[Comparing the effects of peritoneal and subcutaneous injections of bupivacaine on post-appendectomy pain]

This study aimed to compare the effects of peritoneal and subcutaneous injections of bupivacaine 0.5% on post-appendectomy pain and also the efficacy of local anaesthetic injection for postoperative pain relief in peritoneal inflammation with subcutaneous injection. This randomized-clinical trial was conducted on 126 participants [age range, 15-45 years] underwent appendectomy for acute appendicitis in Kashan Shahid-Beheshti hospital. Participants were divided into three groups: bupivacaine [0.5%, ip], bupivacaine [0.5% s.c], and control [no injection]. Pain intensity was evaluated using the visual analogue scale at 6, 12 and 24 hours after surgery. There was no significant difference among the three groups in age, sex, the duration of anesthesia and surgery. Pain intensity [6 h post-surgery] was significantly higher in the subcutaneous group than the peritoneal group, but no significant difference was seen between the two groups at 12 and 24 h post-surgery. Moreover, pain intensity in the peritoneal and subcutaneous groups was significantly lower than the control group at 6 and 12 h post-surgery [P<0.05]. There was a significant difference between the peritoneal and subcutaneous groups as well as between the peritoneal and control groups required analgesics, but the difference was not significant between the subcutaneous and control groups. Although both peritoneal and subcutaneous injections of bupivacaine can reduce postoperative pain in patients undergoing appendectomy, the peritoneal injection can significantly reduce the postoperative analgesic consumption

[Comparing the complications of Gomco and classic methods of circumcision]

There are different surgical procedures for circumcision. Although the classic method is the most common one, it takes more time and causes more pain and complications compared to other methods. The purpose of this study was to compare the complications and the time taken for performing the surgery for Gomco and classic methods of circumcision. This case-control study was performed on 80 neonates referred to the outpatient operating room in Shahid Beheshti hospital for circumcision in 2011 and were divided into two equal groups: one group underwent the classic method and another, the Gomco method. The complications were assessed in two phases: during the surgery by counting bloody gauze pads and one week thereafter using the objective methods, then they were analyzed statistically. The mean age of neonates was 24.8 +/- 12.37 days and no significant difference was seen between two groups. The mean operation duration in the classic method [24.3 +/- 2.5 min] was approximately two times greater than that of the Gomco method [13.3 +/- 2.3 min]. Moreover, the amount of bleeding in the classic method [4.1 +/- 0.6 cc] was over three times greater than that of the Gomco one [1.3 +/- 0.7 cc]. No cases of infection were seen in both groups. Results show that the Gomco method takes less time and causes less pain and fewer complications compared to the classic method and may also be a suitable alternative to the classic method