Comparison of long terms follow up results in patients with cervical disk disease treated with anterior PEEK cage implantation and without it in Rasoul Akram Hospital

Background

Anterior interbody fusion of the cervical spine have become the gold standard for treating spinal diseases, hence the aim of this study was to compare long term follow up results in patients with cervical disk disease treated with anterior PEEK cage implantation and without it in anterior approach.

Methods

Retrospectively 63 patients with known cervical discogenic disorders who went under surgery with and without cage implantation were enrolled. The neurological examination and neurologic function were assessed by using the Japanese Orthopedic Association (JOA) scoring system and neurological cervical spine scale (NCSS) before and 8 years after surgery in each patient and at the end all complications were recorded.

Results

In the first group, there were 15 males and 14 females (mean age: 49±10 years) and in the second group there were 27 male and 7 female (mean age: 47±9 years). The NCSS score was significantly different between two groups after surgery (p = 0.035) but there was no significant difference before surgery (p = 0.163). No statistical significance difference was also observed in JOA score and complications before and after procedure, but JOA post surgery score between two groups had significant difference (p = 0.047).

Conclusion

In conclusion, present study showed that PEEK cage implantation is a highly useful alternative to the conventional treatment methods.     

Footprint Mismatch of Cervical Disc Prostheses with Chinese Cervical Anatomic Dimensions

Background:The footprint of most prostheses is designed according to Caucasian data.Total disc replacement (TDR) has been performed widely for cervical degenerative diseases in China.It is essential to...     

Implementation of Constant Dose Rate and Constant Angular Spacing Intensity-modulated Arc Therapy for Cervical Cancer by Using a Conventional Linear Accelerator

Background:

Volumetric-modulated arc therapy (VMAT) can only be implemented on the new generation linacs such as the Varian Trilogy^® and Elekta Synergy^®. This prevents most existing linacs from delivering VMAT. The purpose of this study was to investigate the feasibility of using a conventional linear accelerator delivering constant dose rate and constant angular spacing intensity-modulated arc therapy (CDR-CAS-IMAT) for treating cervical cancer.

Methods:

Twenty patients with cervical cancer previously treated with intensity-modulated radiation therapy (IMRT) using Varian Clinical 23EX were retreated using CDR-CAS-IMAT. The planning target volume (PTV) was set as 50.4 Gy in 28 fractions. Plans were evaluated based on the ability to meet the dose volume histogram. The homogeneity index (HI), target volume conformity index (CI), the dose to organs at risk, radiation delivery time, and monitor units (MUs) were also compared. The paired t-test was used to analyze the two data sets. All statistical analyses were performed using SPSS 19.0 software.

Results:

Compared to the IMRT group, the CDR-CAS-IMAT group showed better PTV CI (0.85 ± 0.03 vs. 0.81 ± 0.03, P = 0.001), clinical target volume CI (0.46 ± 0.05 vs. 0.43 ± 0.05, P = 0.001), HI (0.09±0.02 vs. 0.11 ± 0.02, P = 0.005) and D95 (5196.33 ± 28.24 cGy vs. 5162.63 ± 31.12 cGy, P = 0.000), and cord D2 (3743.8 ± 118.7 cGy vs. 3806.2 ± 98.7 cGy, P = 0.017) and rectum V40 (41.9 ± 6.1% vs. 44.2 ± 4.8%, P = 0.026). Treatment time (422.7 ± 46.7 s vs. 84.6 ± 7.8 s, P = 0.000) and the total plan Mus (927.4 ± 79.1 vs. 787.5 ± 78.5, P = 0.000) decreased by a factor of 0.8 and 0.15, respectively. The IMRT group plans were superior to the CDR-CAS-IMAT group plans considering decreasing bladder V50 (17.4 ± 4.5% vs. 16.6 ± 4.2%, P = 0.049), bowel V30 (39.6 ± 6.5% vs. 36.6 ± 7.5%, P = 0.008), and low-dose irradiation volume; there were no significant differences in other statistical indexes.

Conclusions:

Patients with cervical cancer treated with CDR-CAS-IMAT using Varian Clinical 23EX can get equivalent or superior dose distribution compared to those treated with IMRT. CDR-CAS-IMAT has a less treatment time and MU, which can reduce the uncertainty factor and patient discomfort in treatment.     

