Medical ethics in cardiac anesthesia

The source of the medical ethics in new sciences is from the principle of modernism. For this reason some of the subjects my not accepted with our Islamic culture. It is necessary that Iranian scientists review the western medical ethics, especially philosophy of medical ethics. Method in this article is qualitative research type, in this article we studied text books and articles about medical ethics, cardiac anesthesia and Islamic ideology. It is necessary to determined theoretical options of medical ethics in the different medical flieds with Iranian Islamic culture for increase quality of medical Treatment

Gabapentin may relieve post-coronary artery bypass graft pain: a double blind randomized clinical trial

One of the most common complaints after coronary artery bypass graft [CABG] is postoperative pain. Gabapentin is an anticonvulsant and antineuralgic agent. To evaluate the analgesic effect of preemptive gabapentin on post-operative pain and morphine consumption after cardiac surgery. A double-blind randomized clinical trial was conducted on 60 male candidates for CABG. The patients were divided into two groups-the gabapentin [n=30] and the control group [n=30]. The test group received 800 mg gabapentin orally two hours before the surgery followed by 400 mg of the drug two hours post-extubation. The control group received placebo instead. Then severity of pain was recorded according to an 11-point visual analog pain scale. The amount of morphine consumed, its side effects and hemodynamic changes were also recorded during and at 2, 6, 12, 18 and 24 hours after extubation. The mean +/- SD cumulative morphine consumption at the first 24 hours after extubation in gabapentin group was 0.9 +/- 1.5 mg while it was 1.5 +/- 4 mg for the control group. Therefore, gabapentin group consumed 38% less than the control group [P=0.01]. The pain scores during rest and coughing at 2, 6, and 12 hours after extubation were also significantly lower in the gabapentin group compared with the control group [P=0.02]. The mean +/- SD mechanical ventilation time was 5.4 +/- 1.7 hours for gabapentin group and 1.6 +/- 4.4 hours for the control group [P=0.035]. The other variables including hemodynamic changes [HR, SBP and DBP], and incidence of nausea, vomiting and respiratory depression showed no significant difference between the studied groups within 24 hours after extubation. Oral pre-medication with gabapentin before CABG significantly reduces post-operative pain and morphine consumption in adult cardiac surgery

Early extubation after complete repairment of teralogy of fallot

Tetralogy of Fallot [TF] with prevalence ratio of 3.5 to 11% is one of the most common cyanotic heart diseases, especially after the infancy. It causes hypoxic cyanosis, blue spells and systemic thromboembolic events, and infections like brain abscess and endocarditis. These patients are usually treated medically and surgically, the ultimate goal of the surgical intervention is complete repairment. They are usually intubated 24 to 48 hours or more after the operation. Intubation, especially if prolonged, causes various complications, which could be reduced by shortening the length of the intubation period. Fifty TF operated patients were extubated four hours after entering ICU. All of them were transferred to the ward without any need for reintubation or any other complication the next day