Comparison of the maternal and neonatal effects of bupivacaine plus fentanyl and ropivacaine plus fentanyl during cesarean delivery

Purpose: The aim of the present study was to compare the anesthetic efficacy, and fetal and maternal effects of 7.5 mg (1 ml) intrathecal 0.75% hyperbaric ropivacaine + 25 ìg (0.5 ml) fentanyl versus 5 mg (l ml) intrathecal 0.5% hyperbaric bupivacaine + 25 ìg (0.5 ml) fentanyl in elective cesarean delivery.Materials and Methods: The study included 40 ASA I–II cases scheduled for cesarean delivery that were randomized into two groups of 20 cases each. Cases in the RF group were administered 0.75% hyperbaric ropivacaine + 25 ìg (0.5 ml) fentanyl and those in the BF group were administered 5 mg (l ml) hyperbaric bupivacaine + 25 ìg (0.5 ml)fentanyl into the spinal space. The time until spinal anesthesia in the T4 dermatome, overall duration of analgesia, hemodynamic parameters, Apgar score of newborns at 1–5 min, fetal blood gas values (pH, PO2, PCO2, HCO3., and BE), maternal side effects, the degree of motor block, maternal need for ephedrine, objective pain scale score, and patient satisfaction were recorded in each group.Results: There were no significant differences between the groups in terms of the parameters evaluated (P > 0.05).Conclusion: In elective cesarean delivery, the combinations of bupivacaine + fentanyl or ropivacaine + fentanyl exhibited similar anesthetic efficacy, and fetal and maternal effects.Key words: Bupivacaine, cesarean, opioid, ropivacain

An evaluation of the effects of perioperatively administered fluids on ischemia/reperfusion injury.

To investigate the effects of normal saline (0.9% NaCl) and 6% Hydroxyethyl Starch 130/0.4(HES) solution on Ischemia/Reperfusion (I/R) injury in patients undergoing knee arthroscopy operations with spinal anesthesia using a tourniquet

Impact of a food voucher program in alleviating household food insecurity in two cities in Senegal during a food price crisis

Cash-based transfer programs is a promising approach to alleviate household food insecurity in low-income countries, however evidence from rigorous impact evaluation in West Africa is still scarce. This study measured the impact of a food voucher distribution of the World Food Program targeting vulnerable households in two cities of Senegal. We used a quasi-experimental design and a propensity score matching to compare beneficiary and non-beneficiary households (n = 1008 in Dakar-Pikine and n = 996 in Ziguinchor) before and after the intervention. Measured outcomes included the standard Household Dietary Diversity Score (HDDS), the Household Food Insecurity Access Scale (HFIAS) and the Coping Strategy Index (CSI). A difference-in-difference approach was used to measure the program impact. In Dakar-Pikine, the mean HDDS decreased between the baseline and endline, similarly in all households (p value = 0.2). In Ziguinchor, the HDDS decreased between the two rounds, but significantly more in the non-beneficiary compared to the beneficiary households (-0.6 vs. -0.3 points, p value = 0.02). According to the HFIAS, severe food insecurity decreased from 83.9% to 64.6% amongst beneficiaries in Ziguinchor, while it remained high amongst non-beneficiaries (p value = 0.0003). A similar protective effect was observed using the CSI. In Dakar-Pikine, the proportion of severely food insecure households did not vary between the 2 rounds in both groups (p value = 0.17). Household's food security deteriorated between baseline and endline, because the intervention was implemented at the time of a global economic crisis. The food voucher program alleviated the effect of this crisis in Ziguinchor, but not in Dakar-Pikine

An evaluation of the effects of perioperatively administered fluids on ischemia/reperfusion injury

Objective: To investigate the effects of normal saline (0.9\% NaCl) and 6\% Hydroxyethyl Starch 130/0.4(HES) solution on Ischemia/Reperfusion (I/R) injury in patients undergoing knee arthroscopy operations with spinal anesthesia using a tourniquet. Methods: The study comprised 48 ASA I-II patients undergoing knee arthroscopy with spinal anesthesia using a tourniquet. The patients were randomised into two groups and after standard monitoring two venous lines were introduced to obtain blood samples and to give intravenous therapy. In the control group (Group A) (n=21) 0.9\% NaCl, 10 ml/kg/hours and in the study group (Group B) (n= 19) 6\% Hydroxyethyl Starch 130/0.4, 10 ml/kg/hours infusion were administered. Spinal anesthesia was applied with 12.5 mg hyperbaric bupivacaine to all patients. The tourniquet was applied and the operation was started when the sensorial block level reached T10 dermatome. Blood xanthine oxidase (XO) and malondialdehyde (MDA) levels as an indicator of ischemia and reperfusion injury were measured in samples before fluid infusion (t1), before tourniquet application (t2), 1 minute before tourniquet release (t3), and at 5 (t4) and 15 (t5) minutes after tourniquet release. Results: No difference was observed between the two groups in respect of demographic parameters, the highest block level, duration before tourniquet application and tourniquet duration (p>0.05). The MDA level after tourniquet application and 15 minutes after tourniquet release was lower in Group B (p0.05). Conclusion: In this study 6\% Hydroxyethyl Starch 130/0.4 solution reduced MDA level which is an indicator of lipid peroxidation. 6\% Hydroxyethyl Starch 130/0.4 solution may be beneficial for Ischemia/reperfusion injuries