Comparison of cardiac stress index with rate pressure product in trans - abdominal prostatectomy

The current study is to evaluate cardiovascular effects of anesthetic medications and volatile anesthetics on cardiac stress using cardiac stress index [CSI] and rate pressure product [RPP] and to determine which of them in useful in evaluating cardiac stress after comparing results obtained from each method. Forty patients, 60-80 years old, who were all performed Trans abdominal prostatectomy, were studied. Patients were divided into tm groups; half of patients were placed in group A and the other half in group B. The study was carried out as a blinded study. CCSI was measured and evaluated in group A and RPP changes were studied in group B. The mean CSI were 60.25 +/- 5.57, 63.05 +/- .54, 55.75 +/- 4.78 and 67.65 +/- 4.88 before anesthesia induction, after induction, before surgical incision and in recovery respectively. There was no meaningful difference among these four stages measurements. RPP mean in four above mentioned stages was 10.15 +/- 0.44, 9.9 +/- 0.69, 6.8 +/- 0.36 and 9.2 +/- 0.61 respectively. There was a significant difference between RPP in stages before anesthesia induction and before surgical incision [P< 0.0001]. Considering the obtained results from this study, it can be seen that even in non-cardiac surgery, the stress level is high in patients in preoperative period. This condition was not clear in RPP index case and was not in accordance with CSI, which means CSI has been able to illustrate existing stress level better and efficiently

wake tracheal intubation via intubating laryngeal mask vs direct laryngoscopy and cervical spine excursion

To compare intubating laryngeal mask airway [ILMA] with direct laryngoscopy in patients with cervical spine injury. Prospective, hospital based study conducted during March 2004 to May 2005, in Imam Khomeini Hospital, Tabriz Medical Science University, Iran. We compared the excursion of the upper cervical spine during tracheal intubation using direct laryngoscopy with awake intubation via Laryngeal mask airway in 40 patients. Intubating laryngeal mask caused less extension [at C2-3 and C1-2] than intubation by direct laryngoscope. Patients, who were locally anesthetized and sedated tolerate intubation well. However laryngoscopy is still the fastest method to secure an airway. In traumatic patients who require intubation and have limitation with cervical spine movement, we can use intubating laryngeal mask in awake patients locally anesthetized as a safe, tolerable and relatively fast method to secure an airway