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Anestesia Department

  • Vision
  • Mission
  • Head of the Department
  • Staff Members
  • Research field
  • Achievements
  • Techniques
  • Structure
  • Training
  • Services Scope
  • Medical services
  • Projects
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To establish a referral centre for renal and hepatic transplantation surgeries



 To safely anesthetize all surgical and interventional procedures, assessment of preoperatively patient’sconditionas well as optimizing post-operative care for surgical patients.

Prof. Mohammed Zeidan Ali
Email: [email protected]




Former Heads 

Staff Members

  1.  Pharmacodynamics and pharmacokinetics of different anaesthetic drugs and adjuvants.
  2.  Comparative studies regarding different airway devices to secure airway during surgery with the least possible hazards andcomplications.
  3.  Fluid Optimisation through comparing different intravenous fluids (crystalloids and colloids) as regard to goal directed therapy during major surgeries
  4.  Conducting experimental studies on new anaesthetic drugs/techniques, this is done in cooperation with the Department of Surgery during experimental surgery.
  5.  Evaluation of different recent monitoring devices and studying their efficacy and safety especially on critically hepatic and renal patients.
  6.  Establishing protocols for post-operative enteral and parenteral nutrition for ICU patients according to patients’ specific needs and medical condition
  1.  Cooperation with famous hospitalsin Germany for training of the anaesthesia staff members on hepatic and renal transplant anaesthesia and post-operative ICU.
  2.  Performing renal transplant operations and multiple hepatic resectionsurgeries.
  3.  Establishing a system for pre-operative liver transplants from living donors as well as establishing a surgical ICU dealing with critically post- operative transplant patients
  4.  Establishing pain clinic as well as clinical nutrition unit.
  5.  Utilizing high technology equipmentincludingfiber-optic endoscopy for endotracheal intubation,Transoseophaeal Doppler-MasimoandPicco for goal-directed fluid therapy,Bispectral indexmonitoring depth of anaesthesia under different aesthetic agents and ultra-sound apparatus for nerve block and vascular cannulation.
  6.  Four innovative prototypes including:
    • Diaphragm-Controlled Tracheobronchial Tube (DC-TBT) for one lung anaesthesia. Patency was issued by the Egyptian Patent Office, Academy of Scientific Research and Technology (ASRT), Arab Republic of Egypt on 15/4/2008.Patent number: 24054;PI:Prof.HossamEl-Din HelmyEl-Sebae
    •  A device for epidural identification and catheterization using continuous hydrostatic pressure. Patency was submitted to the Egyptian Patent Office, ASRT on 2009 and is still pending. Patent number: 871;Investigators:Hossam El-Din Helmy and Prof. Yasser Samhan
    • Anaesthesia device using distilled water injector to get rid of carbon dioxide physically. Patency was submitted to the Egyptian Patent Office, ASRT on 2011 and is still pending. Patent Number: 1028;Investigators:Prof. Hossam El-Din Helmy and Prof. Mohamed Zeidan
    • Multi-Directional Intubating Laryngeal Mask Airway. Patency was issued by the Egyptian Patent Office, ASRT on 2013. Patent number: 1277;Investigators:Prof. Hossam El-Din Helmy and Prof. Mohamed Zeidan
  1.  Thrompoelastometry (Rotem) for coagulation monitoring and blood coagulation factors replacements during liver transplantation and major bloody surgeries.
  2.  Ultra sound guided nerve block and vascular access.
  3.  Difficult intubation management using fibre-optic intubating device.
  4.  Bispectral index for monitoring the depth of anaesthesia
  5.  Goal directed fluid therapy, guided by Picco, Trans-oesophageal Doppler,Masimoor ICON.
  6.  Cardiac output monitoringduring intra- and post-operative procedures using trans-oesophageal Doppler,Masimoor ICON.
  1.  Well-equipped operative suite including two operating theatres with two advanced touch screen monitors including capability of gas analyzer monitoring, cables for pulse, ECG, pulse oximetry, end tidal CO2,bispectral indexand temperature monitoring.
  2.  Trans-oesophageal Dopplerapparatus for cardiac output monitoring.
  3.  Picco and Masimoapparatuses for goal directed fluid therapy in major surgery.
  4.  Fiber-optic intubating devicefor difficult intubation management.
  5.  Thromboelastometry for coagulation monitoring and blood coagulation factors replacements during transplant and major bloody surgeries.
  6.  Ultrasound apparatus for sonar guided nerve block and vascular access.
  7.  Warming devices including Bair Hager mattress, water mattressesand rapid warming infusion pumps for keeping body temperature and warming patients during major,lengthy and bloody surgeries
  8.  Fluid infusion warming apparatus.
  9.  Target control infusion pumps for total intravenous anesthesia
  10.  Updated anesthesia machines with vaporizers for various inhalational anesthetics (desflurane – sevoflurane – isoflurane ) to cope with all different patients’ requirements
  11.  Post-anesthesia care unit (PACU) for patients’ recovery and adequate monitoringtill their transfer to the surgical ward.
  12.  Well-equipped three surgical ICU beds with advanced monitors, infusion pumps, ventilators and crash trolley with DC shock apparatus with option of isolation of patients in specific isolation room.
  13.  Ongoing development of three operating theatres with central pipe system, central condition, recent advanced monitors and anesthesia machines.

