Review Article
Yazdan Dokht Ghaffari; Naser Ghorbanian
Abstract
Introduction: Since general surgeries have a wide range of types of surgeries and the possibility of cognitive disorders in these patients is high and can increase mortality and complications after surgery, the present study was designed and conducted following the question that do changes in blood sugar, ...
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Introduction: Since general surgeries have a wide range of types of surgeries and the possibility of cognitive disorders in these patients is high and can increase mortality and complications after surgery, the present study was designed and conducted following the question that do changes in blood sugar, electrolytes, and blood pressure cause cognitive disorders in patients who are candidates for general surgery under general anesthesia, or not?
Methodology: This article was carried out by using a non-systematic and descriptive review method; the non-systematic method by searching without any restrictions in Web of Science, Google Scholar, Scopus, Medline, and PubMed by using keywords selected based on the mesh including: Blood sugar, glucose, hyperglycemia, hypoglycemia, general anesthesia, surgery, surgery general, pain, electrolyte, vitamin, blood pressure, cognitive impairment, post-surgery, and delirium were done.
Results: A total of 38 articles were found (12 articles related to the relationship between blood glucose and cognitive disorders, 13 articles about electrolytes and cognitive disorders, and 13 articles about blood pressure and cognitive disorders) and it was evaluated that these articles were published from 2005 (one article) to 2022.
Conclusion: The changes and fluctuations of blood sugar, electrolytes, and blood pressure during general anesthesia in patients who are candidates for general surgery are one of the important and fundamental factors in the occurrence of cognitive disorders after surgery. Therefore, preventive measures should be considered for all patients.
Original Research Article
Sara Rozmina; Ahmad Bagheri Moghadam; Seyed Majid Sadrzadeh; Vida Vakili; Hamid Zamani Moghaddam; Morteza Talebi Doluee
Abstract
Background and Aim: Patients with ventilator-associated pneumonia (VAP) have high morbidity and mortality. Some evidence suggests that aspiration of the colonized oropharyngeal and gastric contents can be regarded as a risk factor for the incidence of VAP in patients undergoing endotracheal intubation. ...
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Background and Aim: Patients with ventilator-associated pneumonia (VAP) have high morbidity and mortality. Some evidence suggests that aspiration of the colonized oropharyngeal and gastric contents can be regarded as a risk factor for the incidence of VAP in patients undergoing endotracheal intubation. In this study, we sought to compare the effects of ranitidine and pantoprazole on the incidence of VAP.Subjects and Methods: In this double-blind clinical trial, 180 patients undergoing endotracheal intubation and mechanical ventilation were assigned to two groups based on the inclusion and exclusion criteria. Prophylaxis with pantoprazole and ranitidine was administered for the two groups (n=90 each), and then the patients were followed up for the detection of VAP and clinical signs of pneumonia. Finally, the patients’ demographic and clinical data were analyzed in SPSS, version 18.Results: Of the 180 patients enrolled in the study, 36 (20%) patients were diagnosed with VAP, 19 (52.7%) of whom belonged to the Ranitidine group and 17 (47.2%) pertained to the Pantoprazole group (P=0.1). The daily risk for VAP in the two groups and each group separately was 1.7%.Conclusion: Pantoprazole and ranitidine have similar effects on the incidence of pneumonia caused by endotracheal intubation. However, due to the lack of convincing evidence, further studies are recommended.
Solmaz Fakhari; Eissa Bilehjani
Abstract
Introduction: Cesarean section is one of the most common surgeries in the field of gynecology, after which pain leads to many complications; The aim of this study was to compare the effects of propofol and ketamine on postoperative complications under spinal anesthesia.Material and Methods: In this study, ...
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Introduction: Cesarean section is one of the most common surgeries in the field of gynecology, after which pain leads to many complications; The aim of this study was to compare the effects of propofol and ketamine on postoperative complications under spinal anesthesia.Material and Methods: In this study, in order to compare the effect of propofol and ketamine on pain, chills and nausea and vomiting after cesarean section under spinal anesthesia, 111 patients who were candidates for elective cesarean section were compared in terms of side effects of propofol and ketamine.Results: The rest of the pain intensity in the ketofol and ketamine groups was significantly lower than the other groups, respectively (p <0.05); Also, the rate of drug use in the ketofol and ketamine groups was significantly lower than the other groups, respectively (p <0.05).Conclusion: The combination of ketamine + propofol (ketofol) can control the complications after spinal anesthesia in elective cesarean section.
Review Article
Mansour Rezaei; Ramin Azhough
Abstract
Introduction: Diosmin is effective in inhibiting the inflammatory response pathways and improving the acute and chronic symptoms of hemorrhoids. Very few studies have been conducted in this field, and the effectiveness of this drug in different studies has not been presented in a single study so that ...
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Introduction: Diosmin is effective in inhibiting the inflammatory response pathways and improving the acute and chronic symptoms of hemorrhoids. Very few studies have been conducted in this field, and the effectiveness of this drug in different studies has not been presented in a single study so that it can be used or not used based on its results. Therefore, the present study aims to investigate the effectiveness of Diosmin on pain after hemorrhoidectomy in the form of a systematic review of clinical trial studies.
