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    Ahmed Abd Al Aziz, MD1, Nader Sh. Zaki, MD2,Karim G. Moustafa, MD3, M. Fathy Elshaal
  • 3D Dynamic Ano-rectal Ultra-sonography (Echodefecography) vs. Conventional Defecography in Assessment of Obstructed Defecation.
    Abdrabou N Mashhour, Haitham S.E. Omar, Ramy S. Abdelkader.
  • 3D Dynamic Ano-rectal Ultra-sonography (Echodefecography) vs. Magnetic Resonance Defecography in Assessment of Obstructed Defecation
    Hany MS Mikhail, Mohamed M Raslan, Mohamed Y Elbarmelgi, Ramy S. Abdelkader
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    Adel Morad Abdallah (M.D.)
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    Ahmed S.M. Omar, MD
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    H. Said1, Ahmed Khalil1, Ahmed Fathy Hilal2
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    Ragai S. Hanna1, George Abdelfady Nashed2, Gamal A Makhlouf 3, Nahed A Makhlouf 4, Manal El Sayed Abdelmooty 5
  • The Effectiveness of Combined Wound and Intraperitoneal Local Anesthesia as Pain Relief in Laparoscopic Cholecystectomy: Prospective Case Control Study
    Ragai S. Hanna1 , George Abdelfady Nashed2,Ashraf, A Helmy 3, Gamal A Makhlouf4, Emad Z.K. Said5, Abdelraouf MS Abdelraouf 6
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    Ramy Mikhael Nageeb1, *, MD, and Shaban M. Abdel Mageed2, *, MD
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    Shawki M.K Sharouda1*; Ramy Mikhael Nageeb2*; MD and Shaban M. Abdel Mageed1*, MD
  • Management of Umbilical Pilonidal Sinus: Complete Umbilical Excision and Immediate Reconstruction
    Sherif Abdel Halim MD, MRCS, Hanna Habib MD, Hossam Elsadek MD
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    Ahmed Morad, MD; Wael A Jumuah, MD; Hanna Habib, MD
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    Yasser El Ghamrini, MD. Karim Sabry Abdel Samee, MD, MRCS(Ed), Wael Abdel Aziem Gumuah, MD.
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    Anas Mashal MD; Abdallah Magdy MD,FRCS
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    • The Effectiveness of Combined Wound and Intraperitoneal Local Anesthesia as Pain Relief in Laparoscopic Cholecystectomy: Prospective Case Control Study

    Ragai S. Hanna1 , George Abdelfady Nashed2,Ashraf, A Helmy 3, Gamal A Makhlouf4, Emad Z.K. Said5, Abdelraouf MS Abdelraouf 6
    1,3,4General Surgery Department. Faculty of Medicine, Assiut University. 2General and Bariatric Surgery, Faculty of Medicine, Cairo University. Egypt. 5,6Anesthesia & Critical Care Medicine Department

    Background: Postoperative pain is the main obstacle for safe rapid recovery of patients undergoing laparoscopic cholecystectomy (LC).Aim of the work: To evaluate the efficacy of Levobupivacaine when injected incisionally and intraperitoneally at the end of the LC. Methods: A total of 220 patients, subjected to elective LC, were divided into four Groups. Group I “control” received normal saline both intraperitoneal and at incision site. Group II received Levobupivacaine both intraperitoneal and at incision site. Group III received incisionalLevobupivacaine only. Group IV received intraperitoneal Levobupivacaine only. Dynamic pain by a visual analogue scale (VAS) and cumulative analgesic consumption at 1 h, 6 h, 24 h postoperatively, as well as incidence of side-effects over 48 h after LC was recorded. Results:Compared with those in Group I, the dynamic VAS score (VAS-D) 1 h and 6 h and 24h postoperatively, cumulative Pethidine consumption zero, 25g and 50g, and duration of hospital stay in Group II were less (P<0.05 for each). Furthermore, intraperitoneal and incisionalLevobupivacaine exerts more powerful analgesic effect than single usage with intraperitoneal or incisionalLevobupivacaine (P<0.05). Signs of local anesthetic toxicity did not occur. Conclusions:Levobupivacaine when injected incisionally and intraperitoneallyat the end of the LC was foundeffective and safe to reduce postoperative pain intensity. Keywords: Laparoscopic Cholecystectomy;Levobupivacaine; Intraperitoneal and Incisional; Pain.

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