Knowledge,attitude and practice of cervical cancer screening among market women in Zaria,Nigeria

Background:

Cervical cancer is the most common genital cancer and one of the leading causes of death among female population. Fortunately, this cancer is preventable by screening for premalignant lesions but this is rarely provided and hardly utilised. We assessed the knowledge, attitude and utilisation of cervical cancer screening among market women in Sabon Gari, Zaria.

Materials and Methods:

This was a cross-sectional study to evaluate the knowledge, attitude and practice of cervical cancer screening among market women. A total of 260 women were administered with questionnaires which were both self and interviewer administered. These were analysed using SPSS version 11.

Results:

Respondents exhibited a fair knowledge of cervical cancer and cervical cancer screening (43.5%); however, their knowledge of risk factors was poor. There was generally good attitude to cervical cancer screening (80.4%), but their level of practice was low (15.4%).

Conclusions:

There was a fair knowledge of cervical cancer and cervical cancer screening among Nigerian market women in this study, their practice of cervical cancer screening was poor.     

Indications and outcome of abdominal myomectomy in University of Maiduguri Teaching Hospital: Review of ten year

Background:

Abdominal myomectomy is a common modality of treatment for large and symptomatic uterine fibroid in women who wish to retain their fertility. Though frequently performed the procedure may still be associated with complications.

Materials and Methods:

A retrospective review of all patients who had abdominal myomectomy from January 1999 to December 2008 at the University of Maiduguri Teaching Hospital. Information on the Sociodemographic characteristics, indication for the myomectomy, uterine size, pre and post operative packed cell volume (PCV), intraoperative findings, cadre of surgeon, duration of hospital stay and complications were obtained.

Results:

The rate of abdominal myomectomy was 3.34%. Majority of the patients (79.8%) aged 30–49 years, and most (58.9%) were nulliparas. Abdominal mass (63.7%), menorrhagia (57.7%), and subfertility 55.2% were the leading indications for abdominal myomectomy. Complications were seen in 10.9% of the cases, 55.5 % of which were wound infections. Clinical and intra operative factors associated with complications included menorrhagia (P=0.003), estimated blood loss (EBL) ≥500mls (P=0.005) and post operative PCV of <30% (P=0.081).

Conclusion:

Complication rate after myomectomy was low with menorrhagia and EBL ≥ 500 mls being significantly associated with development of complication.     

Two Different Total Hip Arthroplasties for Hartofilakidis Type C1 Developmental Dysplasia of Hip in Adults

Background:

Total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH) is more complex than the normal hip, with large replacement risks and many complications. Although nonosteotomy THA is convenient to perform, femoral osteotomy shortening can avoid blood vessel and nerve traction injuries. This study aimed to compare osteotomy THA with nonosteotomy to determine reasonable options for operative management of DDH.

Methods:

Data on 48 DDH patients who underwent THA were analyzed retrospectively. The patients were divided into two groups: Group A 29 cases (nonosteotomy), and group B 19 cases (osteotomy). Harris and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, limb length discrepancy (LLD), radiological data on the hip, and claudication were evaluated. Data were analyzed by using paired-sample Student''s t-test, independent-sample Student''s t-test, and Pearson''s Chi-square test; the test level was α =0.05.

Results:

Postoperative Harris (90.7 ± 5.1) and WOMAC scores (88.0 ± 10.6) were significantly improved compared with preoperative Harris (44.8 ± 5.7) and WOMAC scores (42.0 ± 5.3) in group A (P < 0.05). Postoperative Harris (90.4 ± 2.8) and WOMAC scores (88.2 ± 5.9) were significantly improved compared with preoperative Harris (44.4 ± 4.2) and WOMAC scores (43.2 ± 4.3) in group B (P < 0.05). One case of dislocation occurred in group A; after closed reduction, dislocation did not recur. In group A, 2 patients developed cutaneous branch injury of the femoral nerve, which spontaneously recovered without treatment. Postoperative LLD >2 cm was seen in one case in group A and five cases in group B. Postoperative claudication showed no significant difference between the two groups (P > 0.05). No patients developed infection; postoperative X-rays showed that the location of the prosthesis was satisfactory, and the surrounding bone was not dissolved.

Conclusions:

THA is effective and safe for DDH. For unilateral high dislocation DDH patients with limb lengthening ≤4 cm and good tissue conditions, THA without femoral osteotomy may be considered.     

