JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE
Year:2017 | Volume:39 | Issue:4 (100) |Papers Count:10

Introduction: Propacetamol (intravenous acetaminophen) is one of the drugs that have recently been considered in the field of pain management. Initial studies that were evaluated the approaches which have identified the cause of the ease of recovery showed that using the multiple analgesic techniques can improve early recovery. Whit regard to the appropriate safety of paracetamol and given the discectomy is a painful operation which require absolute pain relief particularly in postoperative recovery period without complications, we decided to investigately the effects of intravenous acetaminophen on pain score of patients immediately after the operation and the velocity of patients discharge form recovery. Materials and methods: In this randomized double-blind clinical trial, 52 patients which candidates for lumbar disc surgery were enrolled. Patients were randomly divided into two groups each included 26 patients. In the first group (A) after the operation 15 mg/kg acetaminophen dissolved in 100 ml of normal saline was infused over 20 minutes. In group (B) patients at the end of operation received only 100 ml of normal saline within 20 minutes. During operation, age, sex, weight, duration of anesthesia, time of positioning, time of incisions, suture of incision end time, time of return the patient, the number of discs involved, type of surgery, intraoperative complications and recovery time were record. Results: In our study, the mean rate of nausea and vomiting in the control group was 8. 8% and 1. 15% respectively. The rate of these complications in the intervention group was 10% and 1. 9%, respectively that showed no significant difference between the two groups. The statistical analysis in the intervals 25 minutes after arrival in the recovery Conclusions: according to our results suggest that intravenous acetaminophen use the pain relief after surgery as a useful and safe analgesic. Consider the results this study compared whit previous studies we conclude that in patients underwent major surgery, intravenous acetaminophen is an effective drug whit no significant adverse effects that can make a good analgesic effect.

Introduction: Many patients undergo orthopedic surgeries due to trauma. Postoperative pain is high and severe and many nonsteroidal anti-inflammatory drugs are used for analgesia other than opioids. But their use is limited for fear of drug induced complications especially anti platelet effects. The aim of this study was the evaluation of the non-steroidal anti-inflammatory drugs toxicity on platelets function on patients, undergoing orthopedic patients. Materials and methods: 370 patients were enrolled in this prospective descriptive cross-sectional study. The study group included 185 patients under treatment with non-Steroidal anti-inflammatory drugs, and the patients with no drug therapy were in control group, hematologic variables including hemoglobin, hematocrit, coagulation test, volume of bleeding and platelets were recorded in tow groups. Results: In this study there was no significant difference between two groups in regard to age, sex, tobacco use, coagulation tests and hemorrhage during surgery. The high volume bleeding (control group) and number (study group) was seen. In study group the most aspirin use was noted. The platelets were decreased postoperatively 6. 2%in study and 7. 33% in control group which the least was related to ketorolac and the maximum to naproxen. The postoperative hemoglobin, hematocrit and Platelet reduction was significant compared to the preoperative value. Conclusion: The results of this study showed that using low-dose non-steroidal anti-inflammatory drug in patients undergoing orthopedic surgeries has no toxic effect on platelets and can be use safely.

Background and Objectives: Conscientiousness is a factor that causes the order in the work and the sense of doing the duty in individuals. But sometimes they consider conscientiousness rather than work ethics; nurses make ethical decisions in their work environment, but in practice they can not always act on the basis of their moral obligations, and with an unfavorable experience called stress. This study was conducted on the effect of work conscientiousness and moral sensitivity with ethical stress in nurses working in intensive care units in educational and therapeutic centers affiliated to Zahedan University of Medical Sciences in 2016, Determining the relationship between work conscience and moral sensitivity with ethical stress in nurses working in intensive care units in educational and therapeutic centers affiliated to Zahedan University of Medical Sciences in 2016-2017 Materials and methods: A study was conducted on nurses working in 8 general sections of Zahedan city. Data were gathered through conscientiousness questionnaires, ethical sensitivity and ethical stress questionnaire. Pearson correlation coefficient, percentile and standard deviation were used for analyzing data using SPSS software version 19 Results: There is a positive and moderate correlation between work conscience and ethical stress (P = 0. 05). But there is no correlation between conscientiousness and ethical sensitivity. There is also a positive and moderate correlation between moral sensitivity and ethical stress, therefore, our research hypothesis shows that there is a significant relationship between moral sensitivity and moral stress (P = 0. 01). Conclusion: The results of this study can be helpful for practitioners and policymakers of nursing courses; they are helpful in addressing the issues of redressing and mental health in the workplace.

