Management of Square Carcinoma of the Lower Lip Using Camille-Bernard Flap under Local Anesthesia: When Constraints Dictate Our Attitude

Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.

Cure of Varicocele under Local Anesthesia: Impact on Sperm Parameters

Introduction: Varicocele is one of the most frequent causes of infertility. There are several therapeutic modalities, namely surgery (open and laparoscopic) and conventional radiology. The aim of our study was to evaluate the impact of a varicocele cure under local anaesthesia on spermogram quality. Material and Methods: We conducted a retrospective descriptive study from 1 January 2022 to 31 December 2023 in the urology department of the Hôpital Militaire de Ouakam (HMO). The parameters studied were age, reasons for consultation, time to urology consultation, grade of varicocele, Doppler ultrasound and spermogram data before treatment and 3 months after treatment. Treatment consisted of bilateral subinguinal varicocelectomy under local anaesthetic. Data were entered and analysed using Excel software version 2021. Results: We studied 41 patients. The mean age of the patients was 35.3 ± 6.9 years, with extremes of 22 and 50 years. Thirty-eight of our patients (88.37%) were married. The most frequent reason for consultation was primary infertility (72.09%). 28 patients (68.3%) had a bilateral varicocele on ultrasound. Varicocele was associated with bilateral testicular hypotrophy in 13 patients (31.7%) and unilateral left testicular hypotrophy in 11 patients (26.8%). All patients underwent subinguinal varicocelectomy under local anaesthetic. Mean follow-up was 4.5 months. A clear statistically significant improvement was noted in sperm motility and concentration in postoperative spermograms, with normalisation of the spermogram in 15 (36.5%) of patients. Conclusion: The impact of varicocele on sperm parameters has been clearly established. There are various therapeutic methods for curing varicocele, including varicocelectomy under local anaesthetic, which, in addition to its undeniable economic advantages, can significantly improve sperm parameters in patients with varicocele and prevent their deterioration over time.

Evaluation of the Local Epinephrine Anesthesia without Tourniquet in the Surgical Treatment of Hand Injuries in Adults: About 27 Cases in Sub-Saharan Africa

Background: In sub-Saharan Africa, surgery for hand injuries is usually performed under axillary or general anesthesia. This is often not without consequences. The Wide Awake Local Anesthesia No Tourniquet (WALANT) is, therefore, an anesthetic asset in the surgical treatment of hand injuries. This study aims to share an experience on this technique’s effectiveness and to spark interest among African authors and practitioners. Method: This prospective study focuses on 27 surgeries of hand injuries carried out with WALANT. The study spanned over nine months (November 2021-August 2022) and included 19 men and eight women with a mean age of 35.4 years (extremes: 19 and 54). There were five (18%) flexor tendon ruptures, three of which were in zone 2, eleven (41%) metacarpal fractures, four of which were open, seven (26%) phalangeal fractures, two of which were open, and four (15%) finger springs. The operated lesions were assessed at a minimum of three months. The pain was assessed using the Visual Analog Scale. The QuickDASH score was evaluated for each patient at the end of the follow-up period. Results: Intra-operatively, the mean value of the Visual Analog Scale was 1/10, with extreme values of 1/10 and 3/10. Of the five cases of flexor tendon ruptures, three were located in zone 2 and two in zone 3. The metacarpal fractures were divided into seven closed diaphyseal fractures and four extra-articular metaphyseal fractures. Four of the seven phalangeal fractures were oblique diaphyseal, and three were transverse diaphyseal. The treatment of the protruding fingers followed the conventional technique. The assessment of the QuickDASH score in the months following surgery showed a score of 11.8 in the first month, 10.3 in the second month, and 5.0 in the third month. Conclusion: WALANT is an easy-to-use, unexpensive anesthetic technique that enables shorter operating times. It rarely presents complications. It is recommended for hand surgeries performed with limited technical resources.

