بحوث سكوبس — د. محمد عبد الزهرة صعصاع الموسوي

Background. In the field of intravenous anesthesia, propofol is widely utilized as an induction agent. However, Propofol injection pain is a frequent adverse event that may result in discomfort for patients. Various strategies have been investigated to prevent or alleviate this pain, considering the presence of opioid receptors in the primary afferent nerve endings of peripheral tissues, which suggests a potential role of opioids in mitigating propofol-induced pain. Fentanyl, a short-acting pure opioid agonist commonly used for systemic analgesia during intraoperative and postoperative periods, has been found to possess peripherally mediated analgesic properties within its clinical dosage range. Therefore, the objective of this study was to evaluate the efficacy of a low dose of fentanyl in the fentanyl-propofol combination for reducing propofol injection pain. The objective of our study was to evaluate and compare the efficacy of two distinct doses of fentanyl in mitigating the pain associated with propofol injection. Materials and methods. The study enrolled 90 patients classified as ASA I–II who were scheduled for elective surgery. The study spanned over 4 months, from November 2022 to April 2023, and included patients aged 19 to 65 years. Patients were divided into three groups, each comprising 30 patients. The control group received only 5 ml (50 mg) of propofol. The group M1 received only 5 ml of a mixture of fentanyl and propofol, prepared with 20 ml (200 mg) of propofol and 2 ml (100 µg) of fentanyl, while the group M2 received only 5 ml of a mixture of fentanyl and propofol, prepared with 20 ml (200 mg) of propofol and 4 ml (200 µg) of fentanyl, at an injection speed of 0.5 ml/s. After 10 seconds of medication, patients were asked a standard question about the comfort of the injection, and a verbal rating scale (VRS) was used to assess propofol injection pain. Anesthesia induction was then continued following standard protocols. Statistical significance was set at p < 0.05 for all analyses. Results. The three groups were found to be similar in terms of patient characteristics. In the control group, the incidence of severe pain upon propofol injection was 46.7%, whereas it was 0% in both groups M1 and M2 (p < 0.05). Conclusion. The combination of fentanyl and propofol has been shown to effectively reduce the incidence of propofol injection pain. Interestingly, in this study, no significant difference was observed between the two different doses of fentanyl used in the mixture. This suggests that a low dose of fentanyl may be sufficient in achieving a pain-free environment during propofol induction, thereby offering a cost-effective approach in clinical practice. © The Author(s) 2023.

Background. Postoperative laparoscopic cholecystectomy period is often associated with nausea and vomiting, which is stopped by an antiemetics injected intravenously. Meanwhile, it is known that the oral pregabalin before surgery to potentiate the effect of opioids and nonsteroidal anti-inflammatory medications during anesthesia also has an antiemetic effect. The objective was to evaluate the effect of oral pregabalin to reduce the frequency of postoperative nausea and vomiting in laparoscopic cholecystectomy cases. Methods and Materials. Randomized double blind study. One hundred patients of the American Society of Anesthesiology (ASA) class1 were tested and divided into two groups. The first group did not receive any antiemetics preoperatively. The second group received 75 mg of oral pregabalin 30 minutes before anesthesia. We followed up patients postoperatively in the recovery room and general surgical ward for 24 hours, recorded the incidence of nausea and vomiting, prescription of any antiemetics and developing their side effects. We assessed the risk of developing the incidence of postoperative nausea and vomiting by the use of the Koivuranta score. Results. Statistical analysis using SPSS showed a significant reduction of postoperative nausea and vomiting in the second group (pregabalin) compared with the first group. Conclusion. Preoperative 75 mg of oral pregabalin has antiemetic effect on postoperative time. No significant postoperative side effects were noted. © 2023 Authors. All rights reserved.

Background: sore throat is a well-known complication of endotracheal tube after general anesthesia. Many pharmacological methods to reduce the incidence of sore throat with different lidocaine routes and formulas have used clinically by anesthesia providers. The aim of this review was to explain narratively the efficacy of various ways of lidocaine application in decreasing postoperative sore throat. Methods: All relevant and published data were independently searched by using MEDLINE and EMBASE bibliographic databases, the Cochrane Central Register of Controlled Trials (CENTRAL) and manually using the proper search terms in either the title or abstract. Results: we included 10 studies in this narrative review, involving 1266 participants. 543 of those patients received topical lidocaine therapy, and 723 were introduced as comparative or control groups. 23% (n=226) of lidocaine groups in 3 studies with different forms showed decreased risk of postoperative sore throat, 4 studies ( 39% n= 201) showed no longer significance and 3 studies (38% n= 207 ) showed increased the risk of postoperative sore throat. Authors' conclusions: in our narrative review, most of included studies showed that local anesthetic lidocaine can reduce the incidence of sore throat if used to inflate the endotracheal tube cuff or in combination with other pharmacological or technical ways such diclofenac sodium gel and thermally soften endotracheal tube. © 2020, Advanced Scientific Research. All rights reserved.

Commonly seen complications of tracheostomy include hemorrhage, obstruction, and pneumothorax. These primary complications usually become apparent quickly after the procedure. However, some complications manifest themselves at a later stage. Granular tissue, Scar formation, tracheal stenosis, ulceration, tracheoesophageal fistula and corrosion of the small arteries are not rarely seen secondary complications in tracheostomy(Engels, Bagshaw, Meier, & Brindley, 2009). We report an unusual case of a tracheostomy tube complication in an adult male. © 2020, Advanced Scientific Research. All rights reserved.

Background With emergence of coronavirus-2019 or COVID-19 a diverse number of people have been infected worldwide in a short time, with no specific treatment or vaccine. Infected patients are in danger of creating respiratory failure that necessitating admission to intensive care units (ICU). Thus intensivists (ICU providers) and anesthesiologists must be ready for the newcomers to ICU and to sustain care for them. Method We performed a narrative review via searching in three databases PubMed, Google Scholar and Embase for all studies that mentioned all intensive care admission rates for who infected with coronavirus 2019, manual searching also completed. All the selected reviews were limited to the English language and date also. Result Five researches referred to the rate of ICU admission, about 9.3% of all cases. Male patients were more comparing to female (59% to 41%), median age range were (40-56) years, cases with co-existing diseases range from 23.7%-51%, with ICU admission rate being 5%-32%. An immense number of patients received oxygen therapy (41.3%-76.81%), while 6.7% of cases were under non-invasive ventilation with range from 4.9%-24% and just 3.6% of patients who received invasive ventilation with range from 3.3%-12.32%. Finally the mortality rate was 2.6%. Conclusion The novel virus, COVID-19 has shown to more likely affect older male with underlying conditions such as hypertension, diabetes and others, a point that could expose them to fatal respiratory symptoms, including respiratory failure. So a quite enough of patients might need oxygen support and ICU admission. © 2020, Advanced Scientific Research. All rights reserved.