Group LD Research Articles

Comparison of dexmedetomidine and clonidine as an adjuvant to lignocaine with adrenaline in infiltration anesthesia in tympanoplasty: A randomized controlled trial

Abstract Background: Recent trends in surgical practice involve using local anesthesia for procedures like middle ear tympanoplasty due to its benefits, but patients often experience discomfort. Researchers are investigating alpha-2 agonists like clonidine and dexmedetomidine to enhance pain relief. We conducted a double-blind study comparing dexmedetomidine and clonidine’s effectiveness in extending pain relief after tympanoplasty using local infiltration. Aim and Objective: In light of this context, we undertook a randomized, double-blind investigation to compare the efficacy of dexmedetomidine and clonidine in extending the duration of pain relief via local infiltration for tympanoplasty. Materials and Methods This prospective, randomized, double-blind study was conducted on total of 60 patients belonging to the American Society of Anesthesiologists Class I and II scheduled for tympanoplasty under local anesthesia. All patients were divided into two groups Group LC, received local infiltration with 12 mL of lignocaine (2%) with adrenaline (1:200,000) plus clonidine (1 μg/kg) and Group LD, received local infiltration with 12 mL of lignocaine (2%) with adrenaline (1:200,000) plus dexmedetomidine (1 μg/kg). Results: Both the groups were comparable regarding demographic profile, perioperative hemodynamics, and total duration of surgery. Time of onset of analgesia was faster in Group LD (89.53 ± 5.54 vs. 94.17 ± 6.19 s) (P = 0.0034) and total duration of analgesia was also prolonged in Group LD (562.40 ± 24.82 vs. 332.30 ± 12.39 min) (P < 0.0001). Conclusion: We concluded that in comparison to clonidine, dexmedetomidine is more effective in terms of faster onset and prolongation of total duration of analgesia when used with local infiltration anesthesia.

Surface Roughness Evaluation of Pre- Versus Post-Crystallization Polish of Two High-Strength Silicate Ceramics for Chairside CAD/CAM Technology

This in vitro study evaluated the surface roughness (Sa) of two high-strength silicate ceramics, lithium disilicate IPS e.max CAD, Ivoclar Vivadent (LDS group), and zirconia-reinforced lithium silicate Vita Suprinity, VITA Zahnfabrik (ZLS group). The surface roughness was investigated before and after milling using different polishing systems and timings relative to the final crystallization of the ceramics. Forty-eight samples per group were polished by a single calibrated operator using two polishing systems: Dialite LD (Brasseler) and Lithium Silicate Polishers (Meisinger) for the LDS group and Dialite LD (Brasseler) and Vita Suprinity Polishing Set Technical (VITA Zahnfabrik) for the ZLS group, both pre- and post-crystallization. Surface roughness was measured using a confocal laser microscope (OLS4000 LEXT/Olympus), with scanning electron microscopy (SEM) used to evaluate surface morphological changes. Significant differences in Sa values were found between baseline groups, with ZLS exhibiting lower values. All polishing methods significantly reduced surface roughness compared to baseline (p ≤ 0.05). No significant differences were found in LDS samples when polishing pre- or post-crystallization (p = 0.129), while for ZLS samples, post-crystallization polishing achieved significantly smoother surfaces (p < 0.001). The study concluded that the choice of polishing system and timing did not significantly affect surface roughness for LDS. However, it is recommended that post-crystallization polishing be performed for the optimal smoothness of ZLS. This study aimed to evaluate the post-milling polishing procedures of CAD/CAM high-strength restorations, emphasizing the importance of an optimal surface roughness to prevent issues such as increased risk of abrasion on opposing teeth, enhanced plaque adhesion, and mechanical failures. Investigating these polishing techniques enables clinicians to optimize clinical performance, thereby improving the quality and longevity of high-strength silicate ceramics.

Effect of dexamethasone as an adjuvant to levobupivacaine in transversus abdominis plane (TAP) block for postoperative analgesia in subjects undergoing lower segment cesarean section

