JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE
Year:2020 | Volume:43 | Issue:2 (110)|Papers Count:7

Background: Childbirth pain and the resulting anxiety and fear are among the most challenging issues in women's life. Combined spinal-epidural analgesia (CSE A) is one of the most popular methods of labor pain relief. However, few studies have compared the effect of CSE A on labor with non-pharmacological or no analgesia methods. Objective: The aim of this study was to determine the differences between nulliparous women who received CSE A and nulliparous women who received no analgesia in terms of labor and delivery. Materials and Methods: This observational retrospective study was conducted by surveying patient records related to natural delivery of term nulliparous women between March 20, 2016 and March 19, 2018. Overall, 320 cases were eligible for inclusion in the study. All records of singleton term nulliparous women with ASA I and II who were candidates for low-risk natural delivery were selected, of which 220 cases were related to deliveries without analgesia and 100 cases were related to deliveries with CSE A. Specific variables including duration of stage I of active phase of labor, duration of stage II of active phase of labor, use of assistive devices during delivery, resuscitation of newborns using mask and ambo bag, Apgar score of newborns at 1 and 5 minutes after birth, and use of oxytocin were studied in the two groups. Results: In this study, the demographic characteristics showed acceptable homogeneity of the two groups. In the study of specific variables, it was found that CSE A did not increase the duration of stage I of active phase of labor, while it did slightly prolong the duration of stage II of active phase of labor. CSE analgesia increased the rate of use of assisted labor, while it did not increase the rate of resuscitation of newborns. In addition, CSE analgesia had not decreased the Apgar score of newborns in the first and fifth minutes. It was also found that in the CSE A group, the rate of labor induction by oxytocin infusion was higher. Conclusion: CSE A has no harmful effects on labor or neonate, and despite a slight increase in the duration of stage II of labor and rate of use of assistive devices, it can be chosen as a safe method in labor analgesia if the current scientific principles are followed.

Background and objectives: Reducing postoperative pain, especially in non-pharmacological ways, is always a medical challenge. For this purpose, the aim of this study was to Study of the Effect of Deka-Titan Bracelets on the Control of Pain in Patients after Inguinal Hernia Surgery. Materials and Methods: In this clinical trial, 60 patients undergoing inguinal hernia surgery in Shahid Bahonar Hospital in Kerman in 2018, in two intervention and control groups, were studied. After educating the patients to evaluate their pain using Visual Analouge Scale (VAS), for the intervention group, Deka-Titan bracelet with signal transmission system from both sides of the spinal cord to the bracelet was used by two skin electrodes. For both groups, pethidine was used as an analgesic at the time of pain intensity. Pain was measured before surgery, postoperatively, 2 hours, 6 hours, 12 hours and 24 hours postoperatively. Data were analyzed using independent t-test. Findings: The difference in pain scores between the intervention and control groups in 2nd hours (p = 0. 242), 6th hours (p = 0. 453), 12th hours (p = 0. 387) and 24th hours after surgery (p = 0. 533) Was not significant. Also, the amount of analgesia received between the two groups after surgery was not significantly different (p >0. 05). Conclusion: The use of Deka-Titan bracelet had no effect on reducing pain after inguinal hernia surgery.

Kidney damage is a major global health problem that is caused by a variety of causes, such as ischemiareperfusion, cardiovascular surgery, and radiotherapy. Studies of patients with acute and chronic renal impairment have shown that oxygen balance is disturbed in these patients. As a result, these kidney tissue interactions will be fibrotic and irreversible. Thus, the focus on targeted oxidation of kidney tissue to treat or reduce kidney damage has been on the agenda of many medical teams.

Introduction: Orthopedic surgeries are associated with a high bleeding and need for blood transfusions. Tranexamic acid is a drug used to reduce bleeding during surgery. The aim of this study was to evaluate the effect of tranexamic acid on bleeding caused by femoral fracture surgery. Materials and Methods: In this clinical trial study, 90 patients with femoral fractures who underwent open surgery were studied. Demographic variables such as age and sex and clinical variables such as hemoglobin and bleeding before and after surgery were recorded in patients. Results: In terms of hemoglobin changes, in the control group who did not have intraoperative blood transfusions, hemoglobin decreased by 1± 68. 34 mg / dL before and after surgery and in the case group, this amount decreased by0± 91. 31 mg / dL. This difference between case and control groups was statistically significant (p <0. 001). Preoperative and postoperative hemoglobin in patients without intraoperative blood transfusion was 12± 2. 91 and 10± 8. 89mg / dL, respectively (p <0. 001) and in patients with intraoperative blood transfusion were 11± 37. 59 and 9± 83. 63 mg / dL, respectively (p <0. 001). The amount of bleeding during surgery in the control and case groups was 513. 12± 78. 74and 325. 11± 68. 08 (p <0. 001), respectively, and the amount of bleeding in 6 hours after surgery in the control and case groups were ml, respectively. It was 36. 9± 22. 6 and 22. 89± 8. 95(p <0. 001). Mean bleeding during 6 hours after surgery between case and control groups in different age groups and between the sexes was assessed. The difference between case and control groups was significant in terms of different age groups and between the two sexes. Conclusion: According to this study, tranexamic acid has beneficial effects in reducing bleeding and reducing the rate of intraoperative blood transfusion in patients undergoing femoral fracture surgery.

Introduction: The benefits of reducing anxiety before the operation and effect of this reduction in recovery better, faster recovery, reduced consumption of drugs during anesthesia, better pain tolerance issue has been fixed. Lavender is a medicinal plant, that mentioned a herbal anti-anxiety effect in a number of reference books. The aim of this study was to examine the anxiolytic effect of Elettaria Cardamomum is compared with diazepam. Materials and Methods: This randomized clinical trial, was performed patients 15-60 years undergoing orthopedic surgery at Imam Ali Hospital. Patients were randomly divided into two groups, Group A: 10 got of Elettaria Cardamomum, the second group received 5 mg diazepam. All patients received lavender, diazepam on the night before surgery. Patients anxiety were examined with tools Spielberger the night before surgery and one hour before surgery. Results: Based on the results of variance analysis with repeated measures, there is no significant difference between the two groups in terms of total anxiety score in the post-intervention phase. Conclusion: Elettaria Cardamomum as a prodrug for the treatment of anxiety before surgery is effective as diazepam. However, due to less adverse effects and benefits of lavender extract from the plant to the medication diazepam can be used as a way to reduce anxiety before surgery did better.

With the introduction of the COVID 19 in China, major changes have taken place in patients management. General recommendations for minimum surgeries became widespread only in emergencies. Various centers reported bitter experiences of patient’ s complications and changes in outcome. Among these, two groups of patients require surgery despite the risks of COVID 19, cancer patients and patients requiring emergency surgery. In this study, we report our experience of surgery in these two groups of patients who underwent surgery at the COVID 19 outbreak.