a. Cannulation workshop including theoretical overview and practical training on various cannulation techniques (arterial, central venous and venous).

b. Airway management/intubation workshop including theoretical overview and practical training courses on managing airway problems and various endotracheal intubation techniques as follows:

    •  Recent intubating devices (e.g; air-track).
    •  Supraglottic devices (e.g; I-gel and various types of laryngeal mask air way).
    •  Fiber-optic intubating device.

c. c. Neuro-axial block workshop including theoretical overview and practical training on epidural analgesia (thoracic, lumbar and caudal), spinal analgesia, continues spinal analgesia and combined spinal epidural analgesia.

d. Ultra-sound workshop on vascular access, nerve block and epidural localisation.

e. Recent Monitoring Devices workshop including:Trans-esophageal Doppler (TED) and Picco for cardiac output monitoring; Bispectral index (BIS) for depth of anesthesia monitoring and control; Masimo for fluid replacement therapy and Thrompoelastometry (Rotem) for coagulation monitoring and management.

f. Workshop for clinical nutrition

Services offered by the department are conducted to all patients especially those with chronic hepatic and renal diseases undergoing either surgical or endoscopic interventions for either diagnostic or therapeutic purposes.

· Preoperative assessment

The anaesthesia clinic offers preoperative assessment and evaluation of medical problems, optimization of the patient’s general condition for a safe surgical intervention and minimum hospital stays.

· Intra-operative management

The offered services include:

  1.  Modern anaesthetic techniques and anaesthetic agents (inhalational [e.g. VIMA], intravenous or continuous intravenous infusion [e.g. TIVA], including muscle relaxants and narcotics.
  2.  Recent drugs and techniques used in peripheral nerve blockade, central nerve blockade, acupuncture anaesthesia and analgesia in special surgical techniques.
  3.  Adjusting Anaesthesia for liver resection and liver transplant.
  4.  Adjusting Anaesthesia for laparoscopic surgery either urological or general surgery.
  5.  Use of recent anaesthetic drugs and monitoring to control the depth of anaesthesia to improve patients’ outcome.
  6.  Intraoperative fluid optimization in major abdominal surgery using advanced monitoring (Trans-esophageal Doppler, Masimo and Picco).
  7.  Remote location anaesthesia including
      •  Gastrointestinal endoscopy (ERCP- upper and colonoscopy)
      •  Interventional radiology techniques

· Postoperative management

The offered services include:

  1.  Well-equipped postoperative care unit (PACU) for receiving the patients after surgery, optimizing their general condition, allowing full recovery and safe transfer.
  2.  Studying different analgesic drugs and adjuvants (dexamethasone, gabtineetc…) to improve patients, outcome and decrease postoperative analgesic requirements.
  3.  Studying different agents that could minimize postoperative complications (e.g. nausea and vomiting etc…).
  4.  Studying different narcotics with different doses to reach optimum and safe recovery with minimal side-effects.
  5.  Studying various extradural drug combinations (local anaesthetics, narcotics, adjuvants) for postoperative pain relief after major surgeries.
  6.  The department as well cooperates with other institute departments oneither human or animalstudiesfor evaluating different anaesthetic agents/ techniques as well as their effects on different body organs and systems.

