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Showing 13 results for Anesthesia
Masoud Entezari-Asl , Mohammadreza Ghodrati , Hamid Ebadizare , Khatereh Isazadehfar ,
Volume 2, Issue 2 (6-2002)
Abstract
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 .
Mohammadreza Ghodraty , Ghodrat Akhavan Akbari , Firooz Amani , Shahnaz Rahimi , Nasrin Shahab ,
Volume 3, Issue 3 (9-2003)
Abstract
Background & Objective : Regional anesthesia is a method of choice in cesarean section. But in emergency cesarean sections general anesthesia is usually preferred. On the other hand, intravenous sedative drugs used in general anesthesia induction rapidly crosses the placenta and result in fetal depression. Because of higher prevalence of general anesthesia in Iran it is reasonable to conduct more researches in this field. This study set out to compare the effects of Propofol and Thiopental-Na as induction agents on the neonatal Apgar score and maternal hemodynamic status. Methods: In this double blind clinical trial 60 pregnant women with ASA class I & II were studied. In a random way 30 patients received 2mg/kg Propofol and the rest of them were given 4mg/kg of Thiopental-Na. All these subjects had full term and normal fetus. Pre and post-induction status of the patients was monitored noninvasively after tracheal intubations and during 12 minutes after that. Also time intervals between induction and birth (cord clipping) and between uterus incision and birth were measured. Apgar score of neonates was evaluated through clinical examination in 1st, 5th, 10th and 15th minutes after birth. The data were analyzed in SPSS software using descriptive and analytical statistics such as T-test, chi-square and ANOVA. Results: Apgar score in different times (1.5,10&15 minute) had no significant difference between two groups. (In the 1st minute Propofol was 7.1 ± 2.2 and Thiopental was 74 ± 1.8, in the 5th minute Propofol was 9.2 ± 0.7 and Thiopental was 9.1 ± 0.9) Maximum variation of heart rate and blood pressure in two groups were not significantly different. The time intervals between induction and birth (less than 8 minutes) on the one hand and uterus incision and birth(less than 130 seconds) on the other were similar in two groups. Conclusions : Thiopental-Na and Propofol can be used with similar results for induction of general anesthesia in cesarean section.
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Volume 4, Issue 1 (4-2004)
Abstract
Background & Objective: Spinal anesthesia is one of the usual techniques in the surgery of hip fractures among the aged. On the other hand the hemodynamic complications of this method and the treatment of these complications by abundant Ir liquids and drugs such as Ephedrin and phenylephedrin have potential risk for aged patients. Intrathecal opioids have synergistic effects on the duration and quality of spinal block. Thus a number of efforts have been made to prevent the hemodynamic complications and probability of inadequate block by decreasing the dosage of local anesthetic drug and adding opioid drugs to it. This study investigates the hemodynamic effects and the quality of spinal anesthesia using the above-mentioned method. Methods: Forty-six patients above 60 years of age with hip fracture were randomized into 2 groups (A and B). Group A received a spinal of hyper tonic bupivacaine (5 mg) and fentanyl (20 m g) and group B received 12.5 mg of hypertonic bupivacaine for spinal anesthesia. Vital signs before and during the surgery, quality and quantity of blockage, amount of fluid and Ephedrine used, were recorded every 5 minutes. Results: MAP (Mean Arterial Pressure) fall and the dosage and frequency of ephedrine consumption were significantly different in two groups. MAP decrease in-group A was 23.6 ± 10.79 and in-group B it was 36 ± 11.1 (p=0.001). The average requirement of ephedrine in the groups were 2.25 ± 3.49 mg in-group A and 10 ± 8.45 mg in-group B (P=0.001). The average occurrence of hypotension and ephedrine usage was 0.71 ± 1.08 times in-group A and 2.91 ± 2.94 times in-group B (p=0.001). 29 % of group A had pain in the terminal stage of surgery but this amount in-group B was 13.6%. Tachycardia was 29.2 % in-group A and 68.2 % in group B (p=0.001). Conclusions: Adding 20 m g fentanyl to bupivacaine and decreasing its dosage can prevent the complications of intrathecal anesthesia. (MAP fall and the tachycardia occurred in the process of its treatment) to a great extent. But to lower the incidence of failure and obtain reliable block, more controlled studies must be accomplished.