Establishing a Customized Guide Plate for Osteotomy in Total Knee Arthroplasty Using Lower-extremity X-ray and Knee Computed Tomography Images

Background:

The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty (TKA). This study investigated a customized guide plate for osteotomy placement in TKAs with the aid of the statistical shape model technique using weight-bearing lower-extremity X-rays and computed tomography (CT) images of the knee.

Methods:

From October 2014 to June 2015, 42 patients who underwent a TKA in Guizhou Provincial People''s Hospital were divided into a guide plate group (GPG, 21 cases) and a traditional surgery group (TSG, 21 cases) using a random number table method. In the GPG group, a guide plate was designed and printed using preoperative three-dimensional measurements to plan and digitally simulate the operation. TSG cases were treated with the conventional method. Outcomes were obtained from the postoperative image examination and short-term follow-up.

Results:

Operative time was 49.0 ± 10.5 min for GPG, and 62.0 ± 9.7 min in TSG. The coronal femoral angle, coronal tibial angle, posterior tibial slope, and the angle between the posterior condylar osteotomy surface and the surgical transepicondylar axis were 89.2 ± 1.7°, 89.0 ± 1.1°, 6.6 ± 1.4°, and 0.9 ± 0.3° in GPG, and 86.7 ± 2.9°, 87.6 ± 2.1°, 8.9 ± 2.8°, and 1.7 ± 0.8° in TSG, respectively. The Hospital for Special Surgery scores 3 months after surgery were 83.7 ± 18.4 in GPG and 71.5 ± 15.2 in TSG. Statistically significant differences were found between GPG and TSG in all measurements.

Conclusions:

A customized guide plate to create an accurate osteotomy in TKAs may be created using lower-extremity X-ray and knee CT images. This allows for shorter operative times and better postoperative alignment than the traditional surgery. Application of the digital guide plate may also result in better short-term outcomes.     

A comparison of axillary with rectal thermometry in under 5 children

Background:

Body temperature measurement is a crucial clinical assessment in the care of an acutely ill child, especially the under fives. Most temperature measurements in our hospital are done from the axilla.

Objective:

To study the relationship between temperatures taken in the axilla with those taken in the rectum in febrile and afebrile children less than 5 years.

Materials and Methods:

Rectal and axillary temperatures were taken concurrently in 400 febrile and 400 afebrile children aged less than 5 years using mercury-in-glass thermometers.

Result:

The rectal temperature measurements ranged from 38.0 to 41.4°C and 36.4 to 37.9°C in the febrile and afebrile groups of children respectively while the axillary temperatures ranged from 36.7 to 41.0°C and 35.9 to 37.5°C in the febrile and afebrile groups of children, respectively. There were significant differences between the temperatures measured at the two sites in all the age groups studied. There was good positive correlation between the rectal and axillary temperatures. A linear relationship between axillary and rectal temperatures was derived using the simple regression analysis. The equation is: rectal temperature = 0.94×axillary temperature+2.92.

Conclusion:

Although there''s good correlation between axillary and rectal temperatures, significant difference exits between them that cannot be explained by the addition of any single value or any particular equation.     

Nerve Growth Factor for the Treatment of Spinocerebellar Ataxia Type 3: An Open-label Study

Background:Spinocerebellar ataxia type 3 (SCA3) is the most common subtype of SCA worldwide,and runs a slowly progressive and unremitting disease course.There is currently no curable treatment availabl...     

The evaluation of myomectomies performed during cesarean section in our clinic

Background:

We evaluated the data of patients who had applied myomectomy during cesarean section operation in our clinic between April, 2008 and December, 2010. Objective: I0 n this period, 3689 cesarean sections were done in our clinic, we analyzed their data retrospectively and determined 27 myomectomy cases during cesarean section operation. The age of the patients, the numbers of pregnancy, parities, the rates of abortus, indications of cesarean, pregnancy weeks, residential areas of myoms detected during the cesarean and their size, were recorded. Furthermore, pre-operative and post-operative hemoglobin (Hb) values, differences between hemoglobin values, whether there was bleeding or not, the need of blood transfusion if it occurred, the duration of operation and hospitaization and the pathological diagnoses of myomectomy materials, were examined.

Materials and Methods:

Retrospective study of myomectomies.

Results:

The mean age of patients was 29.6±5.9 (19-42) and mean gestational age was 39.2±1.0(37-42) weeks. The mean size of the fibroids was 5.94±6.29 cm³ (0.96-26.50 cm3). Subserous myoms were the most frequently seen ones (24 of 27 patients=89%) with fundal, corporal localizations in most of the instances. T0 he pre-operative and post-operative values of Hb were 11.8±1.52 (8.6-10.5) and 10.3±2.6 (6.9-13.3) g/dl respectively and the difference was statistically significant (P<0.001). Blood transfusion was not necessary in any patient. The mean duration of the operation was found to be 40.7±13.9 (13-60) minutes.