The department routinely serves approximately 2500 patients per year who undergosurgical, uro-surgical, endoscopic or laparoscopic procedures including:

  1.  Proper pre-operative assessment, control of medical problems and consultation of other medical branches if needed.
  2.  Conducting safely and successfully minor, major and high skilled surgical using the most recent and advanced anaesthetic drugs and techniques.
  3.  The department carries out all types of urological and general surgeries,all laparoscopic surgical procedures either diagnostic or therapeutic, gastrointestinal endoscopies (ERCP-upper endoscopy-colonoscopy, etc…) as well as interventional radiological procedures.

· Internal Projects

a. Effect of isoflurane anaesthesia versus ropivacaine extradural anaesthiesia on the haemostatic system during lower abdominal surgery in patients with normal and affected liver. PI: Prof.Hend Hussein Kamel (2008).

b. Esophageal Doppler Monitoring of Cardiovascular Changes and Assessment of Stress Response in Open versus Laparoscopic Abdominal Surgery. PI: Prof. Yasser MoustafaSamhan (2009).

c. Impact of Sevoflurane and Isoflurane on perioperative Hemostasis and Inflammatory Response during Open and Laparoscopic Surgeries. PI: Prof. Yasser MoustafaSamhan (2009)

d. Thromboelastomertric assessment of inhaled isoflurane and intravenous propofolanesthesia impact on perioperative hemostasis during liver surgery. PI: Prof. Yasser MoustafaSamhan (2009).

e. Effect of co-administration of clonidine, magnesium or ketamine with total intravenous anesthesis (TIVA) on anesthetic requirements guided by bispectral index. PI: Prof. Yasser MoustafaSamhan (2010).

f. Plasma volume expansion during major abdominal surgery the use of Transesophageal Doppler for comparing between Hydroxyethyl starch HES 130/0.4(Vouven) and modified fluid gelatin. PI: Prof.Gehan El Fandy(2010)

g. MasimoPleth Variability Index (PVI) as a Predictor of Fluid Responsiveness in Major Surgeries: A Comparative study with Transesophaheal Doppler Stroke Volume Variation (TEE-SVV) and Invasive Central Venous Pressure Estimation. PI: Prof. Sohila. Omar (2011)

h. The protective effect of insulin against isoflurane or sevoflurane hepatocellular induced apoptosis in laparoscopic cholecystectomy patients. PI: Prof. Khalda G. Radwan (2013)

i. Perioperative effect of Desflurane versus total intravenous anaesthesia on haemostasis guided by thromboelastometry in splenectomy with liver cirrhosis. PI: Prof.Hanan F Khafagy (2013)

j. Impact of Dexmedetomidine Infusion on Desflurane Consumption and Hemodynamics during Laparoscopic Cholecystectomy. PI: Prof. Hanan Khafagy (2015)

k. Effect of low flow Sevoflurane versus low flow Desflurane on hepatic and renal fuctions in hepatitis C (child A) patients undergoing laparoscopic cholecystectomy. PI: Prof. Khalda Radwan (2015)

l. Dexmedetomidine as an adjuvant to Nalbuphine patient controlled analgesia for post-operative pain in laparoscopic surgeries. PI: Prof. Nabaweya Moustafa Kamal (2015)

m. Goal directed propofol sedation with magnesium sulphate versus dexmedetomidine for ERCP procedures. PI: Prof. Hend Kamel (2015)

n. Hemodynamic monitoring and correlation between electrical cardiometry and Esophageal Doppler in patients undergoing abdominal surgery. No. 105 SH. PI: Prof. Abla El-Hadidi (2016)

o. Impact of Desflurane versus Sevflurane on coagulation in radical cystectomy patients. PI: Prof. Khalda Radwan (2017)

p. PerineuralDexmedetomidine versus Dexamethasone as an adjuvant to Bupivacaine single injection in supraclavicular brachial plexus block for arteriovenous fistula. PI: Prof. Khalda Radwan (2017)

q. Evaluation of electrical cardiometry versus masimo radical 7 for goal directed fluid therapy in major abdominal surgery. PI: Prof. Nabaweya Moustafa Kamal (2017)

Allam M, Omar S, Elshanawany F , El Hadidi A , Elsabae H , Radwan K and Elfandy G. (2008).Effect of Low and High Dose of Propofol on Oxidant/Antioxidant Balance. Australian Journal of Basic and Applied Sciences. 2(3): 785-793.

