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Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
Author(s): 

GHIAMAT M.M. | RAZAVI P.

Issue Info: 
  • Year: 

    2002
  • Volume: 

    22
  • Issue: 

    39
  • Pages: 

    4-9
Measures: 
  • Citations: 

    0
  • Views: 

    8306
  • Downloads: 

    0
Abstract: 

Among the drugs falling under the category of muscular relaxants with medium periods of effectiveness, Atracurium can be prescribed to kidney and liver disease patients readily due to its independent elimination from the internal body organs through the plasma mechanism and the Hofmann mechanism. It does not accumulate in the body on long-term intake or repeated dosages. Cis-Atracurium is a refined isomer of Atracurium which has the properties of Atracurium, and in addition, brings about cardiovascular stability in the patient due to non-release of histamine during intake.In this clinical experiment, including two groups of 25, the appropriate time for tracheal intubation was calculated after administration of Atracurium (0.5 mg/kg) and Cis-Atracurium (0.15mg/kg) and based on complete ceasing of the response of TOF (Train of Four). The time average obtained for the Atracurium group was 3.6 minutes (SD=0.4), and for the Cis-Atracurium group, 3.8 minutes (SD=0.3). (p>0.05)With regard to the effectiveness period, the average of the return of 25% of TOF response was calculated at 29 minutes (SD=5) in the Atracurium group, and 56 minutes (SD=6) in the Cis-Atracurium group. (p<0.005)Concerning changes in the blood pressure and heart rate, there was a fall in blood pressure in 52%, a rise in blood pressure in 16%, and no changes in blood pressure in 32% of the patients of group A after administration of Atracurium. There was a fall in blood pressure in 16%, a rise in blood pressure in 12%, and no changes in blood pressure in 72% of the patients of group B after administration of Cis-Atracurium. There was also similar changes in the heart rate as with the blood pressure changes in the two groups.Based on the results obtained and with due regard to the common advantages of Atracurium and Cis-Atracurium, and the higher cardiovascular stability provided by the administration of Cis-Atracurium, this drug can prove an appropriate substitute in surgical operations with medium to long time.

Yearly Impact: مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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Author(s): 

MALEK S. | FROTAN A.

Issue Info: 
  • Year: 

    2002
  • Volume: 

    22
  • Issue: 

    39
  • Pages: 

    10-17
Measures: 
  • Citations: 

    0
  • Views: 

    927
  • Downloads: 

    0
Abstract: 

Airway management is one of the most importants items in anesthesiology. Endotracheal intubation is used currently in general anesthesia; but intubation in 1-4% of cases is difficult, according to anatomic, or pathologic factors. On the other hand endotracheal intubation is accompanied with a group of complication. Laryngeal tube is an alternative to endotracheal intubation.We did this research to evaluate the advantages and disadvantages of the laryngeal tube in Iranian patients.This study was Quasi experimental. Fourty adult ASA physical status I patients with mean age of 33.75±7.8 years participated in our study and under went general anesthesia with usual monitoring for routine surgery.We need to an additive maneuver in 15 patients (37.5%) in order to provide sufficient ventilation and adequate oxygenation. These maneuvers include: increase of pharyngeal tube pressure, cephalad movement of chin and movement of tube 1 cm to inside or outside.We had to extubation only in one patient. All of the patients, except one of them had clinical and laboratory signs of adequate ventilation and oxygenation.In conclusion, the laryngeal tube might be a simple alternative device to secure the airway.

Yearly Impact: مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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Issue Info: 
  • Year: 

    2002
  • Volume: 

    22
  • Issue: 

    39
  • Pages: 

    18-25
Measures: 
  • Citations: 

    0
  • Views: 

    705
  • Downloads: 

    0
Abstract: 

The effect of patient posture on the spread of epidural anesthesia is still controversial. Because of limited use of this technique for foot and perineal region surgery as result of uneven analgesia in the sacral segments, this study was undertaken to assess the difference in the maximum cephalad spread, onset and duration, and sacral segment analgesia with epidural blockade in 3 patients postures, namely: I) 7.5 minutes sitting and then 20° semi -sitting, II) 20° semi - sitting, III) left lateral decubitus.The different position were maintained from the beginning of epidural blockade up to 30 minutes. 60 ASA I-II patients candidated for AP repair were randomly divided into 3 groups as above. Epidural blockade was induced through catheter and with 4 doses of 5 milliliters of 2% lidocaine injected every 2.5 minutes.According to analysis of the data with ANOVA and post Hoc Tucky test, maximum cephalad spread of analgesia was higher on the dependent side of group III, than the nondependent side of the same group (p=0.000) and, group I (p=0.049). Also in the dependent side of group III compared to the nondependent side duration of cephalad spread was accelerated (p=0.018) and the onset of regression of analgesia started later (p=0.016).S4-S5 segment blockade occured in 80% of group III compared to 100% in the other 2 groups (p=0.013). These results show increased and accelerated spread and longer duration of epidural blockade in the more dependent regions according to different patient postures.