Conclusion:

Myomectomies can be performed safely during cesarean section by experienced obstetricians and gynecologists, and myomectomy performed for fibroids in appropriate localizations does not increase post-operative bleeding or maternal morbidity or mortality.     

Alterations of Thymic Epithelial Cells in Lipopolysaccharide-induced Neonatal Thymus Involution

Background:

Vascular endothelial growth factor (VEGF) in the thymus was mainly produced by the thymic epithelial cells (TECs), the predominant component of the thymic microenvironment. The progression of TECs and the roles of VEGF in the neonatal thymus during sepsis have not been reported. This study aimed to explore the alterations of TECs and VEGF level in the neonatal thymus involution and to explore the possible mechanisms at the cellular level.

Methods:

By establishing a model of clinical sepsis, the changes of TECs were measured by hematoxylin-eosin staining, confocal microscopy, and flow cytometry. Moreover, the levels of VEGF in serum and thymus were assessed based on enzyme-linked immunosorbent assay and Western blotting.

Results:

The number of thymocytes and TECs was significantly decreased 24 h after lipopolysaccharide (LPS) challenge, (2.40 ± 0.46)×10⁷ vs. (3.93 ± 0.66)×10⁷ and (1.16 ± 0.14)×10⁵ vs. (2.20 ± 0.19)×10⁵, P < 0.05, respectively. Cortical TECs and medullary TECs in the LPS-treated mice were decreased 1.5-fold and 3.9-fold, P < 0.05, respectively, lower than those in the controls. The number of thymic epithelial progenitors was also decreased. VEGF expression in TECs was down-regulated in a time-dependent manner.

Conclusion:

VEGF in thymic cells subsets might contribute to the development of TECs in neonatal sepsis.     

Primary care management of patients with carpal tunnel syndrome referred to surgeons: are non‐operative interventions effectively utilised?

Aim

To investigate the non‐operative primary care management (splintage, task modification advice, steroid injections and oral medications) of carpal tunnel syndrome before patients were referred to a hand surgeon for decompression.

Design and setting

Preoperative data were obtained on age, gender, body mass index, employment, symptom duration, and preoperative clinical stage for patients undergoing carpal tunnel decompression (263 in the USA, 227 in the UK).

Results

Primary care physicians made relatively poor use of beneficial treatment options with the exception of splintage in the US (73% of cases compared with 22.8% in the UK). Steroid injections were used in only 22.6% (US) and 9.8% (UK) of cases. Task modification advice was almost never given. Oral medication was employed in 18.8% of US cases and 8.9% of UK cases.

Conclusions

This study analyses the non‐operative modalities available and suggests that there is scope for more effective use of non‐operative treatment before referral for carpal tunnel decompression.Carpal tunnel syndrome (CTS) usually develops slowly, often with a fluctuating level of symptoms over several months or years, with only gradual deterioration. In such circumstances appropriate conservative treatment can be extremely effective in controlling symptoms for several years, delaying the need for operative intervention.Decompression of the carpal tunnel is generally considered an effective intervention,^1,2 but some patients are left with persistent problems such as scar sensitivity, in part arising from the intervention. A decision to go forward with an operative intervention is an important issue for patients and their families, even in situations where the procedure is provided free. Indirect expenses for carpal tunnel decompression for a UK patient average £800 sterling (€1100, $1600) (range £65–£3970 (€95–€5800, $130–$7800)).³ A variety of conservative treatment options are available⁴ which can delay the need for operative intervention with its inherent risks.Effective primary care modalities of treatment for CTS include task modification, the use of splints and steroid injections proximal to the carpal tunnel. Oral medication is not considered to be of likely benefit. This study seeks to investigate the primary care management of diagnosed carpal tunnel cases considered to merit surgical decompression and referred by general practitioners to consultant hand surgeons in two communities (USA and UK).     

The Number of Positive Pelvic Lymph Nodes and Multiple Groups of Pelvic Lymph Node Metastasis Influence Prognosis in Stage ⅠA-ⅡB Cervical Squamous Cell Carcinoma

Background:Pelvic lymph node metastasis (LNM) is an important prognostic factor in cervical cancer.Cervical squamous cell carcinoma accounts for approximately 75-80％ of all cervical cancers.Analyses of...     

