Prolongation of action of bupivacaine in caudal block in pediatrics: comparative study between addition of ketamine, clonidine and adrenaline

Regional anesthesia is considered an effective method for providing analgesia both intraoperatively and postoperatively and also decreases the total amount of general anesthesia required for surgery, provides more rapid recovery and faster wake up times. Caudal block is the most useful and common pediatric regional block as it is widely applicable and technically simple. Many factors influence the activity of caudally administrated local anesthetic solutions as dosage, addition of a vasoconstrictor e.g. epinephrine and addition of drugs as Ketamine and Clonidine. In this study, we compared the analgesic efficacy and side effects of Bupivacaine alone, Bupivacaine + Epinephrine, Bupivacaine + Clonidine and Bupivacaine + Ketamine. In the current study the addition of drugs to Bupivacaine has significantly extended the duration of caudal analgesia more than Bupivacaine alone especially with Ketamine and Clonidine

Assessment of combined effect of using radiofrequency and application of Mitomycin-C on success rate of endoscopic endonasal dacryocystorhinostomy

To assess the success rate of endoscopic endonasal DCR with the use of radiofrequency and mitomycin-c application. Thirty patients [30 eyes] were included in the study. Patients were classified into 2 groups, groupl we use endoscopic endonasal DCR with the use of radiofrequency and application of mitomycin-c while in group 2 the standard external DCR was used. The success rate in group 1 ranging from 90 to 95% while in group 2 it was only 80%. The use of radiofrequency and mitomycin-c application together with the endoscopic endonasal DCR increases the success rate to the level of 90-95%

Saphenous vein autograft for long term hemodialysis

The analogous saphenous vein was used as a blood access graft in t he upper arm, between the brachial artery and the axillary vein for lognterm hemodialysis in 18 patients, representing 155 of all patients referred to our outpatient clinic for A-V fistula, in the period from 1/96 to 3/97. This modality was used because 50% of those patients were obese, with deep superficial veins, 27.8% have small inadequate vessels and in 22.2% the superficial veins were thrombosed and exhausted. Patency rate was 83.3% for a follow up period ranging from 15-27 months with a Thrombosis occurred in 16.7%, infection in 5.6%, haematoma in 11.1%, aneurismal dilatation in 11.1% and arterial steal in 5.6% of the patients. Reassessment of 10 patients out of the 18 was done for another 12 months, during this period aneuismal dilation appeared in another 5 patients, arterial steal in one patient, and haematoma at the site of puncture in one patient. Saphenous vein autograft can be considered a good alternative modality for blood access when the primary form can't be used