JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE
Year:2020 | Volume:42 | Issue:4 (108)|Papers Count:8

Introduction: Used for analgesic control during dilation surgery and curettage under general or local anesthesia or paracervical block. The aim of this study was to evaluate the analgesic effect of bupivacaine intrauterine injection in reducing pain after dilatation and curettage. Materials and Methods: In this case series case study, 35 women aged 18-50 years who were candidates for dilatation and elective curettage underwent general anesthesia with sedation. After completion of 25 cc bupivacaine surgery, 0. 25% intrauterine injection was inserted into the uterine cavity through a Foley catheter. Heart rate and blood pressure in the recovery unit and 1, 2, 3, 4 hours after surgery, pain intensity based on VAS, heart rate, paresthesia, pruritus and patients' satisfaction with analgesia were recorded. Results: Transient itching was observed in 3 patients (8. 57%) and transient paresthesia was observed in 2 patients (5. 7%). Nine patients required 100 mg diclofenac suppository. The mean pain score in the recovery unit was 0. 4 and 1 after 4 hours. Heart rate did not change significantly from baseline (p> 0. 05). However, mean arterial pressure increased significantly (p = 0. 001) at 3 h and decreased significantly at 4 h. (p = 0. 03) Conclusion: Intrauterine bupivacaine injection is an effective tool in controlling pain relief after dilation and curettage. However, it can be associated with side effects.

Introduction: The aim of this study was to compare the effect of adding neostigmine to ropivacaine and sufentanil to ropivacaine in spinal anesthesia for hernia surgery. Materials and Methods: In this double-blind clinical trial study, 105 patients who were candidates for herniorrhaphy in Valiasr Hospital in Arak were included in the study and were divided into three groups of 35 based on block randomization method. In all patients, we used 0. 5% ropivacaine 3 ml (15 mg) for spinal. In the first group, patients received 50 micrograms of neostigmine, in the second group, patients received 5 micrograms of sufentanil and in the third group, patients received 1 ml of intrathecal distilled water. Sensory-motor block and pain were recorded in recovery at 1, 2, 4, 6 and 12 hours after surgery and the amount of opiod used. Data were analyzed by SPSS 20 software. Results: At 105 and 120 minutes after the start of surgery in the sufentanil group, the heart rate was lower than in the neostigmine group (P = 0. 027). The placebo group was the smallest (P = 0. 0001). However, there was no statistically significant difference between the two groups of sufentanil and neostigmine in terms of time elapsed until the onset of sensory and motor block or duration of sensory and motor block (P> 0. 05). Except for recovery, the pain was higher in the placebo group than in the other two groups (P = 0. 0001). But no statistically significant difference was observed between the two groups of sufentanil and neostigmine (P <0. 05). The amount of opiod used was higher in the placebo group (P = 0. 0001). But there was no statistically significant difference in the amount of opioid used between the two groups (P <0. 05). Conclusion: In general, it can be concluded that in terms of the severity of sensory and motor block and the amount of postoperative pain and the need for postoperative opioid use in the two groups of sufentanil and neostigmine, no significant difference was observed in the doses used in our study. Both drugs can be used as adjuvants with ropivacaine in spinal anesthesia for hernia surgery, depending on the preferences of the anesthesiologist and the availability of either drug.

Introduction: Aim of this study was effectiveness of topical Tranexamic Acid for reducing bleeding in prostate surgeries. Materials and Methods: This study was clinical trials and double blind. A total of 93 patients who were candidate for prostate surgery were enrolled in Vali-Asr Hospital in Arak. Patients randomize with the envelope method divided into 3 groups. We treat patients with intravenous Tranexamic Acid in first group and we treat patients with oral Tranexamic Acid in second group and we treat patients with topical Tranexamic Acid in third group. We recorded heart rate, blood pressure, percent oxygen saturation, bleeding, surgeon satisfaction and hemoglobin level (before and 6 hours after surgery). Data was then analyzed by SPSS 20. Results: The lowest amount of bleeding was seen in intravenous Tranexamic acid group and the highest amount of bleeding was in topical Tranexamic acid group. Patients' hemoglobin levels before and 6 hours after surgery were not significantly different in the three groups. None of the patients needed blood transfusions. The highest surgeon's satisfaction was in the intravenous Tranexamic acid group and the lowest surgeon's satisfaction was in the topical Tranexamic acid group. Conclusion: Intravenous Tranexamic acid had better effect on bleeding control than other kind of Tranexamic acid. It did not cause cardiovascular complications in patients during surgery. On the other hand, it gave the surgeon satisfaction during surgery. Therefore, it is recommended to use intravenous tranexamic acid in patients undergoing prostate surgery to manage bleeding.

Introduction: Heart transplantation is the golden operation in which heart failure and disease are replaced by a healthier donated heart. Heart transplantation is chosen as a treatment option when medications or other surgeries and procedures have been performed but the heart condition has persisted and has not improved. Materials and Methods: The study conducted in 2016 in the field of research of Shahid Rajaei Medical Research and Training Center was approved. Part of the study was done historically and part was prospectively. The required information was recorded in a checklist that was prepared at all stages before, during and after the operation until the patient is discharged. After entering the information in Excel software, it was analyzed. Results: All anesthesia colleagues at the center were involved in heart transplantation. The surgeons of the center, except for four people, underwent surgery. The total number of heart transplant surgeries in the study period was 210 people. 134 were men (80. 63%) and the rest were women. The mean age of people under 15 years was nine years and the mean age of people over 15 years was 30 years for women and 28 years for men. The average extracorporeal pump time was 131 minutes. The average aortic clamp time was 83 minutes. Conclusion: It seems that several million people in Iran suffer from heart failure and about 25, 000 people are waiting for a heart transplant. About 200 transplants are performed annually in the country. In most patients, there are pulmonary, renal, and liver problems, and anesthesia should be performed with due regard to all aspects and considerations of patients with heart failure, including right and left heart. There are no restrictions on the choice of anesthesia method and the use of equipment for heart transplantation, and there are the necessary facilities to deal with complications during and after the operation and to manage patients in the intensive care unit and after that in the country and centers.

Introduction: Cesarean Section is one of the most popular surgery in the world. The aim of this study is determining of complications and popular complains after spinal anesthesia for cesarean section and reduce of them. Materials and methods: This study was descriptive, cross sectional study of 385 pregnant women who came to hospital for cesarean section and were selected by convenience sampling. Patients 24 hour after surgery were asked with a questionnaire about complications of spinal anesthesia and other complains that bother them. For statistical analysis Chi-square independent, T-test and unilateral analysis of variance were used. Result: Patients, complaints were as follows: back pain (73%), shivering (72/2%), rapid return of pain ((22/6%), muscle pain (14%), awareness during operation ((7. 8%), nausea and vomiting (3. 9%), head ache (3. 4%), sore throat (3. 1%) and itching (2. 6%). Conclusion: Back pain and shivering are major complaints of patients after cesarean section with spinal anesthesia. Investigate the factors affecting these two factors and eliminate them has a major role in increasing patient satisfaction.

Introduction: After the invasion of the Iraqi army in order to occupy parts of the territory of the Islamic Republic of Iran to the western and southern borders of the country, in addition to the armed forces, the Iranian people were mobilized to prevent the advance of the Ba'athist army. One of the units that dealt with the effects of the war from the very first days of the imposed war was the combat medical service in the Armed Forces. Materials and Methods: Action, practice and management in different organizations can be classical, academic or innovative. Combat medicine in warfare with classical management and measures could not meet the enormous needs of the imposed war. In the methods of action, command and management of combat medicine in the holy defense, innovative, jihadi methods have been used. In this research, the management and command practices and the performance of combat medicine in the holy defense are discussed. The research method is a combination of library study, field research in the form of oral interviews and the use of diaries that have been written when actions are taken. Findings: While performing its duty of comprehensive care for the sick, wounded and injured, on the one hand, combat health care was able to maintain the various health dimensions required by the holy defense by holding a series of scientific meetings, meetings, seminars and conferences in different categories. Update the scientific and medical requirements of the war by doing a great deal of work. Reduce the time for transporting the wounded to the field hospital to less than an hour, and provide for the lack of manpower on the fronts by developing and implementing training courses required by the fronts. To work hard to develop the sectors and meet the needs of the health sector. Conclusion: What was done in the holy defense in combat medicine showed extraordinary and impressive methods and behaviors. A great thing that would not have been possible without a hard work. Combat medicine in the sacred defense was able to wisely compensate for the scientific deficit of medical knowledge that was not taught in medical schools.

introduction and objective: Distance education is a blessing in the service of humanity when physical presence through the spread and transmission of Corona virus-2019 endangers the life of individuals. Distance education reduces the anxiety and phobia of Corona virus-2019 disease the purpose of the present study was to investigate the The Effectiveness of Distance Learning English Based on Corona Virus Prevention Training Package on Reduction of phobia and Anxiety of COVID-19 (Corona Virus-2019) Language learners. Materials and Methods: The present study was an semi empirical design with a pre-test and post-test design. The statistical population of this study included patients including distance education language learners in Ardebil province who were selected by Convenient sampling method in 30 subjects (in two groups of 15 experimental and control group). The instrument used in this study was the Coron Anxiety Scale (CDAS) and the Phobia Corona Researcher-made Scale. Data were analyzed using covariance analysis. Results: The results of statistical analysis showed that the educational package designed to reduce corona virus anxiety (F = 3. 003 P <0. 005) and phobia of coronavirus disease (F = 5. 38 P <0. 005). Conclusion: One of the ways that can be used to reduce the prevalence of corona virus (phobia and anxiety) disease at this time is to use a combination of theories to raise awareness of the virus and correct defective thinking.

Postpartum headache is a common symptom that could be very debilitating for the mother who has just taken the responsibility of her newborn care. This complaint is often due to a primary headache process and despite what the majority of patients believe, almost always it is not the spinal or epidural anesthesia consequence. It is of most importance to approach to postpartum headache with a holistic concept, considering the most critical and the most common diagnoses at first. Therefore, it is crucial to check vital signs (especially, blood pressure and level of consciousness) and proper physical examination and taking complete medical history while emphasizing on past headaches history (like migraine), hypertension, eclampsia, preeclampsia, fever, and respiratory disturbances (considering COVID pandemic which fever and headache are common symptoms), nuchal rigidity, fever, and photophobia (considering meningitis). The neurologic examination focused on cranial nerves (especially the 6 th and 7 th which are more susceptible to damage in CSF pressure changes) and sensory and motor functions of the limbs. If a red flag symptom or sign is detected, it is strongly recommended to keep the patient under observation while requesting for additional paraclinical (like brain imaging) and neurologic consultation. The diagnosis of post-dural puncture headache is made based on the exclusion of other diagnoses and is always referred to as an anesthesiologist. The aim of this paper is to know the differential diagnoses of post-partum headache and treatment options, and also to give a guide through PDPH management for the anesthesiologists.