Treatment of Epilepsy with Bipolar Electro-coagulation: An Analysis of Cortical Blood Flow and Histological Change in Temporal Lobe

Background:Bipolar electro-coagulation has a reported efficacy in treating epilepsy involving functional cortex by pure electro-coagulation or combination with resection.However,the mechanisms of bipol...     

Oral misoprostol is an effective and acceptable alternative to vaginal administration for cervical priming before first trimester pregnancy termination

Background

Cervical priming agents mainly prostaglandins in different doses and routes are used during first trimester vaccum aspiration to prevent cervical injury and shorten the abortion procedure. This study was carried out to assess women''s acceptability, the efficacy and side effects of oral versus vaginal administration of misoprostol in facilitating cervical dilatation prior to first trimester vaccum aspiration.

Methods

A randomised control study where 120 women were divided in oral (51) and vaginal (69) group. Each group received 400 mcg of misoprostol either orally or vaginally 04 h prior to first trimester pregnancy termination. Baseline cervical dilatation, women''s acceptability and side effects and complications were noted in both the groups.

Results

There was no difference between the oral and vaginal misoprostol groups with respect to mean cervical dilatation (5.53 mm vs 5.43 mm; p > 0.05). A total of 88% of women in the oral group expressed satisfaction with the route of misoprostol administration as compared to 74% in the vaginal route. The women in the vaginal group were experienced more preoperative vaginal bleeding (43% vs 25%).

Conclusion

Oral administration of misoprostol is an effective alternative to vaginal administration in preinduction cervical ripening prior to first trimester pregnancy termination.     

Elimination Rate of Serum Lactate is Correlated with Amyotrophic Lateral Sclerosis Progression

Background:

Mitochondrial dysfunction plays an important role in the pathogenesis of amyotrophic lateral sclerosis (ALS). We aimed to demonstrate mitochondrial dysfunction in ALS using a lactate stress test and to examine the relationship between mitochondrial dysfunction with motor deterioration.

Methods:

We enrolled 116 patients and observed clinical variables, including the survival state.

Results:

Patients with a rapid slope of revised ALS functional rating scales (ALSFRS-r) (>20 U/year) exhibited the slowest elimination rate (median −4.67 × 10⁻³ mmol∙L⁻¹∙min⁻¹, coefficient of variation, 590.15%), the shortest duration (0.63 ± 0.28 years) and the worst ALSFRS-r (32.59 ± 4.93). Patients with a moderate slope of ALSFRS-r (10–20 U/year) showed a moderate elimination rate (median −11.33 × 10⁻³ mmol∙L⁻¹∙min⁻¹, coefficient of variation, 309.89%), duration (1.16 ± 0.45 years), and ALSFRS-r (34.83 ± 6.11). The slower progressing (<10 U/year group) patients exhibited a rapid elimination rate (median: −12.00 × 10⁻³ mmol∙L⁻¹∙min⁻¹, coefficient of variation: 143.08%), longer duration (median: 3 years, coefficient of variation: 193.33%), and adequate ALSFRS-r values (39.58 ± 9.44). Advanced-phase ALS patients also showed slower elimination rate (ER, quartiles −17.33, −5.67, 4.00) and worse ALSFRS-r (34.88 ± 9.27), while early-phase patients showed a more rapid ER (quartiles −25.17, −11.33, −3.50) and better ALSFRS-r (39.28 ± 7.59). These differences were statistically significant. Multiple linear regression analysis revealed strong direct associations among ER, ALSFRS-r slope (standard beta = 0.33, P = 0.007), and forced vital capacity (predict %) (standard beta = −0.458, P = 0.006, adjusted for ALSFRS-r, course and onset region). However, the data obtained from 3 years of follow-up showed no statistically significant difference in the survival rates between the most rapid and slowest ER groups.

Conclusion:

There is a potential linear relationship between ER and motor deterioration in ALS. Slower ER might be associated with faster disease progression.     

Expression of Potassium Channels in Uterine Smooth Muscle Cells from Patients with Adenomyosis

Background:

Adenomyosis (AM) has impaired contraction. This study aimed to explore the expression of potassium channels related to contraction in myometrial smooth muscle cells (MSMCs) of AM.

