The efficacy of using midazolam or haloperidol for prevention of postoperative nausea and vomitin... more The efficacy of using midazolam or haloperidol for prevention of postoperative nausea and vomiting (PONV) has been investigated before. The main object of the present study was to evaluate the anti-emetic effects of combining administration of intravenous haloperidol with intravenous midazolam on PONV in patients underwent middle ear surgery in comparison with using each drug alone. Study design was randomized, double-blind, placebo-controlled. 80 patients, aged 18-60 years, scheduled for middle ear surgery in Kashani Hospital Medical Center under general anesthesia were enrolled in this randomized, double-blind, placebo-controlled study. Patients were divided into 4 groups of 20 each and received haloperidol 2 mg i.v. (Group H); midazolam 2 mg i.v. (Group M); haloperidol 2 mg plus midazolam 2 mg i.v. (Group HM); saline i.v. (Group C). The incidences of PONV and complete response were evaluated at 0-2 hours after arrival to the PACU and 2-24 hours after arrival to the ward in 4 groups. Patients in group HM had significantly lower incidence of PONV compared with groups H, M, and C throughout 0-24 h (P<00.5). The HM group had the lowest incidence of PONV (0-2, 2-24, and 0-24 h) and the highest incidence of complete response. Postoperative anti-emetic requirement was significantly less in group HM compared with group M or H (P<0.05). Combine administration of haloperidol 2 mg plus midazolam 2 mg significantly reduced PONV better than using each drug alone in patients underwent middle ear surgery under general anesthesia.
Metoclopromide have local anesthetic properties. The main object of performing the present study ... more Metoclopromide have local anesthetic properties. The main object of performing the present study was to evaluate the analgesic effect of metoclopromide 10 mg when added to lidocaine for intravenous regional anesthesia (IVRA) of upper extremities in trauma patients. Ninety patients undergoing upper limb producer were randomly allocated to the three groups to receive 3 mg/kg 2% lidocaine diluted with saline to a total dose of 40 ml (Group L, n = 30) or 10 mg metoclopromide plus 3 mg/kg 2% lidocaine diluted with saline to a total dose of 40 ml (group LM, n = 30) or 3 mg/kg 2% lidocaine diluted with saline to a total dose of 40 ml plus 10 mg metoclopromide intravenously (Group IM, n = 30). Our study showed that the onset times for sensory and motor block were significantly shorter in Group LM compared with Group L and Group IM (4.5 ± 0.7 vs. 5.0 ± 0.7 and 5.0 ± 0.6, respectively, P = 0.006 for sensory block; 6.3 ± 0.7 vs. 5.1 ± 0.9 and 5.9 ± 0.6 respectively, P = 0.000 for motor block). The postoperative VAS scores were significantly less at 1, 5, 10, 15, and 30 minutes after tourniquet release in Group LM compared with Group L and Group IM (P < 0.05). The results of our study showed that adding 10 mg metoclopromide to lidocaine for IVRG in trauma patients reduced intraoperative and postoperative analgesic use till 24 hours and improve quality of anesthesia.
Coughing and laryngospasm are undesirable outcomes occurring during emergence from general anesth... more Coughing and laryngospasm are undesirable outcomes occurring during emergence from general anesthesia. We compared the effect of small doses of propofol, ketamine and a combination of them on the occurrence and severity of coughing and laryngospasm in patients awakening from general anesthesia. 160 patients who were scheduled to undergo operations under general anesthesia were randomly assigned to one of the following groups, 40 in each group: propofol group (0.25 mg/kg intravenous (IV) propofol), ketamine group (0.25 mg/kg IV ketamine), combination group (0.25 mg/kg IV propofol, and 0.25 mg/kg IV ketamine) and control (0.1 ml/kg IV saline). Drugs were administered before extubation at previously defined time. Presence and severity of coughing and laryngospasm were recorded within twominutes after extubation. The presence of coughing in the combination group (27.5%) was less than that in other groups; also it was less frequent in the propofol group (57.5%) than the control (82.5%) (...
