comparative retrospective study between general anesthesia and conscious sedation for oocyte retrieval

To compare data in the in vitro fertilization unit at Prince Ali Hospital regarding the anesthetic method used and its influence on oocyte number, fertilization rate, and pregnancy rate. One hundred seventy-two women underwent oocyte retrieval in the period between January 1st 2010 to January 1st 2011 at Prince Ali Hospital were included in this retrospective study. Of these, 95 patients had general anesthesia [group A] and 67 patients had conscious sedation [group B], 10 patients were converted from conscious sedation to general anesthesia and excluded from the study. In the general anesthesia group, induction was achieved with Fentanyl 1-2 microg/kg IV and intravenous sleeping dose of Propofol 2- 2.5 mg/kg, insertion of a laryngeal mask airway [size 3-4] was followed by assisted ventilation and maintenance with O2, N2O and Isoflurane. In conscious sedation group Midazolam 0.016 mg/kg was administered intravenously followed after two minutes by Fentanyl 50microg IV. Further doses of either drug were administered according to the patient's need. The total number of collected oocytes were 1,102 in group A compared to 596 oocytes in group B. Mean number of collected oocytes was higher in group A [11.6 +/- 4.1], then group B [8.9 +/- 2.9]. There was no statistical difference in fertilization rate between the two groups [69% vs. 67% in groups A and B respectively]. Similarly, there was no statistical difference in clinical pregnancy rate between the two groups [42.4% vs. 40.6%]

Efficacy of combined local anesthetic wound infiltration and paracetamol suppositories in relieving postoperative pain in children

To evaluate the efficacy of combined incisional infiltration with Bupivacine and Paracetamol suppositories with Paracetamol suppositories alone in relieving the postoperative pain associated with surgery of inguinal pathologies. Prospectively, on hundred and ten children whom underwent groin surgery at Prince Rashed Ben Al-Hassan hospital form April 1, 2008 to December 1, 2008 were included in the study. Their ages ranged from six months to 13 years. Surgery was performed under general anesthesia. Patients were randomized into two groups; group A [55 patients] received Paracetamol rectally 30 mg/kg immediately preoperatively, while group B [55 patients] had Paracetamol rectally 30mg/kg and incisional wound infiltration with Bupivacaine 1 mg/kg. Post operative pain was managed by giving Paracetamol. The duration of the postoperative analgesia was estimated based on the time when rescue analgesia was first given. Assessment of the quality of postoperative analgesia was based on the children's behavior. In our study, both parents and older children were willing to cooperate. None of the children in the study groups suffered from local anesthetic toxicity such as arrhythmias, seizures, allergy and hematoma or tissue edema. In group A, 15 children suffered pain in the recovery room and received further analgesia in the form of Paracetamol suppositories, 18 had pain and received analgesia at home within four to six hours after discharge. The remaining 22 suffered pain during the next five days after surgery. In group B, two patients had pain in the recovery room, eight had pain with early mobilization at home and had their first analgesic dose after five to eight hours. The other 45 children had no significant post-operative pain. Group B showed an increased duration of postoperative analgesia with early mobilization. Rescue mean time at which children had their first post-operative dose of analgesia was two to four hours in group A and it was five to eight hours in group B. No patient in group B needed analgesia after day three post-operatively. Wound infiltration with Bupivacaine 1mg.kg combined with rectal Paracetamol 20 mg/kg has a better and valuable efficacy compared to the rectal Paracetamol 30mg/kg alone with respect to providing pain relief following inguinal herniotomy, hydrocelectomy and orchidopexy in children, with a longer duration of pain relief and earlier mobilization

Prevention of hypotension after spinal anesthesia for transurethral resection of the prostate using 6% hetastarch versus lactated ringer's solution

To compare the use of 6% Hetastarch with Lactated ringer's solution for prevention of hypotension after spinal anesthesia for transurethral resection of the prostate. In a randomized double blind study, 60 patients who underwent subarachnoid anesthesia for transurethral surgery were divided into two equal groups: group A were given Lactated ringer's solution and group B were given 6% Hetastarch. One thousand ml of Lactated ringer's solution for group A and 500 ml of 6% Hetastarch for group B was started to be administered intravenously to patients 10 minutes before the administration of the spinal anesthesia. Heart rate, blood pressure and oxygen saturation were recorded prior to, during and after surgery. Also the incidence of nausea and vomiting and the use of ephedrine were recorded. The incidence of hypotension was higher in group A [83%] than in group B [43%]. Systolic blood pressure < 90 mmHg occurred in 25 patients out of 30 who received Lactated ringer's solution compared to 13 patients who received Hetastarch. More patients required ephedrine to treat hypotension in group A than in group B. Nausea or vomiting was lower in group B also. Six percent Hetastarch is superior to Lactated ringer's solution for prevention of hypotension after spinal anesthesia for transurethral resection of the prostate

Controlled trial of wound infiltration with bupivacaine for post operative pain relief after Caesarean Section

The aim of this study was to prove that the use of 0.25% Bupivacaine infiltrated in the surgical wound, is effective for postoperative analgesia. The study was conducted on 45 patients who underwent elective or emergency caesarean section at Prince Hashim Ben Al-Hussein hospital, between January and April 1999. Patients were allocated randomly to three groups, A, B and C respectively, to receive general anesthesia and Bupvacaine [Group A,n=15], spinal anesthesia and 0.25% Bupivacaine [group B,n=15], or only general anesthesia with no supplementation of Bupivacaine at the end of surgery [Control group C, n=15]. Patients were evaluated on an hourly basis for 24 hours using a visual analogue pain scale [VAS], starting from the end of the surgery. The dose for pethidine consumption was also recorded. It was found from the study that neither group A nor group B required any dose of pethidine [the traditional drug used], in the first 6 hours post operatively. While all patients from group C required at least one dose of pethidine. The time taken from the end of the surgery to the first request for analgesia was 6-8 hours for group A, 8-12 hours for group B [spinal], and 0 for group C [control]. The use of 0.25% Bupivacaine by wound infiltration is effective for post operative pain relief, as it reduces the requirements for additional post operative analgesia