Background: Inadequate pain relief after caesarean section is a common problem in every part of the world. Transversus abdominis plane (TAP) block provides adequate post-operative pain relief following abdominal surgeries. TAP block duration is limited to effect of administered local anesthetics. Hence, adjuvant medications are added to local anaesthetic (LA) to prolong the effect of TAP block. The primay objective of this study was to analyse the analgesic effect of dexamethasone added to levobupivacaine in comparison with analgesic effect of levobupivacaine alone in TAP block. The secondary objectives are to analyse the number of supplemental analgesic requirements in the first 24 hrs after surgery and to analyse the duration of postoperative analgesia which is time to first analgesic request from the time of TAP block. Methods: 116 women scheduled for lower segment cesarean section (LSCS), belonging to ASA physical status 2 or 3, aged between 18 and 35 years, under SAB were recruited. Ultrasonogram (USG) guided TAP block was performed on each side after the completion of the surgery. Subjects in group L (n = 58) received TAP block on each side with 20 ml of 0.375% levobupivacaine and group LD (n = 58) with 19 ml of 0.375% levobupivacaine + 1ml (4mg) of dexamethasone. They were evaluated for pain at 10min, 30min, 45min, 1hour, 2hrs, 4hrs, 8hrs, 12hrs and 24hrs after the block using visual analog scale (VAS) score. Duration of postoperative analgesia and requirement of rescue analgesia were also analysed. Results: The post-operative visual analogue scale (VAS) scores were lower in group LD at 8, 12 and 24 hrs (p < 0.05). Mean duration of analgesia was significantly prolonged in group LD with lesser requirement of rescue analgesics (p < 0.05) up to 24 hrs. Conclusion: Dexamethasone (4 mg) as an adjuvant to levobupivacaine in USG guided TAP block reduces post-operative pain scores prolongs the duration of analgesia and decreases demands for rescue analgesics.

Comparison of Analgesic Efficacy of Levobupivacaine with or without Dexamethasone in Lower Abdominal Surgeries under Subarachnoid Block: A Pilot Randomised Controlled Trial

Introduction: Subarachnoid Block (SAB) is a commonly used technique for lower abdominal surgery. Dexamethasone has been proven effective as an additive when used with bupivacaine. However, there has been no study comparing the analgesic efficacy of dexamethasone with levobupivacaine under SAB. Aim: To compare the analgesic efficacy of levobupivacaine with or without dexamethasone in patients scheduled for lower abdominal surgeries. Materials and Methods: A pilot randomised doubleblind controlled trial was undertaken in the Department of Anaesthesiology, University College of Medical Sciences Guru Tagh Bahudur (UCMS-GTB) Hospital, New Delhi, India on 60 patients with Americian Soceity of Anaesthesiolgy (ASA) grade I or II, aged 18-65 years, undergoing lower abdominal surgeries under SAB from January 2021 to August 2022. In Group LS, 12.5 mg of 0.5% isobaric levobupivacaine (2.5 mL) with normal saline (1 mL) was administered, and in Group LD, 12.5 mg of 0.5% isobaric levobupivacaine (2.5 mL) with 4 mg dexamethasone (1 mL) was given. Patients were assessed for sensory and motor block, haemodynamic parameters, pain score, and side-effects. Unpaired t-tests/Mann-Whitney U tests were used to determine significance. A p-value of less than 0.05 was considered significant. Results: The two groups were comparable in terms of demographic profile. The age in the LS group was 37.80±9.98 years, and in the LD group, it was 38.63±12.37 years. The maleto-female ratio in the LS and LD groups was 17:13 and 21:9, respectively. The weight range in both groups was between 50 to 67 kg. The Basal Metabolic Index (BMI) was 22.40±2.43 kg/ m2 and 21.70±2.21 kg/m2 in the LD and LS groups, respectively. All these parameters, including height, had a p-value of more than 0.005, except for the duration of analgesia. The duration of effective analgesia was also longer in the LD group (247.00±36.69 min) than in the LS group (138.50±22.52 min) with a p-value of <0.001. The time of onset of sensory block was 9.13±2.98 minutes in the LD group and 10.30±3.06 minutes in the LS group, which was statistically insignificant. Conclusion: Authors concluded addition of 4 mg (1 mL) of dexamethasone to 2.5 mL of 0.5% isobaric levobupivacaine provides a clinically longer duration of effective analgesia with early onset and better quality of sensory and motor block than 2.5 mL of 0.5% isobaric levobupivacaine alone. Therefore, 4 mg of dexamethasone with 2.5 mL of 0.5% isobaric levobupivacaine is recommended for lower abdominal surgeries under SAB.

Comparison of levobupivacaine with dexamethasone versus levobupivacaine for ultrasound-guided transversus abdominis plane block in lower abdominal surgeries in a tertiary care hospital in Chengalpattu district – A randomized control trial