Ulusal Travma Ve Acil Cerrahi Dergisi Turkish Journal of Trauma Emergency Surgery Tjtes, Feb 1, 2009
Microalbuminuria, which predicts organ failure, probably predicts the necessity of mechanical ven... more Microalbuminuria, which predicts organ failure, probably predicts the necessity of mechanical ventilation as well as its duration. The primary goal of this study was to determine the incidence and presence of a relationship between microalbuminuria and duration of mechanical ventilation in trauma intensive care unit (ICU) patients. Sixty admitted critically ill trauma patients were categorized by duration of mechanical ventilation to group A (< or =7 days) or group B (>7 days) in this prospective observational study. We measured serial spot urine micro-albumin-creatinine ratios (ACR) on admission to the ICU (ACR-1), at 24, 72, and 120 hours after admission, and on the days of beginning and discontinuation of mechanical ventilation (ACR-2 and ACR-3, respectively). Seventy percent of the patients had microalbuminuria and 63.3% had an ACR > or =100 mg g-1 at admission. ACR-1 [mean (SE)] in patient groups A and B was 30 (6) and 63 (16) mg g(-1) (p=0.0002); ACR-2 was 40 (4) and 52 (8) (p=0.007); and ACR-3 was 30 (11) and 44 (11), respectively (p=0.023). For all patients, mean (SE) ACR-2 fell from 37 (4) to 34 (8) mg g(-1) on the day of discontinuation of mechanical ventilation (p<0.01). The ACR can be used in estimating the risk of prolonged mechanical ventilation, even on the first day of admission of critically ill trauma patients.
Ulusal Travma Ve Acil Cerrahi Dergisi Turkish Journal of Trauma Emergency Surgery Tjtes, Nov 1, 2008
The predictive ability of body mass index (BMI) or C-reactive protein (CRP) as a simple, inexpens... more The predictive ability of body mass index (BMI) or C-reactive protein (CRP) as a simple, inexpensive, and dynamic marker of critical illness in patients requiring mechanical ventilation (MV) is unknown. This study was thus conducted to determine the incidence and presence of a relationship between the predictors of BMI or CRP and duration of MV in trauma patients admitted to the intensive care unit (ICU). This prospective observational study included 72 critically ill trauma patients. Admitted patients were categorized by duration of MV to Group A (< or =7 days) and Group B (>7 days). The biological status of patients was assessed by the serial measurement of CRP on admission to the ICU (T1), at 48 and 72 hours after admission, and on the day of beginning (T2) or discontinuation (T3) of MV. Data on BMI, serum albumin, and the Sequential Organ Failure Assessment (SOFA) score were also collected at T2 or T3. At T3, the SOFA score, BMI, albumin, and CRP were significantly higher in patients in Group B compared with Group A (p<0.01). The incidence of low BMI (< or =20 kg/m2) or high CRP (>10 mg/L) in patients in Group B was significantly higher at T2 or T3 compared with Group A (p<0.05). At T3, CRP was determined as the most powerful predictor of >7 days of MV followed by BMI. Both BMI and CRP, comparable with the SOFA score, can be used in estimating the risk of prolonged MV.
Feyz Journals of Kashan University of Medical Sciences, 2008
Background: Although the predictive criteria for duration of mechanical ventilation may help to e... more Background: Although the predictive criteria for duration of mechanical ventilation may help to evaluate the right time of disconnecting a patient from the ventilator, the efficacy of the APACHE ( Acute physiology, Age and Chronic Health Evaluation) or IPS (Infection Probability ...
