ABSTRACT
The Apgar score [Appearance, Pulse, Grimace, Activity, and Respiration] of newborn babies immediately after birth is a determining factor involved with mortality of newborns after birth. Regarding the disagreement on advantages and possible disadvantages of propofol rather thiopental in the available references, the study was triggered with the aim of analyzing effects of two mentioned drugs on babies' apgar score, mothers' nausea, vomit and time necessary for mothers' recovery. In this double-blind clinical trial, a total of 230 healthy women who were volunteered to undertake cesarean operation were selected and then divided randomly into two equal groups using statistical blocking. One group was treated by propofol while other one was treated by thiopental. The prescribed drugs for both groups were identical except the anesthesia induction drug. Babies' Apgar score 1 and 5 minutes after birth and recovery period, mothers' nausea and vomiting after operation were recorded. Apgar score I minute 1 [p=0.041] and apgar score in minute 5 [p=0.034] for propofol group were meaningfully higher than those for thiopental group. Recovery time from anesthesia was not different meaningfully in two groups [p=0.67]. Statistical analysis of nausea and vomit in both groups showed that they are lower in propofol group rather thiopental group [p=0.028]. It seems that in cesarean operations, after sufficient fluid therapy, propofol can be a proper drug to achieve anesthesia. Moreover it exerts less impact on cesarean babies' apgar and stimulates lower levels of nausea and vomiting in mothers
ABSTRACT
Cardiovascular operations are associated with an inherent bleeding tendency that sometimes leads to severe bleeding and transfusion requirement. Pharmacological intervention to minimize post-bypass bleeding and blood product transfusions has received increasing attention from both medical and economic viewpoints. This double-blind, randomized, placebo-controlled clinical trial recruited three groups of patients [each group consisting of 50patients] undergoing on-pump coronary artery bypass graft surgery [CABG] and blindly randomized them to receive either low aprotinin, tranexamic acid, or placebo. The results were, subsequently, evaluated and compared between the groups. All the patients were operated on by one surgeon and the same surgery team. The following variables were similar between the groups, and there was no statistically significant difference between the groups in terms of these variables: age [p value = 0.308], sex [p value = 0.973], hyperlipidemia [p value = 0.720], hypertension [p value = 0.786], smoking [p value = 0.72], and diabetes [p value = 0.960]. The amounts of drainage from chest tubes were less in the aprotinin and tranexamic acid groups than the amount in the placebo group; the difference was statistically important [p value < 0.001]. There was no statistically significant difference with respect to need for reoperation for bleeding between the three groups [p value = 0.998]. Complications following surgery in the three groups were statistically the same and not significantly different. All the complications [myocardial infarction, pericardial effusion, neurological complication and renal complication] had a good course, and all the patients were discharged from the hospital uneventfully. There was no mortality in any group. Low-dose aprotinin and tranexamic acid can significantly reduce blood loss and transfusion requirement in CABG without importantly increasing mortality and morbidity