Masuood Parish, Soosan Rassoli, Mohammad Reza Afhami, Farnaz Moslemi,
Volume 5, Issue 2 (6-2005)
Abstract
Background & Objectives: Oculocardiac reflex (OCR) is presented with bradycardia and other arrhythmias, is induced by mechanical stimulation and therefore, encountered during strabismus surgery. The aim of this study is to determine the incidence and risk factors of cardiac arrhythmias during strabismus surgery in children and adults. Methods: In this prospective, randomized and double-blind study, 46 patients ASA class I and II underwent elective strabismus surgery with general anesthesia and were allocated to one of the two groups: children under 12 and adults over 12. All patients received standard general anesthesia based on their age. Demographic data, type of involved muscle, the incidence, (type and frequency) and the cause of arrhythmias and skillfulness of the surgeon (professor-assistant) were recorded. Results: There were 26 patients in children group and 20 patients in adult group. The overall incidence of arrhythmias was 91% with 96.15% in children and 85% in adults. There was not any significant difference in the incidence of arrhythmias, and the mean rate of occurence between two groups. Most of the arrhythmias were due to external ocular muscles traction. Conjunctival traction and pressure on the globe were the other causes. Stimulation of median rectus muscle as the most important arrythmogenic factor was seen in 13 children and 12 adults. Bradycardia and tachycardia were among common arrhythmias, but there was no significant difference between two groups (P>0.05) in terms of their incidence. Conclusion: This study showed that the incidence of arrhythmias during strabismus surgery is high in both children and adults. This reflex does not often lead to hemodynamic compromise, however, for its early diagnosis and treatment, close and continuous monitoring of the patient as well as cooperation and communication between anesthesiologist and surgon is needed.
Khatere Seylani, Masoome Aghamohammadi, Khlil Rostami, Vadood Noroozi,
Volume 5, Issue 3 (9-2005)
Abstract
Background & Objective: Postoperative nausea and vomiting is the most common complication of anesthesia with an approximate prevalence of 30% up to 70% (in high risk patients). In recent years several articles have investigated the effects of antiemetic and anesthetic drugs on postoperative nausea and vomiting, but the nonpharmacological methods, which are cost-effective and have no side effects, are rare. Since it is essential for patients to be on fast before surgeries which require general anesthesia, occurrence of dehydration and extra cellular fluid volume deficit and subsequently nausea and vomiting are expected and anticipated. Thus in this study the effect of preoperative intravenous fluid on postoperative nausea and vomiting was explored. Methods: This clinical trial study was performed in two experimental and control groups, with 30 subjects in each. Experimental group were given a 1- liter bolus of intravenous normal saline preoperatively in addition to routine IV fluid. Finally the incidence of postoperative nausea and vomiting was observed and compared between two groups. Results : According to statistical tests, the differences between age, preoperative and postoperative NPO duration, use of antiemetics and the duration of hospitalization in two groups were statistically significant but the differences between other demographic variables and the volume of intraoperative intravenous fluid received during the surgery were not. Results showed that experimental group had significantly lower incidence of nausea and vomiting (20% and 10% respectively) in comparison with control group (50%). According to chi-square test, the rate of postoperative nausea and vomiting was significantly different in two groups. (p=0.015 and p=0.001 respectively) Also, preoperative NPO duration had significant relationship with postoperative vomiting (p= 0.05). Conclusion: Regarding the positive effect of intravenous fluid therapy on postoperative nausea and vomiting as a cost effective and harmless method in surgery, its use is recommended.
