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Comparative Study of Adductor Canal Block with Adductor Canal Block Plus Ipack for Postoperative Analgesia in Patients Undergoing Total Knee Arthroplasty
Madiha Kafeel,
Shankaranarayana Paniye,
Shilpa Gopala Krishna Bhat
Issue:
Volume 9, Issue 2, December 2021
Pages:
23-27
Received:
24 May 2021
Accepted:
30 June 2021
Published:
8 July 2021
DOI:
10.11648/j.ijacm.20210902.11
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Abstract: BACKGROUND: Total Knee Arthroplasty (TKA) is a common surgical procedure for advanced osteoarthritis. Pain management in patients undergoing TKA is the critical component for better recovery and early ambulation. Peripheral nerve blocks is a better alternative to systemic analgesics in relieving pain after TKA. The aim of the study was to compare the VAS score and rescue analgesia requirement in ACB+IPACK group compared to ACB alone in patients undergoing the total knee arthroplasty. METHOD: This observational study is conducted in Yenepoya Medical College Hospital, Mangalore who are in the age group from 40 to 80 years admitted for elective total knee replacement surgery during the period of October 2020 to December 2020 after approval from the ethical committee and written informed consent from participants. The patients were selected by closed envelope method into two groups; as group 1 patients received ACB+IPACK and group 2 received ACB only. Pain assessment was done by a 10 cm visual analogue scale (VAS); 0: no pain; 10: worst imaginable pain. Patient were reassessed for pain and any side effects like nausea, vomiting, gastric irritation and respiratory depression at 8 hours, 12 hours and 24 hours or till the need of rescue analgesia. RESULT: The mean age of the patients in the study group was 58.7 years. The VAS score atrest after 8th hr, 12th hr and 24th hr showed a significantly lower score in ACB+IPACK group compared to the ACB group. However, there was no significant pain noted in two groups to provide the rescueanalgesics. CONCLUSION: ACB+IPACK is safer and efficient than ACB alone for postoperative pain management in patients undergoing total knee arthroplasty.
Abstract: BACKGROUND: Total Knee Arthroplasty (TKA) is a common surgical procedure for advanced osteoarthritis. Pain management in patients undergoing TKA is the critical component for better recovery and early ambulation. Peripheral nerve blocks is a better alternative to systemic analgesics in relieving pain after TKA. The aim of the study was to compare t...
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An Examination of the in Vitro Effects on Fibroblasts of Periarticular Injection Solution Applied in Total Hip and Knee Arthroplasty
Muhammed Sadik Bilgen,
Zeynep Kahveci,
Ilkin Cavusoglu,
Muren Mutlu,
Omer Faruk Bilgen,
Aysun Yilmazlar
Issue:
Volume 9, Issue 2, December 2021
Pages:
28-31
Received:
16 June 2021
Accepted:
29 June 2021
Published:
8 July 2021
DOI:
10.11648/j.ijacm.20210902.12
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Abstract: The number of indications for total hip and knee surgery is increasing. The anesthesia and analgesia techniques are very important and effectivity on success of total hip and knee arthroplasty. Multimodal analgesia makes a great contribution to pain treatment after surgery. Periarticular injection of an analgesic solution is a component of multimodal analgesia. However, it has long been unclear whether such injections damage tissue. The fibroblasts were cultured in 5 mL of D-MEM/F-12 medium in each well of a 6-well culture dish. After 1 hour, we added 5 mL of prepared periarticular injection solution to each well of the study group. To determine the effects of the solution on the fibroblasts, we assessed viability rates at the end of 24, 48, and 72 hours. When we compared the control and the study group, we did not encounter any apoptotic or dying cells in either group, which we interpreted to mean that the periarticular injection solution did not show a lethal effect on fibroblasts. Therefore, we conducted an in vitro and electron microscope study to research this issue. We found that the number and viability of fibroblasts did not change significantly with periarticular injection and thus concluded does not cause cell damage and can safely be used.
Abstract: The number of indications for total hip and knee surgery is increasing. The anesthesia and analgesia techniques are very important and effectivity on success of total hip and knee arthroplasty. Multimodal analgesia makes a great contribution to pain treatment after surgery. Periarticular injection of an analgesic solution is a component of multimod...
