Nerve stimulator-guided pudendal nerve block vs general anesthesia for postoperative pain management after anterior and posterior vaginal wall repair: a prospective randomized trial.

Study Objective: Compare the effectiveness of nerve stimulator-guided pudendal nerve block (PNB) vs general anesthesia (GA) for anterior and posterior (AP) colporrhaphy in terms of pain relief and analgesic consumption within 24 and 48 hours postoperatively.

Design: Prospective randomized trial.

Patients: Fifty-seven patients whose ages ranged between 20 and 53 years scheduled to undergo AP colporrhaphy due to the presence of cystorectocele.

Spectrum of Phenotypes Associated with Mutations in LRBA.

To date, several germline mutations have been identified in the LRBA gene in patients suffering from a variety of clinical symptoms. These mutations abolish the expression of the LRBA protein, leading to autoimmunity, chronic diarrhea, B-cell deficiency, hypogammaglobulinemia, functional T-cell defects and aberrant autophagy. We review the clinical and laboratory features of patients with LRBA mutations and present five novel mutations in eight patients suffering from a multitude of clinical features.

Effect of one anesthetic exposure on long-term behavioral changes in children.

Study Objective: To determine the association between one anesthetic exposure and behavioral outcome at age 10 to 12 years.

Design: Retrospective comparative study.

Setting: University-affiliated pediatrics department.

The effectiveness of pudendal nerve block versus caudal block anesthesia for hypospadias in children.

Background: Caudal block (CB) has some disadvantages, one of which is its short duration of action after a single injection. For hypospadias repair, pudendal nerve block (PNB) might be a suitable alternative since it has been successfully used for analgesia for circumcision. We evaluated PNB compared with CB as measured by total analgesic consumption 24 hours postoperatively.

Guided paravertebral blocks with versus without clonidine for women undergoing breast surgery: a prospective double-blinded randomized study.

Background: Paravertebral blocks (PVBs) have been introduced as an alternative to general anesthesia for breast cancer surgeries. The addition of clonidine as an adjuvant in PVBs may enhance quality and duration of analgesia and significantly reduce the consumption of analgesics after breast surgery. In this prospective randomized double-blind study, we assessed the significance of adding clonidine to the anesthetic mixture for women undergoing mastectomy.

General anaesthesia combined with bilateral paravertebral blockade (T11-T12-L1) vs general anaesthesia for bilateral varicocelectomy. A randomized double-blind clinical trial.

Introduction: Varicocelectomy is a common operation in urology associated with considerable postoperative pain. The aim of this prospective, randomized, double-blind study was to investigate whether a combination of general anesthesia and bilateral nerve stimulator guided paravertebral nerve blocks could provide better postoperative pain relief compared to general anesthesia in combination with placebo paravertebral nerve block.

Methods: Sixty patients scheduled for varicocelectomy were randomized prospectively.

Multilevel nerve stimulator-guided paravertebral block as a sole anesthetic technique for breast cancer surgery in morbidly obese patients.

In this case series, we present the effectiveness of multilevel nerve stimulator-guided paravertebral block (PVB) technique in obese women of body mass index ≥30 kg/m(2) undergoing breast cancer surgery with or without axillary dissection. Twenty-six obese women were included in this case series. Block classification, hemodynamics and complication rate, postoperative nausea and vomiting, postoperative analgesic consumption, post-anesthesia care unit (PACU) stay, and hospital stay were recorded.

Preoperative vs. postoperative bilateral paravertebral blocks for laparoscopic cholecystectomy: a prospective randomized clinical trial.

Background: The aim of this clinical trial was to determine the potential analgesic effect of preoperative paravertebral blockade in patients undergoing laparoscopic cholecystectomy.

Methods: Sixty patients scheduled for laparoscopic cholecystectomy were randomized to one of two groups with 30 patients each: bilateral nerve stimulator guided paravertebral blockade at the T5 to T6 level either prior to induction of general anesthesia (Group 1) or blockade immediately postoperatively (Group 2).

Results: The preoperative paravertebral block group had significantly lower visual analog scale scores compared with the postoperative paravertebral block group both at rest 12 hours postoperatively (1.

A survey of blood pressure in Lebanese children and adolescence.

Background: Blood pressure varies between populations due to ethnic and environmental factors. Therefore, normal blood pressure values should be determined for different populations.

Aims: The aim of this survey was to produce blood pressure nomograms for Lebanese children in order to establish distribution curves of blood pressure by age and sex.

Prevalence of physical activity among Lebanese adults: a cross-sectional study.

Background: This survey aims to assess the prevalence of physical activity among adult Lebanese, and to report the relationship between sociodemographic variables and physical activity behavior highlighting the correlates discouraging people to carry out physical activity.

Methods: A cross-sectional study using an anonymous self-reported questionnaire was conducted on 346 adults from four Lebanese districts. Demographic characteristics, physical activity, smoking status, alcohol consumption, and medical history were obtained.

The effectiveness of clonidine-bupivacaine repeated nerve stimulator-guided injection in piriformis syndrome.

Objectives: Piriformis syndrome (PS) is often refractory to conventional therapies. Guided injection techniques generally necessitate a computed tomography or fluoroscopic guidance that may not be available in most pain management centers in addition to its relative high cost. The aim of this clinical trial is to investigate whether clonidine-bupivacaine nerve-stimulator guided injections are effective in achieving long-lasting pain relief in PS compared with bupivacaine guided injection.