Ali Mohammadian Erdi , Nahid Manochehrian,
Volume 7, Issue 2 (6-2007)
Abstract
Backgrond & Objectives: Perioperartive shivering is a common complication which interferes with monitoring of patients and it increases oxygen consumption (up to 500%) which can be life-threating in patients with a low cardio pulmonary reserve. This study compared the efficiency and complications of two perioperative antishivering drugs. (Tramadol and Meperidine). Methods: All of the 70 patients under went cesarean section with spinal Anesthesia, were categorized in two groups of 35 persons, and treated as clinical trial, double blind with tramadol and meperidine. Then they were compared in terms of the interval between administration of drugs and stoping of shivering and their complications. Results : The mean age in patient were 27 years, youngest one was 17 and the oldest was 39 years. The average interval of stopping of shivering during tramadol using (2.57 min) is less than meperidine (6.24 min). The frequency of nausea and vomiting in meperidine group was more than that of the tramadol group. Regarding the incidence of pruritus and sedation after using of drug in both groups, there was no considerable difference between them. Respiratory and pulse rate changes, and decreasing of arterial oxygen saturation in post injection period to preinjection period of meperidine, didn't show any significant changes. In systolic and diastolic blood pressure changes, there was no significant change in both groups. Conclusion: Perioperative shivering treatment by tramadol is better than meperidine because of its faster onset of stopping of shivering and its low complications in cesarean section with spinal anesthesia.
Majid Pourshaikhian, Abdolhosein Emami, Rabiollah Farmanbar, Ehsan Kazam Neghad, Vadood Norouzi,
Volume 10, Issue 2 (6-2010)
Abstract
Background and objectives: High incidence of postoperative shivering leads to complications such as increased oxygen consumption, intracranial & intraocular pressure and pain. Some drugs including pethedine, dexamethasone and doxapram are used for prevention of shivering. The aim of this study is to compare the effect of dexamethasone and doxapram in prevention of post-anesthetic shivering. Methods: This study is a double blind clinical trial including 90 patients in ASA 1 and 2 classes. The patients were under general anesthesia for elective abdominal and chest surgery with same the anesthesia techniques. Samples were randomly divided into three groups (two drug received groups and one control group). First group received dexamethasone 0.1 mg/kg, the second group doxapram 0.75 mg/kg and the control group 3 ml of distilled water as injection. The visible shivering observed after each treatment. Collected data were analyzed using Chi-square, Fisher exact and ANOVA tests By SPSS 16 and p ≤ 0.05 was considered significant. Results: Our results showed a significant difference between shivering in drug received and control groups. Shivering was significantly decreased in drug received groups (p = 0 . 05) but there was no significant difference between them. Conclusion: This study showed that both drugs of dexamethasone and doxapram are effective in prevention of post-anesthetic shivering and can be substituted with pethedine. In addition to antishivering effect, doxapram has a respiratory stimulant effect that is, that is clinically important in postoperative stage.
Parviz Amri Maleh, Mojdeh Camvar ,
Volume 14, Issue 2 (7-2014)
Abstract
Background & objectives: Eisenmenger syndrome associated with pregnancy increases the maternal morbidity and mortality . Therefore, in the most of such patients the termination of pregnancy is recommended. Case report: A 29 -year-old woman at the 7 th week of gestational age was candidate for therapeutic abortion with history of Eisenmenger syndrome due to atrial septal defect (ASD) . Spinal a nesthesia was performed in sitting position at the L4-5 interspace with 10 mg of bupivacaine . The p atient was laid in the supine position after 2 minutes. The surgery lasted about an hour . Blood pressure and heart rate did not change significantly during operation. Conclusion : Modified s pinal anesthesia with bupivacaine is recommended for therapeutic abortion in patients with Eisenmenger syndrome.
Mir Mohammad Taghi Mortazavi, Masoud Niazi, Naser Rezapour, Masoud Parish,
Volume 15, Issue 4 (1-2015)
Abstract
Background & objectives: Surgery of upper part of femor in elderly patients can be due to the fracture of femoral neck, shaft and arthroplasty. Hemodynamic changes and complications of the anesthesia are among the major concerns. The aim of this study was to compare the hemodynamic changes in low dose isoflurane with propofol in upper femoral surgeries in elderly patients.