Methods: The present study was a systematic review that was designed and conducted based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. The search was done in SID, Magiran, Embase, PubMed, Cochrane Library, Scopus, and Web of Science databases by following the entry and exit criteria and the keywords such as pain, hemoroide, hemorrhoidectomy, Diosmin, surgery, and post-operative.
Results: 824 patients participated in these 4 randomized clinical trial studies (with a high quality). The instrument used to assess pain intensity in all studies was the Visual Analogic Scale. Diosmin tablets were prescribed in two forms: 500 mg (in three studies) and 300 mg (in one study) after hemorrhoidectomy. In three studies, Diosmin tablets led to a reduction in pain intensity after hemorrhoidectomy, and in one study, no significant difference was seen.
Conclusion: The results of our study indicated that the use of 500 mg Diosmin oral tablets can lead to a reduction in pain intensity after hemorrhoidectomy. Due to the lower number of studies, the results of this study should be used with caution.
Original Research Article
Navid Kalani; Mojtaba Ghaedi; Elham Javidmehr; Hasan Zabetian
Abstract
Background: To relieve the pain caused by propofol injection, a wide range of medicinal and non-pharmacological methods have been investigated. The present study was conducted with the aim of comparing two drugs, ephedrine and dexamethasone, on the pain caused by propofol injection in patients undergoing ...
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Background: To relieve the pain caused by propofol injection, a wide range of medicinal and non-pharmacological methods have been investigated. The present study was conducted with the aim of comparing two drugs, ephedrine and dexamethasone, on the pain caused by propofol injection in patients undergoing elective surgery.Methods: This double-blind randomized clinical trial study was conducted on 60 patients who were candidates for elective surgery referred to Peymaniyeh Hospital in Jahrom City. Patients were divided into two groups A: dexamethasone with a dose of 8 mg/kg and group B: ephedrine with a dose of 5 mg using a table of random numbers. Dexamethasone and ephedrine were injected within 5 seconds, and after 30 seconds, propofol 1% in the amount of 3 ml (equivalent to 30 mg) was injected into the corresponding vein at a speed of 0.5 ml per second. After the injection, the patient was clearly asked about pain or discomfort at the injection site, and the answer was yes or no, and if there was pain, its severity was recorded in the questionnaire based on verbal descriptions. The data was analyzed using SPSS Software (version 21) and using descriptive (frequency, number, standard deviation, and mean) and inferential (Chi-square test) statistics. P<0.05 was considered as significant.Findings: 60 patients included in the study were divided into two groups of 30 dexamethasone and ephedrine. There was no statistically significant difference between both groups in terms of demographic characteristics (age, gender, and weight) and they were the same. Comparing the pain made by propofol injection in dexamethasone and ephedrine groups, using the Chi-square test, showed that the frequency of pain in the ephedrine group (33.3%) was not significant compared with dexamethasone group (40%) (P=0.23).Conclusion: Based on the results of the present study, although more people in the ephedrine group were pain free, the amount of pain in the ephedrine and dexamethasone groups was not statistically significant.
Original Research Article
Navid Kalani; Mohammad Sadegh Sanie Jahromi; Reza Sahraeai; Shahram Shafa; Mojtaba Ghaedi; Mahbobeh Ranjbar; Hasan Zabetian
Abstract
Introduction: Pain and anxiety after surgery is an unpleasant experience that occurs following various stimuli and humans react to it. This process causes physiological disorders in all body systems. Therefore, the purpose of this study is to compare the effect of oral melatonin and gabapentin ...
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Introduction: Pain and anxiety after surgery is an unpleasant experience that occurs following various stimuli and humans react to it. This process causes physiological disorders in all body systems. Therefore, the purpose of this study is to compare the effect of oral melatonin and gabapentin on pain and anxiety in patients undergoing upper extremity orthopedic surgery under general anesthesia.Methods: In this double-blind randomized clinical trial study, 90 patients with anesthesia class 1 and 2 underwent upper limb orthopedic surgery with general anesthesia. Patients were divided into 3 groups, gabapentin, melatonin, and placebo. VAS scale was used to measure patients' pain. Patients' hemodynamic symptoms were further investigated. Data analysis was done using descriptive and inferential statistical tests at a significance level of P<0.05.Results: 90 patients underwent upper limb orthopedic surgery under general anesthesia. There was no significant difference between the three groups of gabapentin, melatonin, and placebo in the incidence of pain at different times (P<0.05). Trends in mean diastolic blood pressure was not significant (P=0.612). Trends in the average heart rate from the time before entering the operating room to recovery and its exit was not significant (P<0.05).Conclusion: The results of the present study showed that both gabapentin and melatonin drugs have no effect on postoperative pain in patients undergoing upper limb orthopedic surgery, and it may be better to use other drugs or in combination with other sedative drugs.
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