Introduction: Transversus abdominis plane (TAP) block is a regional technique for analgesia of the anterolateral abdominal wall. Ultrasound guidance is now considered the gold standard in TAP blocks. It involves the injection of a local anesthetic solution into a plane between the internal oblique muscle and transversus abdominis muscle. Since the thoracolumbar nerves originating from the T6 to L1 spinal roots run into this plane and supply sensory nerves to the anterolateral abdominal wall, the local anesthetic spread in this plane can block the neural afferents and provide analgesia to the anterolateral abdominal wall. Levobupivacaine is a local anesthetic from the amino amide class of medications. Adjuvants are drugs when added along with local anesthetics have a synergistic action to improve the duration and quality of analgesia. Objectives: The objective of this study was to study the effectiveness of ultrasound-guided transversus abdominis plane block using levobupivacaine with dexamethasone in terms of hemodynamic stability and duration of postoperative analgesia and pain scores (visual analog scale [VAS]), time of requirement of rescue analgesics among patients who have undergone lower abdominal surgeries. Methods: This is a double-blinded randomized control trial. This study was conducted among 60 patients who have undergone lower abdominal surgeries in a tertiary care hospital. Postsurgery, intraoperatively prior shifting out the patient, two groups received transversus abdominis plane block, one received 28 ml of 0.25% levobupivacaine with 2 ml of normal saline and another group received 28 ml of 0.25% levobupivacaine with 2 ml (8 mg) dexamethasone. Duration of postoperative analgesia and the efficacy between the two groups were compared with hemodynamic parameters and VAS score. Results: The study groups were not significantly different in terms of demographic data or the American Society of Anesthesiologists Grading. The mean onset of breakthrough pain was significantly higher in the L group. The time of requirement of rescue analgesics was also significantly shorter in the L group compared to the LD group. The VAS pain score was significantly lower in the Group LD as compared to the L group. Conclusion: Hence, it was noticed that dexamethasone when added to levobupivacaine had better hemodynamic stability in terms of blood pressure, heart rate, saturation, respiratory rate, and mean arterial pressure. The requirement of rescue analgesics was also reduced in this group and the time of breakthrough pain was also prolonged. This group had significantly lower pain scores.

Comparison of dexmedetomidine and clonidine as an adjuvant to levobupivacaine in transversus abdominis plane (TAP) block for postoperative analgesia following inguinal hernia repair

Postoperative analgesia for inguinal hernia procedures can be provided safely and effectively with USG guided TAP blocks. In the TAP block following inguinal hernia repair, we compared the analgesic effectiveness of dexmedetomidine and clonidine.: Seventy four patients undergoing inguinal hernia repair under spinal anesthesia were randomly divided in to Group LD (n=37) and Group LC (n=37). Patients in Group LD received a unilateral USG-guided TAP block with 0.5% levobupivacaine 18ml and dexmedetomidine 1 μg/kg in NS to make a total 20ml at the conclusion of surgery after regression of sensory block to the T10 dermatome, whereas patients in Group LC received 0.5% levobupivacaine 18ml and clonidine 1 μg/kg. Duration of postoperative analgesia, quality of analgesia (VAS), total rescue analgesic consumption in 24 hours and adverse effects were noted.Time for the initial application of rescue analgesia took substantially longer in Group LD (1006.49± 29.89 min) than in Group LC (512.35 ±27.14 min) (p ≤0.0001). At 8h, 16h, and 20h postoperatively, Group LD had a significantly lower VAS score both at rest and during hip flexion. It was discovered that Group LD had considerably decreased overall analgesic consumption. Incidence of postoperative side effects was comparable between two groups.: In comparison to clonidine, TAP block with dexmedetomidine as an adjuvant to levobupivacaine greatly prolongs postoperative analgesia and lowers 24-hour analgesic use.

Comparative Evaluation of Levobupivacaine and Levobupivacaine with Dexmedetomidine in Infraumbilical Surgeries

Background and Aim: Spinal anesthesia is a widely used technique providing faster onset with effective and uniformly distributed sensory and motor block. Due to decreased cardiovascular and central nervous system toxicity, levobupivacaine is a good alternative for spinal anesthesia. Present study was done to compare the effects of adding of dexmedetomidine to levobupivacaine in prolonging the analgesia produced by epidural levobupivacaine alone in patients undergoing infraumbilical surgeries. Material and Methods: A prospective study was carried out which included 100 adult patients between the age group of 20 and 65 years of physical status American Society of Anesthesiologists Classes I and II who underwent infraumbilical surgeries. Group L patients received 3 ml (15 mg) of 0.5% isobaric levobupivacaine + 0.3 ml normal saline while Group LD patients received 3 ml (15 mg) of 0.5% isobaric levobupivacaine + 0.3 ml (3 μg) dexmedetomidine. The two groups were compared with respect to the onset and duration of sensory and motor block and hemodynamic stability. Results: In Group LD, increase in VAS was observed at 210 min and the first dose of rescue analgesia was given at 5th h postoperatively. The second dose of recue analgesia was given at 12th h and the third dose was given at 21st h. Postoperative VAS scores at different time intervals were significantly lower in Group LD than Group L, thus indicating superior analgesia. The time of request of the first dose of rescue analgesia was delayed in Group LD and the difference in the two groups was highly significant (P < 0.001). Conclusion: Epidural administration of dexmedetomidine with levobupivacaine hydrochloride 0.5% results in faster onset of sensory and motor blockade compared to levobupivacaine hydrochloride 0.5% alone. Dexmedetomidine as an adjuvant to levobupivacaine hydrochloride 0.5% provides superior quality of analgesia without any significant hemodynamic instability.

