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Showing 5 results for Entezariasl
Ghodrat Akhavan Akbari , Masoud Entezariasl , Firooz Amani ,
Volume 6, Issue 3 (Autumn 2006)
Background and Objectives: Laryngoscopy and tracheal intubation could lead to hemodynamic responses in the from of hypertension and tachycardia as well as arrhythmia and myocardial ischemia. This alterations can be life-threatening particularly in elderly people. This clinical trial compared the effects of two rapid-onset narcotics, Alfentanil and Remifentanil, on the hemodynamic responses to the induction and tracheal intubation in elderly patients.
Methods: This double-blind clinical trial was conducted on 40 subjects aged 65 and above. They were candidate of cataract surgery under general anesthesia. The patients were randomly allocated to two groups of 20. The first group, was gaiven Alfentanil 10 m g/kg and for second group Remifentanil 0.5 m g/kg was injected prior to the induction of anesthesia. Both groups were similiar in the method of anesthesia except in narcotics. The first group was infused with Alfentanil 1 m g/kg/min and Remifentanil 0.1 m g/kg/min was used for the second group. Hemodynamic variations including heart rate, systolic, diastolic and mean arterial blood pressure were measured and recorded eight times (before induction, aften injection, after intubation and five times during anesthesia). Data were analyzed with SPSS software using descriptive and analytical statistics such as T-test, chi squre and ANOVA.
Results: Immediately after injection of narcotic drugs, all hemodynamic variants decreased. Howerver diastolic blood pressure in Remifentantil group significantly more than Alfentanil group (P<0.05). After laryngoscopy and tracheal intubation all hemodynamic variants increased and slowly decreased in less than 10 minutes. Systolic, diastolic and mean arterial blood pressure decreased significantly in remifentanil group than alfentanil group (P<0.05). Although heart rate decreased during few minutes after intubation, there was not significant difference between two groups regarding this decrease (P>0.05). Ephedrin was used to treat severe hypotention in those under Remifentanil (11 patients) more than those under Alfentanil (4 patients) (P<0.05).
Conclusions: According to the resukts of this study Remifentanil could prevent hemodynamic variation induced by laryngoscopy and treacheal intubation more than Alfentanil. However in some cases Remifentanil leads to hypotension during anesthesia. There is no important difference between two drugs in increasing heat rate after laryngoscopy and intubation.
Masoud Entezariasl, Khatereh Isazadefar , Ghodrat Akhavanakbari,
Volume 7, Issue 3 (Autumn 2007)
Background & Objectives: Postoperative nausea and vomiting are among the main complication after anesthesia and various methods are used for the prevention of this complication. In this study, the effect of the pre induction use of 10mg Metoclopramide’ 8 mg Dexamethasone and the combination of the both, on decreasing in the rate of nausea and vomiting after cataract surgery in intravenous anesthesia is compared with placebo.
Methods: In this double blind clinical trial, one hundred patients of cataract surgery who are appropriate for this study were, randomly divided in to four groups. In the group of placebo (P), 2cc normal saline, in group (M), 10mg metoclopramide, in group (D), 8mg Dexamethasone, and in group (M+D), 10mg metoclopramide and 8 mg Dexamethasone, one minute before the induction of anesthesia was injected. Patients were received the anesthetic drugs in the sameway and after the tracheal intubation infusion of propofol was started. After the end of surgical operation, the appearance of nausea and vomiting in the recovery room and also 6 and 24 hours after the surgery are recorded in the patients' information forms. Finally the data were analysed by statistical software of SPSS and the statistical tests.
Results: After the use of these drugs, the rate of nausea in the recovery room decreased from 44% in placebo to 20% in metoclopromide group, 16% in Dexamethasone group, and 8% in combination of metoclopromide and Dexamethasone and the rate of vomiting decreased from 20% in placebo group to 4% in metoclopromide group, 4% in Dexamethasone group, and 0% in combination of these two drugs, both the nausea and vomiting the effect of combination of metoclopromide and Dexamethasone in decreasing of postoperative mausea and vomiting was significant (P<0.05). The 24 hour following of nausea and vomiting, also had the same results.
Conclusion: With regrard to the results of this study, implication of the combination of 10mg metoclopromide and 8mg Dexamethasone before the induction of anesthesia remarkably decreased the rate of postoperative nausea and vomiting and is useful for the high risk groups for this complication especially in out patient surgery.
Masoud Entezariasl, Ghodrat Akhavan Akbari , Khatereh Isazadeh Far,
Volume 7, Issue 4 (Winter 2007)
Background & Objective: With consideration the daily increased development of outpatient surgeries and high rate of these operations in elderly patients, rapid and safe recovery of patients for coming back to daily life is necessary. In this clinical trial study recovery time and nausea and vomiting after the use of two rapid-onset narcotic, alfentanil and remifentanil in elderly patients has been compared.
