ABSTRACT
The most important side effect of venous [Bier] block is systemic toxicity induced by local anesthetics. This is occurred by accidental tourniquet release after drugs' injection. Effects of sensory and motor block of lidocaine increase by use of subanesthetic dose of ketamine with lidocaine simultaneously and its toxicity reduces. To evaluate the sensory and motor block via venous block in patients under upper extremity, surgeries induced by lidocaine compared to lidocaine and ketamine. Forty ASA physical status I-II patients, undergoing elective surgery of the hand or the forearm, were studied in Shahid Rajaee University Hospital. Patients divided in two groups randomly [n= 20]. The affected extremity was exsanguinated by elevating it and wrapping it with an esmarsh bandage. The proximal double- cuffed tourniquet was inflated on the arm of affected extremity and local anesthetics administered [each patient in control group received with 40 ml of lidocaine 0.5% and each patient in intervention group received 40 ml of lidocaine 0.25% plus ketamine 0.1% [40 mg]]. Sensory blocking was assessed by using a blunt pin every 1 minute after local anesthetic injection. Motor block also assessed based on patient's ability to move the operative hand fingers. Data were analyzed using t- test. The mean time of sensory and motor blocks were 4.25 +/- 0.63 and 7.65 +/- 0.24 minutes in control group and 4.35 +/- 0.62 and 8.35 +/- 0.67 minutes in intervention group resoectively. Time of motor block was significantly longer in lidocaine and ketamine group compared to lidocaine group [p= 0/003]. Using lidocaine combined with ketamine is safe method for the intravenous regional anesthesia especially in surgeries on hand or forearm. In this method lidocaine doses for blocking is lessen and reach to nontoxic level
ABSTRACT
During the laparoscopic surgery, intra abdominal pressure [IAP] will be elevated then the hemodynamic changes could be occurred. This study was conducted to determine whether the pre-treatment with oral clonidine can attenuate the laparoscopic hemodynamic changes. Forty patients whom were candidate for elective surgery under general anesthesia, were randomly divided into two equally groups. One group received preoperative oral clonidine peel and the second group received preoperative placebo. Then the collected data was analyzed with Chi - square and T-Student test. Also the repeated measurement analysis of variance tests was performed by SPSS software ver. 13.The results were reported by mean +/- SD. P lower than 0.05 was considered as statistically significant level. Two groups were similar about the demographic parameters including age, weight and sex [p>0.05]. In the clonidine group hemodynamic changes such as SBP, DBP, HR and ECG abnormalities were lower during anesthesia [P<0.05]. Pre-medication with oral clonidine can be attenuated the hemodynamic changes during the laparoscopic surgery such as SBP, DBP and HR. Also decrease in the ECG abnormalities during anesthesia were reported
Subject(s)
Humans , Premedication , Cholecystectomy, Laparoscopic , Hemodynamics , PlacebosABSTRACT
The absolute rest of Gastrointestinal tract is leading to mucousal destitution and atrophy because of intestinal mucous dependent on luminal feeding for life. The important of prophylactic treatment against stress ulcer in ICU patients was obvious. This study have done to evaluate effects of drugs on gastric feeding tolerance in ICU patients. In this clinical trial study, 50 patients were randomly divided in two groups and received ranitidine or sucralfate for stress ulcer. The demographic variables [age, sex, weight], APACHE II score, TISS, episodes of dairrhea, emesis and gastric retention > 250 CC/6h have been determined in both groups. The data was analyzed by SPSS software using Chi2and T-test and fisher exact test and Mann-Whitney U tests. There were no statistical differences about demographic variables in both groups [P>0.05]. Comparison about the important difference wasn't between APACHE II and TISS scores. The rate of diarrhea and emesis in sacralfate group were lesser than ranitidine group [P<0.05]. Against stress ulcer, prophylaxis with sucralfate has better effect on gastric gavage tolerance than ranitidine