Abosedira M (2008). The Esmolol – Mivacurium Drug Interaction Under Isoflurane Anaesthesia. Journal of Medical Sciences. 8(5): 477-483.

Abosedira M (2008). The influence of dexmedetomidine co-induction on propofol induction requirement, pressor response & recovery profile. The Medical Journal of Cairo University. 76(4) Suppl. II: 69-73.

Abosedira M (2008). Adding Clonidine or Dexmedetomidine to Lidocaine during Bier’s Block: A Comparative Study. Journal of Medical Sciences; Vol 8.

El Hadidi A (2008): Sugammadex, A New Selective Relaxant Binding Agent For Antagonism Of Profound Rocuronuim Induced Neuromuscular Block. The Scientific Journal of Al-Azhar Medical Faculty (Girls). 29(1): 1353-1361.

El-Hadidi A, El-Tawdy A, Zeidan M and Farouk M (2008). Effect of Clonidine on Bupivacaine and Levobupivacaine in Postoperative Epidural Analgesia after Lower Abdominal Surgery. Kasr El Aini Medical Journal. 14(9): 51-59.

El Hadidi A, Omar O, Eltawdy A and Zaky A (2008). Haemostatic effect of conjugated oestrogen (PREMARIN) during transurethral resection of the prostate. Scientific Journal of AL-Azhar Medical Faculty (Girls).29(3): 223-232.

Omar S, Dessouki A, Osman E, El Hadidi A, Kamel H and Samhan Y (2008). Effect of propofol fentanyl anesthesia on hepatocellular integrity during induced hypotension. Journal of Medical Science.8(3): 275-280.

Radwan K, Khafagy H, Abdel Bar M and Omar S (2008). Optimal neuraxial midazolam dose co-administered with bupivacaine during herniorrhaphy. Medical Journal of Cairo University; 76(4) suppl. III: 213-218.

Omar S, Abo Sedira M , Youssef M , Zeidan M, Desoukhy A and El Fandy G (2008). The Anti-Oxidant Effects of Sevoflurane Anaesthesia and surgery: A Preliminary study. Journal of Medical Sciences .8(7): 641-647.

Abosedira M, Khafagy H, Youssef M, El Fandy G (2009). Does midazolam improve caudal ropivacaine analgesia in adults? Internet Journal of Anesthesiology.23 (2).

Kamal N, Omar S, Radwan K and Yousef A (2009). Bispectral index monitoring tailor’sclinical anaesthetic delivery and reduces anaesthetic drug consumption. Journal of Medical Sciences. 9(1): 10-16.

Botros R, Zeidan M, El- Sabea H and Abdel-Bar M (2009). Endotracheal Intubation using Airtraq® Laryngoscope versus LMA Fastrach™ in Adult Patients: A Comparative Study. The Egyptian Journal of Medical Sciences. 30 (2): 759-775.

Yousef M; Khafagy H; Elshanawany F; El-sabae H; Omar S; Allam M, Kamel H (2009). Hepatocellular Integrity during Sevoflurane anesthesia with Induced Hypotension. Journal of the Egyptian Society of Parasitology. 39(2): 641- 651

Omar S , Radwan K, Youssef M,Khafagy H, Kamal N, El-sabae H andKamel H (2009).A Non-opioid Fast-track Anesthetic Regimen for Colonic resection. Journal of the Egyptian Society of Parasitology. 39: 849-864.

Radwan K, Youssef M, El Tawdy A, Zeidan M and Kamal N(2010).Melatonin versus Gabapentin.A comparative study as preemptive medications. The Internet Journal of Anesthesiology (US). 23 (1)

Omar S, Youssef M, Radwan K, Khafagy H. Kamal N.(2010) What’s new in attenuating hemodynamic response to laryngoscopy and intubation? Egyptian Journal of Schistosomiasis and Infectious and Endemic Diseases. 32: 27-34

Khafagy H, Refaat A, El-Sabae H and Youssef M (2010).Efficacy of epidural dexamethasone versus fentanyl on postoperative analgesia during lower Abdominal Surgery. Journal of Anaesthesia. 24:531-536

Omar S, Youssef M, Radwan K, Khafagy H and Kamal N.(2010) What’s new in attenuating hemodynamic response to laryngoscopy and endotracheal intubation?. Egyptian Journal of Schistosomiasis and Infectious and Endemic Diseases; 32: 27-34.