Total spinal anesthesia caused by lidocaine during unilateral percutaneous vertebroplasty performed under local anesthesia:A case report

BACKGROUND Intradural anesthesia caused by anesthetic drug leakage during percutaneous vertebroplasty(PVP)has rarely been reported.We here report a 71-year-old woman who suffered this rare and life-threatening complication during PVP.CASE SUMMARY A 71-year-old woman,who suffered from 2 wk of severe back pain with a visual analog score of 8,came to our outpatient clinic.She was later diagnosed with a newly compressed L1 fracture and was then admitted in our department.PVP was initially attempted again under local anesthesia.However,serendipitous intradural anesthesia leading to total spinal anesthesia happened.Fortunately,after successful resuscitation of the patient,PVP was safely and smoothly performed.Great pain relief was achieved postoperatively,and she was safely discharged on postoperative day 4.The patient recovered normally at 3-mo follow-up.CONCLUSION Total spinal anesthesia secondary to PVP by anesthetic drug leakage rarely occurs.In cases of inadvertent wrong puncture leading to drug leakage when performing it under local anesthesia,surgeons should be highly vigilant during the whole procedure.Electrocardiogram monitoring,oxygen inhalation,intravenous cannula set prior to surgery,regular checking of motor activity and a meticulous imaging monitoring with slower pushing of anesthetic drugs,etc.should be highly recommended.

INFLUENCE OF LOCAL INFILITRATION ANESTHESIA OF SCALP-POINT ON ACUPUNCTURE INDUCED CHANGES OF CEREBRAL BLOOD PERFUSION DETECTED BY SPECT

Objective: To observe the influence of local infiltration anesthesia at the scalp point on acupuncture stimulation induced changes of cerebral blood perfusion in the brain. Methods: Experiments were conducted in 10 healthy volunteer subjects (8 males and 2 females) who were ordered to take a lying position on a specific bed with their heads keeping in a fixed position. Scalp point used was Motor Area (MS 6). The first syringe needle (gauge 5) was inserted into the scalp from the upper 1/5 of MS 6 and the second syringe needle inserted into the scalp from the middle 2/5 of MS 6 and advanced downward, with the two needles connected to a HAN’s Therapeutic Apparatus. Images of the brain were then taken before and after electroacupuncture (EA) stimulation, and after local injection of 1% lidocaine [mixed with epinephrine (1∶200,000, 3 mL)] plus EA by using Siemens ECAM/ICON Single Photo Emission Computed Tomography (SPECT). Intravenous injection of Ethyl cysteinate dimmer 555 MBq was performed before displaying cerebral images. Data of blood functional changing rat (BFCR%) were analyzed quantitatively using a mathematic model. Results: Before EA stimulation, the blood perfusion and function of cerebral cortex, thalamus, basal ganglion and cerebellum on both sides of the brain were basically symmetry. Following EA of MS 6, BFCR% of the contralateral thalamus, parietal lobe and the frontal lobe increased significantly. Following local infiltration anesthesia, BFCR% of the contralatral thalamus declined markedly (P<0.05). The results of quantitative analysis were in agreement with those of visual observation. Conclusion: Local infiltration anesthesia of the scalp point can significantly weaken or block EA stimulation induced changes of BFCR%.

General anesthesia versus local anesthesia for penetrating keratoplasty: a prospective study

AIM:To examine which anesthesia general or local is more effective for penetrating keratoplasty(PKP).METHODS:Patients with indications for PKP(n=141)were enrolled in a prospective study and randomly divided into general anesthesia group(group A,70 eyes)and local anesthesia group(group B,71 eyes).Patients received optical PKP(group A1,30 eyes;group B1,30eyes)or therapeutic PKP(group A2,40 eyes;group B2,41 eyes).Measurement of anterior chamber treatment time(T)for PKP patients and the ratio(R)of the area of the pupils to that of recipient graft region.T and R values,as well as perioperative and postoperative complications,were compared between groups A and B using t-test orχ2test.RESULTS:Patients were followed for 2wk after PKP.T was(13.45±8.64)min for group A and(7.36±5.24)min for group B,a statistically significant difference(P【0.001).The R value for group A was stable during the operation,while for PKP patients in group B the value initially increased then gradually decreased to normal after suturing.In group B,extrusion of intraocular contents occurred in 5 eyes,and iridal prolapse occured in 11cases;no perioperative complications occurred in group A.Relapse rate for fungal keratitis was 13.04%in group B and 0%in group A.CONCLUSION:Under general anesthesia,pupils remaine stable during PKP and perioperative complications are averted.General anesthesia gives more time to treat pathological changes in the anterior chamber and treatment success rate is higher.