Daily automated feedback enhances self-regulated learning: a longitudinal randomized field experiment.

The goal of the present study was to investigate the effects of automatically generated, adaptive feedback on daily self-regulated learning (SRL) in an experimental field study. University students reported their application of SRL strategies in the morning and in the evening over the course of 36 days using electronic learning diaries. Students were randomly assigned to the experimental group with feedback (LDF, n = 98) or the control group without feedback (LD, n = 96). Based on their self-reports, students in group LDF received daily written feedback regarding their satisfaction with the study day, adherence to time schedule, procrastination, and effort. This feedback either reinforced students in their study approach (confirmative feedback), encompassed information on learning outcomes or processes (informative feedback), or included feed forward on how to improve learning processes (transformative feedback). Multilevel analysis of daily process data revealed better average goal setting, planning and adherence to time schedule, as well as higher self-efficacy, and satisfaction with the study day in group LDF compared to group LD. Motivation, procrastination and effort were not affected by feedback. In contrast to the process measures, pre-post comparisons of students' self-reported general use of SRL strategies (trait measures) did not reveal any effects of feedback on SRL. Further explorative analyses investigated the effects of confirmative, informative, and transformative feedback on next day's learning behavior, showing that confirmative and transformative feedback had stronger effects on students' satisfaction and procrastination than informative feedback. Transformative feedback, which included specific strategies for moving forward, was effective in improving time management. Results provide theoretical insight into the interplay of feedback and SRL and offer practical implications regarding the design of feedback in a learning context.

Prophylactic use of a lidocaine constant rate infusion versus saline in dogs undergoing balloon valvuloplasty for management of pulmonic stenosis: A randomized control trial

ObjectiveTo evaluate the effect of a prophylactic lidocaine constant rate infusion (CRI) on the incidence and malignancy of catheter-induced ventricular ectopic complexes (VECs) during balloon valvuloplasty for management of pulmonic stenosis in dogs. Study designSingle-centre, prospective, randomized study. AnimalsClient-owned dogs (n = 70) with pulmonic stenosis. MethodsDogs were randomly assigned to one of two anaesthetic protocols: administration of lidocaine 2 mg kg–1 bolus followed by a CRI (50 μg kg–1 minute–1; group LD) or a saline placebo (group SL) during balloon valvuloplasty. All dogs were premedicated with methadone (0.3 mg kg–1) intramuscularly and a digital three-lead Holter monitor was applied. Anaesthetic co-induction was performed with administration of alfaxalone (2 mg kg–1) and diazepam (0.4 mg kg–1), and anaesthesia was maintained with isoflurane vaporised in 100% oxygen. CRIs were started on positioning of the dog in theatre and discontinued as the last vascular catheter was removed from the heart. All dogs recovered well and were discharged 24 hours postoperatively. Blinded Holter analysis was performed by an external veterinary cardiologist using commercially available dedicated analysis software; p < 0.05. ResultsOf the 70 dogs enrolled in the study, 61 were included in the final analysis: 31 in group LD and 30 in group SL.There was no significant difference between sinus beats (p = 0.227) or VECs (p = 0.519) between groups. In group LD, 19/31 (61.3%) dogs had a maximum ventricular rate ≥250 units and 20/30 (66.7%) dogs in group SL (p = 0.791). Conclusion and clinical relevanceIn this study, the use of a prophylactic lidocaine bolus followed by CRI in dogs undergoing balloon valvuloplasty for management of pulmonic stenosis did not significantly decrease the incidence nor the malignancy of VECs during right heart catheterization compared with a saline CRI.

Perioperative lidocaine and dexmedetomidine intravenous infusion reduce the serum levels of NETs and biomarkers of tumor metastasis in lung cancer patients: A prospective, single-center, double-blinded, randomized clinical trial.

