Journal of Anesthesiology and Pain
Year:2012 | Volume:2 | Issue:8|Papers Count:7

Aim and Background: hypothermia is a common complication in surgeries patients and may have serious consequences in both mother and fetal in cesarean surgery. This study was implemented to assess the effect of intravenous (IV) infusion of warm fluids on decreasing hypothermia in mothers and its consequences on newborns.Methods and Materials: This randomized controlled clinical trial was done on 70 candidates of elective caesarean surgery. First group received IV infusion of 38oC fluids, second group got IV infusion of room temperature fluids. Mother's core temperature, during the surgery and after the surgery, systolic blood pressure, pulse rate, postoperative shivering and APGAR of newborns were assessed.Findings: The administration of warmed fluids prevented shivering (p<0.01) and hypothermia 30 minutes postoperatively and 1 hour after in the recovery (p<0.01). There were no significant differences in other variables.Conclusions: Infusion of warmed IV fluids can decrease hypothermia and its complications namely shivering in cesarean section.

Aim and Background: Bleeding during functional endoscopic sinus surgery (FESS) remains a challenge for both surgeons and anesthesiologists despite several modalities available for improving the surgical field. This study was conducted to evaluate the effect of oral clonidine premedication on blood loss and the quality of the surgical field in FESS.Methods and Materials: In a placebo-controlled clinical trial, a total of 84 American Society of Anesthesiologists (ASA) physical status I–II patients undergoing endoscopic sinus surgery for chronic sinusitis were randomly allocated to receive either oral clonidine 0.2 mg or identical looking placebo tablets 90 min before arrival at the operating room.Findings: Blood loss in the clonidine group was 214±67 ml on average and that in the placebo group was 276±78 ml (mean±SD, p\0.01). The median (range) bleeding score in the clonidine group was significantly lower than that in the placebo group (2 (1–3) vs.2.5 (2–4), p<0.0001).Accordingly, the surgeon was more satisfied with the surgical field in the clonidine group than with that in the placebo group (median score, 4 (3–5) vs.3 (1–5), p<0.001).Conclusions: Premedication with oral clonidine 0.2 mg can effectively reduce bleeding during FESS.

Aim and Background: Stress of surgery transfers some neurological and hormonal signals which triggers some physiological responses like adrenergic stimulation, increase in noradrenalin, cortisol, growth factor, decrease in insulin and increase in insulin resistance resulting in hyperglycemia during surgery. In this study a comparison is done between general anesthesia which by blocking brain's signals decreases reactions to the stress of surgery and hyperglycemia, and spinal analgesia which blocks hormonal and adrenergic reactions by peripheral effect.Methods and Materials: This randomized control clinical trial study was performed on 60 ASA I, II patients candidate of inguinal hernioraphy. The patients were randomly allocated to general anesthesia or spinal anesthesia with T12 level. Blood sugar of the patients was measured by glucometer 1 hour before the surgery and 1 hour and 6 hours postoperatively.Findings: There was no significant difference in blood sugar levels before the surgery between two groups but it was lower 1and 6 hours postoperatively in spinal anesthesia group.Conclusions: Spinal analgesia more effectively controls rises in blood sugar during the surgery and may be a suitable alternative for general anesthesia in patients with metabolic disorders.

Aim and Background: Long exposure to inhalant anesthetic gases especially halothane, among the known hepatotoxic agents, is a serious health risk for the staff of operating room. Current study was performed to compare the level of hepatic enzymes between Operating's room staff and other therapeutic wards’ personnel out of the operating room.Methods and Materials: A total of 100 personnel from educational hospitals were included and their demographic and occupational information were recorded. Hepatic function tests and bilirubin were analyzed. In cases with values more than normal, in order to rule out hepatitis B and C, Hbs-Ag, Hbs-Ab and HCV-Ab were tested.Findings: Demographic information and employment span were comparable in two groups. The average of ALT, AST were significantly higher among operating room's staff in comparison with the other group (P<0.05) and there was no significant difference between the average of GGT and ALP between two groups (P>0.05). ALT, AST and GGT indicated significantly increase with the age of personnel (more than 40 years) and increase in employment period (more than 15 years).Conclusions: The operating room's staff in educational hospitals of Ardabil may be exposed to hepatotoxic agents that caused significant rise in hepatic enzymes.

Aim and Background: Postoperative pain is a frequent complication in young children undergoing general anaesthesi. Sevoflurane anaesthesia in children has been related with higher incidence of postoperative emergence delirium in comparison with halothane, which some blame the pain as it's main reason. The current study was designed to compare the effect of caudal block versus Apotel adminstraion on postoperative pain in pediatrics undergoing inguinal herniorrhaphy under sevoflurane anaesthesia.Methods and Materials: In this clinical trial, 60 children aged 2-8 years who were candidate for elective inguinal herniorrhaphy were included. After maintenance with sevoflurane, the patients were randomly allocated to receive caudal anesthesia or intravenous Apotel 15 mg.kg-1. After extubation, patient's pain scores were assessed with Children's Hospital of Eastern Ontario Scale (CHEOPS). Fentanyl was administered in cases suffered from acute pain with CHEOPS≥10.Findings: Postoperative pain in caudal block group was significantly lower than in Apotel group (CHEOPS=7.2 vs 8, p=0.017) and opioid was administered much more in Apotel group (p=0.003).Conclusions: Caudal block in comparison with Apotel is more effective in postoperative pain reduction and is associated with less need for opioids.

Aim and Background: Optimal postoperative pain management is necessary after minor general surgery. Although pregabalin had been showed efficacy against neuropathic pain, very limited evidence support its postoperative analgesic efficacy. The aim of this study was to evaluate the analgesic efficacy of premedication with single oral dose of pregabalin for minor general surgery.Methods and Materials: Sixty patients candidate for minor general surgery under general anesthesia were randomly allocated into the two groups, In intervention group Pregabalin 150 mg, and in control group placebo was administered one hour before surgery. Anesthesia method was similar in both groups. If pain score (Visual Analogue Scale, VAS) was more than three, pethidine 25mg intravenous was administrated. VAS, opioid consumption, and side effects were recorded for 24 hours after surgery.Findings: Demographic data was not significantly different between two groups. VAS and opioid consumption during the 24 hours postoperative period in pregabalin group was significantly less than the placebo group without any more side effects (p<0.01).Conclusions: Preoperative administration of single oral dose of pregabalin 150 mg reduced post operative pain and opioid consumption for 24 hours following minor general surgery.