ABSTRACT
Background: spinal Anesthesia has numerous indications in lower abdomen surgery, but duration of analgesia and anesthesia is one of the limitations of this method. Lidocaine-the most common drug in Spinal anesthesia causes a short term anesthesia and analgesia which is lower than one hour. Today different kinds of drugs are for enhancing onset increasing intensity and analgesia duration in spinal anesthesia such as magnesium sulfate which it blocks NMDA receptors
Materials and Methods: in the randomized double blind clinical trial study, 80 patients candidate for first cesarean surgery in Shariati Hospital were divided into two groups. In control group 2ml Lidocaine 5% + 0.5ml sterile water was injected and in the study group 2ml Lidocaine 5% + 0.5ml magnesium sulfate 10% without preservative was injected. The patients were immediately tilted to head up position
Results: level of sensory block was evaluated by pin-prick test in midclavicular line. Analgesia duration was considered from the time of injection until the patient's request for analgesic or complaining of pain. Anesthesia level was T6 in most patients. Analgesic duration in case group was between 160.8+49.1 min, in control group was 113.3+7.3 min. That is statistically significant [p=0.001]
Conclusions: when Mgso4 is added to lidocaine in spinal anesthesia, the duration of analgesia is increased significantly [P<0.05]. This increase of duration of analgesia was not accompanied by increase of side effects. Based on the results of our study, complications such as nausea, vomiting, dyspnea during the surgery and in the recovery room, hypotension during surgery were not statistically different between two groups [p>0.05]
ABSTRACT
Labor pain is considered as one of the most important causes of stress for the parturient. The aim of this study was to compare the effects of subcutaneous injection of 1% lidocaine with normal saline in the lumbosacral region on labor pain reduction and their complications. Seventy para 2, term ASA I parturient were enrolled in a randomized clinical trial and randomly allocated to lidocaine group [injection of 0.5 ml 1% lidocaine or control group [injection of 0.5 ml normal saline]. Drugs were injected subcutaneously at 4 points in lumbosacral region [Michaelis' rhomboid] by an insulin syringe. Labor pain was assessed by visual analogue scale 15, 40 and 60 minutes after injections. There were no significant differences among age, systolic and diastolic blood pressures and fetal or maternal age between groups. The pain intensities in lidocaine group were significantly lower 15, 40 and 60 minutes after injections compared with normal saline group. There was no significant difference between normal saline pain intensity after injection compared with before injection but in lidocaine group all the post-injection pain intensities were significantly lower compared to pre-injection. There -were no cases of hemodynamic instability or fetal complications. Subcutaneous injection of 1% lidocaine in the Michaelis rhomboid region is accompanied by minimal hemodynamic changes or complications and significant reduction in labor pain
Subject(s)
Humans , Female , Lidocaine , Lidocaine/administration & dosage , Injections, Subcutaneous , Lumbosacral RegionABSTRACT
Background: Total Intravenous Anesthesia [TIVA] compared to general anesthesia has some pits and falls. Many drugs have been employed for this anesthesia. Propofol is accounted as the last advent anesthetic drug. It belongs to alkyl phenol families and has been accounted one of the best choices for the continuous infusion. Invention of midazolam as the first water soluble benzodiazepine was also an important event in anesthesia and it can be used as continuous infusion for the anesthesia
Materials and Methods: In this randomized controlled clinical trial, alfentanyl plus propofol or midazolam were used for TIVA anesthesia in 60 female patients undergoing Dilatation and Curettage [D and C] in Dr. Shariati hospital in March 2002 till March 2003. They were allocated reandomly in two group of alfentanyl plus propofol [propofol group] or alfentanyl plus midazolam [midazolam group]
Results: There was no significant difference in mean of age between propofol group and midazolam group [P>0.05], also There was no significant difference in preanesthesia condition such as blood pressure and heart rate between propofol group and midazolam group [p>0.05]. After induction of anesthesia there was a gross blood pressure decrease in both group that it was greater in midazolam group [85 mmHg versus 73 mmHg, P<0.05 ] following this, there was an increase in heart rate in both groups that it was modest in propofol group [98 Beat/Sec versus 118 Beat/Sec, P<0.05]. There was no significant difference in mean infused alfentanyl [P>0.05] also there was just one naloxane injection in midazolam group that have no significant difference between groups [P>0.05]. Recovery room stay was significantly lower in propofol group [25 minutes versus 39 minutes, P<0.05]
Conclusion: The results of this study was similar to Vuyk et.al. In their study there was a significant lower recovery time estimated by psychomotor reflexes and there was significant lower drowsiness, place and time orientation time compared to midazolam group. Finally according to the results of this study it can be resulted that TIVA with propofol is more suitable than midazolam and it can lower hospitalization time and cost. In future studies using other narcotics and other narcotics-anesthetic compounds with various dose can be mentioned