combination of infiltrative bupivacaine with low-pressure laparoscopy reduces postcholecystectomy pain. a prospective randomized controlled study

To evaluate the efficacy of combined infiltrative bupivacaine with low intraperitoneal pressure insufflation in reducing the post-laparoscopic pain in patients undergoing laparoscopic cholecystectomy [LC]. This randomized prospective single-blind study included 473 patients undergoing LC. The study took place at University Hospital Center [Mother Teresa,] Tirana, Albania between January 2006 to September 2009. The patients were divided in 4 groups: Group 1 [n=120] with intra-abdominal insufflation pressure 15 mm Hg and no infiltrative bupivacaine [HPNBG]; Group 2 [n=122] with intra-abdominal insufflation pressure 15 mm Hg and with 5 ml infiltrative bupivacaine 0.5% in abdominal minincisions [HPBG]; Group 3 [n=l 10] with intra-abdominal insufflation pressure under 10 mm Hg and no infiltrative bupivacaine [LPNBG]; and Group 4 [n=121] with intra-abdominal insufflation pressure under 10 mm Hg and infiltrative bupivacaine [LPBG]. There were statistically significant differences [p=0.003] between groups regarding incisional pain intensity, between LPBG and HPNBG [p=0.001], between LPBG and HPBG [p=0.037], between LPBG and LPNBG [p=0.001[, as well the shoulder-tip pain intensity [p=0.001]; between LPBG and HPNBG [p=0.001], between LPBG and HPBG [p=0.001], and between LPBG and LPNBG [p=0.031[. We found statistically significant differences related to pain beginning time [ANOVA test, p=-0.027]; between LPBG and HPNBG [p=0.04l], between LPBG and HPBG [p=0.031], and between LPBG and LPNBG [p=0.05]. The combination of infiltrative bupivacaine with low intraperitoneal pressure insufflation shows to be more efficient in reducing the post-laparoscopic pain, compared with other regimens

comparison of the effects of sufentanil and fentanyl on intraocular pressure changes due to easy and difficult tracheal intubations

To study the effects of sufentanil and fentanyl on intraocular pressure after easy and difficult intubations. From January 2006 to January 2008 there were included 120 patients undergoing general anesthesia at University Hospital Center [Mother Theresa] Service of Anesthesia and Intensive Care, Tirana, Albania. The patients were divided into 2 groups, 60 patients each receiving Sufentanil [group S], and Fentanyl [group F], 2 minutes before intubation. Fourteen patients were found to have difficult laryngoscopy and tracheal intubations [8 in group S. and 6 in group F], in which several attempts to intubate were carried out. We compared the intraocular pressure values before, and 2 minutes after the intubations between the 2 groups, and also between the 2 groups that resulted as difficult intubations. The mean intraocular pressure measured 2 minutes after intubation in group S was lower than in group F. Mean intraocular pressure changes in the 2 groups were: 1.67mm Hg in group S, and -1.77mm Hg in group F. The small groups included patients with difficult intubation; mean intraocular pressure changes were + 1.93 mm Hg in group S, and +3.7 mm Hg in group F. Both drugs blunt the increased intraocular pressure during laryngoscopy and tracheal intubations, but in difficult intubation, sufentanil presented better protection than fentanyl