Comparison of perceived pain and patients’ satisfaction with traditional local anesthesia and single tooth anesthesia: A randomized clinical trial

BACKGROUND Contemporary innovations in the area of local anesthesia have attempted to provide an absolutely pain free experience for patients.Since the introduction of Computer-Controlled Local Anesthetic Delivery Systems to dentistry,many studies have compared its efficacy and safety to conventional anesthesia.However,very few studies have compared single tooth anesthesia(STA)and traditional local anesthesia.AIM To compare pain rating,changes in blood pressure,and heart rate during the local anesthetic injection.The secondary objectives were to measure the patients’level of satisfaction and the differences in anesthetic efficiency between the STA system and traditional local infiltration.METHODS A randomized controlled trial was conducted and a total of 80 patients with dental restorative needs were enrolled for the study.The patients were evaluated for their general physical status and oral clinical findings before enrollment.Information regarding perceived pain,changes in heart rate and blood pressure,and patients’satisfaction was collected using an electronic data form and was analyzed using paired and unpaired t-tests.RESULTS No significant difference was noted in perceived pain(P=0.59)and systolic blood pressure(P=0.09)during anesthetic injection using both traditional and STA techniques.STA patients had a significantly higher heart rate during anesthesia,although a statistically significant difference was noted among the traditional anesthesia and the STA groups even before anesthesia.During the restorative procedure,less pain was perceived by STA patients on the Wong-Baker FACES pain scale,which was statistically significant(P<0.001).Analyses of post-procedure patient responses showed that STA patients had a significantly better treatment experience and preferred to have the same method of injection in the future(P=0.04).CONCLUSION STA system can provide less painful and more comfortable restorative treatment procedures in comparison to the traditional infiltration technique.

Percutaneous nephrolithotomy for treating upper urinary calculi under local anesthesia(report of 1363 cases)

Objective To discuss the feasibility of pereutaneous nephrolithotomy ( PCNL) for treating upper urinary calculi under local anesthesia. Methods One thousand three hundred and sixty - three patients who suffered

Breast Conserving Surgery and Sentinel Lymph Node Biopsy under Local Anesthesia for Breast Cancer

Background: Breast conserving surgery and sentinel lymph node biopsy has become the standard operation for early breast cancer. This operation has been performed under local anesthesia for patients that would like short-term admission or for those not indicated for general anesthesia due to complications. This report presents the outcomes of breast conserving surgery and sentinel lymph node biopsy under local anesthesia. Patients and Methods: The study included 61 patients with breast cancer that were all definitely diagnosed before surgery. The indications were preoperatively diagnosed localized DCIS, invasive carcinoma measuring less than 3 cm in tumor diameter on ultrasound, and tumors with negative axillary lymph nodes. The surgical procedures included breast conserving surgery associated with sentinel lymph node navigation biopsy. Results: The surgery could be performed under local anesthesia in all 61 patients, and no patient was converted to general anesthesia. Four patients had sentinel lymph node metastasis. Surgical stumps were positive in 18 patients (29.5%). Ten Gy of boost irradiation of the tumor bed was added to the conventional breast irradiation for these patients. There were no serious complications associated with surgery. Conclusion: Breast conserving surgery and sentinel lymph node biopsy for early breast cancer can be performed safely under local anesthesia. This procedure contributes to shortening the length of hospitalization and thereby saving medical resources without deceasing the quality of treatment.

Bloodless Outpatient Surgical Treatment of Rectocele and Cystocele under Local Anesthesia

