ABSTRACT
The administration of crystalloid fluids is considered as the first line treatment in management of trauma patients. Infusion of intravenous fluids leads to various changes in hemodynamic, metabolic and coagulation profiles of these patients. The present study attempted to survey some of these changes in patients with mild severity trauma following normal saline infusion. This study comprised 84 trauma patients with injury of mild severity in Shahid Rajaei Hospital, Shiraz, Iran, during 2010-2011. The coagulation and metabolic values of each patient were measured before and one and six hours after infusion of one liter normal saline. Then, the values of mentioned parameters on one and six hours after infusion were compared with baseline measures using repeated measures analysis of variance. Eighty four patients included in the present study [76% male]. Hemoglobin [Hb] [df: 2; F=32.7; p<0.001], hematocrit [Hct] [df: 2; F=30.7; p<0.001], white blood cells [WBC] [df: 2; F=10.6; p<0.001], and platelet count [df: 2; F=4.5; p=0.01] showed the decreasing pattern following infusion of one liter of normal saline. Coagulation markers were not affected during the time of study [p>0.05]. The values of blood urea nitrogen [BUN] showed statistically significant decreasing pattern [df: 2; F=5.6; p=0.007]. Pressure of carbon dioxide [PCO2] [df: 2; F=6.4; p=0.002], bicarbonate [HCO3] [df: 2; F=7.0; p=0.001], and base excess [BE] [df: 2; F=3.3; p=0.04] values showed a significant deteriorating changes following hydration therapy. It seems that, the infusion of one liter normal saline during one hour will cause a statistically significant decrease in Hb, Hct, WBC, platelet, BUN, BE, HCO3, and PCO2 in trauma patients with mild severity of injury and stable condition. The changes in, coagulation profiles, pH, PvO2, and electrolytes were not statistically remarkable
ABSTRACT
Despite several recent innovations in phacoemulsification surgery, importance of pupil diameter in this surgery is becoming more evident. To compare the effect of opioid agonist [fentanyl] versus opioid agonist-antagonist [buprenorphine] on pupil diameter in cataract surgery and to choose the best opioid in high-risk phacoemulsification surgery. In this randomized double-blinded clinical trial, 60 patients who were candidates for elective phacoemulsification surgery were randomly divided into two equal groups: experimental [buprenorphine, 0.3 microg/kg] and control [fentanyl, 1 microg/kg]. Pupil diameter was measured preinjection and at several times postinjection. Blood pressure was recorded at several intervals, as well as shivering, nausea and vomiting, and recovery time. Mean [SD] recovery time was significantly less in the control group [19.46 +/- 5.43] than in the experimental group [33.23 +/- 10.75] [P < 0.0001]. The constriction effect [ie, pupillary diameter in mm] was significantly lower in the experimental group [0.53 +/- 0.45] than in the control group [1.06 +/- 0.52] [P=0.0001]. The percentages of constriction effect in experimentaland control groups were 7.68% and 15.07%, respectively. The eye was two times more constricted in the control group in comparison with the experimental group after induction of anesthesia. Buprenorphine is a better solution to decrease pupil constriction in comparison with fentanylinhigh-risk phacoemulsification surgery