Galal K, Abdel-Bar M, El-Tawdy A, Zeidan M and Kamal N (2010).Melatonin versus Gabapentine.A Comparative Study as Preemptive Medications. The Internet Journal of Anesthesiology.23 (1)

Omar S, Kamal N, Radwan K, Botros R, Ziedan. Osman E and Kamel H. (2010).Sub-Antibiotic Doses of Erythromycin as a Prokinetic in Abdominal Surgeries: Reviving the Old. Journal of the Egyptian Society of Parasitology. 40 (3): 811- 822

Radwan K, Omar S, Youssef M, Khafagy H, Kamal N and Sabra.(2010) Pre-operative Intravenous Co-administration of Ranitidine and Metoclopramide Effecton Gastric Content in Laparoscopic Cholecystectomy. The Medical Journal of Cairo University; 78 (2): 125-130.

Khafagy H, Hussein N, Radwan K, Refaat A, Hafez H, Essawy F andKamel H. (2010) Effect of General and Epidural Anesthesia on Hemostasis and Fibrinolysis in Hepatic Patients. Hematology.15(5): 360-366.

Zeidan M, Refaat A, Botros R and El-Sabea H (2011). Controlled Mechanical Ventilation with LMA Supreme™ versus i-gel™ in Anesthetized Adult Patients. Journal of the Egyptian Society of Parasitology. 41 (2): 365-376

HutagalungR, MarquesJ, KobylkaK, ZeidanM, KabischB, BrunkhorstF, ReinhartK andSakrY(2011). The Obesity Paradox in Surgical Intensive Unit Patients. Intensive Care.37(11):1793-9.

Ziedan M, Botros R, El Tawdy A, Refaat A, Kamal N (2011). Controlled Mechanical Ventilation with LMA Supreme versus I-gel in Anesthetized Adult Patients. Journal of the Egyptian Society of Parasitology.41 (2): 365-378.

Osman E, Khafagy H, Samhan Y, Hassan M, El-Shanawany F, Fathallah A and El-fandy G (2012). In vivo Effects of Different Anaesthetic Agents on Apoptosis. Korean Journal ofAnesthesiology.63(1): 18-24.

KhafagyH, Botros R, Osman E, Zeidan M andSamhan Y (2012).Perioperative Effects of Various Anesthetic Adjuvants with TIVA Guided by Bispectral Index. Korean Journal of Anesthesiology. 63(2): 113-119.

Sakr Y, Zeiden M and Marques J (2012).Prognosis and outcome of critically ill obese patient.Critical Care Management of the Obese Patient. Wiley-Blackwell (an imprint of John Wiley & Sons Ltd) Chapter 32.Page: 211-217. ISBN:0470655909. EAN:9780470655900.

Botros R, Abdel Bar M ,Zeidan M and El- Sabea H (2012).Endotracheal Intubation using Airtraq® Laryngoscope versus LMA Fastrach™ in Adult Patients: A Comparative Study. The Egyptian Journal of Medical Sciences, 30 (1-2): 447-463.

AlMasry A, Boules M, Boules N and Ebied R (2012).Optimal method for selecting peep level in Ali/Ards patients under mechanical ventilation. Journal of the Egyptian Society of Parasitology, 42 (2): 359-372

Apel M, Maia V, Zeidan M, Schenkoete C , Wolf G, Reinhart K and Sakr Y (2013). End-Stage Renal Disease and Outcome in a Surgical Intensive Care Unit. Critical Care. 17:R298

Samhan Y, El-Sabae H,Khafagy H, Maher M (2013).A pilot Study to Compare Epidural Identification and Catheterization using a Saline-Filled Syringe versus a Continuous Hydrostatic Pressure System. Journal of Anaesthesia. 27:607-610.

Sayed H, Zayed M, El Qareh N, Khafagy H, Helmy A and Soliman M (2013). Patient safety in the operating room at a governmental hospital. Journal of the Egyptian Public Health Association.88: 85-89.

Khafagy H, Hussein N, Madkour M, Mahmoud O, Mansour A, Yussif M, Botros R, Samhan Y (2014). Perioperative effects of anesthesia and surgery on inflammation-coagulation interaction. Life Science Journal.11(12): 900-906.

