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  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 1^st, 5^th, 10^th and 15^th 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 1^st minute Propofol was 7.1 ± 2.2 and Thiopental was 74 ± 1.8, in the 5^th 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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 Background & Objectives: One of the most common ways in intubation without muscle relaxant is using propofol and remifentanil. The common practice is injection of remifentanil and then propofol. This occasionally produces severe hemodynamic changes. The aim of this study is to inject propofol followed by remifentanil for evaluating the effect of the order of injection on decreasing these complications.

 Methods: 40 patients with American Society of Anesthesia (ASA) class I-II, who underwent minor elective surgery with airway mallampati class I-II entered the study. Patients were randomized into 2 groups each with 20 patients. The first group received 2.5mg/kg propofol followed by 1.5 g/mg remifentanil while the second group received 1.5 g/mg remifentanil followed by 2.5 mg/kg propofol. Laryngoscopy and hemodynamic changes were compared in two groups.

 Resutls: There was no difference between two groups in laryngoscopy attempts (P=0.145) but the frequency of easy laryngoscopy in the first group (85%) was more than the second group (60%) (P=0.031). Systolic blood pressure changes after laryngoscopy in the first group (20 7.7 mmHg) was less than the second group (28 6.7 mmHg) (P=0.001). There was no statistical significant difference between two groups in diastolic blood pressure and heart rate changes (P=0.88, P=0.86 respectively).

 Conclusion: Administrations of propofol before remifentanil during anesthesia induction produces acceptable hemodynamic changes in patients.

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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.