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  Background & objective : Recovery state or post - anesthetic awakening is one of the most dangerous anesthetic stages . Respiratory, cardiovascular and other complications such as nausea, vomiting, shivering, pain and restlessness have been reported . This study designed to investigate prevalence of this complications and its probable risk factors in Ardabil Fatemi and Alavi hospitals.

  Methods : In this prospective study, 160 patients were selected in Alavi and Fatemi hospitals during winter of 2001. We completed a sheath for everybody about their history of medical diseases, pervious history of anesthesia, addiction, drug abuse, smoking, physical class of ASA, type of anesthesia, time and place of surgery . Data was analyzed by SPSS software.

  Results : These results were obtained in patients after surgery in recovery room: shivering
36.3 % , pain 26.9 % , restlessness 21.3 % , respiratory complications 13.8 % , cardiovascular complications 12 % , nausea and vomiting 8.8 % . We found significant correlation between some risk factors with complications, e. g: shivering with history of medical diseases, drug abuse and place of surgery and so, pain with restlessness, respiratory complication and place of surgery .

  Conclusion : This study according to similar studies revealed higher prevalence of some of post - anesthetic complications as shivering, pain and restlessness in our samples .

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  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.

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  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.

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Background & objectives: Cardiac arrhythmia after CABG surgery is a common complication which results in other side effects. Therapeutic effect of prophylactic magnesium administration is controversial and there are many different ideas in this case. The aim of this study was to evaluate the therapeutic effects of magnesium in reducing cardiac arrhythmia after CABG.

Methods: The clinical trial enrolled 140 patients undergoing CABG. Based on the initial blood levels of magnesium, patients were divided into two groups, one group with low serum magnesium and the other group with normal one. The low serum magnesium group treated with magnesium preoperatively and had normal serum magnesium level before operation. Postoperatively, both groups were randomly divided into two sub-groups, one receiving 2 gr. of magnesium sulfate and the other group received placebo. Both groups monitored for occurrence of arrhythmia in the ICU – OH for 3 days. Data were analyzed with statistical methods. P value of <0.05 was considered statistically significant.

Results: The results showed that the occurrence of arrhythmia in any of the sub-groups was not significantly different from each other (p> 0.05). There was no significant relationship between blood levels of magnesium and arrhythmia at different days (p> 0.05).

Conclusions: Blood level of magnesium and prophylactic magnesium administration have not effect on reducing arrhythmia after CABG surgery. The highest incidence of arrhythmias happened in the hypomagnesium group without prophylaxis on the third day after surgery, but this difference was not statistically significant.

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Background & objectives: Local systemic filling pressure measurement can be used to determine other hemodynamic parameters such as venous return and the stressed volume. The aim of the present study was to evaluate the relationship between local systemic filling pressures and central venous pressure.
Methods: In this study, candidate patients of cardiac surgery in Imam Khomeini hospital of Ardabil, in the first half of the 1397, were chosen and studied by their satisfaction, then an intra-arterial catheter inserted to the upper limb, a tourniquet closed to the same arm.  The arterial pressure measured during the surgery. Central vein pressure was also measured simultaneously. Finally, other variables obtained from transesophageal echocardiography and demographic data were recorded in each patient's checklist.
Results: 43 patients (71.7%) were man and 17 (28.3%) were women. The Mean CVP, MSFP, CO, and CI were 8.3±4.5 mmHg, 17.0±6.1, 3.27±1.1, and 1.89±0.7, respectively. Ten patients (16.7%) had mild heart failure, 42 patients (70%) had a moderate heart failure and 8 patients (13.3%) had severe heart failure. There were positive and significant relationship between CVP and MSFP (r=0.478: p=0.001). The EF status has no significant effects on CVP with SBP, DBP, MAP, CO and CI. There was significant and reverse correlation between PSF value with CO, and CI in severe heart failure (p<0.05).
Conclusion: we concluded that the local MSFP is a good and valuable substitute for CVP measurement, especially in severe heart failure