Effect of low dose ephedrine and lidocaine on pain and hemodynamic changes due to propofol injection

The aim of this study was to compare the intensity of pain and hemodynamic changes during propofol injection when pretreatment is performed with ephedrine and lidocaine. In a randomized double blind clinical trial [IRCT: 2766] in Shahid Rajaee Hospital during the year 2009, 99 patients with ASA physical status I and II, aged 20 to 50 years were recruited. The patients were planned to undergo elective surgeries under general anesthesia and had no history of cardiocascular, neurologic, or allergic diseases. The subjects were randomly assigned into three groups to receive 40mg intravenous lidocaine [group L], 30|jg/kg ephedrine [group E] or 2ml normal saline [group P]. After one minute, 2mg/kg propofol was injected into a dorsal hand vein. Pain was assessed using face pain scale [FPS]. Arterial blood pressure and heart rate were also recorded before induction, just before intubation, and one minute after intubation. Hemodynamic changes and also the incidence and intensity of pain in group L were less than the other groups. The patients in group L had significantly lower FPS compared with group P [P=0.004] and patients in group E had lower FPS compared with group P; however, the difference was not statistically significant [P=0.247]. Pretreatment with a small dose of ephedrine [30 micro g/kg] reduces the incidence and intensity of propofol induced pain. Although lidocaine is more effective, ephedrine results in a more stable hemodynamic status

[Prevalence of awareness during anesthesia induced by three different techniques for cesarean section]

Awareness during anesthesia causes many psychological problems for the patients and the society. To compare the prevalence rate of awareness during cesarean section with three anesthetic techniques. Through a prospective clinical trial, 178 patients were randomly divided into three sets as group A [101], group B [50], and group C [27] based on the type of drug received. The induction of anesthesia was carried out using thiopental 5 mg/kg in group A and propofol 2-2.5mg/kg in groups B and C. Maintenance of anesthesia was accomplished using halotan and N[2]O in groups A and B and propofol infusion and N[2]O in Group C. Following the extraction of neonate, only fentanyl [1.5mg/kg] was administered for groups A and B while in Group C fentanyl [1.5mg/kg] plus midazolan [2mg] was used. Muscle relaxant used in three Groups was the same. During the time between induction of anesthesia to extubation of tracheal tube, a tape containing part of Quran was played. Eight hours after wakefulness and using a questionnaire, the patients were asked about feeling of pain during surgery, remembering of Quran voice or accidents during surgery. The data were analyzed using chi-square test. Among 178 patients under the study, 7 cases [3.9%] had awareness of grade I during anesthesia in which 2 patients were the members of group A [2%], 3 patients of group B [6%] and 2 patients of Group C [7.4%]. The differences found in the study were not significant from a statistical point of view [p>0.05]. There was no direct relationship between the age, educational status and indication of CS with the prevalence of awareness during anesthesia. The prevalence of awareness during anesthesia in CS by three different anesthetic techniques [Thiopental-halotan, propofol-halotan, and propofol-midazolam] was almost equal

[ comparative study on incidence of post tubal ligation vomiting between two different anesthetic airway managements]

Nausea and vomiting are considered as two common clinical complications? following anesthesia and surgery. The occurrence of such complications causes the patient tobe kept in recovery room and hospital for longer periods of time and also leads to electrolyte disturbances, dehydration and hemorrhage from the site of sutures. To compare the incidence of post tubal ligation vomiting in patients following the application of two different anesthetic techniques [mask and combination of cuffed pharyngeal tube and esophageal obtorator tube].This was a single blind, randomized clinical trial in which 122 cases as candidates for tubal ligation were studied at Qazvin Kosar hospital in 2001-2002. The subjects, all with ASA class I, were randomly divided into two groups as A and B. The anesthetic drug for induction and maintenance was similar in two groups. Ventilation of patients was carried out using masks in group A and a combination of cuffed pharyngeal tube [Tashayod tube] and atracheal tube inserted into esophagus in group B. There was no statically significant difference between the incidence of vomiting among both groups with values of 23.3% and 14.5% for groups A and B, respectively When parameters such as mean age, weight and the duration of surgery were compared in two study groups, no significant difference was found, statistically. The incidence of post tubal ligation vomiting in study groups following the application of two different anesthetic techniques was similar

Comparison of neonate apgar score in two induction anesthetic techniques with thiopental and propofol in cesarean section

Drugs used in management of anesthesia in cesarean induce depressive effect on neonatal apgar. To determine and comparing the propofol and thiopental effects on neonate apgar score. Through a prospective single blind randomized clinical trial, sixty patients operated for cesarean section in 2002 in Qazvin Kosar hospital were randomly divided in two groups as A and B. Induction of anesthesia was carried out using thiopental 4mg/kg and propofol 2 mg/kg in groups A and B respectively. The time from the induction of anesthesia to child birth and also the time of uterus incision to child birth were measured. Neonate apgar scores were recorded. Following 1 and 5 minutes intervals. The results were analyzed using Spss soft ware and T test. The average of apgar score at 1 minute in thiopental group and propofol group were 8.83 +/- 0.379 and 8.93 +/- 0.253 respectively. The difference between group A and B was statistically insignificant. The apgar scores at minutes in two groups were 10 and statically insignificant. Based on our results there was no statistically significant difference between two groups in the time of induction of anesthesia and uterus incision to child birth. Propofol and Thiopental showed similar effects on neonate apgar score in cesarean