Day 2 :
Dean of Nursing College, An-Najah National University, Palestine
Keynote: Comparison of intra-peritoneal instillation of bupivacaine and morphine hydrochloride versus bupivacaine and magnesium sulfate for post-operative pain relief after laparoscopic cholecystectomy - A randomized double-blind comparison study
Time : 10:00-10:45
Aidah Alkaissi is currently a Dean of Nursing College at An-Najah National University, Palestine. She is also coordinator of the Master programs of Nurse Anesthetists and Critical Care Nursing. She graduated BSN, MSN, PhD in Anesthesiology from Linköping University, Sweden. She also has Bachelor of Law degree from Arabic University of Beirut, Lebanon. She has published more than 17 papers in reputed journals and has been serving as a Vice Chairman of IRB at An-Najah National University.
The purpose of this study is to compare the analgesic effect of intra-peritoneal instillation of bupivacaine plus morphine hydrochloride versus bupivacaine plus magnesium sulfate in patients undergoing laparoscopic cholecystectomy under general anesthesia. Hundred patients were randomized to one of the following groups: (Mo group) (n=50) receiving intra-peritoneal instillation of 30 ml 0.25% bupivacaine and 3 mg morphine, (Mg group) (n=50) receiving intra-peritoneal instillation of 0.25% bupivacaine plus 50 mg/kg magnesium sulfate to a total volume of 30 ml. Postoperative pain was evaluated using visual analog scale (0-10). There are significant differences between Mo and Mg groups in the total VAS score (P value <0.05). In the Mo group, the mean of total VAS (2.09) was significantly lower than the mean of total VAS in the Mg group (2.71); which means that patients in the Mo group had significantly less intensity of pain than patients in the Mg group (p=0.006). There is a significant difference between n(%) of patients complaining of moderate to severe postoperative pain in Mo group 15/50 (30%) compared to Mg group 25/50 (50%) (p=0.0423). When estimating the size of the treatment effect of morphine hydrochloride plus bupivacaine, found that the relative risk reduction of moderate to severe pain postoperatively is 0.40. As a conclusion, intra-peritoneal instillation of combination of bupivacaine with morphine hydrochloride is superior to bupivacaine plus magnesium sulfate to reduce the intensity and incidence of postoperative pain in patients undergoing laparoscopic cholecystectomy surgery without significant increase of side effects. This peripheral effect of opioid provides a new approach to pain relief that can have major clinical benefits.
MSN degree from University of Dammam with a first-class honor,Royal Commission Hospital, Saudi Arabia
Time : 10:45-11:30
Rokaia M Al-Shualah has completed her MSN degree from University of Dammam with a first-class honor. She is leading Nursing Education & Training at Royal Commission Hospital in Saudi Arabia. She has published in many national and international journals, lately in the show edition of Arab Health Magazine & Journal of Nursing and Healthcare. She has participated in many national and international conferences. She is a member in Saudi Heart Association, The Saudi Critical Care Society and European Society of Cardiology.
Post cardiac catheterization puncture site care is usually done with a tight pressure dressing in many institutions and cardiac centers due to the belief that it should prevent the bleeding. This practice is uncomfortable to the patients. Nurses have also described difficulty in assessing the sheath insertion site in the groin when a pressure dressing is in place. A new way of dressing using transparent film dressing (TFD) has approved and rated better with regard to: comfort, less pain, decrease hematoma formation and facilitates nurses’ assessment of puncture wound site after femoral sheath removal. The aim of this study was to determine the efficacy of using a small transparent non-pressure dressing compared with the traditional controlled pressure dressing applied to the femoral artery puncture wound to maintain haemostasis with respect to 3 outcomes: patient satisfaction, bleeding or hematoma formation, and ease of nursing assessment of the groin puncture site after the procedure. 80 post cardiac catheterization patients were randomized to have their groins dressed either with pressure dressing or TFD. 100% in TFD group vs. 55% in pressure dressing group reported feeling very comfortable (p value of 0.003). Hematoma formation was equal in the two dressing groups with no incidence of bleeding complications. Nurses rated the ease of assessing the groin significantly higher for TFD than for pressure dressings (p value of 0.000). Dressing of the puncture site after cardiac catheterization with TFD was more comfortable than the conventional pressure dressing without any difference in hematoma or bleeding complications.