ABSTRACT
Objectives: To compare ultrasound guidance [USG] and electrical neurostimulation guidance [ENSG] in axillary brachial plexus block in terms of block performing time, sensory and motor block quality, and patient satisfaction
Methodology: 200 patients undergoing elective carpal tunnel syndrome surgery were randomly assigned to one of two groups equally; the USG group or the ENSG group. Axillary blocks were performed with a mixture of 15 ml of lidocaine 2% and 15 ml of bupivacaine 0.5% [a total of 30 ml solution]. Sensory block was evaluated with a pinprick test and motor block was evaluated via the Bromage scale by a blinded observer
Results: Block performing time was significantly shorter in the USG group than in the ENSG group [P<0.001]. The sensory and motor block onset times were significantly shorter and the additional analgesic requirements were significantly lower in the USG group than in the ENSG group [P<0.001]
Conclusion: USG is better than ENSG in axillary brachial plexus block in terms of block performing time, block quality and patient satisfaction
ABSTRACT
In this study, we examined the euphoric effect of propofol and its high satisfaction ratio regarding its liability to be abused, particularly in painless procedures, such as colonoscopy. Fifty subjects aged between 18 and 65 years who fulfilled the criteria for ASA 1-2 and were prepared for colonoscopy were enrolled into this study. For intravenous sedation induction, 2 mg/kg propofol was used, and additional injections were administered according to BIS values. After colonoscopy, the subjects were taken to a recovery room and observed for 30 minutes. Patients were interviewed with the modified Brice questionnare regarding the incidence and the content of dreams. A 5-point Likert scale was used to classify their dreams, and the content of the dreams was also recorded. To assess the subjective effects of propofol, the patients were asked to use the Hall and Van der Castle emotion scale; their biological states were also assessed. The patients' feelings regarding propofol were each rated as absent or present. We used the Morphine-Benzedrine Group scale to measure the euphoric effects of propofol. At the end of the study, subjects scored their satisfaction on a five-point scale. There were no statistically significant differences in sex age, weight, propofol dose, or satisfaction ratio [p > 0.05] in the groups, although male patients received a higher dose of propofol and had higher satisfaction ratio. Patients reported no residual after-effects. The incidence of dreaming was 42%. There was no statistically significant difference in dreaming between the sexes, but male patients had a higher dreaming ratio. Dreamers received higher propofol doses and had a higher satisfaction ratio [p > 0.05]. All dreamers reported happy dreams regarding daily life, and their mean MBG score was 10.5. There was no correlation between MBG scores and propofol doses [r= -0.044, p= 0.761]. We conclude that propofol functions as a reward; that patients enjoy its acute effects; and that no residual after-effects should arise. We suggest that propofol may carry potential for abuse, and further abuse liability testing is indicated