Pulmonary function changes after interscalene brachial plexus anaesthesia; comparison between 0.75% ropivacaine and 0.5% bupivacaine

This study was carried out on 20 adult patients, scheduled for shoulder and arm surgery. After monitoring of the patients for heart rate, non invasive blood pressure and pulse oximetery. They were allocated randomely to receive 20 ml of either 0.75% ropivacaine [group I] or 0,5% bupivacaine [group II] for interscalene bradial plexus [ISBP] block. The patients demographic data were similar in both groups, the onset of sensory block and motor block were significantly prolonged in group I in comparison to group II [12.08 +/- 0.69 min and 15.05 +/- .0.69 min in group I vs 10.10 +/- 0.70 min and 12.25 +/- 0.72 min respectively] P< 0.0001. A significant reduction in pulmonary function occurred in both groups after 5 minutes till 30 minutes of the block. Forced vital capacity [FVC] decreased by 9% after 5 min to 40% after 30 minutes in group I and by 13% to 39% in group II. forced expiratory volume after one seconds [FEVl] decreased by 12% to 18% in group I and from 13.5% to 18.5% in group II. The peak expiratory flow rate [PEFR] decreased from 11% to 26.3% in group I, and from 11% to 32% after 30 minutes. No significant difference between both groups as regard FVC. FEVI, and PEFR at any time of measurement. We concluded that both 0. 75% ropivacaine and 0.5% bupivacame can be used for interscalene brachial plexus block,, but owing to the less cardiac toxicity of ropivacaine. it is recommended to be widly used

Comparasion of three normovolaemic haemodilutions on pulmonary gas exchange and tissue oxygenation in cardiac surgery with extracorporeal circulation

Cardiopulmonaary bypass [CPB] with haemodilution is currently used as a common adjunctive measure in cardiac surgery. However, there is still much controversies as regards the effect of haemodilution on pulmonary gas exchange and tissue oxygenation after cardiac surgery with extracorporeal circulation. We have studied 60 adult patients, ASA II and III who were undergoing elective coronary artery bypass graft operation with CPB. Patients were allocated info three groups according to their final haematocrit after the end of extracorporeal circulation; group [I] haematocrit above 30%, group [2] haematocrit from 25%-30%, and group [3] with haematocrit between 21%-25%. Our study showed a significant impairment of pulmonary gas exchange after cardiopulmonary bypass as shown immediately after the end of bypass and continued all over the study period as shown by a decrease in the arterial oxygen partial pressure [PaO2] and arterial alveolar oxygen tension PaO2 /PAO2 and an increase in alveol-arterial oxygen tension gradient P [A-a] O2 and pulmonary shunt Qs /Qt. while no significant effect of the different haematocrit values was noted on the pulmonary gas exhange, in addition the tissue oxygenation parameters showed a stability in the oxygen consumption VO2 in spite of a marked decrease in the oxygen delivery DO2 this may be achieved through an increase in both oxygen extraction O2EX% and cardiac index CI

Single injection paravertebral block improves outcome after thoracic surgery

This study was carried out on 30 adult patients undergoing elective thoracotomy and pulmonary resection. After induction of general anaesthesia, a single injection paravertebral block was performed at the level of T4/5, ipsilateral to thoracotomy. Heart rate showed a significant decrease 15 and 20 minutes after the block [P= 0.034 and 0.014 respectively]. Mean arterial blood pressure showed a significant decrease after 10, 15 and 20 minutes of the block [P= 0.013, 0.014 and 0.014 respectively]. The mean onset time of action was 15.6 +/- 4.09 minutes, the duration of analgesia was 162 +/- 33.17 minutes with a postoperative analgesia for 17.33 +/- 9.7 hours. No supplemental analgesia or painful restricted movement were detected for the first six hour and 75 mg diclofenac sodium was started to be given after 12 hours postoperatively. Only three patients in this study needed 50 mg pehidine hydrochloride after 24 hours. Single injection paravertebral block is an effective, safe and reliable technique that can offer a post-thoracotomy analgesia for the first postoperative day

Hashish cultivation in the state of Southern Darfour, Sudan

In an attempt to arrive at an adequate planning process for the effective and successful control of hashish production, cultivation areas in Southern Darfour and Bahr Elgazal States in Sudan were investigated during the cultivation period in September 1994. Data on hashish production and the socioeconomic status of the people in the area of production were collected. Attempts made at the prevention of hashish production in the area during the study are reported and discussed. The results of this work are presented together with some recommendations

Regional distribution of cholinergic enzymes in the CNS of three mammalian species

Regional distribution of choline acetyltransferase [ChAT] and acetylcholinesterase [AChE] in twelve regions of the CNS of Gerbillus pyramidum, Cavia porcellus and Rousettus aegyptiacus were determined. Species and regional variations in the two enzymes were observed. AChE was markedly higher than that of ChAT in the 3 animals studied. The highest activity of the cholinergic enzymes was in the caudate and putamen while the lowest was in the cerebellum [except for the bat cerebellum], which may be related to an increased role of the cerebellum in the motor functions of this flying mammal