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Background: The aim of the study was assessment of post-operative outcomes of rectus sheath block and comparison ofoutcomes between rectus sheath block and sub cutaneous bupivacaine.Materials and Methods: This study enrolled 58 patients who were scheduled to undergo laparotomy. Group I – 30 patientsreceived rectus sheath block using bupivacaine by placing catheters in between the muscle and posterior rectus sheath.Group II – 28 patients received bupivacaine infiltration by placing catheters in the subcutaneous plane. Visual analog scale(VAS) score, peak expiratory flow rate (PEFR), rescue analgesia, and complications were noted and follow-up of thesepatients was done.Results: Both the groups were comparable, hemoglobin concentration and anesthesiologists grades (statisticallyinsignificant). The majority of the patients from rectus sheath block group had VAS scores <5 comparing to subcutaneousinfiltration group which was statistically very significant (P ≤ 0.001). There was a statistically significant improvement ofpost-operative PEFR values in Group I as compared to Group II (P < 0.001). In Group I, 20 patients showed VAS scoreof 1 (no pain) at rest as compared only four patients in Group II. Rate of infection was more common in group receivingsubcutaneous infiltration.Conclusion: The patients from rectus sheath block group showed a statistically significant decrease in post-operative painin terms of VAS scores compared to that of subcutaneous bupivacaine infiltration group. There was statistically significantdecreased use of opioids as rescue analgesic in the rectus sheath group compared to that of the subcutaneous bupivacaineinfiltration group.
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Background: It is well-known since long time the beneficial effects of misoprostol particularly as a cervical softening agent in obstetric practice. Keep in view, study aimed to evaluate the efficacy of vaginal misoprostol 400 mcg before endometrial biopsy in premenopausal women.Methods: All the 200 patients were classified into two groups viz. study group (Group I) with 100 patients and control group (Group II) with 100 patients. To Group I patients, 400 mcg of misoprostol was given vaginally, 4 hours prior to the commencement of endometrial biopsy whereas no medication was received by Group II patients.Results: In the present study, the base line cervical dilatation is found to be 5.8±1.3 mm in Group I patients whereas 3.8±0.92 mm in Group II patients which is significantly higher (p<0.05). Only 32 patients in Group I required further dilatation whereas 88 patients in Group II underwent further dilatation. The mean time required for further dilatation in Group I and Group II patients was 42.6±17.4, 64.6±16.8 sec respectively and was significantly higher in Group II patients (p<0.05). Out of 100 patients in Group I, only 2% of patients complained severe pain whereas in Group II 48% of patients experienced intolerable pain and required anesthesia.Conclusions: Vaginal administration of 400 mcg misoprostol 4 hours prior to endometrial biopsy in premenopausal women had a significant effect on cervical resistance and cervical dilatation.
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OBJECTIVES: Trigeminal neuralgia (TN) is undurable paroxysmal pain in the distribution of the fifth cranial nerve. Invasive treatment modalities for TN include microvascular decompression (MVD) and percutaneous procedures, such as, radiofrequency rhizotomy (RFR). Gamma Knife radiosurgery (GKRS) is a considerable option for patients with pain recurrence after an initial procedure. This study was undertaken to analyze the effects of gamma knife radiosurgery in recurrent TN after other procedures. METHODS: Eleven recurrent TN patients after other procedures underwent GKRS in our hospital from September 2004 to August 2016. Seven patients had previously undergone MVD alone, two underwent MVD with partial sensory rhizotomy (PSR), and two underwent RFR. Mean patient age was 60.5 years. We retrospectively analyzed patient's characteristics, clinical results, sites, and divisions of pain. Outcomes were evaluated using the Visual Analog Scales (VAS) score. RESULTS: Right sides were more prevalent than left sides (7:4). The most common distribution of pain was V1 + V2 division (n = 5) following V2 + V3 (n = 3), V2 (n = 2), and V1 + V2 + V3 (n = 1) division. Median GKRS dose was 80 Gy and the mean interval between the prior treatment and GKRS was 74.45 months. The final outcomes of subsequent GKRS were satisfactory in most cases, and at 12 months postoperatively ten patients (90.0%) had a VAS score of ≤ 3. CONCLUSIONS: In this study, the clinical result of GKRS was satisfactory. Invasive procedures, such as, MVD, RFR are initially effective in TN patients, but GKRS provides a safe and satisfactory treatment modality for those who recurred after prior invasive treatments.
Subject(s)
Humans , Microvascular Decompression Surgery , Radiosurgery , Recurrence , Retrospective Studies , Rhizotomy , Trigeminal Nerve , Trigeminal Neuralgia , Visual Analog ScaleABSTRACT
BACKGROUND:Sodium hyaluronate injection after arthroscopic debridement of knee osteoarthritis can reduce postoperative pain and improve joint function, but there is a controversy on the time for the hyaluronate injection after arthroscopic debridement of knee osteoarthritis. OBJECTIVE:To observe the time of hyaluronate injection after arthroscopic debridement of knee osteoarthritis, and to compare recent rehabilitation effect of knee sodium hyaluronate injection for knee function after arthroscopic debridement of knee osteoarthritis between injection just after knee arthroscopy and injection 2 weeks after knee arthroscopy. METHODS:The clinical data of 100 knee osteoarthritis patients undergoing sodium hyaluronate injection immediately and 2 weeks after arthroscopic debridement were analyzed with prospective randomized control ed trial method, and the preoperative visual analog scale score, Lysholm score, 6 weeks postoperative visual analog scale score, 3 months postoperative visual analog scale score, and 3 months postoperative Lysholm score were recorded. The effects of recently rehabilitation of knee joint after surgery in two groups were compared. RESULTS AND CONCLUSION:There was no significant difference in postoperative visual analog scale score between immediate injection group (6.52±2.38) and 2 weeks postoperative injection group (6.54±2.37). The preoperative Lysholm score in the immediate injection group (43.44±16.18) was lower than that in the 2 weeks postoperative injection group (51.12±16.3). The 6 weeks postoperative visual analog scale score in the immediate injection group (3.2±2.46) was significantly higher than that in the 2 weeks postoperative injection group (5.1±2.68). The 3 months postoperative visual analog scale score/Lysholm score in the immediate injection group (2.72±2.70)/(80.58±15.63) were significantly higher than those in the 2 weeks postoperative injection group (4.72±3.07)/(64.96±21.68). The results indicate that sodium hyaluronate injection immediately after arthroscopic debridement of knee osteoarthritis is more favorable for recent rehabilitation.