Neutrophil extracellular traps (NETs) can enhance the metastasis of non-small cell lung cancer (NSCLC). As biomarkers of tumor metastasis, metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) together with NETs are essential to endothelial-to-mesenchymal transition (EMT). We hypothesized that intravenous infusion of lidocaine and dexmedetomidine could reduce the production of NETs and biomarkers of tumor metastasis after video-assisted thoracic surgery (VATS) in NSCLC patients. The trial included 132 NSCLC patients undergoing VATS. The patients were equally randomized to a placebo group (Group C), a lidocaine group (Group L, intravenous lidocaine 8 mg/kg/h for 15 minutes before anesthesia, 2 mg/kg/h during surgery, and 1 mg/kg/h until 24 hours after surgery), a dexmedetomidine group (Group D, intravenous dexmedetomidine 2 μg/kg/h for 15 minutes before anesthesia, 0.5 μg/kg/h during surgery, and 0.25 μg/kg/h until 24 hours after surgery), and a dexmedetomidine plus lidocaine group (Group LD, combination use of lidocaine and dexmedetomidine). The primary outcome was the production of myeloperoxidase (MPO) and citrullinated histone-3 (H3Cit), biomarkers of NETs, on postoperative day (POD) 1. MMP-3, MMP-9, and VEGF-α, as biomarkers of tumor metastasis, were also evaluated on POD 1. The baseline patient characteristics and perioperative data did not differ between the study groups. MPO was significantly decreased in Groups L, D, and LD (-197.08 ± 34.01, -137.37 ± 32.41, and -189.45 ± 33.73 U/ml, P<0.001, respectively) compared with Group C (-106.51 ± 25.44 U/ml). H3Cit was also lessened in Groups L, D, and LD (-49.51 ± 9.11, -34.80 ± 10.37, and -51.82 ± 8.98 ng/ml, P<0.001, respectively) compared with Group C (-24.73 ± 7.65 ng/ml). Lidocaine and dexmedetomidine also reduced MMP-3 (-69.08 ± 13.22, -52.84 ± 13.78, -85.34 ± 12.59 vs. -40.55 ± 10.71 ng/ml in Group L, D, LD vs. Group C, P<0.001, respectively), MMP-9 (-8.46 ± 1.68, -6.07 ± 1.82, -9.67 ± 1.43 vs. -4.28 ± 1.29 ng/ml in Group L, D, LD vs. Group C, P<0.001, respectively), and VEGF-α (-95.55 ± 22.53, -71.65 ± 18.77, -104.89 ± 15.49 vs. -51.73 ± 16.27 pg/ml in Group L, D, LD vs. Group C, P<0.001, respectively) on POD 1. In NSCLC patients, continuous perioperative intravenous infusion of lidocaine and dexmedetomidine significantly reduced the production of NETs and tumor metastasis biomarkers on POD 1. Meanwhile, it also decreased inflammation, protected cellular immune function, reduced pain and opioid consumption, and improved the quality of postoperative recovery. chictr.org.cn, identifier: 187049.

Physical and mechanical changes on titanium base of three different types of hybrid abutment after cyclic loading.

This study investigated the physical and mechanical changes in the titanium base of three different hybrid abutment materials after cyclic loading by estimating the post-load reverse torque value (RTV), compressive side fulcrum wear pattern of titanium base, and surface roughness. A total of 24 dental implants were divided into three groups (n = 8 each): Group Z, LD, and P used zirconia, lithium disilicate, and polyetheretherketone, respectively, for hybrid abutment fabrication. RTV was evaluated after cyclic loading with 50 N for 1.2 × 106 chewing cycles. The compressive sides of the titanium bases were analyzed using a scanning electron microscope, and the roughness of the affected areas was measured using an optical profilometer after loading. Datasets were analyzed using Kruskal-Wallis test followed by Mann-Whitney tests with the Bonferroni correction (α = .05). Twenty-three samples passed the test; one LD sample fractured after 770,474 cycles. Post-load RTV varied significantly depending on the hybrid-abutment material (P = .020). Group P had a significantly higher median of post-load RTVs than group Z (16.5 and 14.3 Ncm, respectively). Groups LD and P showed minor signs of wear, and group Z showed a more pronounced wear pattern. While evaluating compressive side affected area roughness of titanium bases, lower medians were shown in group LD (Ra 0.16 and Rq 0.22 µm) and group P (Ra 0.16 and Rq 0.23 µm) than in group Z (Ra 0.26 and Rq 0.34 µm); significant differences were found only among the unaffected surface and group Z. The hybrid abutment material influences the post-load RTV. Group Z had a more pronounced wear pattern on the compressive side of titanium base; however, the surface roughness was not statistically different among the hybrid-abutment groups.

Evaluation of shear bond strength and translucency of zirconia-reinforced lithium silicate and lithium disilicate: An in vitro study.