Methods:

Uterine tissue samples from 22 patients (cases) with histologically confirmed AM and 12 (controls) with cervical intraepithelial neoplasia were collected for both immunohistochemistry and real-time polymerase chain reaction to detect the expression of large conductance calcium- and voltage-sensitive K⁺ channel (BKCa)-α/β subunits, voltage-gated potassium channel (Kv) 4.2, and Kv4.3. Student''s t-test was used to compare the expression.

Results:

The BKCa-α/β subunits, Kv4.2, and Kv4.3 were located in smooth muscle cells, glandular epithelium, and stromal cells. However, BKCa-β subunit expression in endometrial glands of the controls was weak, and Kv4.3 was almost undetectable in the controls. The expression of BKCa-α messenger RNA (mRNA) (0.62 ± 0.19-fold decrease, P < 0.05) and Kv4.3 mRNA (0.67 ± 0.20-fold decrease, P < 0.05) decreased significantly in the MSMCs of the control group compared with the AM group. However, there were no significant differences in BKCa-β subunit mRNA or Kv4.2 mRNA.

Conclusions:

The BKCa-α mRNA and the Kv4.3 mRNA are expressed significantly higher in AM than those in the control group, that might cause the abnormal uterus smooth muscle contractility, change the microcirculation of uterus to accumulate the inflammatory factors, impair the endometrium further, and aggravate the pain.     

Efficacy and Safety of Tenofovir and Lamivudine in Combination with Efavirenz in Patients Co-infected with Human Immunodeficiency Virus and Hepatitis B Virus in China

Background:

The prevalence of hepatitis B virus (HBV) infection is high among individuals infected with human immunodeficiency virus (HIV) in China. Both HIV and HBV can be treated with tenofovir disoproxil fumarate (TDF) and lamivudine (3TC), so we evaluated the safety and efficacy of combination antiretroviral therapy (ART) that included TDF, 3TC, and efavirenz (EFV) among ART-naive individuals who were co-infected with HIV and HBV.

Methods:

One hundred HIV/HBV co-infected ARV-naive individuals were started on the regimen of TDF, 3TC, and EFV, and the levels of plasma HBV DNA, HIV RNA, and biochemical evaluation related to the function of liver and kidney were analyzed.

Results:

Concerning efficacy, this study found that by week 48, the vast majority co-infected participants receiving this ART regimen had undetectable HBV DNA levels (71%) and/or HIV RNA levels (90%). Concerning safety, this study found that the median estimated glomerular filtration rate of participants decreased from baseline (109 ml·min⁻¹·1.73 m⁻²) to week 12 (104 ml·min⁻¹·1.73 m⁻²) but was almost back to baseline at week 48 (111 ml·min⁻¹·1.73 m⁻²).

Conclusion:

This combination ART regimen is safe and effective for patients with HIV/HBV co-infection.

Trial Registration:

ClinicalTrials.gov, {"type":"clinical-trial","attrs":{"text":"NCT01751555","term_id":"NCT01751555"}}NCT01751555; https://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT01751555","term_id":"NCT01751555"}}NCT01751555.     

Verapamil as an Adjunct to Local Anaesthetic for Brachial Plexus Blocks

Background

Calcium channel blockers potentiate the effects of local anaesthetics. We examined the effect of adding verapamil to local anaesthetic solution on anaesthetic duration in patients undergoing surgery under brachial plexus block.

Methods

This study was a prospective, randomized, controlled, double blind study. Sixty patients undergoing elective upper limb surgery were divided into two groups of 30 each. Group A received 40 ml of 1% lignocaine with 0.25% bupivacaine, while Group B patients had 2.5 mg verapamil added.

Result

Onset of sensory blockade time was marginally faster in Group B (23.2 ± 3.94 minutes) as compared to Group A (23.9 ± 4.13 minutes). However this difference was statistically not significant. The increase in duration of sensory blockade in Group B (185 ± 46.52 minutes) as compared to Group A (157 ± 44.28 minutes) was statistically significant (p= 0.011). Increase in duration of motor blockade in Group B (161 ± 46.14 minutes) as compared to Group A (149 ± 42,76 minutes) was statistically not significant (p = 0.15). Similarly prolongation of analgesic duration in Group B (318 ± 69.54minutes) as compared to Group A (302 ± 0.69 minutes) was statistically not significant (p=0.18).

Conclusion

We conclude that adding verapamil to brachial plexus block can prolong sensory anaesthesia without any effect on analgesic duration.Key Words: Brachial plexus block, Verapamil