Middle East Journal of Anaesthesiology, Oct 1, 2007
BACKGROUND/OBJECTIVE: No previous study exists to evaluate admission serum magnesium level as a p... more BACKGROUND/OBJECTIVE: No previous study exists to evaluate admission serum magnesium level as a predictor of morbidity or mortality. The aim of this study was to define the prevalence of admission hypomagnesemia in critically ill patients and to evaluate its relationship with organ dysfunction, length of stay, and mortality.METHODS: A retrospective study was done on 100 patients > or =16 years old, admitted to the medical-surgical intensive care unit (ICU) at the University Hospital over 2 years period. Observations were made on admission total serum magnesium level, a variety of lab tests related to magnesium, need for ventilator, duration of mechanical ventilation, hospital/ICU lengths of stay, and general patient demographics.RESULTS: The serum magnesium level (normal value, 1.3-2.1 mEq/L) was measured at admission. At admission, 51% of patients had hypomagnesemia, 49% had normal magnesium levels. There was significant difference in mortality rate (55% vs 35%), the length of hospital (15.29 +/- 0.66 vs 12.81 +/- 0.91), or ICU (9.16 +/- 0.53 vs 5.71 +/- 0.55) stay between these two groups of patients (p < 0.05 for all). Hypomagnesemic patients more frequently had total hypocalcemia, hypokalemia, and hyponatremia. A total of 51 patients developed hypomagnesemia during their ICU stay; these patients had higher Acute Physiology And Chronic Health Evaluation II (APACHE II) (14.16 +/- 1.03 vs 10.80 +/- 0.94) and Sequential Organ Failure Assessment (SOFA; 10.89 +/- 0.90 vs 7.58 +/- 5.01) scores at admission (p < 0.01 for both), a higher maximum SOFA score during their ICU stay (14.75 +/- 0.73 vs 8.08 +/- 0.52, p < 0.01), a more need to ventilator (58.6% vs 41.4%, p < 0.05), and longer duration of mechanical ventilation (7.2 vs 4.7 day, p < 0.01) than the other patients. The ROC curve of SOFA score in the hypomagnesemia yields significantly better results than APACHE II. An increase of 5 units in the APACHE II or SOFA measured on admission increase relative probability of hypomagnesemia by a factor of 0.12 and 0.16 respectively.CONCLUSION: Development of hypomagnesemia during an ICU stay is associated with guarded prognosis. Monitoring of serum magnesium levels may have prognostic, and perhaps therapeutic, implications.
The aim of this study was to compare the efficacy intravenous (IV) ondansetron with ketamine plus... more The aim of this study was to compare the efficacy intravenous (IV) ondansetron with ketamine plus midazolam for the prevention of shivering during spinal anesthesia (SA). Ninety patients, aged 18-65 years, undergoing lower extremity orthopedic surgery were included in the present study. SA was performed in all patients with hyperbaric bupivacaine 15 mg. The patients were randomly allocated to receive normal saline (Group C), ondansetron 8 mg IV (Group O) or ketamine 0.25 mg/kg IV plus midazolam 37.5 μg/kg IV (Group KM) immediately after SA. During surgery, shivering scores were recorded at 5 min intervals. The operating room temperature was maintained at 24°C. The incidences of shivering were 18 (60%) in Group C, 6 (20%) in Group KM and 8 (26.6%) in Group O. The difference between Groups O and Group KM with Group C was statistically significant (P < 0.05). No significant difference was noted between Groups KM with Group O in this regard (P > 0.05). Peripheral and core temperat...
The purpose of the present study was to evaluate the efficacy of midazolam-ondansetron combinatio... more The purpose of the present study was to evaluate the efficacy of midazolam-ondansetron combination in prevention of postoperative nausea and vomiting (PONV) after middle ear surgery and its comparison with using midazolam or ondansetron alone. One hundred and forty patients were enrolled in four groups to receive midazolam 0.75 mg/kg in group M, ondansetron 4 mg in group O, midazolam 0.75 mg/kg and ondansetron 4 mg in group MO, and saline 0.90% in group S intravenously just before anesthesia. Assessment of nausea, vomiting, rescue antiemetic, and side effects of study drugs such as headache and dizziness was carried out postoperatively for 24 h. The incidence of PONV was significantly smaller in group MO than group M and group O, while there was no significant difference between group M and group O during the first 24 h postoperatively. Requirement to the additional antiemetic was significantly more in group S (71.4%) compared to other groups, while in group MO (11.4%) was lower than group M (31.4%) and group O (34.3%). Our study showed that prophylactic administration of midazolam 0.75 mg/kg combined with ondansetron 4 mg was more effective than using midazolam or ondansetron alone in prevention of PONV after middle ear surgery.