To analyze the effect of various surface treatment protocols on shear bond strength between the ceramic and resin cement (RC) and influence of zirconia on the translucency of LD as compared to zirconia-reinforced lithium silicate (ZLS). In-Vitro Study. Specimens (14 mm × 12 mm × 2 mm) (n = 135) and (14 mm × 12 mm × 1 mm) (n = 45) of ZLS computer-aided design/computer-aided manufacturing glass ceramic block and LD were fabricated, respectively. All the ZLS specimens were crystallized and were tested for the translucency parameter and ceramic-resin shear bond strength. Two different types of surface treatment were used on the ZLS and LD samples. The specimens were treated using the hydrofluoric acid (HF) etching or air abrasion with diamond particles (DPs). The specimens were then bonded using self-adhesive RC to a composite disc of 10 mm and thermocycling was performed. A universal testing machine was used to evaluate ceramic-resin shear bond strength after 24 h. The translucency of the specimens was evaluated using the spectrophotometer by calculating the difference in color between the readings over a black background and a white background. Data were statistically analyzed using the independent sample t-test and analysis of variance with Bonferroni's correction and comparison was made between the specimens. Independent sample t-test demonstrated statistically significantly higher translucency for group ZLS (61.44 ± 22) as compared to group LD (20.16 ± 8.39) (P < 0.001). Group ZLS showed statistically significant higher shear bond strength when surface treatment using HF or air abrasion with synthetic DPs was performed as compared to untreated group (3.58 ± 0.45) (P < 0.001). Moreover, air abrasion group (16.79 ± 2.11 megapascal [MPa]) demonstrated statistically significant higher shear bond strength as compared to HF etched group (8.25 ± 0.30 MPa) (P < 0.001). Furthermore, statistically significant higher shear bond strength was noted when air abrasion was done for group ZLS (16.79 ± 2.11 MPa) as compared to group LD (10.82 ± 1.92 MPa) (P < 0.001). However, on surface treatment with HF, a statistically significantly lower shear bond strength was noted for group ZLS (8.25 ± 0.30 MPa) as compared to group LD (11.29 ± 0.58 MPa) (P = 0.001). ZLS demonstrated higher translucency compared to LD restorations. DP abrasion of ZLS is recommended to achieve higher shear bond strength between the ceramic and RC.

The Effect of Dry Period Length on Average Milk Yield in Early Lactation Period in Anatolian Buffaloes

This study aimed to investigate the effect of short and long dry period on milk yield in next early lactation period in Anatolian buffalo. The buffaloes (n=64) were assigned to three groups as a short dry period (Group SD; n=17; ≤6 weeks), a normal dry period (Group ND; n=20; 8-10 weeks) and a long dry period (Group LD; n=27; ≥12 weeks). Early lactation milk yields and lactation numbers of all groups were compared statistically. It was observed that there was no difference between SD, ND and LD groups in terms of lactation numbers (p &gt;0.05). The milk yield in the early lactation was lower in the SD group compared to the other groups (p 0.05). However, it was found that the milk yields of the ND and LD groups were similar in the early lactation period. In conclusion, short dry period had a negative effect on milk yield in early lactation period in Anatolian buffaloes. On the other hand, animals with normal and long dry periods had a similar milk yield. However, we think that milk yield should be followed throughout all lactation period for a more precise result.

Effect of dexpanthenol on wound healing in penile fracture model: An experimental study.

In the present study, we aimed to investigate the effect of dexpanthenol on wound healing at the histopathological level on cavernous tissue. Forty-four Wistar albino rats weighing 220-250 g were used. The rats were randomly divided into four groups as Group B, Group S, Group LD, and Group SD. In Group B, the incision was not repaired and left to secondary healing. In Group S, the incision line was repaired with 5/0 polyglactin suture. In Group LD, 0.25 mg/kg dexpanthenol was applied subcutaneously below the repaired wound region once a day during 14 days. In Group SD, 500 mg dexpanthenol was applied intraperitoneally once a day during 14 days. No fibrosis was observed in 8 (80%) rats in group SD. Fibrosis rates were significantly lower in Group SD compared to Group B, Group S, and Group LD (p = 0.013, p = 0.005, and p = 0.003, respectively). Systemic dexpanthenol administration significantly decreased fibrosis in penile fracture model on rats.

A Comparative Study to Evaluate the Efficacy of Dexmedetomidine and Clonidine to Accentuate the Perioperative Analgesia of Caudal 0.25% Isobaric Levobupivacaine in Pediatric Infraumbilical Surgeries

