JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE
Year:2016 | Volume:38 | Issue:4 (96)|Papers Count:11

Introduction: Electroconvulsive Therapy (ECT), as a treatment in psychiatric disorders has changed over the years. Nowadays, using hypnotic and muscle relaxant drugs are important part of ECT. Following ECT there are major changes in hemodynamic indices, making the cardiovascular and cerebral events as potential outcomes especially in elderly so the scientist is researching to find better ways to control hemodynamic changes with minimal effect on convulsion duration and recovery time in ECT candidates. The ideal medication is the one which controls hemodynamic indices but does not affect the convulsion and recovery time so different drugs tested. In this study we decided to evaluate the effect of Esmolol.Methods and Materials: Forty patient’s candidate for ECT were randomly assigned into two groups of Esmolol (E) and placebo (P). Anesthetic drugs were the same in both groups, in E group patients received 100 mg of bolus intravenous esmolol and in P group they received equal volume of normal saline just before ECT. Patients were under close monitoring during and after procedure and the hemodynamic indices, convulsion time and duration of recovery recorded for each patient.Results: We found a meaningful difference in heart rate and blood pressure in both groups in 1 st, 3 rd Pand 5 th Pminutes after ECT (P<0.05), convulsion time and recovery duration was not meaningfully different between two groups.Conclusion: Esmolol could provide stable hemodynamic indices in ECT candidates without affecting the convulsion time and recovery duration (P>0.05).

Background: Several methods exist for reducing postoperative cystoscopy pain. This study compared the effects of lidocaine gel and methoxyflurane on cystoscopy pain.Materials and Methods: In this randomized clinical trial patients between 20 to 55 years undergoing cystoscopy were enrolled after obtaining written informed consent. Furthermore, heart rate, blood pressure, arterial oxygen saturation and pain (based on numerical scores from zero to100) before intervention when prescribing medication, when entering the device through the bladder and 15 minutes after the operation. two groups were compared. Methoxyflurane was applied by PENTHROX inhaler. (Methoxyflurane % concentration 0.5-0.7%). For each patient a maximum of 1 vial (about 3ml) was administered. Two weeks later, BUN, Cr, SGPT, SGOT, Alkaline phosphatase were measured.4TResults: The numerical scores for pain were clearly lower for Methoxyflorane (p<0.0001). Interest of the patient to repeat the method used was significantly higher in Methoxy group (P<0.0001). 28.30 of those in Methoxy vs.18/30 patients in the L group favored to repeat same practice. Opioid usage was significantly lower in Methoxy group (P<0.0001). Systolic blood pressure in both4T growps were the same. Cystoscopic pain during insertion to bladder was significantly lower in Methoxy group.Conclusion: Methoxyflurane is an effective analgesic for pain associated with rigid cystoscopy in men less than years. It reduced the amount of opioid drug during entering the cystoscope into the bladder.

Introduction: Spinal anesthesia is one of the common methods for lower extremities surgery due to its ease of appliance. However, anesthesia duration is reduced in opium addicted patients. In recent years, different additives have been proposed to lengthen the anesthetic and analgesic duration of local anesthetics albeit each additive has its own side effects. In this study we assessed the effects of Dexmedetomidine on duration of spinal anesthesia in opium addicted patients who were candidates for lower extremities surgery.Materials and methods: Sixty opium addicted patients, candidate for lower extremities surgery, divided in two groups of 30 patients as case and control. In case group, spinal anesthesia was done using 15 mg of Bupivacaine and 5 mg of Dexmedetomidine and in control group with only 15 mg of Bupivacaine. The time of sensory and motor block induction, duration of blocks and duration of analgesia were recorded and compared.Results: sensory and motor blocks achieved earlier and lasted longer in case group than in control group. Analgesia lasted longer in case group as well.Conclusion: Dexmedetomidine can increase anesthetic duration of Bupivacaine in spinal anesthesia in opium addicted patients.

Introduction: Postoperative nausea and vomiting are one of the most common complications after surgery. Today, several new anesthetic drugs used for anesthesia induction and maintainers, which can have anti-nausea effects.Aim: Compare general anesthesia with propofol and thiopental on incidence and severity of nausea and vomiting after general surgery Materials and methods: In this clinical trial 60 patients undergoing general surgery were divided randomly into two groups. In the first group of induction-dose 2mg / kg propofol and in the second group, induction-dose 5mg / kg thiopental was done. Based on self-reporting scale and check list number was performed vomiting, evaluating the severity and incidence of nausea and vomiting in three stages, after, 2 and 6 hours after surgery. Data were analyzed by Spss software.Results: The results showed that the age, gender, duration of NPO, operation time, there was no significant difference among the three groups According to independent t test in the recovery and 2 hours after surgery, the difference was significant between severity and incidence of nausea and vomiting between the two groups. But this difference was not significant at 6 hours after surgery.Conclusion: This study showed that propofol divided doses, have a good effect, similar to the control of nausea and vomiting after surgery is. Therefore, administration of Propofol (with divided doses and without the need for pumps) is simple, cheap and without serious side effects.

Background: The current study is to evaluate cardiovascular effects of anesthetic medications and volatile anesthetics on cardiac stress using cardiac stress index (CSI) and rate pressure product (RPP) and to determine which of them in useful in evaluating cardiac stress after comparing results obtained from each method.Materials and methods: 40 patients, 60-80 years old, who were all performed trans abdominal prostatectomy were studied. Patients were divided into two groups, half of patients were placed in group A and the other half in group B. The study was carried out as a blinded study. CSI was measured and evaluated in group A and RPP changes were studied in group B.Results: The mean CSI were 60.25±5.57, 63.05±5.54, 55.75±4.78 and 67.65±4.88 before anesthesia induction, after induction, before surgical incision and in recovery respectively. There was no meaningful difference.RPP mean in four above mentioned stages was 10.15±0.44, 9.9±0.69, 6.8±0.36 and 9.2±0.61 respectively. There was a meaningful difference between RPP in stages before anesthesia induction and before surgical incision (P<0.0001).Conclusion: Considering the obtained results from this study, it can be seen that even in noncardiac surgery, the stress level is high in patients in the stage before surgery. This figure was not clear in RPP index case and was not in accordance with CSI, which means CSI has been able to illustrate existing stress level better and efficiently.

Introduction: Central venous cathater has several applications in heart surgery. One of the uncommon complication of central venous cannulation is described in this paper.Case report: Right subclavian vein was cannulated in a 3-month infant who underwent cardiac surgery and pacemakar implantation. Because of previous central line doesn’t has correct function, another central venous line was inserted successfully through Left jugular vein on second post-op day. Chect X-ray demonsrated ectopic location of the catheter.Conclusion: Central venous catheter can be inserted in ectopic position.