Either general or regional anesthesia can be used for lumbar disk surgery. The common anesthetic ... more Either general or regional anesthesia can be used for lumbar disk surgery. The common anesthetic technique is general anesthesia (GA). The aim of this study was to compare the intra and postoperative outcomes of spinal anesthesia (SA) with GA in these patients. Seventy-two patients were enrolled in the study. They were randomized into two groups with 37 patients in GA Group and 35 ones in SA Group. The heart rate (HR), mean arterial pressure (MAP), blood loss, surgeons satisfaction with the operating conditions, the severity of postoperative pain based on visual analogue scale (VAS) and analgesic use were recorded. The mean blood loss was significantly less in the SA Group compared to GA Group (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Intraoperative maximum blood pressure and heart rate changes were significantly less in SA Group (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The surgeons satisfaction was significantly more in the SA Group (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The number of patients who used postoperative analgesic as well as postoperative mean VAS was significantly less in SA Group in comparison with GA group (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05 for both). Our study showed that SA was superior to GA in providing postoperative analgesia and decreasing blood loss while maintained better perioperative hemodynamic stability without increasing adverse side effects.
Background and purpose: Propofol causes pain and hypotension when it was injected. Magnesium (Mg)... more Background and purpose: Propofol causes pain and hypotension when it was injected. Magnesium (Mg) and ketamine are antagonists of the N-methyl-d-aspartate (NMDA) receptor ion channel and cause analgesia. In view of the analgesic activity of Mg and ketamine, we tested the ...
The efficacy of using midazolam or haloperidol for prevention of postoperative nausea and vomitin... more The efficacy of using midazolam or haloperidol for prevention of postoperative nausea and vomiting (PONV) has been investigated before. The main object of the present study was to evaluate the anti-emetic effects of combining administration of intravenous haloperidol with intravenous midazolam on PONV in patients underwent middle ear surgery in comparison with using each drug alone. Study design was randomized, double-blind, placebo-controlled. 80 patients, aged 18-60 years, scheduled for middle ear surgery in Kashani Hospital Medical Center under general anesthesia were enrolled in this randomized, double-blind, placebo-controlled study. Patients were divided into 4 groups of 20 each and received haloperidol 2 mg i.v. (Group H); midazolam 2 mg i.v. (Group M); haloperidol 2 mg plus midazolam 2 mg i.v. (Group HM); saline i.v. (Group C). The incidences of PONV and complete response were evaluated at 0-2 hours after arrival to the PACU and 2-24 hours after arrival to the ward in 4 groups. Patients in group HM had significantly lower incidence of PONV compared with groups H, M, and C throughout 0-24 h (P&amp;amp;amp;amp;amp;amp;lt;00.5). The HM group had the lowest incidence of PONV (0-2, 2-24, and 0-24 h) and the highest incidence of complete response. Postoperative anti-emetic requirement was significantly less in group HM compared with group M or H (P&amp;amp;amp;amp;amp;amp;lt;0.05). Combine administration of haloperidol 2 mg plus midazolam 2 mg significantly reduced PONV better than using each drug alone in patients underwent middle ear surgery under general anesthesia.