Sakr Y, Maia V,Santos C,Stracke J, Zeidan M, Bayer O and Reinhart K (2014).Adjuvant selenium supplementation in the form of sodium selenite in postoperative critically ill patients with severe sepsis. Critical Care. 18:R68.

Zeidan M, Saeed R, El- Sabea H, Abdel-Bar M, Abo-Sedira M(2014). Cisatracurium Dose-Response Relationship in Patients with Chronic Liver Disease. Egyptian Journal of Anaesthesia. 30, 197-202

Abdallah E, El-Shishtawy S, Mosbah O, Zeidan M (2014).Comparison between the effects of intraoperative human albumin and normal saline on early graft function in renal transplantation. International Urology and Nephrology.46(11):2221-2226.

El-Fandy GG, Omar SH, El-Desouky AA, Kamel HH, Refaat AI (2014).Fluid optimization with hydroxyethyl starch 130/0.4 compared with modified fluidgelatin guided by esophageal Doppler during major abdominal surgeries. Journal of the Egyptian Society of Parasitology.44(1):151-160.

Khafagy HF, Hussein NA, Madkour ME, Mahmoud OM, Mansour AZ, YussifMF, Abbas AA and Samhan YM (2014). Perioperative effects of anesthesia and surgery on inflammation-coagulation interaction. Life Science Journal. 11 (12): 900- 906.

El-Sabae HH, Khafagy HF (2015).Non-logarithmic equation for acid base state in the blood. International Journal of Anesthesiology Research. 3(2):50-52.

Botros R, Ziedan M, Boules M and Samhan Y (2015). Does Intrathecal Midazolam Improve Hyperbaric Bupivacaine-Fentanyl Anaesthesia In Elderly Patients? Ains Shams Journal of Anaesthesiology.8(4):602-607.

Ebied RS, Ali MZ, Khafagy HF, Maher MA, Samhan YS (2016).Comparative study between continuous epidural anaesthesia and continuous Wiley Spinal® anaesthesia in elderly patients undergoing TURP. Egyptian Journal of Anaesthesia. 32, 527-533.

Hassan HF, Ali MZ, Refaat AI, Ebied RS, Abdelhak MM, El-Hadidi AS, El-Sharkawy NG (2016).Pulse-induced Continuous Cardiac Output Monitor versus Trans-esophageal Doppler Monitor for Optimization of Fluid Management in Patients Undergoing Major Abdominal Surgery. A Comparative Study. British Journal of Medicine and Medical Research. 16(2): 1-15.

Sakr Y, Dünisch P, Santos C, Matthes L, Zeidan M, Reinhart K, Kalff R, Ewald C(2016).Poor outcome is associated with less negative fluid balance in patients withaneurysmal subarachnoid hemorrhage treated with prophylactic vasopressor-inducedhypertension .Annals of Intensive Care. 6(1):25.

Ahmed. M. Essam AM, Ali MZ, Maher MA, Mokhtar AL, Omar SH, El-Sebae HH, Hafez MH (2016).Masimo® Plethysmograph Variability Index as a Tool for Assessment of Fluid Responsiveness in Elective Major Abdominal Surgeries British Journal of Medicine and Medical Research.16(2): 1-11.

Samhan Y, Radwan K, Youssef M, Ebeid R, Zeidan M, El Bendary O, Hassan M (2016). Hemodynamic changes and stress response during BIS-guided TCI anesthesia with propofol-fentanyl in laparoscopic versus open cholecystectomy. Egyptian Journal of Anaesthesia.32, 45-53

Ebied RS, Ali MZ, Khafagy HF, Maher MA, Samhan YS (2017).Bougieguided endotracheal intubation using the Air-QTM Intubating Laryngeal Airway: A prospective randomized clinical study. Egyptian Journal of Anaesthesia.33: 107-112.

Khafagy HF, EbiedRS, MohamedAH, El-saidMH, El-haddadAM, El-Hadidi AS, Samhan YM (2017).Effect of dexmedetomidine infusion on desflurane consumption andhemodynamics during BIS guided laparoscopic cholecystectomy: a randomized controlled pilot study. Egyptian Journal of Anaesthesia. 33: 227-231.