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To evaluate ultrasound guidance effect in pain relief during intrauterine device (IUD) insertion.Four different databases were searched from inception till June 2022. We selected randomized controlled trials (RCTs) that compared transabdominal ultrasound guidance versus traditional non-guided IUD insertion among women undergoing IUD placement for contraception. We used Revman software during performing our meta-analysis. Our primary outcome was the pain score during IUD insertion as evaluated by the Visual Analog Scale (VAS). Our secondary outcomes were the procedure insertion time, satisfaction, and incidences of complications and misplaced IUDs.Seven RCTs were retrieved with a total number of 1267 patients. There was a significant reduction in the VAS pain score during IUD insertion among the ultrasound-guided group (MD = -1.91, 95% CI [-3.08, -0.73], P = .001). The procedure insertion time was significantly shorter within the ultrasound guidance group compared with the control group (MD = -1.35, 95% CI [-1.81, -0.88], P .001). Moreover, more women were significantly satisfied with the procedure among the ultrasound-guided group (P .001). In addition, ultrasound-guided IUD insertion was linked to significant decline in incidences of complications and misplaced IUDs.Ultrasound guidance can be used as a modified technique during IUD insertion as it decreases pain, procedure time, and rates of complications and misplaced IUDs with better patient satisfaction.

The best tool for management of postherpetic neuralgia (PHN) is a matter of debate. The use of ultrasound-guided erector spinae plane block (ESPB) in patients with PHN may decrease pain severity and the need for analgesics.The objective of this clinical study was to test the efficacy of ESPB with and without the addition of magnesium sulphate on pain control and analgesic consumption in patients with PHN.Randomized controlled double-blinded trial.A single university center.A total of 75 patients with PHN were included in the study. Patients were randomly divided into 3 equal groups. Group A received sham ESPB (2 mL normal saline), Group B received ESPB with 20 mL of bupivacaine (0.25%), and Group C received ESPB with 20 mL of bupivacaine (0.25%) and 100 mg magnesium sulphate. All patients received standard medical care. The pain score, the consumption of pregabalin and acetaminophen, the incidence of complications, and the patient's satisfaction were measured and recorded.In comparison to the control group, the use of real ESPB with or without the addition of magnesium significantly decreased the Numeric Rating Scale score for pain during the first week of follow-up (P0.05); decreased the mean daily consumption of pregabalin and acetaminophen from the third to the twelfth week of follow-up (P0.05); and increased the level of patients' satisfaction (P = 0.03). The addition of magnesium sulphate showed an insignificant difference in comparison to the use of bupivacaine alone in ESPB (P ? 0.05).The study was limited by being a singlecenter study, using a single-level injection, and using a single volume of local anesthetic mixture.ESPB with or without adding magnesium sulphate is an effective pain management tool for cases of PHN. It leads to a significant decrease in pain score and analgesic requirements.

The aim of this study was to evaluate the effect of preoperative pregabalin on postoperative analgesia in patients undergoing radiofrequency ablation (RFA) of hepatic focal lesions (HFLs).This randomised controlled study was carried out on 70 adult patients for whom RFA was indicated to treat hepatocellular carcinoma. They were randomised into two groups: Group I: 35 patients who were given a placebo before the procedure and Group II: 35 patients who were given 150 mg of oral pregabalin one hour before the procedure. The primary outcome was the analgesic effect in the form of postoperative pain severity and the need for opioid analgesics.In the immediate postoperative period there was no significant difference between the two groups on pain assessment by the visual analogue pain scale (VAS Pain; p = 0.84). However, the medians of Group II VAS Pain were significantly (p 0.001) less than Group I 3,2,1,1,1,0 vs. 4,3,3,2,2,2, respectively when measured every four hours until 24 hours. The number of required doses of rescue analgesia and total required dose of morphine in the first 48 hours postoperatively of Group II were significantly (p 0.001) less than Group I. Side effects such as nausea and vomiting and delayed discharge were significantly less frequent in Group II when compared with Group I:20vs. 45.7%, 17.1 vs. 45.7% and 11.4 vs. 37.1%, respectively (p = 0.02, 0.01 and 0.01, respectively).Pre-emptive oral pregabalin is safe and effective for postoperative analgesia in patients scheduled for radiofrequency ablation of focal lesions in liver.