Metoclopromide have local anesthetic properties. The main object of performing the present study ... more Metoclopromide have local anesthetic properties. The main object of performing the present study was to evaluate the analgesic effect of metoclopromide 10 mg when added to lidocaine for intravenous regional anesthesia (IVRA) of upper extremities in trauma patients. Ninety patients undergoing upper limb producer were randomly allocated to the three groups to receive 3 mg/kg 2% lidocaine diluted with saline to a total dose of 40 ml (Group L, n = 30) or 10 mg metoclopromide plus 3 mg/kg 2% lidocaine diluted with saline to a total dose of 40 ml (group LM, n = 30) or 3 mg/kg 2% lidocaine diluted with saline to a total dose of 40 ml plus 10 mg metoclopromide intravenously (Group IM, n = 30). Our study showed that the onset times for sensory and motor block were significantly shorter in Group LM compared with Group L and Group IM (4.5 ± 0.7 vs. 5.0 ± 0.7 and 5.0 ± 0.6, respectively, P = 0.006 for sensory block; 6.3 ± 0.7 vs. 5.1 ± 0.9 and 5.9 ± 0.6 respectively, P = 0.000 for motor block). The postoperative VAS scores were significantly less at 1, 5, 10, 15, and 30 minutes after tourniquet release in Group LM compared with Group L and Group IM (P &amp;amp;lt; 0.05). The results of our study showed that adding 10 mg metoclopromide to lidocaine for IVRG in trauma patients reduced intraoperative and postoperative analgesic use till 24 hours and improve quality of anesthesia.
Coughing and laryngospasm are undesirable outcomes occurring during emergence from general anesth... more Coughing and laryngospasm are undesirable outcomes occurring during emergence from general anesthesia. We compared the effect of small doses of propofol, ketamine and a combination of them on the occurrence and severity of coughing and laryngospasm in patients awakening from general anesthesia. 160 patients who were scheduled to undergo operations under general anesthesia were randomly assigned to one of the following groups, 40 in each group: propofol group (0.25 mg/kg intravenous (IV) propofol), ketamine group (0.25 mg/kg IV ketamine), combination group (0.25 mg/kg IV propofol, and 0.25 mg/kg IV ketamine) and control (0.1 ml/kg IV saline). Drugs were administered before extubation at previously defined time. Presence and severity of coughing and laryngospasm were recorded within twominutes after extubation. The presence of coughing in the combination group (27.5%) was less than that in other groups; also it was less frequent in the propofol group (57.5%) than the control (82.5%) (...
Ulusal Travma Ve Acil Cerrahi Dergisi Turkish Journal of Trauma Emergency Surgery Tjtes, Feb 1, 2009
Microalbuminuria, which predicts organ failure, probably predicts the necessity of mechanical ven... more Microalbuminuria, which predicts organ failure, probably predicts the necessity of mechanical ventilation as well as its duration. The primary goal of this study was to determine the incidence and presence of a relationship between microalbuminuria and duration of mechanical ventilation in trauma intensive care unit (ICU) patients. Sixty admitted critically ill trauma patients were categorized by duration of mechanical ventilation to group A (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =7 days) or group B (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;7 days) in this prospective observational study. We measured serial spot urine micro-albumin-creatinine ratios (ACR) on admission to the ICU (ACR-1), at 24, 72, and 120 hours after admission, and on the days of beginning and discontinuation of mechanical ventilation (ACR-2 and ACR-3, respectively). Seventy percent of the patients had microalbuminuria and 63.3% had an ACR &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =100 mg g-1 at admission. ACR-1 [mean (SE)] in patient groups A and B was 30 (6) and 63 (16) mg g(-1) (p=0.0002); ACR-2 was 40 (4) and 52 (8) (p=0.007); and ACR-3 was 30 (11) and 44 (11), respectively (p=0.023). For all patients, mean (SE) ACR-2 fell from 37 (4) to 34 (8) mg g(-1) on the day of discontinuation of mechanical ventilation (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). The ACR can be used in estimating the risk of prolonged mechanical ventilation, even on the first day of admission of critically ill trauma patients.
