Sahiwal

Researchers are comparing two ultrasound-guided nerve block techniques, the Supra-inguinal Fascia Iliaca Block (S-FICB) and the Pericapsular Nerve Group (PENG) block, to evaluate their effectiveness in managing pain during positioning for spinal anesthesia in patients undergoing femur fracture surgery. This study aims to determine which block provides better pain relief, longer duration of analgesia, opioid-sparing effects, and fewer complications. The research is conducted in a controlled, randomized manner with patients who have confirmed femur fractures and are classified as ASA I, II, or III. Participants will be randomly assigned to receive either the S-FICB or the PENG block under ultrasound guidance before spinal anesthesia. Both blocks involve injection of 20 mL of 0.5% bupivacaine near specific nerve areas using sterile technique and ultrasound visualization. After the block, patients will be positioned for spinal anesthesia once their pain score is reduced to less than 4 on a numeric rating scale. During surgery, monitoring includes electrocardiogram, pulse oximetry, non-invasive blood pressure, and urine output following ASA standards. Postoperatively, pain will be assessed regularly, and rescue analgesia with paracetamol or nalbuphine will be provided if needed. Participants will undergo detailed evaluation including medical history, injury assessment, and pain measurement before and after the nerve block. Pain scores will be recorded at rest and during movement, and time to effective pain relief will be noted. Postoperative pain will be monitored every 2 hours for 24 hours. Researchers will track analgesic use and any complications. The study helps identify the nerve block technique that may improve patient comfort and pain control during femur fracture surgery.

Laparoscopic surgery is widely preferred due to its reduced intraoperative and postoperative complications. This trial evaluates the effects of dexmedetomidine versus lignocaine infusions on perioperative heart rate, blood pressure, postoperative pain, and gastrointestinal recovery in patients undergoing laparoscopic cholecystectomy. The study addresses conflicting previous findings to provide local evidence and is conducted as a randomized controlled trial over 12 months at Sahiwal Teaching Hospital. Patients aged 20 to 70 undergoing laparoscopic cholecystectomy under general anesthesia are randomly assigned to two groups. Group A receives an intraoperative dexmedetomidine infusion (0.2-0.4 µg/kg/h), while Group B receives lignocaine infusion (1-2 mg/kg/h). Anesthesia induction includes preoxygenation, propofol, nalbuphine, succinylcholine, and maintenance with isoflurane, nitrous oxide, oxygen, and atracurium. Intraoperative monitoring involves ECG, blood pressure, oxygen saturation, carbon dioxide, and temperature. Postoperative recovery includes pain assessment and rescue analgesia as needed. Participants have preoperative assessments and are monitored intraoperatively with heart rate and mean arterial pressure recorded at specific intervals. Postoperative pain is measured using a visual analogue scale, with rescue analgesia given when pain reaches 4 or more. The time to first rescue analgesia, total opioid consumption, nausea, vomiting, and gastrointestinal function recovery are tracked using the I-FEED scale at 6, 12, and 24 hours post-surgery. Follow-up occurs in intensive care for 24 hours after surgery to assess these outcomes and safety.