Methods: This prospective clinical trial study was done on 60 patients over 65 year-old elderly patients with ASA physical status of I and II that were candidate for upper femoral surgery in two groups (inhalational: isoflurane 0.5-0.6 MAC) and (total intravenous anesthesia with propofol 50-100 mic/kg/min). Hemodynamic changes were compared in these groups with the same anesthetic depth (HR-SBP-DBP-MBP-SaO₂).
Results: There was no significant difference in heart rate, age or sex between two groups. In isoflurane group SBP on 20 and 25th minutes and DBP and MBP on 20, 25 and 35th minutes were significantly higher than propofol group. In propofol group SaO₂ was significantly more than isoflurane group on induction, start of surgery and on 5, 25, 35 and 45th minutes of surgery.
Conclusion: In anesthesia with the same Bi-Spectral Index, isoflurane provides more stable hemodynamic parameters than propofol.
Mehrab Hojjat, Parviz Amri, Shahnaz Barat, Ali Bijani, Valiollah Amri,
Volume 15, Issue 4 (1-2015)
Abstract
Background & objectives: This study was designed to compare the effect of general and spinal anesthesia on hemoglobin and hematocrit values in women following cesarean section.
Methods: This clinical trial study performed on 88 ASA class 1 pregnant women who were candidate for elective cesarean. Forty six patients received general anesthesia with isoflorane 0.75, N2O 50% and O2 and also 42 patients received spinal anesthesia with 12 mg of bupivacaine. The patients with a systemic disease or other causes of intraoperative excessive bleeding were excluded. All the operations were performed by same surgeon. Pre- and post-operative Hb and HCT values and Apgar score were recorded in both groups.
Results: Previous cesarean section history was the cause of surgery in 21 patients in group one and 22 patients in group two. Both groups were similar in age, weight, height and parity. The preoperative mean Hb or HCT values did not differ significantly between two groups. In both groups, postoperative mean Hb and HCT values were decreased significantly. Postoperative Hb and Hct reduction was significantly higher in general anesthesia group (p<0.05). There was no significant difference between two groups regarding Apgar score.
Conclusion: This study showed higher postoperative Hb and Hct reduction in general anesthesia than spinal anesthesia.
Saeideh Shakeri Hosseinabad, Gholamreza Shabanian, Sheida Shabanian , Mahmoud Rafiean , Souleiman Kheiri, Zahra Lorigooini, Koubra Masoodi,
Volume 17, Issue 3 (10-2017)
Abstract
Background & objectives: Pain is one of the most common post-operative complications of cesarean section, which is very important for mother in nursing a baby and breastfeeding. Finding ways to overcome this pain has always been a concern for researchers. Considering the application of plants in traditional medicine as sedatives, this study evaluated the effect of Dill seed oil on post-operative pain in patients with spinal anesthesia.
Methods: This double-blind, clinical trial was conducted on pregnant women who met the inclusion criteria and referred to Hajar hospital in Shahrekord, Iran during 2015-2016. By simple random sampling, the patients were divided into two groups. In the first group, 10 cc Dill (Anethum graveolens L.) seed oil was prescribed at intervals of half an hour and one hour before spinal anesthesia and half an hour , one hour and two hours after spinal anesthesia. In the second group, placebos (standard treatment) were prescribed at the same intervals. Pain and vital signs, including blood pressure, nausea , vomiting, heart rate, bleeding , use of narcotics and NSAID and any additional medications (such as atropine and ephedrine) were recorded and rechecked during surgery , thirty minutes after spinal anesthesia and one hour, four hours and twelve hours after cesarean section.
