Ali, H. M., and A. Wahdan, "Using dexamethasone as an adjuvant to levobupivacaine in epidural anesthesia to change the pain intensity and duration in painless labor.", Saudi journal of anaesthesia, vol. 12, issue 2, pp. 209-214, 2018 Apr-Jun. Abstract

Background and Objective: This is a randomized controlled trial aiming at comparing the effectiveness of levobupivacaine alone versus a levobupivacaine with dexamethasone in the epidural injection for painless labor.

Patients and Methods: This is a comparative randomized controlled double-blinded clinical trial with 49 patients were included in this study, all of them were primigravidas and were during vaginal delivery with a cervical dilatation ≥4 cm. Patients were included randomly in one of two groups either Group C (26 cases) with epidural levobupivacaine 0.125% in normal saline or Group D (23 cases) with epidural levobupivacaine 0.125% in normal saline combined with dexamethasone 8 mg. The duration of a second dose request, total dose given, neonatal outcome and adverse effects of epidural were recorded.

Results: Group D showed a longer duration of analgesia than Group C (80.5 ± 12.39 min in Group D vs. 61.75 ± 10.74 min in Group C) with a < 0.05 (0.001). Furthermore, the patients in Group D received smaller dose of levobupivacaine than those in Group C with a statistically significant difference (90.87 ± 33.42 vs. 127.21 ± 40.68 mg with = 0.002). There were no statistical differences between the two groups regarding hemodynamics, pain score, neonatal outcome, and complications.

Conclusion: Dexamethasone in epidural analgesia for painless labor has a prolonged duration of analgesia with no complications for both the mother and the infant.

Ali, H. M., "Comparison of 3 Different Dexmedetomidine Doses and Their Effect on the Duration of Spinal Anesthesia", Journal of Anesthesia & Clinical Research, vol. 8, issue 9, pp. 1-6, 2017.
Ali, H. M., "Open Appendectomy Using Ultrasound Guided Transversus Abdominis Plane Block: A Case Report", anestrghesia and pain medicine, pp. 1-2, 2017.
Ali, H., "Cervical epidural puncture guided by fluoroscopy in comparison to acoustic signals: Clinical results", Saudi Journal of Anesthesia, vol. 11, issue 3, pp. 305-308, 2017.
Ali, H. M., M. F. Mahmoud, M. M. Hashim, and A. A. Fahmy, "Dexamethasone preventing dural puncture headache", Journal of Pain Management, vol. 7, issue 4, pp. 273-277, 2015. 1939-5914_7_4_front_matter.pdf
Alkhalaf, M. M., H. M. Ali, and R. Al Otaibi, "Difficult airway in a pediatric case of pycodysostosis.", Anesthesia, essays and researches, vol. 9, issue 1, pp. 124-6, 2015 Jan-Apr. Abstract

Pycodysostosis is a genetic autosomal rare disease with an incidence of 1:1.7 million births; the pathophysiology of the disease is related to mutation of cathepsin K gene. Sleep apnea, respiratory difficulties because of chest and oral abnormalities may cause a challenge to the anesthetist during intubation and/or mechanical ventilation. In this case report we will discuss a case of pycodysostosis with a difficult airway.

Salama, A. K., and H. M. Ali, "Comparative study of hyoscine doses as antisialagogue for patients receiving ketofol sedation undergoing colonoscopy procedures.", Anesthesia, essays and researches, vol. 10, issue 1, pp. 94-7, 2016 Jan-Apr. Abstract

OBJECTIVE: To compare the effects of different regimens of hyoscine as antisialagogue in patients undergoing ketofol sedation for colonoscopy procedures.

PATIENTS AND METHODS: In this prospective double-blind randomized controlled trial 200 American Society of Anesthesiologists I-II aged 20-60-year-old undergoing colonoscopy were randomly assigned into four equal groups, group A received 5 mg hyoscine intravenous, group B received 10 mg, group C received 20 mg intravenous, and control group (D) that was received saline. All patients were sedated using ketofol titrated to achieve Ramsey Sedation Score 4, hemodynamic variables and occurrence of increased secretions were evaluated and recorded.

RESULTS: Hyoscine in a dose of 10 mg was the optimum dose to achieve least salivation with the least side effect while hyoscine 5 mg was not efficient to achieve dry field or good surgical conditions. However, hyoscine 20 mg achieved dry field and fair surgical conditions in expenses of tachycardia.

CONCLUSION: Hyoscine 10 mg was the least effective dose that significantly reduced hypersalivation in patients receiving ketofol sedation for colonoscopy procedures, this dose was as effective as 20 mg in draying secretion but with significantly less tachycardia.