Introduction: Inhalation induction is a common method in pediatrics anesthesia . There is not suitable clincial guide for assessmen depth of anesthesia before intubation, in this study adequacy of Jaw thrust as a guide for this assessement was evaluated.Methods: In a clinical trial study 90 pediatric patient, ASA1 & 2, six month to 5 year old age, were divided in case and control groups. Inhalation inductions were done by 4% Halothane, 4lit/min O2 and 4Lit/min N2o under spontaneous ventilation. In case and control groups, Jaw thrust and ordinary methods were utilized respectively for assessment of depth of anesthesia befor intubations. Changes in HR, SpO2, end tidal of halothane and duration of induction, duration of laryngoscopy, reactions to intubations and complications were measured and then analyzed by t - test and Chi squar statistical tests.Results: Duration and complications of larynogscopy were greater in case than control group. Conclusion: Jaw thrust alone is not a good clinical test assessment of depth of anesthesia before intubations in inhalation anesthesia. Probaly one and half to two minutes after negative respones to jaw thrust is a suitable time for intubations in pediatrics inhalation anesthesia .

This research was carried out on 48 patients aged from 12 to 67 who refered to Oral Surgery Department at Tabriz Dental school for their teeth extraction.Patients were divided into 4 groups as follow:Group A1: Patients with teeth on both sides of lower jaw to be extracted. One side, was adopted as Experimental while the other side was considered as control (Inferior alveolar nerve block anesthesia or mental nerve block anesthesia).Group A2 Patients with teeth on both sides of lower jaw to be extracted, with the difference that only on one side Mod I.O.A was adopted with no injection of any kind on the other side. Group B: Patients with teeth only on one side of the lower jaw to be extracted, in which Mod I.O.A was employed.Group C: Patients, in whom inferior alveolar nerve block anesthesia was failed and then Mod I.O.A was adopted for Extractions.To perform this technique, a manual terphinator was designed. Use of this device removes the need for incision of mucosa and the bone at the apex of the tooth. This is because, these tissues will be perforated. rated during the technique, with an access to spongeous bone.Results showed, the effect of the anesthetic solution in this technique is rapid, short and limited. In addition there is no relationship between the degree of anesthesia with age, sex or the kind of tooth to be extracted. In spite of the passage of the anesthetic solution from the midline, it's distribution through the bone differs among the different people.

Introduction. Despite of vital role of blood and it"s components as an only curable treatment, it"s transfusion is accompanied by many complications. In the other way, the most important adverse effects of anemia is decrease in oxygen supply to the tissues. Therefore, it is essential to determine those patients need to blood transfusion and exact hemoglobine and hematocrite level which transfusion become necessary. Recent studies show that during general anesthesia due to vasodilation in the level of microcirculation and passage of many red blood cells from microcirculation there is a decreasing in hemoglobine level measured in peripheral veins which named plasma skimming. So, during sampling of hemoglobine and hematocrite from peripheral veins, there is a pseudodecrease in Hb and HCT levels. In this study we want to determine this decrease in Hb and HeT. Methods. Study was done in 182 patients with ASA 1 and 2 undergoing general or local anesthesia for cataract surgery. Duration of nill per os (NPO), preoperotive and intraoperative intravenous fluid administration were simillar in two groups. A sample of blood for preoperative evaluation and another one immediately after operation achevied and compared with each other. Results. There was not significant differences between mean Hb and HCT in two groups preoperotive. But postoperative, there was a significant differences between mean Hb and HCT in general anesthesia vs local anesthesia (P<0.01). This decrease in Hb and HCT was orderly 0.91±1.14 gr/dl for Hb and 2.862±3.6 percent for Hct. Discussion. In determining of Hb and HCT immediately after general anesthesia, there is some pseudo decrease due to plasma skimming that must be appreciated.

Background: Patient safety is one of the main elements of the quality of health services. Our aim of this study was to compile a complete checklist for the three stages of anesthesia. Methods: This research was a cross-sectional descriptive-analytical study. First, an internet search was conducted in databases to identify checklists related to safe Anesthesia. The WHO Safe Anesthesia Checklist was designated as the main checklist. Then, a brainstorming session was held with experts and according to the determined fields, the initial draft was compiled. Face and content validity were conducted. The reliability of the checklist was measured with Cronbach's alpha and intra class correlation index (ICC) methods. Results: The initial draft was compiled with 34 items. 29 items scored higher than 0.79 in terms of CVI (content validity index) The value of CVI of 5 items was less than the permissible limit and the edge of the border, which was revised and corrected by the research group. 2 items were returned to the research process according to the survey of experts and their necessity CVR (content validity ratio) (value >0/62) and 3 items were removed from the research process. Cronbach's alpha was calculated as 0.876 for the first evaluator and 0.870 for the second evaluator, and the percentage of agreement between the evaluators was 0.956 (P<0.001). Conclusion: We developed and evaluated a checklist for the three stages of anesthesia through an evidence-based study. We hope   this checklist can reduce and prevent clinical errors.