Ulusal Travma Ve Acil Cerrahi Dergisi Turkish Journal of Trauma Emergency Surgery Tjtes, Nov 1, 2008
The predictive ability of body mass index (BMI) or C-reactive protein (CRP) as a simple, inexpens... more The predictive ability of body mass index (BMI) or C-reactive protein (CRP) as a simple, inexpensive, and dynamic marker of critical illness in patients requiring mechanical ventilation (MV) is unknown. This study was thus conducted to determine the incidence and presence of a relationship between the predictors of BMI or CRP and duration of MV in trauma patients admitted to the intensive care unit (ICU). This prospective observational study included 72 critically ill trauma patients. Admitted patients were categorized by duration of MV to Group A (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =7 days) and Group B (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;7 days). The biological status of patients was assessed by the serial measurement of CRP on admission to the ICU (T1), at 48 and 72 hours after admission, and on the day of beginning (T2) or discontinuation (T3) of MV. Data on BMI, serum albumin, and the Sequential Organ Failure Assessment (SOFA) score were also collected at T2 or T3. At T3, the SOFA score, BMI, albumin, and CRP were significantly higher in patients in Group B compared with Group A (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). The incidence of low BMI (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =20 kg/m2) or high CRP (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;10 mg/L) in patients in Group B was significantly higher at T2 or T3 compared with Group A (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). At T3, CRP was determined as the most powerful predictor of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;7 days of MV followed by BMI. Both BMI and CRP, comparable with the SOFA score, can be used in estimating the risk of prolonged MV.
Feyz Journals of Kashan University of Medical Sciences, 2008
Background: Although the predictive criteria for duration of mechanical ventilation may help to e... more Background: Although the predictive criteria for duration of mechanical ventilation may help to evaluate the right time of disconnecting a patient from the ventilator, the efficacy of the APACHE ( Acute physiology, Age and Chronic Health Evaluation) or IPS (Infection Probability ...
Middle East Journal of Anaesthesiology, Oct 1, 2007
BACKGROUND/OBJECTIVE: No previous study exists to evaluate admission serum magnesium level as a p... more BACKGROUND/OBJECTIVE: No previous study exists to evaluate admission serum magnesium level as a predictor of morbidity or mortality. The aim of this study was to define the prevalence of admission hypomagnesemia in critically ill patients and to evaluate its relationship with organ dysfunction, length of stay, and mortality.METHODS: A retrospective study was done on 100 patients > or =16 years old, admitted to the medical-surgical intensive care unit (ICU) at the University Hospital over 2 years period. Observations were made on admission total serum magnesium level, a variety of lab tests related to magnesium, need for ventilator, duration of mechanical ventilation, hospital/ICU lengths of stay, and general patient demographics.RESULTS: The serum magnesium level (normal value, 1.3-2.1 mEq/L) was measured at admission. At admission, 51% of patients had hypomagnesemia, 49% had normal magnesium levels. There was significant difference in mortality rate (55% vs 35%), the length of hospital (15.29 +/- 0.66 vs 12.81 +/- 0.91), or ICU (9.16 +/- 0.53 vs 5.71 +/- 0.55) stay between these two groups of patients (p < 0.05 for all). Hypomagnesemic patients more frequently had total hypocalcemia, hypokalemia, and hyponatremia. A total of 51 patients developed hypomagnesemia during their ICU stay; these patients had higher Acute Physiology And Chronic Health Evaluation II (APACHE II) (14.16 +/- 1.03 vs 10.80 +/- 0.94) and Sequential Organ Failure Assessment (SOFA; 10.89 +/- 0.90 vs 7.58 +/- 5.01) scores at admission (p < 0.01 for both), a higher maximum SOFA score during their ICU stay (14.75 +/- 0.73 vs 8.08 +/- 0.52, p < 0.01), a more need to ventilator (58.6% vs 41.4%, p < 0.05), and longer duration of mechanical ventilation (7.2 vs 4.7 day, p < 0.01) than the other patients. The ROC curve of SOFA score in the hypomagnesemia yields significantly better results than APACHE II. An increase of 5 units in the APACHE II or SOFA measured on admission increase relative probability of hypomagnesemia by a factor of 0.12 and 0.16 respectively.CONCLUSION: Development of hypomagnesemia during an ICU stay is associated with guarded prognosis. Monitoring of serum magnesium levels may have prognostic, and perhaps therapeutic, implications.