Yearly Impact: مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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Issue Info: 
  • Year: 

    2002
  • Volume: 

    22
  • Issue: 

    39
  • Pages: 

    26-32
Measures: 
  • Citations: 

    0
  • Views: 

    3477
  • Downloads: 

    0
Abstract: 

Capnography is one of the most important monitoring that is recommended by American Society for Testing and Material in 1998 (ASTM98) for every patient under anesthesia.Usually sampling of expired gas in capnography commonly obtained from side or mid stream. Badgwell and et al recommended that sampling of expired gas for Capnography for patient under one year should be taken from distal end of endotracheal tube.In this study to determine accuracy of ventilation with modified Jackson Rees system, we studied 622 infants and children who were ventilated with this system. Expired gas for CO2 monitoring sampled at distal and proximal end of endotracheal tube and the arterial Pco2 (PaCO2) simultaneously measured.In this paper we studied the accuracy of ventilation with modified Jackson Rees system in 62 infants and children. We sampled the expired gas for CO2 analysis from both proximal and distal of the endotracheal tube and measured PaCO2 simultaneously.In our experience we found that PETCO2-d (distal end - tidal PCO2) was close to PaCO2, but PETCO2-p(proximal end - tidal PCO2) was insignificantly greater than PaCO2 especialy in infant who were less than 10kg. As we did not find any significant difference between measurement of PETCO2-d (distal end tidal PCO2) and PETCO2-p (proximal end tidal PC02), we suggest to measure PETC02-p instead of PETC02-d, in any infant less than 10kg and children weighting more than 10kg who Ventilated by modified Jackson Rees system.

Yearly Impact: مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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Author(s): 

VALIOLLAH H. | ALIMIAN M.

Issue Info: 
  • Year: 

    2002
  • Volume: 

    22
  • Issue: 

    39
  • Pages: 

    33-38
Measures: 
  • Citations: 

    0
  • Views: 

    1038
  • Downloads: 

    0
Abstract: 

Today with progressing in laser technology, role of laser in upper respiratory airway surgery is well known. In such a situations usually general anesthesia is the method of choice and knowledge about complications and trating the complications during and after anesthesia is essential.This study was designed to evaluate the frequency of intra and postoperative complications in upper airway laser surgery.In this descriptive study 50 patients aged between 5 to 60 years old who where candidates for upper respiratory airway surgery with CO2 laser in Hazrat Rasool Hospital in Tehran were selected non randomly within 2 years. Data were gathered during and within 24 hours after general anesthesia and then during visit in ENT clinic subsequently.In this study among complications during general anesthesia only endotracheal tube cuff ignition was detected with frequency of 2% and the only postoperative complication detected during visit in clinic was acquired glottic web with frequency of 2%.Using safe methods in laser procedures for airway surgery such as inflation of tracheal cuff with normal saline, protection of endotracheal tube by metal tapes and use of proper oxygen concentration in inspiratory gas flow can diminish intra and postoperative complications significantly.

Yearly Impact: مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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Issue Info: 
  • Year: 

    2002
  • Volume: 

    22
  • Issue: 

    39
  • Pages: 

    39-44
Measures: 
  • Citations: 

    0
  • Views: 

    1201
  • Downloads: 

    0
Abstract: 

Post dural puncture headache (PDPH) is a known and discomfortable complication of spinal anesthesia. Previous studies have shown that the incidence of PDPH increases with the thickness of the spinal needle and the number of punctures in the dura matter. Recently, in order to decrease PDPH, thinner needles have been used to perform spinal anesthesia. However, the use of thinner needles reqiures expertise, and teaching such skills to residents of the university hospital is a difficult task; a task, which at the end increases the number of dura punctures and consequently the incidence of PDPH.For assessing these probabilities, an antrospective, randomized study with 400 patients (ages 18 to 45) who were in ASA physical status classes 1 and 2 was done. Four groups, each with 100 patients, were selected and underwent spinal anesthesia with 23 and 25-gauge needles conducted by first, second and third year residents of anesthesiology and anesthesiologists. Patients were assessed after 48 hours.The results of this study illustrates that the incidence of repeated attempts (and dural punctures) is higher in residents of anesthesiology and using thinner needles when compared to the number of attempts (and punctures) demonstrated by anesthesiologists and using thicker needles.Anesthesiologists conducted fewer repeated attempts and subsequently had fewer PDPH patients. The incidence of PDPH after using 23 and 25 - gauge needles was not different.Therefore, a novice will attempt more dural punctures with thinner needles. Hence, the repeated attempts with a 25-gauge needle will result in the same number of PDPH incidence when compared to the use of a thicker needle fo a single puncture.In conclusion, the use of 23-gauge needles for spinal anesthesia should be restricted to the teaching of the anesthesiology residents.