Bilateral guided cervical block for Zenker diverticulum excision in a patient with ankylosing spondylitis.

Patients with severe ankylosing spondylitis (AS) have difficulties in tracheal intubation. An 87-year-old man with severe AS was scheduled for Zenker diverticulum (ZD) excision. It was decided to proceed with combined bilateral cervical plexus blockade using a nerve stimulator.

Nerve stimulator-guided occipital nerve blockade for postdural puncture headache.

Postdural puncture headache (PDPH) is one of the most common complications of spinal anesthesia, where adequate hydration with bed rest in the horizontal position is the initial recommendation. Epidural blood patch is to date the most effective treatment, but it is an invasive procedure that may result in serious complications. The aim of the current study was to conduct a prospective, randomized, single-blinded comparison between bilateral occipital blockade and conventional expectant therapy in adults suffering from PDPH.

Nerve stimulator-guided repetitive paravertebral block for thoracic myofascial pain syndrome.

Myofascial pain syndrome (MPS) may persist for many years and is often refractory to traditional therapeutic approaches including pharmacotherapy, focal tenderness infiltration by local anesthetic and corticosteroids, physical therapy and behavioral modification. This report describes three cases of MPS following coronary artery bypass graft, inadequate positioning during abdominal hysterectomy, and excessive physical effort refractory to conventional therapeutic approaches. Three patients were successfully treated with repeated nerve stimulator-guided paravertebral block using a mixture of bupivacaine and clonidine.

Fecoprevalence and determinants of Helicobacter pylori infection among asymptomatic children in Lebanon.

Statement Of The Problem: Helicobacter pylori plays a major etiologic factor in the pathogenesis of chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and mucosa associated lymphoid tissue lymphoma. However, most of the infected subjects remain asymptomatic. The aim of this study is to establish fecoprevalence of Helicobacter pylori infection in a convenient non-probabilistic sample of asymptomatic Lebanese children.

Occipital nerve blockade for cervicogenic headache: a double-blind randomized controlled clinical trial.

Cervicogenic headache is a chronic hemicranial pain, usually occurring daily. This randomized, double-blind, placebo-controlled trial evaluated the effectiveness of nerve stimulator-guided occipital nerve blockade in the treatment of cervicogenic headache. The reduction in analgesic consumption was the primary outcome measure.

Repetitive occipital nerve blockade for cervicogenic headache: expanded case report of 47 adults.

Purpose: To evaluate the repetitive occipital nerve blocks using a nerve stimulator in the treatment of cervicogenic headache.

Methods: This prospective noncomparative clinical interventional case-series study included 47 patients suffering from cervicogenic headache using a repetitive guided occipital nerve blockade.

Results: Forty-one patients (87%) required more than one injection to achieve six-month pain-relief period.

Nerve stimulator guided pudendal nerve block versus general anesthesia for hemorrhoidectomy.

Purpose: A randomized clinical trial was undertaken to test the hypothesis that patients receiving a nerve stimulator guided pudendal nerve block for hemorrhoidectomy would experience more effective and prolonged postoperative analgesia and shorter hospital stay compared to patients receiving general anesthesia.

Methods: This was a prospective randomized observer-blinded study. Following Ethics Committee approval and informed consent, 80 patients scheduled for hemorrhoidectomy were randomized to two groups of 40 patients each: general anesthesia alone, or nerve stimulator guided pudendal nerve block.

Thoracic paravertebral block: influence of the number of injections.

Background And Objectives: The purpose of this study was to assess the radiographic and clinical distribution of 1 to 4 paravertebral injections by use of the same total volume of local anesthetic mixture.

Methods: Sixty-nine patients scheduled for surgical interventions suitable for bilateral PVB were included in the study and were randomly assigned to 1 of 3 treatment groups. Group 1 received 4 paravertebral injections on one side versus 1 injection on the contralateral side (23 patients), group 2 received 4 injections versus 2 injections (23 patients), and group 3 received 4 injections versus 3 injections (23 patients).

Addition of clonidine and fentanyl: comparison between three different regional anesthetic techniques in circumcision.

Background: Several techniques have been used for alleviating post-circumcision pain with regional anesthetics being more effective than systemic opioids. Our aim was to compare the effectiveness of dorsal penile block, ring block (RB) and dorsal penile block associated with RB in reducing post-circumcision pain in children.

Methods: We conducted a prospective randomized double-blind clinical trial on 100 boys aged between 1 month and 5 years undergoing elective circumcision.

Nerve stimulator-guided paravertebral blockade combined with sevoflurane sedation versus general anesthesia with systemic analgesia for postherniorrhaphy pain relief in children: a prospective randomized trial.

Background: Improvement of the duration of postoperative analgesia is desirable in children undergoing inguinal hernia repair.

Methods: Fifty children aged 5-12 yr were prospectively randomized to receive either paravertebral nerve blockade or general anesthesia (sevoflurane-fentanyl-nitrous oxide-oxygen) combined with standardized postoperative systemic analgesia, both combined with light sevoflurane anesthesia, for inguinal hernia repair.

Results: Mean pain scores were significantly lower in paravertebral nerve blockade patients compared with patients treated with systemic analgesia during the entire 48-h observational period (P < 0.