep in the first night after surgery.

BackgroundFlexible laryngeal mask airway may be used instead of the endotracheal tube in children presented for elective repair of tongue trauma, as it may shorten the time for extubation and recovery with the amelioration of stress response to airway management.ObjectivesThis study aimed to evaluate the extubation time and hemodynamic response to the endotracheal tube or flexible laryngeal mask airway in children presented for tongue trauma repair.MethodsThe study recruited 90 children presented for elective repair of tongue trauma that were randomly assigned into the following groups: the ETT group for which the airway was controlled by a cuffed endotracheal tube and the LMA group for which the airway was controlled by a flexible laryngeal mask. The intubation time, surgical time, total anesthesia time, extubation time, recovery time, changes in the hemodynamic parameters, and the incidence of complications were measured.ResultsThe use of flexible laryngeal mask airway instead of endotracheal tube significantly decreased the extubation time to 7.47 ± 2.74 min (P < 0.0001) and the recovery time to 52.67 ± 11.16 min (P = 0.001) while no significant differences were observed in the intubation time (P = 0.874), surgical time (P = 0.411), and total anesthesia time (P = 0.725). In addition, the changes in the hemodynamic parameters were significantly lower with flexible laryngeal mask airway both during airway securing and at the start of the surgery (P < 0.05). Moreover, it significantly decreased the incidence of postoperative cough, stridor, and sore throat (P = 0.039, 0.006, and 0.027, respectively).ConclusionsThe flexible laryngeal mask airway can be used instead of the endotracheal tube in children undergoing the repair of tongue trauma, as it decreases the extubation time, recovery time, and hemodynamic changes to the airway control.