Results: The findings showed a significant difference between the two groups in the third stage of the study (4 hours after cesarean section) only in respiratory rate and in the fourth stage of the study (12 hours after cesarean section) in all vital signs (p<0.05). Also, the pain and nausea rate in the third and fourth stages of the study in the case group (Dill seed oil) were lower than those of the control group, indicating a significant difference in the pain level (p<0.05). The bleeding rate and use of NSAIDs and opioids twelve hours after caesarian section in the case group were significantly lower than those of the control group (p<0.05).
Conclusion: considering the effect of Dill (Anethum graveolens L.) seed oil on reducing pain, bleeding rate and use of narcotics and NSIADs, it can be used in women undergoing cesarean section.
Hamid Kayalha , Marzie Khezri , Shram Rastak , Habib Mehdi Pour , Mohammad Sofiabadi ,
Volume 18, Issue 3 (10-2018)
Abstract
Background & objectives: Electroconvulsive therapy (ECT) is the main therapeutic technique in psychiatric diseases. The use of anesthesia for ECT is necessary. In these patients, selection of anesthesia with minimal hemodynamic changes is very important. The aim of this study was to compare the hemodynamic effects of two anesthetics including sodium thiopental and propofol in patients undergoing ECT.
Methods: This study was performed on 84 patients (50 males and 34 females) who were anesthetized for ECT in 22- Bahaman Hospital, Qazvin University of Medical Sciences (QUMS). Initially, the hemodynamic status of patients was recorded. Then, they randomly received either sodium thiopental or propofol as an anesthetic and succinylcholine as a muscle relaxant. Hemodynamic changes, including systolic and diastolic blood pressure, pulse rate in the 1, 3 and 10 minutes after ECT, as well as seizure duration and recovery time were recorded. The data were analyzed by SPSS v.20 using independent t-test.
Results: the sodium thiopental group, showed the highest changes in systolic and diastolic blood pressure and heart rate in the third minute (45%, 64% and 26% respectively). In the propofol group, the highest systolic, diastolic and mean arterial blood pressure changes were 55%, 64% and 43% respectively, at the 10th minute, but the highest pulse rate (33%) occurred in the 3rd minute. The blood pressure changes were significant between the two groups (p<0.05). The post-shock seizure duration was less with sodium thiopental, but recovery from anesthesia was shorter with propofol (p<0.05).
Conclusion: Our findings showed that in the anesthetic required for electroshock, sodium thiopental had a slightly better hemodynamic stability than propofol. Therefore, it seems appropriate to use it as an anesthetic for ECT.
Mahzad Yousefian, Ali Mohammadian-Erdi, Afshan Sharghi, Mina Deldadeh Moghaddam,
Volume 24, Issue 2 (7-2024)
Abstract
Background: One of the major challenges in surgery is pain control after surgery. The present study was conducted with the aim of investigating the role of magnesium sulfate in improving the quality of anesthesia in patients who are candidates for appendectomy surgery.
Methods: In this clinical trial study, 42 people in the control group and 42 people in the intervention group were randomly included. For the intervention group, 50 mg/kg of magnesium sulfate was injected and for the control group, the same amount of distilled water was injected as a placebo. After surgery, the patients were examined for pain, nausea and vomiting, anxiety, blood pressure and heart rate, and the satisfaction of the surgeon in terms of muscle relaxation. Collected data were analyzed in SPSS-26 by statistical methods and p<0.05 was considered as significant level.
Results: The average pain of the patients in the first, third, sixth and twelfth hours of the study in the intervention group with 1.4, 2.66, 3.3 and 3.19 were significantly lower than the control group. In terms of relaxation, a significant difference was observed between the two groups in the first, third, sixth, twelfth and eighteenth hours of the study. In the examination of nausea and vomiting of patients, no significant difference was observed between the two groups. During surgery, a significant difference was observed in patients receiving magnesium sulfate compared to the control group in terms of surgeon satisfaction.
Conclusion: Magnesium sulfate was effective in controlling patients' pain and anxiety and surgeon's satisfaction during surgery, but it was not effective in controlling patients' nausea and vomiting.
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