BackgroundCaudal block is an efficient way to offer perioperative analgesia for painful sub-umbilical interventions. It enables early ambulation and periprocedural hemodynamic stability. These are important advantages over general anesthesia, notably in preterm babies and in children with cardiopulmonary comorbidities. In this study, we aimed to compare the effect of dexmedetomidine and clonidine to accentuate the perioperative analgesia of 0.25% isobaric levobupivacaine in pediatric caudal anesthesia.MethodologyA prospective double-blind randomized control study was conducted on 60 patients with the American Society of Anesthesiologists (ASA) physical status I, between the ages of one to six undergoing infraumbilical abdominal surgery under caudal anesthesia in the Department of Anaesthesia, Sardar Patel Medical College, Bikaner. Patients were randomly allocated to the following three groups of 20 each: group L, 1 mL/kg of levobupivacaine 0.25%; group LD, 1 mL/kg of levobupivacaine 0.25% with 0.5 µg/kg of dexmedetomidine; and group LC, 1 mL/kg of levobupivacaine 0.25% with 0.5 µg/kg of clonidine. Intraoperative and postoperative hemodynamic parameters were recorded for 24 hours. Patients’ pain scores, sedation scores, and Bromage scores were recorded. In our study, the main observation was the duration of analgesia and the total analgesic requirement for 24 hours.ResultsThere was a significant difference in the duration of analgesia among the three groups (p < 0.001). Group LC had the highest duration of analgesia of 492.00 (50.01) minutes, followed by group LD 486.00 (54.71) minutes, and the lowest in group L 291.00 (40.25) minutes. There was a significant difference between the three groups in terms of the total dose of analgesics in 24 hours (p < 0.001), with the median total dose of analgesics being the highest in Group L. Three groups differed significantly in terms of motor block, which was limited to up to 180 minutes in groups LC and LD with no residual motor block.ConclusionsThe addition of α2 agonists such as clonidine or dexmedetomidine at a dose of 0.5 µg/kg as an adjuvant to caudal levobupivacaine (0.25%) at 1 mL/kg significantly prolongs the duration of opioid-free analgesia in children undergoing infraumbilical abdominal surgeries without prolonging the motor blockade and any side effects. Moreover, dexmedetomidine does not offer a significant advantage over clonidine regarding the analgesia duration.

A Comparative Study of Dexmedetomidine and Tramadol as an Adjuvant to Levobupivacaine in Ultrasound Guided Transverse Abdominus Plane Block in Pediatric Patients Undergoing Laproscopic Orchidopexy

Background: Transverse abdominus plane (TAP) block is a regional anesthetic technique which provides an excellent analgesia without major adverse effects. The primary aim of this study was to evaluate the efficacy of dexmedetomidine in comparison to tramadol when added as adjuvant to levobupivacaine in TAP block on duration of post operative analgesia following laproscopic orchidopexy.&#x0D; Methods: Sixty American Society of Anaesthesiologists (ASA) grade 1 pediatric patients undergoing laproscopic orchidopexy under general anaesthesia were randomized into two groups (GroupLD and Group LT). Group LD recieved ultrasound guided bilateral TAP block with 0.3 ml/kg 0.25% levobupivacaine with 1µg/ kg of dexmedetomidine on both sides and Group LT recieved TAP block with 0.3 ml/kg 0.25% levobupivacaine with 1mg/ kg of tramadol. During the first 24 h postoperatively, we assessed hemodynamic stability, respiratory depression, and postoperative pain using face, legs, activity, cry, consolability (FLACC) pain scale.&#x0D; Results: Total duration of analgesia (986.67 ± 47.29 min vs. 690 ± 53.49 min, P value- 0.000), and the total consumption of paracetamol in the first 24 hours postoperatively (324.28 ± 35.5 mg vs. 580.14 ± 38.23, P value – 0.000) were statistically highly significant in group LD in comparison to group LT. The FLACC score were lower in Group LD as compared to group LT and side effects profile were similar in both the groups.&#x0D; Conclusion: Dexmedetomidine in a dose of 1 μg.kg-1 when added to levobupivacaine in ultrasound guided transverse abdominus plane block significantly prolongs the duration of postoperative analgesia as compared to tramadol with levobupivacaine without major side effects.

Intraoperative Deliberate Hypotension: Comparison of Dexmedetomidine Infusion Alone and in Combination with Iignocaine

Aim: To explore the effects of dexmedetomidine infusion combined with lignocaine on the intraoperative hemodynamic profile. Study Design: randomized, double-blind study Place and Duration of Study: Department of Anesthesia, Isra University Hospital, Hyderabad from 1st May 2021 to 31st October 2021. Methodology: Sixty patients from the daily operation list were randomly assigned to group D (dexmedetomidine intravenous infusion only) and group LD (dexmedetomidine plus lignocaine intravenous infusion) using a sealed envelope system. Results: The majority of the patients presented ASA status II (41.7%) were in the age group of 35-44 years (23.3%) and had BMI ranging from 25-34. Analysis of various clinical parameters showed a significant difference between group D and LD in terms of reduced heart rate, average mean arterial pressure, and need for transfusion. A higher number of patients receiving combination infusion had negligible blood loss with reference to patients maintained at dexmedetomidine alone. The satisfaction levels of the surgeon and attending anesthetist were significantly higher for surgical outcomes in the group receiving a combinative infusion of dexmedetomidine and lignocaine. Conclusion: The hemodynamic profiles of patients undergoing different surgeries showed significant favor for the combination of dexmedetomidine and lignocaine infusion as compared to infusion of dexmedetomidine only. Keywords: Deliberate hypotension, Intraoperative, Hemodynamic, Dexmedetomidine, Lignocaine