Introduction: Increasing use of regional anesthesia instead of general anesthesia may be the most important factor in decreasing anesthetic difficulties (e.g. difficult intubations, aspiration pneumonia, and analgesic side effect) in caesarean section. Quality of regional anesthesia is improved by adding morphine, fentanyl and sufentanil. The function of Epinephrine is dose-dependent. For instance, in small dosage, it has stimulating effects on Beta1 and Beta2 causing venous stasis to minimize. However, in large doses, Epinephrine’s Alfa adrenergic is dominant. This study aimed at investigating the potential hemodynamic effects of adding Epinephrine to lidocaine during spinal anesthesia on expecting mothers who are candidates of caesarean section.Materials and Methods: This study was a prospective, randomized, double-blind, controlled trial on 100 pregnant women who were candidates for caesarean section with ASA class I, II in the year of 1387.The subjects of the study were divided into two groups, (1) and (2) on the basis of the randomized digital table as follows: Group 1: 80 mg lidocaine 5% +2 micro gram sufentanil Group2: 80 mg lidocaine 5%+2 micro gram sufentanyl+0.2 mg (0.2cc) Epinephrine. Both groups received the drugs intrathecally. Vital signs such as systolic and diastolic blood pressure, pulse rate and SPO2 were recorded both before the anesthesia and thereafter every 5 minutes until the end of the operation. The measuring procedure continued during and after the recovery stage. Besides, the side effects and the drugs needed were recorded.Results: According to the findings in this study, there weren't any significant differences between the two groups in terms of age, weight, ASA, NPO timing and the previous surgery. There weren't any significant differences between the two groups of the study in terms of systolic and diastolic blood pressure, either. However, some hypotension was noted in Adrenaline group. Also, there weren't any significant differences in PR but some bradycardia was seen in Adrenaline group, too. There weren't any significant differences in SPO2 and side effects (nausea, vomiting, dysphagia, respiratory disorder, shivering) between the two groups.Conclusion: Adding Epinephrine to Lidocaine 5% increased the duration of spinal aesthesia in caesarean section whereas no significant difference was observed in terms of hemodynamic and side effects. Nevertheless, regarding the emergence of hypotension and bradycardia observed in the Adrenaline group, no matter how rare, close control of hemodynamic in this group is essential.

Introduction. Vitreous loss (VL) is one of the most serious ocular complications during cataract surgery without correct management may causes other serious complications and sometimes visual loss. By selecting the correct method of anesthesia (general or local anesthesia) it is possible to reduce the incidence of this complication and consequent events. The aim of this research is to determine the incidence of VL in cataract surgery with local and general anesthesia and comparing them with each other.Methods. This survey was conducted in 210 patients over 40 years old who had been operated for cataract surgery. Subjects were randomized in two groups (general vs local anesthesia). There is no premeditations in anyone.Findings. The incidence of VL in general and local anesthesia was 3.6 and 9.1 percent, respectively (P<0.05). The groups were similar with respect to demographic data and potential confounding variables.Conclusion. The incidence of vitreous loss during cataract surgery under local anesthesia is more than general anesthesia. If general anesthesia is contraindicated, it is better to use sedative drugs during local anesthesia for cataract surgery to prevent vitreous loss.

Background & Objective: The use of anaesthetics has become a crucial aspect of clinical practice, particularly considering the increasing number of caesarean deliveries worldwide. The present study was conducted with aim to compare the effects of general and spinal anaesthesia on maternal and neonatal outcomes in term singleton pregnancies with elective caesarean section.Materials & Methods: This prospective and case-control study was conducted on 100 patients randomly allocated into two equal groups: general anaesthesia (n=50) and spinal anaesthesia (n=50). Hemodynamic variables of the mother were measured preoperatively, intraoperatively, and postoperatively, and neonatal outcome was assessed by the Apgar score.Results: In the general anaesthesia group, systolic and diastolic blood pressure showed only mild reductions after induction and during delivery, with values stabilising postoperatively. Meanwhile, heart rate transiently increased after induction before returning to baseline. In contrast, the spinal anaesthesia group demonstrated a more pronounced hypotensive response, with systolic and diastolic pressures reaching their lowest levels at delivery, followed by gradual postoperative recovery; heart rate also declined steadily after induction. The mean time between anaesthesia induction and baby extraction was 7.2±1.5 minutes, well within the safe range (5-10 minutes), supporting favourable maternal and neonatal outcomes. The median one-minute Apgar score was higher in the spinal anaesthesia group.Conclusion: In elective caesarean, maternal and neonatal outcomes are better with spinal anaesthesia. Nonetheless, both methods are still heavily used, dependent and clinically indicating dependent