ABSTRACT
Hyperthyroidism can occur with pregnancy. Thyroid storm is a life-threatening exacerbation of hyperthyroidism. The mortality rate for thyroid storm remains surprisingly high at approximately 20%. A 21-year-old primigravida woman presented at 25 weeks, with severe pre-eclampsia and uncontrolled hyperthyroidism was scheduled for emergency cesarean section. Treatment includes rapid alleviation of thyrotoxicosis and general supportive care. Thyroid function tests may not help in differentiating thyroid storm from symptomatic hyperthyroidism. The major risk of anesthesia in the poorly controlled thyrotoxic patient is thyroid storm, which must be aggressively treated with beta-blockers, iodide, and antithyroid drugs
ABSTRACT
Postoperative pain relief is one of the most important therapeutic aims, especially in orthopedic patients. This study was designed to compare the analgesic requirement in smoker and non smoker men after ORIF surgery under general Anesthesia. This was a "cohort study". 116 patients with fractures of both tibia and fibula, were placed in 2 equal groups, G.A was performed with halothan 0.8% and fentanyl and atracurium under mechanical ventilation. 4, 8 and 24 hours after the surgery, post operative pain was evaluated by means of VAS in recovery room. Collected data were recorded in designed questionnaires and injected doses of the opioid drug [pethidine 1 mg/kg] was extract from the patient's sheets. Data were analyzed by means of SPSS. Mann Whitney and T-tests were used for comparison of pain sensation in smokers and non smokers and analyzing quantitative data respectively. In summary, pain sensation and opioid requirement were more in smokers than nonsmokers, and with respective p values of 0.033 and 0.003, significant differences were detected in both aspects. The results of this study revealed that smokers felt more pain, and needed more opioid for pain relief. Therefore smoker men need more pain control