A prospective randomized, controlled, double blinded study to compare the analgesic efficacy of lidocaine (3 mg/ kg 0.5%) with dexmedetomidine (0.5 mcg / kg) and lidocaine (3mg/ kg 0.5%) with normal saline for intravenous regional anesthesia in patients posted for upper limb surgeries

Intravenous regional anaesthesia may be defined as reversible state of anaesthesia, produced by administration of local anesthetics into the venous system of upper and lower extremities. This technique is simple, effective, cheap and quite safe for operations on limbs especially in emergency situations. The present study involves the comparison of analgesic efficacy of Lidocaine with normal saline vs lidocaine with dexmedetomidine in intravenous regional anesthesia. A total of 120 patients belonging to both sexes of ASA – I or ASA – II and between the age groups of 18 to 50 yrs, admitted for various orthopaedic surgeries on forearm were included in the study. They are prospectively randomised in to two groups: Group L-Lidocaine 3mg/kg 0.5%+1 ml normal saline diluted with normal saline made to 40 ml and Group LD –Lidocaine 3mg/kg0.5%+Dexmedetomidine 0.5μg/kg (diluted to 1ml) diluted with normal saline made to 40 ml. Results analysed and discussed. The addition of 0.5 µg/kg dexmedetomidine to lidocaine for intra venous regional anaesthesia has significant analgesic effect. It shortens the onset of sensory and motor block onset, improved tourniquet tolerance and prolonged postoperative analgesia with stable cardiorespiratory parameters.

Metabolomic Profiling Reveals Protective Effects and Mechanisms of Sea Buckthorn Sterol against Carbon Tetrachloride-Induced Acute Liver Injury in Rats.

The present study was designed to examine the efficacy and protection mechanisms of sea buckthorn sterol (SBS) against acute liver injury induced by carbon tetrachloride (CCl4) in rats. Five-week-old male Sprague-Dawley (SD) rats were divided into six groups and fed with saline (Group BG), 50% CCl4 (Group MG), or bifendate 200 mg/kg (Group DDB), or treated with low-dose (Group LD), medium-dose (Group MD), or high-dose (Group HD) SBS. This study, for the first time, observed the protection of SBS against CCl4-induced liver injury in rats and its underlying mechanisms. Investigation of enzyme activities showed that SBS-fed rats exhibited a significant alleviation of inflammatory lesions, as evidenced by the decrease in cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), and gamma-glutamyl transpeptidase (γ-GT). In addition, compared to the MG group, the increased indices (superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), total antioxidant capacity (T-AOC), and total protein (TP)) of lipid peroxidation and decreased malondialdehyde (MDA) in liver tissues of SBS-treated groups showed the anti-lipid peroxidation effects of SBS. Using the wide range of targeted technologies and a combination of means (UPLC-MS/MS detection platform, self-built database, and multivariate statistical analysis), the addition of SBS was found to restore the expression of metabolic pathways (e.g., L-malic acid, N-acetyl-aspartic acid, N-acetyl-l-alanine, etc.) in rats, which means that the metabolic damage induced by CCl4 was alleviated. Furthermore, transcriptomics was employed to analyze and compare gene expression levels of different groups. It showed that the expressions of genes (Cyp1a1, Noct, and TUBB6) related to liver injury were regulated by SBS. In conclusion, SBS exhibited protective effects against CCl4-induced liver injury in rats. The liver protection mechanism of SBS is probably related to the regulation of metabolic disorders, anti-lipid peroxidation, and inhibition of the inflammatory response.

Comparison of Levobupivacaine with dexmedetomidine in Infraumbilical surgeries

Introduction: Due to decreased cardiovascular and central nervous system toxicity, levobupivacaine is a good alternative for spinal anesthesia. Dexmedetomidine when used intrathecally is associated with prolonged motor and sensory block, hemodynamic stability, and less requirement of rescue analgesia in 24 h. Materials and Methods: We assumed that sevoflurane will provide clinically acceptable conditions for endotracheal intubation comparable to propofol-suxamethonium in children. All patients received diazepam 0.2 mg/kg orally, the night before surgery. The patients were preloaded with Lactated Ringer's solution 15 mL/kg. They were monitored with automated noninvasive blood pressure, pulse oximetry, and electrocardiogram. Results: In Group LD, increase in VAS was observed at 210 min and the first dose of rescue analgesia was given at 5th h postoperatively. The second dose of recue analgesia was given at 12th h and the third dose was given at 21st h. Postoperative VAS scores at different time intervals were significantly lower in Group LD than Group L, thus indicating superior analgesia. The time of request of the first dose of rescue analgesia was delayed in Group LD as it was demanded at 309.93 ± 23.19 min and in Group L was at 168.30 ± 12.32 min. The difference in the two groups was highly significant (P< 0.001). Conclusion: Sevoflurane provides clinically acceptable intubating conditions and can be a suitable alternative to propofol-suxamethonium for endotracheal intubation in children.