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Attenuation of Pressor Response to Laryngoscopy in Severe Preeclampsia: Comparison the Efficacies Between Intravenous Nitroglycerine and Intravenous Hydralazine
Nahida Sultana,
ABM Rashedul Amir,
Hasina Momtaz,
Md. Abu Taher
Issue:
Volume 9, Issue 2, December 2021
Pages:
32-37
Received:
13 February 2021
Accepted:
4 June 2021
Published:
11 August 2021
DOI:
10.11648/j.ijacm.20210902.13
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Abstract: Introduction: Preeclampsia is one of the most commonly disorders of pregnancy. The pressor response to laryngoscopy is known to be exaggerated in patients with severe preeclampsia. The aim of this study was to assess the preoperative blood pressure control in severe preeclamptic mother with intravenous nitroglycerine is more effectively attenuate the haemodynamic response to laryngoscopy in comparison to treatment with intravenous hydralazine. Methods: This randomized fixed sealed envelope lottery method study was conducted in the Department of anaesthesiology of Dhaka Medical College Hospital, Dhaka, between October 2014 to March 2015 Total of 60 patients with severe preeclampsia and gestational age more than 36 weeks, who were presented for elective or urgent caesarean delivery under general anaesthesia were randomly divided into two groups, group A, n=30 received 50 mcg intravenous nitroglycerine. Group B received 5mg hydralazine intravenously very slowly. Heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) were simultaneously recorded in the mother at pre-induction, pre-laryngoscopy, and at 1min, 3 min, and 5 min after laryngoscopy. Result: The patients in group A and group B showed no significant difference in HR, SAP, DAP and MAP at pre induction and pre laryngoscopy. But there is significant difference (P<0.05) at 1, 3, 5 min after laryngoscopy. The mean heart rate at 1, 3 and 5 minutes after laryngoscopy were significantly (p<0.05) higher in group B than group A. The mean SAP, DAP, MAP were also significantly (p<0.05) higher in group B than group A at 1, 3, 5 min after laryngoscopy. Conclusion: Women with severe preeclampsia who were preoperatively treated with intravenous nitroglycerine provides a safe and more effective prophylaxis for patients with severe preeclampsia undergoing cesarean delivery under general anesthesia, in attenuating haemodynamic responses to laryngoscopy.
Abstract: Introduction: Preeclampsia is one of the most commonly disorders of pregnancy. The pressor response to laryngoscopy is known to be exaggerated in patients with severe preeclampsia. The aim of this study was to assess the preoperative blood pressure control in severe preeclamptic mother with intravenous nitroglycerine is more effectively attenuate t...
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Brachial Plexus Neuropraxia in Immediate Postoperative Period After Unilateral Total Mastectomy in a Hospital in Southern Huila: Case Report
Mario German Orozco Sandoval,
Felipe Andres Beltran Torres,
Laura Cristina Fandiño,
Nellyth Julieth España Tobar,
Stefany Mejía Buesaquillo,
Xsara Camila Rodríguez Cerón,
Alejandra Katherine Franco Torres
Issue:
Volume 9, Issue 2, December 2021
Pages:
38-40
Received:
17 September 2021
Accepted:
26 October 2021
Published:
30 October 2021
DOI:
10.11648/j.ijacm.20210902.14
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Abstract: Gynecomastia is a pathology in which there is an increase of the mammary gland in men, its etiology is varied and imprecise, the incidence ranges between 32 to 36%, the diagnosis is based on anamnesis and physical examination directed to define if it is physiological or requires medical intervention, the therapeutic conduct of choice is surgical treatment consisting of bilateral or unilateral mastectomy as the case may be, like other surgical interventions, breast surgery can give rise to neurological lesions evidenced in the immediate postoperative period, most of which are not related to the surgical act but to the position of the patient during the procedure. Neurological lesions of peripheral nerves refer to a transient dysfunction without structural damage until the permanent loss of the integrity of the peripheral nerve. In relation to the present case the lesions specifically of the brachial plexus correspond to 2⁄3 of the lesions produced during the perioperative period affecting the sensory and motor innervation for the entire upper limb since it is constituted by the communications that are established between the anterior branches of the spinal nerves; It is a rare event with an incidence that corresponds to less than 1%, it is a phenomenon difficult to identify and prevent due to its multifactorial etiology, however, mechanical factors related to the patient's position during the procedure such as hyperabduction of the upper limb or hyperextension in external rotation of the upper limb are associated as the main risk factors. Its exact incidence is unknown because most of the published cases do not show neurological lesions, thus motivating the report of the present case.
Abstract: Gynecomastia is a pathology in which there is an increase of the mammary gland in men, its etiology is varied and imprecise, the incidence ranges between 32 to 36%, the diagnosis is based on anamnesis and physical examination directed to define if it is physiological or requires medical intervention, the therapeutic conduct of choice is surgical tr...
