Effect of combined fentanyl with bupivacaine in Pediatric Spinal anesthesia

This study was carried out in the department of anesthesia and reanimation at Alassad ,Tishreen university Hospitals , Lattakia , Syria , during the year 2014-2015 , and included 45 patients of either sex (5-15 kilogram of weight ) undergoing lowerabdominal and urologic procedures. Patients were divided into three groups : Patients of group A : received spinal anesthesia by using combination between bupivacaine (0.4 mg/kg ) and normasaline (placebo) . Patients of group B : received spinal anesthesia by using combination between bupivacaine (0.4 mg/kg ) and fentanyl (0.2 mcg/kg ) . Patients of group c : received spinal anesthesia by using combination between bupivacaine (0.4 mg/kg ) and fentanyl (0.6 mcg/kg ) . The goal of the study is studying the effects of combination between fentanyl and bupivacaine in the spinal anesthesia for the children whom prepared to subumblical operations . Conclusion : Combination between fentanyl and bupivacaine reduced to use postoperative narcotics and increased the duration of spinal anesthesia, in addition to provided hemodynamic stability during the operation.

pars-plana-vitrectomy under retrobulbar anesthesia using a combination of Bupivacaine 0.5% and lidocaine 2%

Aim: Study of advantages of retrobulbar anesthesia and its complications in posterior vitrectomy using 0.5% bupivacaine with lidocaine 2% Materials and Methods: Number of study patients: 1000 patients who underwent a retrobulbar anesthesia usinga combination of 4 ml bupivacaine 0.5% + 6 ml lidocaine 2% for a Pars-planaposterior vitrectomy. Results: Patients aged between 16-85 years, 55% of whom were males and 45% females, the indications of the Pars-plana vitrectomy were: 45% diabetic retinopathy, 15% macular hole, 10 lens-luxation , 7% artificial lens dislocation, 5% chorioiditis,5% posttraumatic vitreous haemorrhage , 5% macular pucker, 5% rhegmtogenous retinal detachment, 5% intraocular foreign body, 0.5% endophthalmitis. Complications: 0.4% retrobulbar hemorrhage, 2% elevated intraocular pressure, 0.2%, expulsive choreoidale haemorrhage, pain 8%, fear, anxietyand tension 0.2%, eyelid haematome 4%, patient movement 1.3% , diplopia 1%, ptosis 1,3%, low heart rate and low arterial pressure 0.3%. Conclusion : retrobulbar anesthesia is recommended with the combination of bupivacain and lidocaine in the posterior vitreorectomy, with some exceptions such as drug allergies, single eye, high myopy, advanced optic nerve lesions, children, no coopertion.