Background: Surgical treatment of rectocele and cystocele is usually performed in a hospital setting under regional (spinal or epidural) or general anesthesia, and patients commonly have to stay in the hospital for at least one or two days. The possibility of performing the surgery under local anesthesia, as an outpatient procedure with minimal bleeding and pain, no surgical assistants, with immediate discharge and, most importantly, without compromising postoperative results, is appealing. To our knowledge, no studies have evaluated whether performing rectocele and/or cystocele rectocele repair under local infiltration anesthesia and without separation of the vaginal mucosa from the underlying fascia achieves these goals. Objective: The aim of this study is to describe a new surgical technique for outpatient treatment of cystocele and rectocele under local anesthesia, and our initial results. Materials and Methods: Forty women underwent outpatient surgical repair of rectocele and/or cystocele between April and September 2020 at the ambulatory procedure room of the authors’ clinics. The technique consists of a triangular-shaped CO2 laser vaporization or electrocauterization of the posterior and/or anterior vaginal epithelium, followed by plication of the edges of the triangle with 0 polygalactin suture. A perineorrhaphy was always performed concomitantly with rectocele repair, and a transobturator sling was performed in women presenting with concomitant stress urinary incontinence. Postoperative evaluation included POP-Q measurement for each patient six months after the procedure, and resolution of prolapse was considered when anterior and/or posterior vaginal wall presented as stage 0 or 1. Pre and postoperative POP-Q measurements were analyzed using Wilcoxon signed-rank test. Results: The mean operating time was 21 minutes (range: 14 - 38 minutes). All patients tolerated the procedure well and were discharged immediately afterwards. There were no intraoperative or postoperative complications, and all patients had satisfactory healing of the vaginal mucosa. Bleeding from the rectocele and/or cystocele repair was minimal, and nobody required extra-anesthesia or transfer to a hospital surgical theater. At six month follow-up, pre and postoperative POP-Q measurements of points Ap, Bp, Aa and Ba were all statistically significant (Ap 1.6 ± 1.2 × -2.4 ± 0.9, Bp 2.6 ± 1.6 × -2.7 ± 1.4, Aa 1.4 ± 1.1 × -2.3 ± 0.8, and Ba 2.4 ± 1.5 × -2.5 ± 1.2) respectively, revealing satisfactory resolution of both rectocele and cystocele. Conclusion: Our initial results suggest that rectocele and cystocele may be safely and effectively treated under local anesthesia in an outpatient setting using this new technique.

Outpatient varicocelectomy performed under local anesthesia

Aim： To report a series of varicocelectomy performed under pure local anesthesia. Methods： From July 1988 to June 2003, a total of 575 patients, aged between 15 and 73 years, underwent high ligation of the internal spermatic vein for treatment of a varicocele testis under a regional block in which a precise injection of 0.8 % lidocaine solution was delivered to involved tissues after exact anatomical references were made. A 100-mm visual analog scale （VAS） was used to assess whether the pain level was acceptable. Results： The surgeries were bilateral in 52 cases, and unilateral in 523 cases. All were successfully performed on an outpatient basis except in the case of two patients, who were hospitalized because their surgeries required general anesthesia. Overall, 98.6 % （567/575） of men could go back to work by the end of the first post-operative week and only 8 （1.4 %） men reported feeling physical discomfort on the eighth day. The VAS scores varied from 11 mm to 41 mm with an average of （18.5 ± 11.3） mm that was regarded as tolerable. Conclusion： This study has shown varicocelectomy under local anesthesia to be possible, simple, effective, reliable and reproducible, and a safe method with minimal complications. It offers the advantages of more privacy, lower morbidity, with no notable adverse effects resulting from anesthesia, and a more rapid return to regular physical activity with minor complications.

New Anesthetic Technique for Dacryocystorhinostomy: 218 Cases with Local-Anesthesia Ultrasonographic Guided and Blunt Cannula

Introduction: Epiphora is a common ophthalmologic complaint and referrals to oculoplastics and, in the presence of lower complete lacrimonasal duct obstruction, may lead to mild to severe complications, thus requiring surgery to create a new drainage path. The external dacryocystorhinostomy with silicon intubation is the surgical technique with better long-term outcomes and performed in the institutions where this study was conducted. Can be performed under either general or loco-regional anesthesia, or a combination of both. Methods: This article presents a revision of 218 consecutive cases from December 2016 to June 2021 in two specialized centers with the same standardized surgical and anesthetic technique. Results: 242 surgical prontuaries were selected, with 218 filling the inclusion criteria. 13% of the patients required additional anesthetic infusion before the beginning of the surgery;2.7% of the patients required field anesthetic infusion during the surgery and 6.4% required supplementary sedation, thus meaning a positive outcome, as the number of patients with intraoperative complaints was low, and the overall comfort was high. During the follow up, no patient required pain medication after 24 hours. Discussion: This study points towards the feasibility of the described technique in an outpatient fashion, with low, mild and tolerable side effects associated.

The Shortage of Local Anesthesia and Palliative Care Medications in Minor Postoperative Orthopedic Surgical Procedures in Ecuador

This white paper discusses the Ecuadorian healthcare system specifically the lack of proper anesthesia and post-operative pain medication and touches base with centralized hospitals. This paper articulates the specific problems inhibiting the usage of these proper medications, specifically looking at a hospital in Quito, Ecuador. Present day tribal situations are also discussed as they are a significant part of the population that is affected by the shortages of pain medication and anesthesia. Solutions are presented to solve the problems the country faces and how it is relevant today.