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Mortality of Severe Trauma Adults Patients in Polyvalent Intensive Care Unit at University Hospital of Brazzaville, Republic of Congo
Christ Mayick Mpoy Emy Monkessa,
Marie Elombila,
Gilles Niengo Outsouta,
Peggy Dahlia Gallou Leyono-Mawandza,
Marina Aurole Bokoba-Nde Ngala,
Giresse Bienvenu Tsouassa Wa Ngono,
Hugues Brieux Ekouele-Mbaki,
Gilbert Fabrice Otiobanda
Issue:
Volume 9, Issue 2, December 2021
Pages:
41-48
Received:
4 October 2021
Accepted:
28 October 2021
Published:
5 November 2021
DOI:
10.11648/j.ijacm.20210902.15
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Abstract: Aim: To describe the profile of severe trauma adults who died in polyvalent intensive care unit at University Hospital of Brazzaville. Materials and methods: It was a retrospective, cross-sectional study carried out in polyvalent intensive care unit of University Hospital of Brazzaville, during 30 months period. We included all severe trauma who died, aged 18 years or over patients regardless of age or sex and treated for at least one hour in intensive care. Epidemiological, clinical and therapeutic parameters were recorded and analyzed with Excel 2016 for Windows. Results: During the study period, 35 deaths out of 90 severe trauma patients were recorded, i.e. a lethality rate of 38.8%. The mean age was 42.4±18.6 years (sex ratio=7.5). Admissions were primary in 58.8%. Road traffic collisions (RTC, 73.5%) were the most common mechanism of injury involved. In intensive care, 82.4% of patients presented with severe trauma brain injury (TBI), of which 50.0% was isolated. Respiratory (47.1%) and hemodynamic (17.6%) distress were observed. Pickup and transport of trauma victims were not medical. Oxygen therapy (91.2%), blood transfusion (23.5%), use of vasopressor amines (47.1%) and osmotherapy (23.5%) were necessary. The patients were intubated and ventilated then sedated in 64.7%. Surgical management concerned 20.6% and was dominated by neurosurgical indications. Neurological distress (61.8%) was the main cause of death. Conclusion: The lethality rate of severe trauma patients was high, affecting young males, victims of both RTC and severe TBI. This confirms the need to promote collaboration and communication between hospital structures, to set up pre-hospital care structures, to improve the technical platform and to train staff involved in their care.
Abstract: Aim: To describe the profile of severe trauma adults who died in polyvalent intensive care unit at University Hospital of Brazzaville. Materials and methods: It was a retrospective, cross-sectional study carried out in polyvalent intensive care unit of University Hospital of Brazzaville, during 30 months period. We included all severe trauma who di...
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The Effect of Saline Flush After Rocuronium Bolus on Intubating Conditions in Adult Patients Undergoing Elective Surgery: A Randomized Controlled Trial
Ian Odari,
Vitalis Mung’ayi,
Rajpreet Bal,
David Odaba
Issue:
Volume 9, Issue 2, December 2021
Pages:
49-56
Received:
14 October 2021
Accepted:
3 November 2021
Published:
10 November 2021
DOI:
10.11648/j.ijacm.20210902.16
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Abstract: Background: In emergency surgeries requiring endotracheal intubation, the time to effect of neuromuscular blocking drugs is a crucial time to avoid hypoxia and aspiration into the lungs. Various strategies have been undertaken to shorten this time. All these methods have positive results but some are associated with side effects. The effectiveness of a muscle relaxant can either be assessed using the train of four or intubating conditions on the Goldberg scale. In this study, we investigated the effects of a 20 ml saline bolus following intravenous rocuronium at 0.6 mg/kg on the proportions of patients with excellent intubating conditions at one minute. Methodology: Fifty-two patients were randomly allocated to the saline bolus group or the no saline flush group. Anaesthesia was induced using propofol and remifentanil via target-controlled infusion (TCI) and maintained with the same. Rocuronium 0.6 mg/kg intravenous (IV) was administered followed by a 20 ml saline flush in the study group compared to administration of 0.6 mg/kg rocuronium without a saline bolus in the control group. Intubation conditions were assessed using the Goldberg scale filled by the intubating doctor. The onset of neuromuscular block was assessed by the train of four T1 height depression with an accelerometer attached to the adductor pollicis muscle. Results: There were 25 patients in each group. Patients in both groups were comparable with respect to demographic profiles. In the group with a flush, 18 (62.1%) patients had “excellent” and seven (33.3%) patients had “good” intubating conditions as opposed to 11 (37.9%) having “excellent” and 14 (66.7%) having “good” intubating condition in the group without a flush. The distribution of intubating conditions for the two groups showed a difference of 24.2% in the proportion of patients with excellent intubating conditions which was statistically significant (P=0.042). There was no association between twitch height at one minute and intubating conditions. Conclusion: In this group of patients studied, the administration of a 20 ml saline flush after 0.6mg/kg rocuronium significantly increases the proportion of patients with excellent intubating conditions as compared to rocuronium without a saline flush.
Abstract: Background: In emergency surgeries requiring endotracheal intubation, the time to effect of neuromuscular blocking drugs is a crucial time to avoid hypoxia and aspiration into the lungs. Various strategies have been undertaken to shorten this time. All these methods have positive results but some are associated with side effects. The effectiveness ...
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