Yearly Impact: مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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Issue Info: 
  • Year: 

    2002
  • Volume: 

    22
  • Issue: 

    39
  • Pages: 

    45-51
Measures: 
  • Citations: 

    0
  • Views: 

    1496
  • Downloads: 

    0
Abstract: 

Pethidine, a well known opioid, has local anaesthetic properties (1,2) and has been shown to be effective intrathecally as a sole agent. We studied 60 women, aged 20-40 years, in 4. groups each contains 15 patients (Bupicacaine group = B and Pethidine group= P). Pethidine 30 mg in P30, 50 mg in PSO, 70 mg in P70 and 12.5 mg Bupivacaine in B group were injected. In all patients spinal anaesthetics agent was given in sitting position and L3-4 interspace. The onset, extent and duration of sensory and motor blockade, post operative analgesia and adverse effects such as nausea, vomiting, hypotension, bradycardia, itching and shivering were studied.The collected data were analyzed with Kruskal - Wallis, Chi2, Fischer exact tests and analysis of variance. P-value<0.05 was significant. The onset of block was slower in Pethidine groups. Hemodynamic changes were not significant. Duration of sensory and motor block were shorter in Pethidine groups and. the differences between P50 and P70 was significant (longer in P70). Nausea occured more in Pethidine groups than B group. Itching was seen only in P groups and shivering only in B groups.Pethidine with doses of 50-70 mg can be an alternative for local anaesthetics. Pethidine can provide surgical anaesthsia and long duration post operative analgesia, and can prevent shivering, Anaeesthetic technique.

Yearly Impact: مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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Issue Info: 
  • Year: 

    2002
  • Volume: 

    22
  • Issue: 

    39
  • Pages: 

    52-56
Measures: 
  • Citations: 

    0
  • Views: 

    1233
  • Downloads: 

    0
Abstract: 

Cesarean section (C/S) is one of the most common surgeries which has been done and selection of the best methods of anesthesia should be taken into consideration. One of the most important difficulties in C/S is intraoperative bleeding. Assessment and control of bleeding - as possible as can decrease mortality and morbidity rates.In this study one of the two methods of anesthesia (general anesthesia and regional anesthesia) has been done randomly in one hundred of patients for whom elective C/S has been performed and the changes of hematocrit - hemoglobin (Hct-Hb) was compared in two groups. Patients with interfering factors such as obesity, preeclampsia, ... (which could increase bleeding) were omitted from this study.There were no demographic data differences between two groups. It was concluded that Hct-Hb content was reduced significantly in patients who had received general anesthesia with halothane (5.71 and 1.71 gr/dl respectively) in comparision to second group (3.71 and 1.30 g/dl) 1 (p<0.05).Although it seems that general anesthesia can increase the amount of bleeding in C/S, any of the patients didn't need tranfusion.Thus in selection of methods of anesthesia in C/S (in addition to their own advantages and disadvantages) we must consider the effect of halogenated agents.

Yearly Impact: مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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Issue Info: 
  • Year: 

    1381
  • Volume: 

    22
  • Issue: 

    39
  • Pages: 

    57-70
Measures: 
  • Citations: 

    0
  • Views: 

    423
  • Downloads: 

    0
Keywords: 
Abstract: 

آیا انجام سزارین تحت بیهوشی عمومی با هالوتان در مقایسه با بی حسی نخاعی سبب افزایش مقدار خونریزی می گردد؟ این مطالعه با بررسی 130 مادربستری در بیمارستان روئین تن آرش تهران که در سه ماه اول سال 1379 عمل جراحی سزارین داشته اند به این سوال پاسخ می دهد. حاملگی ها همه کامل، تک قلو، بدون شروع درد زایمان و هرگونه عارضه ای بوده اند. نیمی از بیماران بیهوشی عمومی به روش معمول (تیوپنتال سدیم، سوکسنیل کولین و هالوتان و نایتروس اکسید) و نیمی دیگر بی حسی نخاعی (1.5 میلی لیتر لیدوکائین 5%) دریافت داشته اند.

Yearly Impact: مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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