JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE
Year:2016 | Volume:38 | Issue:3 (95) |Papers Count:11

Introduction: Despite significant advances in medicine and survival rates of premature infants, the infants also suffer from neurological disability and abnormal growth. Based on theories, supportive care of premature infants on growth and development and function of neural-behavioral therapy was effective and provided by certain types of stimuli. This study aimed to investigate the effect of mother's voice on physiological responses in premature infants.Materials and methods: In this clinical trial in 1392, and to double blind rest, 240 premature infants hospitalized in neonatal intensive care teaching hospital of Mashhad, randomly three simple in one of three intervention groups I (mother's voice) and the second intervention (female voice of strangers) and will be the control group.50 dB with a loud voice, in the evening shift and for 20 minutes using the phone for babies, was two groups will play and record physiological responses. Collected data using SPSS 19 statistical software will be calculated.Results: In this study, infants with gestational age 36-30 weeks. Boys are born with less weight. Weight inclusion in boys is more than the girls in the control group opposed to this. Apgar score at birth do not differ in terms of male and female infants. Physiological responses between males and females has decreased after the intervention.Conclusions: The results of this study showed that both the mother's voice sounds strange woman and physiological responses of preterm infants who have a positive impact (P<0.05) and this effect is more mother's voice.

Introduction: Failure of extubation means to need to provide ventilatory support during 24-48 hours after endotracheal tube extubation and several studies have been conducted about it.Materials and methods: This study was performed on mechanically ventilated patients who admitted to intensive care unit of Urmia Emam Khomeini hospital during March 2014 -March 2015. Demographic charachtristics (age, sex), duration of mechanical ventilation, duration of endotracheal intubation, ICU and hospital stay, failure of extubation, endotracheal reintubation and mortality rates obtained from patients medical records and collected in data sheets, and assessed by means of SPSS ver.20 at the end of study.Results: Data related to 580 patients were enrolled in this study. Almost 53 percent of patients were male. Among patients who were studied, 72.8% of them had been discharged and 27.2% hadbeen dead. In present study, the frequency of extubation failure was 11.7%. The outcome measures that were studied, were statistically significant between two groups of patients (with and without failure of extubation) (p<0.05).Conclusion: In our study, the rate of extubation failure and related outcomes were in acceptable range.

Background: An open eye is the main cause of eye injury in general anesthesia. In addition eye care and anesthesia duration affect the extent of injury. Eye complication may be depend on type of tracheal intubation (intranasal US. Intra oral).Materials and methods: In this descriptive cohort study, 600 candidate of dental rehabilitation under general anesthesia were included. In cadence of eye complications, after recovery and two days after anesthesia. In addition to number of patients with open eyes were registered.Data were analyzed statistically.Results: 13 % of eyes was found to be open at the end of anesthesia. Eye injury symptoms were observed in 4.8 % of samples after recovery in with redness and soreness was mainly found. Two days after anesthesia 1.58 % eyes revealed symptoms. Increased anesthesia duration was associated with more eye complications.Discussion and conclusion: In this study, 13% of eyes was open after anesthesia. And 0.38 % revealed complications.An appropriate approach for eye care is applying eye ointment and fixation of tracheal tube with sponge pad and tape.

Introduction: Sore throat after surgery is an unpleasant complication in patients after general anesthesia with tracheal intubation. The incidence of this complication is 21-65%. Althadin tablets which are available in 700 mg tablets for sucking, are made of Althea officinalis, Glycyrhizzaglabra and Menthapiperita and have anti-inflammatory activity. The effect of Althadin has not yet been studied on sore throat after tracheal intubation. So, we decided to study the preemptive effect of single dose Althadin on sore throat after tracheal intubation.Materials and methods: We divided 70 patients who were supposed to undergo urologic surgeries, with general anesthesia and tracheal intubation, into two groups with 35 patients in eachbased on determining the sample size with convenience sampling method. After ethics committee confirmation and getting informed consents for using Althadin tablets to control sore throat after surgery, NRS scales were explained to the patients, and then they were divided into two random groups of case and control. In case group, one Althadin tablet were given to the patients, while no Althadin were given tothe control group. After the patients wake up, severity of sorethroat was scaled in recovery room and also after 2, 6, and 24 hours after the surgery, by NRS scale and by a medical student who was unaware of the groups.Results: The results show that, although the mean of sore throat severity in the second, sixth and twenty fourth hours after surgery were lower in patients who had received single doseAlthadin, this difference was not significant. No side-effects of althadin were reported.Conclusion: Single dose Althadin before urologic surgeries with general anesthesia, had no effects in reducing sore throat after tracheal intubation.

