Effectiveness of ultrasound-guided rhomboid intercostal and sub-serratus block for perioperative analgesia in male patients undergoing combined power-assisted liposuction with pull-through excision of the gland for breast definition and reshaping.

BACKGROUND: The newly introduced ultrasound guided interfacial rhomboid intercostal and sub-serratus (RISS) block technique demonstrated promising efficacy in managing perioperative pain among patients undergoing abdominal and thoracic procedures. Thus, this study investigated the efficiency of bilateral ultrasound-guided RISS (US-RISS) as a perioperative pain control technique in male subjects receiving gynecomastia surgery. METHODS: This prospective randomized study involved sixty patients who underwent gynecomastia surgery. Individuals were randomly divided into two groups: the RISS group (N.=30) and the control group (N.=30). After anesthesia induction, the patients received bilateral US-RISS using 40 mL of 0.25% levobupivacaine, or conventional intravenous analgesia with no intervention, respectively. The primary outcome was the overall morphine consumption in 24 hours, and the secondary endpoints involved the time elapsed till rescue analgesia was requested, the quality of recovery after 24 hours and side effects' incidence. RESULTS: Morphine consumption was noticeably decreased in the RISS group compared to the control group, with 14.07±4.91 mg and 35.83±1.70 mg mean values, respectively (P<0.001). Furthermore, in the RISS group, the initial rescue analgesia request occurred significantly later than in the control group, with mean values of 15.58±1.41 hours and 0.96±0.63 hours, respectively (P<0.001). Additionally, within the RISS group, there was a high quality of recovery observed, with a low incidence of opioid-related adverse events in comparison to the control group. CONCLUSIONS: Bilateral US-RISS block is a beneficial intervention in gynecomastia surgery for pain management and improves the quality of recovery.

Effect of induced acute mild arterial hypertension on postoperative analgesic requirements after laparoscopic ovarian cystectomy: a randomized double blinded study.

Objective: To evaluate the effectiveness of inducing acute hypertension during laparoscopic ovarian cystectomy on postoperative nalbuphine analgesic requirements. Methods: The total dose of nalbuphine used in the hypertension group was significantly lower than that in the control group (p <0.001). The VAS score was significantly lower in the hypertension group on arrival to PACU and during the period between 1 and 6 hours postoperatively. Results: The total dose of nalbuphine used in the hypertension group was significantly lower than that in the control group (p <0.001). The VAS score was significantly lower in the hypertension group on arrival to PACU and during the period between 1 and 6 hours postoperatively. Conclusion: This study demonstrates that pharmacologically induced mild acute intraoperative hypertension significantly reduces postoperative nalbuphine consumption and pain scores following laparoscopic ovarian cystectomy. Trial registration in Pan African Clinical Trial Registry: identification number for the registry is PACTR201508001247179.