Methods: In this double-blind clinical trial 40 elderly patients (age above 65) candidated to cataract surgery with general anesthesia were studied. The patients were divided randomly into two groups and for first group alfentanil was injected 10 m g/kg and for second group remifentanil 0.5 m g/kg during 30 seconds one minute before induction. Both two groups were under general anesthesia with same method and during the anesthesia first group took infusion of alfentanil 1 m g/kg/min and second group remifentanil 0.1 m g/kg/min. At the end of surgery the time intervals between end of anesthesia drug adminstration and autonomic respiration, eyes opening with stimulation, verbal response and discharge of recovery room, also the incidence of complications related to narcotic drugs especially nausea and vomiting were recorded. The data were analyzed in SPSS software using descriptive and analytical statistics as T-test, chi square and ANOVA.
Results: The time of autonomic respiration in alfentanil group was 2 minutes and in remifentanil group 3.3 minutes,this time in alfentanil groupe1.3 minutes shorter but the difference was not significant. The time of eyes opening with stimulation, verbal response and discharge of recovery room were not significantly different. During recovery incidence of nausea and vomiting in remifentanil group (30% of patients) was significantly more than alfentanil group (5% of patients) (P<0.05).
Conclusion: The time of recovery between alfentanil and remifentanil group was not significantly different, but incidence of nausea and vomiting in remifentanil group was higher than alfentanil group significantly.
Ghodrat Akhavanakbari, Masoud Entezariasl, Khatereh Isazadehfar, Tiba Mirzarahimi,
Volume 12, Issue 4 (winter 2012)
Background & Objectives: Uncontrolled postoperative pain can cause many adverse effects such as tachycardia, hypertension, myocardial ischemia, decreased alveolar ventilation and poor wound healing. In this study we evaluated the preoperative administration of pregabalin in relieving postoperative pain after lower limb orthopedic surgery and reducing the need for opioids and their possible side effects.
Methods: This study is a randomized, double-blind clinical trial. It was performed on 60 patients under lower limb surgery in Fatemi Hospital. Patients were randomly allocated to two groups, one group has received a 150 mg pregabalin capsule 2 hours before surgery and the other group has received placebo as a control. In both groups at 2, 6, 12 and 24 hours after surgery, the patients were evaluated and the pain score by a visual analogue scale (VAS), the score of sedation by Ramsay sedation scale and the incidence of nausea and vomiting were recorded in the checklists. Then, the data were analyzed by SPSS v16. P <0.05 was considered significant.
Results: In this study 51.7% of patients were male and 48.3% were female. The age averages of these patients in both group were similar (p=0.578). Visual analog pain scores at 2 h after surgery reduced in pregabalin group (p<0.0001). Similar reduction was observed in other studied hours (p<0.0001) too. In the pregabalin group nausea and vomiting scores at all hours, sedation levels at 2 h and 6 h postoperation, and pethidine consumption in all hours have significantly been reduced (p<0.05).
Conclusion: Preoperative administration of pregabalin is an effective method for reducing postoperative pain for patients, and with reduction in pethidine consumption, it can decrease problems of opioid usage.
Masoud Entezariasl , Khatereh Isazadehfar, Zahra Noorani,
Volume 13, Issue 2 (summer 2013)
Background & Objectives: Postoperative nausea and vomiting (PONV) is one of the most common complications of anesthesia and without prophylactic intervention occurs in about one-third of patients under general anesthesia. The aim of this study was to compare the efficacy of ondansetron and metoclopramide in reducing PONV after laparoscopic cholecystectomy.
Methods : In this study, 90 patients undergoing laparoscopic cholecystectomy were randomly allocated into three equal groups (n=30) and in the first group 10 mg metoclopramide, in the second group 4 mg ondansetron and for placebo group 2 cc normal saline preoperatively were injected. Anesthesia complications in recovery and nausea and vomiting in recovery and 6 hours and 24 hours after surgery were evaluated. Data were analyzed by SPSS software with chi-square test and analysis of variance (ANOVA). P<0.05 was considered significant.
Results: The incidence of nausea in placebo group was 66.7 %, in metoclopramide group was 43.3 % and in ondansetron group was 33.3 %. The difference only between placebo and ondansetron groups was significant (p=0.019). The incidence of vomiting in placebo group was 56.7%, in metoclopramide group was 20% and in ondansetron group was 26.7% and there was significant difference between placebo and ondansetron groups (p=0.035) and between placebo and metoclopramide groups (p=0.007), whereas there was not any significant difference between intervention groups (p=0.12). Also anti-emetic drug administration in ondansetron group (40%) in comparison with metoclopramide (63.3%) and placebo (66.7%) was lower, but this difference was not statistically significant (p= 0.07).
Conclusion: For prevention of vomiting after laparoscopic cholecystectomy, both metoclopramide and ondansetron are effective. In comparing these two drugs, in preventing of nausea ondansetron is more effective than metoclopramide, whereas there was not any significant difference between two drugs in preventing of vomiting.