Online ISSN: 2515-8260

Keywords : adjuvants


The efficacy of intrathecal fentanyl and buprenorphine as an adjuvant to bupivacaine in caesarean section

Dr. Naziya Sultana, Dr. Triveni N Hiremath, Dr. Gayathri Bhat, Dr. Kiran K N

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3068-3073

Introduction: The addition of intrathecal opioids to local anaesthetics has been found to improve the quality and duration of sensory and motor blockade, providing post-operative pain relief for a longer period.
Method: 60 parturients of ASA grade I and II scheduled for elective LSCS under subarachnoid block were randomly allocated into 2 groups. Group A were administered 2ml of 0.5% hyperbaric bupivacaine with 90 µg of buprenorphine (0.3 ml). Group B were administered 2ml of 0.5% hyperbaric bupivacaine with 15 µg of fentanyl (0.3 ml). Efficacy of buprenorphine and fentanyl as adjuvants in terms of haemodynamic variables, onset and duration of sensory block and motor block along with side effects were recorded.
Results: There were no significant hemodynamic changes between the two groups. There was significant decrease in the time required to reach peak sensory blockade in fentanyl when compared to buprenorphine group compared to control group (p value <0.0001). Mean duration of analgesia was significantly prolonged in Group A (309.23±14.32 min) than Group B (284 ± 15.22min). There was no significant effect on Apgar score of the neonate.
Conclusion: Intrathecal hyperbaric bupivacaine with opioid as adjuvants are well tolerated by the parturient and neonate during caesarean section with quality analgesia and increased duration of post-operative analgesia

Giant Cell Tumor Treatment by Curettage and Bone Cement in Proximal End of Tibia

Mohammed Basheer Wali, Elsayed Eletawy Soudy, Mohsen Fawzy Omar, Mohamed Ismael Kotb

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4046-4054

Background: Surgical treatment stills the most effective treatment for a giant cell
tumor of bone (GCTB). The aim of the present study was to evaluate the outcomes
of surgical treatment of giant cell tumor in proximal end of tibia by curettage and
bone cement. Patients and methods: This clinical trial study was conducted on 18
patients underwent surgical treatment of giant cell tumor in proximal end of tibia
by curettage and bone cement at orthopedic department, Zagazig University
Hospitals. Their age was ranged from 22 to 41 years. Two thirds (66.7%) of the
studied group were females and one third (33.3%) of them were males (2:1). After
completion of the investigations, staging of the tumor was recorded using
Campanacci's radiological grading method. Postoperative follow up was done to
assess the functional outcome and to detect the presence of complications. Results:
The present study showed that, 83.3% had companaccis grade I and grade II
(16.7%). 88.8% underwent cement and hydrogen peroxide and 11.2%underwent
cement, hydrogen peroxide and internal fixation. Regarding MSTS, only 33.3% of
them had intermediate pain, all patients had enthused emotional acceptance and
66.7% had unlimited walking ability and 22.2% had intermediate gait. Post
operative follow up showed the recurrence rate was zero (0.0%) after a follow up
time (11.2±1.04) months ranged from 9 to12 months. There was only 11.1% of
patients had superficial infection. Conclusion: Surgical treatment of a giant cell
tumor of bone using Cement filling after extended curettage is provide a good
oncological outcome and joint preservation. Curettage with adjuvants is a feasible
first choice treatment option for GCTB with Cement filling does not increase the
recurrence rate.