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Rebound pain is extreme pain that persists after the effects of regional anesthesia wear off. Rebound pain occurrence and intensity are influenced by patient, surgical, and anesthesia-related factors. The incidence and severity of rebound pain after peripheral nerve block resolution are both reduced by the use of perioperative multimodal strategy. The purpose of the current paper was to evaluate the frequency, seriousness, and risk factors for rebound pain following peripheral nerve block resolution.A cross-sectional study centred on 384 patients who had received peripheral nerve blocks was carried out from August 20, 2021, to June 30, 2022. A semi-structured questionnaire was used to gather information within 24 h following the block's performance. SPSS 25 was used to enter and analyze the data. The change from well-controlled pain while the block is operating to severe pain within 24 h of block performance is known as rebound pain. Both univariate and multivariable analyses were used to examine the relationship between various parameters (patient, surgical, and anesthetic-related factors) and rebound pain. In the multivariable analysis, a P-value of 0.05 or lower is regarded as statistically significant.The incidence of rebound pain after peripheral nerve block was resolved was 61.7% (95% CI: 56.5-66.7) with a mean rebound pain score of 4.19 ± 2. Of the total 237, 120(50.6%) had severe rebound pain after the peripheral nerve block was resolved. The use of preoperative intravenous dexamethasone (AOR: 2.6, 95%CI: 20.29-24.57), preoperative pain (AOR: 3.9, 95%CI: 41-57.4), type of surgery (AOR: 6.5, 95%CI: 1.45-11.7), post-operative NSAID (AOR: 2.2, 95%CI: 17.69-20.8), and opioid use (AOR: 2.2, 95%CI: 19.1-22.56) were independent risks associated with rebound pain.and Recommendation: Rebound pain occurred in 61.7% of patients and had independent associations with preoperative pain, dexamethasone premedication, type of surgery, use of an adjuvant, use of postoperative opioids, and NSAIDs. Therefore, clinicians should continue to use preventative strategies, especially for patients at higher risk of experiencing rebound pain.

Background. Patient satisfaction is a crucial component in determining the quality of healthcare in anesthesia services. This study aimed to assess patient satisfaction and associated factors on perioperative anesthesia services. Methods. Institutional-based cross-sectional study was conducted from May 16 to June 22, 2021, at the University of Gondar Comprehensive Specialized Hospital. Data were entered into Epi-data version 3.1 and exported to STATA version 14.1. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval, and a p value

Liver disease is a multisystem condition that is classified as acute or chronic depending on the length of time. Cirrhosis patients are expected to undergo surgery in the last two years of their lives, according to estimates. In patients with elevated liver enzyme levels, anesthesia and surgery may deteriorate liver function. Preoperative identification, optimization and anesthetic management are essential for optimum outcomes in patients with liver disease undergoing surgery.The literatures are searched using medical search engines like Google scholar, PubMed, Cochrane library and HINARI to get access for current and update evidence on perioperative optimization of patients with liver disease. The key words for literature search were (liver disease OR liver failure) AND (liver disease OR perioperative management) AND (non-hepatic surgery OR anesthesia). After searching using these search engines then collected by filtering based on the level of significance to this guideline with proper appraisal and evaluation of study quality with different level of evidences.and recommendations: Patients with liver disease presenting with non-hepatic surgery might have postoperative complications that can lead to death. Efforts should be expended to favorably alter a patient's preoperative Child's class before undertaking an elective operation.

Introduction Cesarean section is the most common surgery done in the world and it results moderate to severe pain. Untreated pain interrupts the mother to care her baby and may lead to the development of chronic pain. It may also have negative impacts on respiratory, cardiovascular and other systems. Land mark technique of transversus abdominis plane block and wound infiltration have been practiced to manage post-operative pain after cesarean section. Objective Comparing the analgesic efficacy of transversus abdominis plane block versus wound infiltration for post cesarean section pain management. Methods An institution based prospective cohort study was conducted on 82 parturients who delivered by cesarean section under spinal, North west Ethiopia, from March10 to June 2nd, 2020. Data was collected using a structured questionnaire and 82 consecutive parturients were included in this study until the desired sample in each groups was achieved. Parametric data was compared by independent student t –test and non-parametric data was compared by Mann-Whitney U test and presented as mean ± standard deviation or median (interquartile range) as appropriate. Result Post-operative numerical rating scale of pain after cesarean section at 2, 4 and 6 h were not significantly different, but there were significant differences at 8, 12 and 24 h between groups. Diclofenac consumption was not significantly different on 24 post-operative hour between the two groups (P = 0.246). Time to first analgesia requirement was prolonged in transversus abdominis plane block (p Conclusion And recommendations: Transversus abdominis plane block had long lasting and more efficient analgesia, reduced tramadol consumption and prolonged time to first analgesia request for parturients delivered by cesarean section within 24 h as compared to skin infiltration. We recommend transversus abdominis plane block than skin infiltration for post-operative pain management after cesarean section.