Transcarotid transcatheter aortic valve implantation with a novel balloon expandable Myval^(■) THV under the local anesthesia

Since it was first acquainted to us in 2002,tr-anscatheter aortic valve implantation(TAVI)was rapidly applied and earned worldwide approval.TAVI is the standard of care for patients with symptomatic severe aortic stenosis(AS),at in-termediate to high-risk and in some low-risk pa-tients in light of the recent data,principally if it can be performed transfemoral approach.

Addition of Capsaicin to Local Anesthetics for Spinal Anesthesia in Rats Shortens Motor Deficits and Prolongs Anti-Nociception

Background and Objectives: Sensory-selective anesthesia, greater or longer-lasting anti-nociception than motor or autonomic deficits, is often clinically desirable but traditional local anesthetics rarely have such selective actions. Addition of capsaicin to tertiary amine local anesthetics has recently been reported to affect a preferential prolongation of nociceptive over motor block in rat sciatic nerve. We hypothesized that this combination when used intrathecally will also prolong nociceptive block. Methods: Under sevoflurane inhalation anesthesia, rats were injected intrathecally either with local anesthetics (bupivacaine, lidocaine, and articaine) alone or simultaneously with capsaicin. Motor block was evaluated by the contractile function of foot muscles, from proximal to distal. Anti-nociception was assessed by reductions in nocifensive withdrawal and vocalization induced by pinching the skin fold over the lateral metatarsus. Durations and degrees of deficits were assessed, along with complete recovery times and compared between local anesthetics alone and in combination with capsaicin. Results: Addition of capsaicin to any of the local anesthetics shortened motor deficits. Bupivacaine, lidocaine and articaine motor blocks were reduced upon combination with capsaicin to 0.32, 0.32 ans 0.43 of the duration from the respective local anesthetic alone. Duration of anti-nociceptive action was increased by capsaicin only for articaine. The ratios of block nociceptive to sensory block durations were 3.5, 5.1 and 3.3 for the respective local anesthetics. Conclusions: Intrathecal injection of capsaicin combined with local anesthetics produced a preferentially longer anti-nociceptive deficit. These combinations have potential clinical applications, including peri-operative spinal anesthesia and pain management.

Tubal Ligation under Local Anesthesia in a Country with Limited Resources: 56 Cases of Wife and Husband’s Experience in the Gynecology-Obstetrics Department of Ignace Deen National Teaching Hospital, Conakry, Guinea

Tubal ligation is a surgical sterilization procedure that provides permanent and reliable contraception to women.?Tubal obstruction is a method of permanent birth control that can be performed after mini-laparotomy under local anesthesia. Objective:?To determine the outcome of tubal sterilizations by mini-laparotomy under local anesthesia performed in clients who underwent the surgical operation in the Maternity Ward of Ignace Deen National Hospital. Patients and Methods:?The Gynecology and Obstetrics Department of Ignace Deen National Hospital was used as the place for the study. The study involved all the women seeking voluntary surgical contraception. This was a retrospective study of a descriptive type carried out from January 1, 2017 to December 31, 2018. A consent form was filled out and signed by spouses after an interview and a systematically carried out pre-operative clinical and para-clinical assessment. Results:?During the study period, 56 tubal ligations were performed i.e. 4.72 percent of all family planning methods. The recruiting for the surgical contraception involved clients whose typical profile is that of women with an average age of 35, mostly housewives (35.71%), major multiparous (69.63%) with 6 living children on average. Married women made up the bulk of the recruiting i.e. 96.44%. Unmarried women made much more use of other methods. Indications of personal convenience were the most frequently encountered common reason. Among medical causes, high blood?pressure concerned the majority of cases: 38% of the indications. Surgical contraception in between was more practiced than the post-partum one. The recorded complication was the parietal hematoma due to a lack of hemostasis and it accounted for 1.79% of cases. The progress was uncomplicated in?98.68% of cases. Forty couples (71.42%) expressed their feelings of satisfaction against only 6 cases of regret (10.71%). Conclusion:?The surgical contraception has become a requirement for modern couples. Tubal ligation by?mini-laparotomy is a simple operation and a harmless method of contraception that allows clients to use permanent contraception. Carried out on an outpatient basis, incidents and accidents are rare and may have psychological repercussions that are difficult to assess. The technical mastery of the gesture helps to minimize these incidents.