The aim of this study was to compare the efficacy intravenous (IV) ondansetron with ketamine plus... more The aim of this study was to compare the efficacy intravenous (IV) ondansetron with ketamine plus midazolam for the prevention of shivering during spinal anesthesia (SA). Ninety patients, aged 18-65 years, undergoing lower extremity orthopedic surgery were included in the present study. SA was performed in all patients with hyperbaric bupivacaine 15 mg. The patients were randomly allocated to receive normal saline (Group C), ondansetron 8 mg IV (Group O) or ketamine 0.25 mg/kg IV plus midazolam 37.5 μg/kg IV (Group KM) immediately after SA. During surgery, shivering scores were recorded at 5 min intervals. The operating room temperature was maintained at 24°C. The incidences of shivering were 18 (60%) in Group C, 6 (20%) in Group KM and 8 (26.6%) in Group O. The difference between Groups O and Group KM with Group C was statistically significant (P < 0.05). No significant difference was noted between Groups KM with Group O in this regard (P > 0.05). Peripheral and core temperat...
The purpose of the present study was to evaluate the efficacy of midazolam-ondansetron combinatio... more The purpose of the present study was to evaluate the efficacy of midazolam-ondansetron combination in prevention of postoperative nausea and vomiting (PONV) after middle ear surgery and its comparison with using midazolam or ondansetron alone. One hundred and forty patients were enrolled in four groups to receive midazolam 0.75 mg/kg in group M, ondansetron 4 mg in group O, midazolam 0.75 mg/kg and ondansetron 4 mg in group MO, and saline 0.90% in group S intravenously just before anesthesia. Assessment of nausea, vomiting, rescue antiemetic, and side effects of study drugs such as headache and dizziness was carried out postoperatively for 24 h. The incidence of PONV was significantly smaller in group MO than group M and group O, while there was no significant difference between group M and group O during the first 24 h postoperatively. Requirement to the additional antiemetic was significantly more in group S (71.4%) compared to other groups, while in group MO (11.4%) was lower than group M (31.4%) and group O (34.3%). Our study showed that prophylactic administration of midazolam 0.75 mg/kg combined with ondansetron 4 mg was more effective than using midazolam or ondansetron alone in prevention of PONV after middle ear surgery.
Either general or regional anesthesia can be used for lumbar disk surgery. The common anesthetic ... more Either general or regional anesthesia can be used for lumbar disk surgery. The common anesthetic technique is general anesthesia (GA). The aim of this study was to compare the intra and postoperative outcomes of spinal anesthesia (SA) with GA in these patients. Seventy-two patients were enrolled in the study. They were randomized into two groups with 37 patients in GA Group and 35 ones in SA Group. The heart rate (HR), mean arterial pressure (MAP), blood loss, surgeons satisfaction with the operating conditions, the severity of postoperative pain based on visual analogue scale (VAS) and analgesic use were recorded. The mean blood loss was significantly less in the SA Group compared to GA Group (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Intraoperative maximum blood pressure and heart rate changes were significantly less in SA Group (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The surgeons satisfaction was significantly more in the SA Group (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The number of patients who used postoperative analgesic as well as postoperative mean VAS was significantly less in SA Group in comparison with GA group (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05 for both). Our study showed that SA was superior to GA in providing postoperative analgesia and decreasing blood loss while maintained better perioperative hemodynamic stability without increasing adverse side effects.
Background and purpose: Propofol causes pain and hypotension when it was injected. Magnesium (Mg)... more Background and purpose: Propofol causes pain and hypotension when it was injected. Magnesium (Mg) and ketamine are antagonists of the N-methyl-d-aspartate (NMDA) receptor ion channel and cause analgesia. In view of the analgesic activity of Mg and ketamine, we tested the ...
Mohammadreza Safavi, Azim Honarmand, Elham Ghorbani Dasgerdi, Ghasem Mohammad Sharifi
Department ... more Mohammadreza Safavi, Azim Honarmand, Elham Ghorbani Dasgerdi, Ghasem Mohammad Sharifi Department of Anesthesia, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Papers by Azim Honarmand
Department of Anesthesia, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran