JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE
Year:2019 | Volume:41 | Issue:1 (105)|Papers Count:7

Background: During and after cardiac surgery, bleeding occurs that resulting postoperative anemia. If patients have anemia before operation, the rate of blood transfusions increase that make several complications. Materials and methods: In this study, patients entered to the operating room prior to the anesthesia induction an arterial catheter was placed and hemoglobin and hematocrit level was detected. so anemia level is determined as: Hb less than 8 g/dl: Severe anemia; Hb between 8 to 10 g/dl: moderate anemia and Hb 10-12( for women) and 10-13 (for men): Mild anemia; and according to hematocrit, less than 45% for men and less 37% for women include anemia. The study also looked at the age, sex, and weight of patients and for the association of anemia with the above mentioned variables. Also, during surgery amount of blood transfusion to the patients was evaluated. The need for transfusion was evaluated according to Hb level. Result: In this study, 526 patients were studied in one year period. The mean hemoglobin level of patients was 13. 1 g/dl and the mean hematocrit was 39. 3%. In this study, 30. 2% of patients were anemic. According to the anemia classification, 62. 9% of anemic patients had Mild anemia, 36. 4% moderate anemia and0. 5% severe anemia. Of 526 patients, 342(60. 9%) did not need to receive packed red blood cells (PC). In this study, of 220 patients were received PC due to surgical bleeding. Of this group 114 patients have normal hemoglobin and 106 patient were anemic. Conclusion: Patients with anemia needed to receive more blood, as well as female patients, older patients, patients with a lower BMI, patients with longer duration of operation, needed to receive more blood. According to the studies, blood transfusion is associated with side effects and increases the length of hospital stay and hospital costs. Therefore, performing diagnostic evaluation and therapeutic before elective surgery can reduce the need for transfusion and thereby reducing the complications that leads to reduce the length of stay in the hospital and reduce costs and more studies are needed in this field.

Introduction: Pulmonary edema is the main reason behind the pregnancy of a pregnant mother in the intensive care unit and the timely diagnosis of these harmful effects on the mother and the fetus, we decided to study the present study with the aim of Determine the frequency, Predisposing Factors and Outcome of Acute Pulmonary Edema in Pregnant Women Referred to Hospitals in Tabriz: 13921393. Materials and Methods: This study was a cohort study in which 22, 250 patients were evaluated in Tabriz Educational Centers in May 1392 in Tabriz. A total of 2750 patients were selected based on a checklist of the researcher-made checklist. Data were analyzed by ANOVA for quantitative variables and chi-square test for qualitative variables. Results: The prevalence of acute pulmonary edema in high-risk pregnancies is 1. 2% and in the total population of pregnant women is 0. 15%. The most common causes of acute pulmonary edema in pregnancy are preeclampsia (52. 9-18%), heart disease (26. 5%-9) and infection (23. 5%-8). In terms of neonatal outcomes, the weight of newborns in the acute lung group was lower and the Apgar score of 1 minute and 5 minutes was lower, and IUGR in the acute pulmonary edema group was 1. 9 times more than the control group (RR=1. 9; 95%CI[1. 1-3. 5]) and cases of fetal death in the group of lung edema, 2. 5 times the control group ( RR=2. 5; 95%CI[1. 1-5. 9]). Conclusion: Knowledge of the underlying factors and the implications of acute pulmonary edema in pregnancy can lead to their timely diagnosis in suspected women and, finally, a reduction in the costs incurred on the health of the community can be seen.

