ABSTRACT
Background: There are two methods for ventilation in gynecological laparoscopy: volume-controlled ventilation [VCV] and pressure-controlled ventilation [PCV]
Objective: To compare the lung mechanics, hemodynamic response and arterial blood gas analysis and gas exchange of two modes of VCV and PCV using laryngeal mask airway [LMA] at different time intervals
Materials and Methods: Sixty infertile women referred for diagnostic laparoscopy, based on ventilation mode, were randomly divided into two groups of VCV [tidal volume: 10 ml/kg] and PCV. In the PCV group, ventilation was initiated with a peak airway pressure [tidal volume: 10 ml/kg, upper limit: 35 cm H[2]O]. In both groups, the arterial blood samples were taken in several time intervals [5, 10 and 15 min after LMA insertion] for blood gas evaluation. Also the lung mechanics parameters were continuously monitored and were recorded at different time intervals
Results: There were no significant differences for patient's age, weight, height and BMI in two groups. The peak and plateau airway pressure were significantly higher in VCV group compared to PCV group 5 and 10 min after insertion of LMA. PaO[2] was significantly higher after 10 and 15 min in VCV group compared to PCV group [p=0.005 and p=0.03, respectively]. PaCO[2] showed significant increase after 5 min in PCV group, but the differences were not significant after 10 and 15 min in two groups. The end tidal CO2 showed significant increase after 10 and 15 min in VCV compared to PCV group
Conclusion: Both VCV and PCV seem to be suitable for gynecological laparoscopy. However, airway pressures are significantly lower in PCV compared to VCV
ABSTRACT
Pain diagnosis is a frustrating effort especially due to the barriers in communication with patients in low level of consciousness; therefore this study ,aimed at the evaluation of utilizing BPS by nurses for patients who are unable to express their pain because of their low level of consciousness, has been designed. This research is a semi-empirical study on sixty eight nurses chosen with a census method from the staff of ICU in selected hospitals of Hamadan University of Medical Sciences. The subjects' abilities in diagnosis and determining the intensity of pain have been measured in three phases of resting, changing position and secretion suction in ICU patients before and after utilizing behavioral pain scale [BPS]. In Resting phase%25.5 in BPS pre-training,%56 in BPS post training, in changing position phase%58 in BPS pre-training,%76 in post training, and in secretion suction phase%60 in BPS pre-training and%80 in BPS post training of the nurses were able to determine the pain intensity. After being trained, also the number of the nurses who reported the intensity of pain in the mentioned phases was increased compared to BPS pre-training. [P<0/05]. The results of this study in utilizing BPS indicate that this scale has been effective in diagnosing and monitoring pain in patients with low levels of consciousness Therefore teaching and utilizing this kind of scale can be effective to raise the quality of medical treatment and pain management in ICU