Pneumocephalus Following Combined Spinal-Epidural Anesthesia: A Case Report Analysis

Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.

Inguinal Hernia Repair with Local Anesthesia in the Outpatient—10 Year Experience

Objective: To demonstrate the feasibility of inguinal hernia repair with local anesthesia in an out-patient regime, with safety, efficacy and short learning curve. Methods: We prospectively evaluated 1186 patients undergoing inguinal hernia repair under local anesthesia on an outpatient basis between November 2004 and March 2014. Of the total number of hernias surgically treated in this period, 755 were operated on the right, 394 on the left and 37 bilateral. We used clinical, surgical and psychosocial criteria for inclusion in the procedure. The parameters for exclusion were complex, irreducible or recurrent hernia, obesity (BMI greater than 30 kg/m2), patient’s refusal and psychiatric disorder. All patients underwent elective surgery and were analyzed regarding surgical outcome, complications and hospital stay. Results: All operations were completed successfully. In no case there was a need to change the anesthetic method. Surgical time was similar to that conducted with other methods of anesthesia and there were no cases of adverse effects of local anesthetics. Intra-operative complications amounted to approximately 2.64%. There was no need for hospital admissions greater than 24 hours. Conclusion: The procedure is feasible and causes no perioperative significant pain, is safe, can be performed by residents under supervision, has satisfactory patient acceptance and complications similar to those observed in a conventional herniorrhaphy, allowing lower time and cost of hospitalization and faster access to treatment.

Analyzing the Impact of Scene Transitions on Indoor Camera Localization through Scene Change Detection in Real-Time

Real-time indoor camera localization is a significant problem in indoor robot navigation and surveillance systems.The scene can change during the image sequence and plays a vital role in the localization performance of robotic applications in terms of accuracy and speed.This research proposed a real-time indoor camera localization system based on a recurrent neural network that detects scene change during the image sequence.An annotated image dataset trains the proposed system and predicts the camera pose in real-time.The system mainly improved the localization performance of indoor cameras by more accurately predicting the camera pose.It also recognizes the scene changes during the sequence and evaluates the effects of these changes.This system achieved high accuracy and real-time performance.The scene change detection process was performed using visual rhythm and the proposed recurrent deep architecture,which performed camera pose prediction and scene change impact evaluation.Overall,this study proposed a novel real-time localization system for indoor cameras that detects scene changes and shows how they affect localization performance.

Effectiveness and safety of rocuronium or nitroglycerin plus ropivacaine on pain during intravenous regional anesthesia:A double-blind randomized controlled trial

Objective:To compare the effects of adding rocuronium and nitroglycerin to ropivacaine in intravenous regional anesthesia(IVRA)on pain and hemodynamic parameters.Methods:This randomized controlled trial was done in 2023.Participants were 177 candidates for forearm operation surgery under IVRA selected from Valiasr Hospital,Arak,Iran.They were allocated by block randomization to three different groups,namely nitroglycerin group,rocuronium group and control group.Hemodynamic parameters were recorded before tourniquet application up to postoperative recovery time.Sensory block and motor block onset and duration and pain were also evaluated.The data analysis was carried out by IMB SPSS software 20.0.Results:177 Eligible patients were included in study,with 59 in each group.Time to sensory and motor block onset in the nitroglycerin group was significantly less than the other groups and the time of motor block in the rocuronium group was statistically higher than the control and the nitroglycerin groups(P<0.001).Seven participants in the nitroglycerin group experienced headache and three from the rocuronium group experienced dizziness.The side effects occurrence in the nitroglycerin group was more prevalent than in the control and rocuronium groups(P=0.009).Conclusions:Nitroglycerin significantly reduces the time to sensory and motor block onset,while rocuronium is more effective in prolonging the time of motor block.Although there is no difference between nitroglycerin and rocuronium respecting the pain score and opioid need administration,nitroglycerin is associated with a higher prevalence of medication side effects.Therefore,both nitroglycerin and rocuronium can be used as adjuvant for IVRA.The final choice relies on patients’conditions and anesthesiologists’judgment.