Background and Aim: Oxycodone is a μ-opioid receptor agonist and is generally indicated for the relief of moderate to severe pain. The aim of this study was to compare the analgesic efficacy of oral oxycodone and intravenous ketorolac for postoperative pain in patients undergoing laparoscopic cholecystectomy. Materials and methods: In this double blinded study 60 patients underwent laparoscopic cholecystectomy classified into 2 groups Ketorolac (n=30) and Oxycodone (n=30) randomly. Anesthesia induction and intubation was the same in both groups. Postoperative pain, blood pressure and heart rate was measured 1, 2, 4, 6 and 12 hours after surgery in both groups. Post-operative nausea and vomiting and shivering also was compared between two groups. Results: there was no significant differences between two groups considering age, gender and ASA class. Also, no significant difference between two groups comparing systolic and diastolic blood pressure and heart rate in mentioned hours (P>0. 05). Mean NRS was significantly lower in Oxycodone in compare with Ketorolac group, except in sixth hour (p<0. 05). Need for morphine consumption in ketorolac group was meaningfully higher than the other group (p<0. 001). Incidence of postoperative nausea and vomiting was a little higher in oxycodone group. Conclusion: oral oxycodone is a good choice in controlling postoperative pain considering efficacy, easily consumption and low incidence of adverse effect.

Background: The role of the non-technical skills in reducing undesired errors is significant and there are a few methods that improve the effectiveness of CPR's non-technical skills. The aim of this study was to determine the effect of Seven-Stage Response Plan of cardiopulmonary resuscitation (SSRP-CPR) on non-technical skills of nursing and anesthesiology students. Material and methods: The current quasi-experimental study included forty-two undergraduate nursing and anesthesiology students that divided in stratified sampling and random allocation into the experimental (SSRP-CPR) and traditional groups. All participants completed a course of CPR technical skills, and then participated in a 4-hour workshop. The trainings included routine method of CPR and Seven-Stage Response Plan in traditional and experimental groups, respectively. Data were collected by using the Team Emergency Assessment Measure (TEAM) Tool and were analyzed by SPSS 20. Results: The mean total scores of team's performance in SSRP-CPR group (35. 08± 9. 63) were significant and higher than the traditional group (23. 46± 5. 68), (p<0. 002). Furthermore, the mean score of non-technical skills categories including leadership (p

Introduction: Awareness during anesthesia is a side effect associated with general anesthesia and refers to a condition in which brain awakens by a stimulus during a period of general anesthesia. The experiences are stored in explicit memory and patient might recall a few things after recovering from anesthesia. The experiences are sometimes in the form of pain perception, but the patient is not able to show a reaction due to the administration of muscle relaxants, the feeling of weakness and helplessness caused by intraoperative awareness might cause some patients to develop lasting and significant psychological issues. Given the importance of monitoring and maintaining the depth of anesthesia, this study aimed to determine the incidence of awareness and recall during general anesthesia. Materials and methods: A total of 400 patients who were referred to Besat Hospital and underwent various surgical procedures in 2016 were involved in this study. Data collection was performed using a questionnaire previously utilized by other researchers to study the same topic. Patients were visited 24 to 36 hours after recovery and interviewed about their experiences before, after and during operation. The data collected from each patient were then recorded in the patients questionnaire form. Results: data were obtained from patients indicates that out of 400 patients, 249 patients were men (62. 3%) and 151 patients were women (37. 7%). In order to induce, propofol was used in 71. 8%, thiopental sodium in 27. 3% and ketamine in 0. 9% of patients. Benzodiazepines were used as preanesthetic agents in 87. 8% of cases. Ten patients (2. 5%) had pointed to issues that suggested consciousness during anesthesia. The only significant connection in this study was found to be the lack of use of benzodiazepines and awakening during anesthesia. Conclusion: Given the increased risk of awakening during anesthesia without use of benzodiazepines as preanesthetic drugs, we suggest administration of these agents as far as possible in general anesthetics. Also, our findings indicate that the prevalence of consciousness during anesthesia is higher in our country compared to other countries.

Wegener's granulomatosis is a systemic autoimmune vasculitis that is associated with vascular involvement and can affect any organ. The most important organs of involvement are kidneys, upper and lower respiratory tract. Because Wagner is a rare and dangerous disease, it can lead to death if not treated at the right time with medication and sometimes surgery with special anesthesia considerations. We report a 17-year-old female patient with Wegener's granulomatosis who scheduled thoracotomy surgery under general anesthesia with a diagnosis of bronchopulmonary fistula.