Introduction: Rhinoplasty is a surgery with minimal complications but implication of deliberate hypotension using hypnotics and opioids may potentially increase the morbidity and mortality, therefore, using LMA may decrease hypnotic and opioid use and decrease these potential side effects. Study of hypnotic and opioid use during rhinoplasty and comparing sore throat and hemodynamic indices may provide invaluable information. Methods and Materials: hundred patients with ASA Classification I, aged 18 to 40 years, with no history of co-existing diseases who were candidate for rhinoplasty, allocated randomly into two groups of spiral ETT and spiral LMA. Anesthesia technique was the same in both groups and depth of anesthesia were kept the same in both group (CSI: 40-60). Sore throat evaluated using Numerical Rating Scale (NRS). Amount of each medication recorded and calculated at the end of surgery. Indices were being recorded up to 8 hours after surgery. Results: there was no statistically meaningful difference between two groups concerning demographic data. There was no difference between two groups concerning pre-induction Systolic, diastolic, mean pressure and heart rate. Systolic blood pressure in LMA group was far behind the ETT group in 30, 90 and 150 minutes after induction (P<0. 05) which was statistically meaningful. The other hemodynamic indices and sore throat were not statistically different between two groups. Total dose of Propofol and Remifentanil was far less in LMA group (P<0. 05). Conclusion: Using LMA, decreases hypnotic and opioid use in Rhinoplasty to keep the stable depth of anesthesia.

Background and Aim: The importance of accurately determining the prognosis of patients admitted to the ICU and the potential benefits of using severity of disease scoring systems will determine the need to use valid accreditation guidelines for studies publishing. This study examines the status of observing the STROBE criteria by Iranian researchers in the reports of studies related to the prognosis of patients admitted to the ICU. Methods and materials: In this cross-sectional study, by selecting appropriate keywords, in a systematic review, all prognostic cohort articles published by Iranian researchers in prestigious domestic and international journals and included at least one of the severity scoring systems were evaluated according to STROBE's statement (June 2012 to June 2018). Initially, Persian databases including Magiran, SID, IranDOC and Iranmedex, and the English databases including PubMed and Scopus were searched and 1941 articles were found, then, with the removal of duplicate and unrelated articles, and observing the entry criteria, the final selection of 32 articles was selected. Data were analyzed by SPSS version 25 and descriptive statistic and analytical analyzes using Kruskal-Wallis tests, linear regression and Spearman correlation coefficient were performed. Results: In 32 articles reviewed, the overall agreement rate for studies with STROBE's statement was 58. 26% (19. 81 ± 4. 92% of 32 scores). According to the statement, the explanation of how to deal with incomplete data, the reasons for not attending each phase, and the use of the workflow chart, were the most weaknesses of the published articles reporting. The linear regression test indicated that the scores of the parts of the methods and the results were good indicators for predicting the final STROBE score (p = 0. 003 and p = 0. 005, respectively). Conclusion: The quality of the reported cohort articles published by Iranian researchers was at an acceptable level. Full compliance with the recommendations of the most up-to-date reporting guidelines is recommended to achieve the best available evidence.

Sustainable monitoring of cardiovascular system and its effective factors are considered as a permanent challenge for the surgical team. The need to control the condition of the heart and to better understand its condition has led to a supervisory topic called advanced hemodynamic monitoring, along with all previous regulatory approaches. This is a set of different techniques for instantaneous monitoring cardiovascular status and its influencing factors (In order to timely intervene and to establish the relationship between hemodynamic components to physiological conditions). Cardiac output, as the most important cardiac function index, is an integral part of cardiac monitoring systems. Measuring this indicator over the past few years has seen a wideranging change that clearly highlights its importance. However, the creation of new systems to reduce patient harm has also been a top priority for these monitoring systems. Cardiac surgery is one of the most serious cases requiring accurate assessment of cardiac output and advanced hemodynamic monitoring. The careful and successful conduct of cardiac surgeries depends on the correct and timely recognition of the function and hemodynamic status in order to proper intervention. The importance of measuring this indicator and the extent of changes in its techniques reveals the need for an accurate study in this area. Therefore, the present study investigates various cardiac output measures in cardiac surgery.

Background: Trisomy 9 is a severe disease with growth and mental retardation. Complete form of Trisomy 9 is the most severe form. Mosaic form of Trisomy 9 or partial form is less severe. Most of the cases are in this category. The severity of the syndrome is depends on the percentage of affected cells. Their clinical findings are widely variable. Many cases of complete form of Trisomy 9 die in infancy or early childhood. Case report A diagnosed Trisomy 9, 19 months-old boy with undecending testes was referred to our department. His genotype and phenotype was compatible with partial form Trisomy 9 with consideration different abnormalities of this syndrome uneventful Anesthesia was performed in this patient. These rare cases should be introduced in literature to improve and knowledge and reduce possible disruptions and morbidities and mortalities.