Introduction: Spine surgery is one of the most common major surgeries for patients with spine disorders. Postoperative pain after major spine surgery is moderate to severe. The aim of this study is to compare duration of analgesia with bupivacaine and intravenous paracetamol alone and in combination in patients undergoing major surgery of the spine after surgery.Methods: In this double blinded randomized clinical trial, 150 patients with elective spine surgery were divided randomly into three groups (n=50). Paracetamol group: Intravenous infusion of 15 mg / kg paracetamol 20 minutes before the end of surgery and normal saline as placebo poured by the surgeon on extradural, bupivacaine group: bupivacaine 0.125% 10 ml poured by the surgeon on extradural and intravenous infusion of 100 ml normal saline 20 minutes before the end of surgery and paracetamol plus bupivacaine group: bupivacaine 0.125% 10 ml poured by the surgeon on extradural and intravenous infusion of 15 mg / kg paracetamol 20 minutes before the end of surgery. Hemodynamic parameters, pain scores immediately after surgery, 30 and 180 minutes after surgery, duration of analgesia, the incidence of side effects (nausea, vomiting, itching), opioid consumption and the first time of analgesic request were recorded.Results: Systolic, diastolic, mean arterial pressure, heart rate and pain score showed no significant changes at the designated time points between three groups (p>0.05). No Side effects were reported in any of the patients.Conclusion: It seems that intravenous infusion of15 mg / kg paracetamol with bupivacaine 0.125% 10 ml poured by surgeon on extradural area, in major spine surgery lead to increase of hemodynamic stability, prolonged duration of analgesia and reduction of side effects related to opioids.

Introduction: Concerning the lack of Anesthesiology rotation for medical students in their clinical education, their knowledge and insight about this specialty is limited. In this study we tried to evaluate the insight of medical students about Anesthesiology.Materials methods: Medical students in the last two years of their education of six universities in Iran were asked to fill the questionnaire about their objective insight about Anesthesiology and asked them about the main factors for potential postgraduate study in Anesthesiology.Results: One hundred and eighty two questionnaires returned to researchers. Analysis showed the lack of insight among medical students about Anesthesiology. The most important factor for potential post graduate study of Anesthesiology was financial ones.Discussion: Medical students are not familiar with Anesthesiology. They have no insight about the abilities of anesthesiologists and their fields of responsibility. Rotations in during clinical education would potentiate their abilities and improve their insight about this specialty.

Introduction: Nausea and vomiting are common in patients after minor gynecological surgeries.This study was performed to assess prophylactic effects of Deroperidol, Dexamethasone and metoclopramide on nausea and vomiting after hysteroscopy surgery.Materials and methods: 120 patients ASA 1, 2 undergoing diagnostic hysteroscopy were randomly allocated in 4 groups: group 1 received deroperidol 1.25 mg / IV, group 2 received dexamethasone 8 mg /IV, group 3 received metoclopramide 10mg/IV and group 4 received normal saline immediately after induction of Anesthesia. Frequency of nausea and vomiting and rescue treatments were recorded in PACU and 24 hours after surgery. Recovery Steward scores were assessed at 15 and 30 minutes in PACU.Results: Demographic parameters of patients in trial groups were similar. Frequency of nausea and vomiting in deroperidol was significantly lower than the other groups (p=0.000) However, incidence of nausea was the same among groups. The number of patients who required rescue treatment at PACU was less in deroperidol group than other groups.(p=0.03).The mean number of nausea and vomiting per patient in 24 hours was 1.2, 1.46, 1.66 and 1.71 for group 1, 2, 3 and 4.The steward recovery scores of groups were similar in 30 minutes at PACU. However, in 15 minutes in group 1 was lower than group 3, 4 but not different from group 2.Conclusion: Over all, prophylactic administration of deroperidol, dexamethasone and metoclopramide decrease PONV but deroperidol is the most effective agent.

Background: One of the most common and unpleasant side effects of surgery and anesthesia are nausea and vomiting, which causes spasms, aspiration and demand for drugs. The researchers suggest several drugs and methods to be able to reduce its complications.Objective: Compare adequate intraoperative fluid therapy with Ondansetron on the incidence and severity of nausea and vomiting after general surgery Methods: In this double blind clinical trial, 120 patients undergoing general surgery participated.Patients were randomly divided into 3 groups. Group 1- adequate intraoperative fluid therapy-, Group two- pharmacological intervention with Ondansetron 0.06 mg per kg of body weight - and group three - without prophylactic intervention-. the severity and incidence of nausea and vomiting evaluating Based on self-reporting scale in three stages - After surgery, 2 and 6 hours after surgery-. the data were analyzed with Spss software.Results: The results showed that the three groups were similar in terms of intervening variables..According one-way ANOVA, severity and incidence of nausea and vomiting were significantly different among the three groups in the recovery phase.Conclusion: Adequate fluid therapy can reduce the incidence of nausea and vomiting after surgery.

Introduction: We present a case of anesthesia complication during percutaneous nephrolithotomy which ended in mortality.Case report: A 16 years old man, during percutaneous nephrolithotomy deteriorated with hypotension, hypoxia, bradyarythmia and then ventricular fibrilation and cardiovascular arrest occurred.Unwanted changing bag/ventilator sector switch of anesthesia machine (Drager: model Fabius) from ventilator mode to spont mode during changing position was recognized as etiology of apnea and cardiopulmonary arrest of the patient.Discussion: During prone PCNL one of the critical steps is changing position from lithotomy to prone considering that respiratory complications may occur not only during intubation but also after the ETT is in place.