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  Background & Objectives : Laryngoscopy and tracheal intubation may lead to tachycardia, hypertension and dysrhythmia or myocardial ischemia. In this double blind study, the effects of midazolam and lidocaine on hemodynamic response to endotracheal intubation have been examined.

  Methods : 52 ASA class one patients, aged 20-50, who were candidate for elective inguinal hernia surgery with general anesthesia, were randomly assigned to two groups. All patients received normal saline or Ringer's lactate solution (5ml/kg) about 5-10 minutes before induction of anesthesia and were preoxygenated for 3 minutes. Group 1 received midazolam (0.05 mg/kg) and group 2 received lidocaine (1.5 mg/kg) during 3 minutes prior to intubation. Anesthesia was induced with fentanyl (100 µ g) and thiopental (5 mg/kg) and trachea was intubated by the aid of succinyl choline (1.5 mg/kg). Anesthesia was maintained with halothane (0.5-0.75%) and equal proportions of nitrous oxide and oxygen. Systolic and diastolic blood pressure, mean arterial pressure (MAP) and heart rate were recorded before premedication and intubation, as well as immediately two and five minutes after intubation. The data were analyzed by SPSS software using paired t-test.

  Results : After intubation�Systolic and diastolic blood pressure, MAP and heart rate increased in both groups compared to the baseline values. The difference in increasing diastolic blood pressure and MAP between the two groups was significant (p<0.05), but the difference in increasing systolic blood pressure and heart rate between two groups was not statistically significant. The increase in diastolic blood pressure and MAP in group 1 was significantly more than group 2 (p<0.05).

  Conclusion : Clinically, midazolam was as much effective as lidocaine in controlling response to intubations. Consequently it can be used as an alternative lidocaine in intubations. It has also other priorities such as amnesia, anti-anxiety and anti-agitation.

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  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.

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  Background & Objectives: ECT is one of the most common methods in treatment of different types of psychological disorder. The effectiveness of this therapy has direct relation to the duration of convulsion. Knowing the rate of efficacy of anesthetic drugs over convulsion by ECT and preventing of hemodynamic complications are important. This study was conducted to compare effect of Propofol with Sodium Thiopental in the induction of anesthesia during ECT.

  Methods : The subjects of this randomized, controlled and trial study were 16 patents with psychotic disorders. These patients received Sodium Thiopental and Succinylcholine or Propofol and Succinylcholine during 72 sessions of ECT. Duration of subjective and objective convulsion and hemodynamic changes (HR and MAP) as well as side effects of anesthesia and ECT was recorded. The collected data were analyzed by SPSS.

  Results: Duration of subjective and objective convulsion was lower in Propofol taken group than Sodium Thiopental taken patients, but this difference was not statistically significant (p=0.32). The variation of hemodynamic parameter was lower among Propofol taken patients.We observed significant difference between two groups regarding to increase of arterial BP’ mean after taking drugs and immediately after ECT (p=0.04). There was not significant difference from view points of prevalence of respiratory, Hemodynamic complications, nausea, vomiting and restlessness between two groups.

  Conclusion: Duration of convulsion in induction of anesthesia in ECT with Propofol and Sodium Thiopental was not different.

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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 25^th minutes and DBP and MBP on 20, 25 and 35^th 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 45^th minutes of surgery.

Conclusion: In anesthesia with the same Bi-Spectral Index, isoflurane provides more stable hemodynamic parameters than propofol.

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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.