Analyzing the effects of intra-operation video-clip display on hemodynamic and satisfaction of patients during lumbar discectomy under spinal anesthesia

Most neurosurgeons and anesthesiologists prefer the less invasive intervention for most surgeries; recently, the lumbar anesthesia is more popular method. In this study we have tried to distract the attention of the patients to their favorite video-clip instead of their surrounding operating room background to evaluate the hemodynamic as well as their satisfaction during the operation. 80 patients who were scheduled for an elective one level discectomy under the regional spinal anesthesia enrolled in this prospective randomized clinical trial. The patients were randomized with sealed envelope method and each envelope was randomly assigned from this set of envelops to be either in case group one [video group] or control groups two [no audio and video and only head phone on their ears] group. In all patients, systolic and diastolic blood pressure, pulse rate and SPO2 were measured and recorded in the questionnaire charts. Of the 80 patients with Lumbar disk herniation, 53 patients were male and 27 female. The mean age for all patients was 44 year. Systolic and diastolic blood pressure at the end of surgery was significantly lower in video group [P=0.045 and 0.004]. Systolic Blood pressure differences between 3[rd] and 5[th] and the end of the surgery with minute zero was significantly less in the video group. [P=0.025, 0.018 and 0.030]. Diastolic blood pressure differences between 3[rd] and 5[th] and the end of the surgery with minute zero was significantly less in the video group. [P=0.051, 0.019 and 0.15]. Pulse rate differences between first, 3[rd], 5[th] and exactly before leaving the recovery room with minute zero was significantly less in the video group. [P=0.015, 0.028, 0.030 and 0.008]. According to our study, by displaying patient's favorite video clip during the surgical intervention we could highly reduce the patient's attention to what is happening in operating room and therefore, decrease their anxiety and stress

Can selection of mechanical ventilation mode prevent increased intra-abdominal pressure in patients admitted to the intensive care unit?

Increased intra-abdominal pressure [IAP] results in dysfunction of vital organs. The aim of the present study was to evaluate the effect of mechanical ventilation mode on IAP. In a cohort study, a total of 60 patients aged 20-70 years who were admitted to the ICU and underwent mechanical ventilation were recruited. Mechanical ventilation included one of the three modes: Biphasic positive airway pressure [BIPAP] group, synchronize intermittent mandatory ventilation [SIMV] group, or continuous positive airway pressure [CPAP] group. For each patient, mechanical ventilation mode and its parameters, blood pressure, SpO2, and status of tube feeding and IAP were recorded. Our findings indicate that the study groups were not significantly different in terms of anthropometric characteristics including age [64.5 +/- 4, P = 0.1], gender [male/female 31/29, P = 0.63], and body mass index [24 +/- 1.2, P = 0.11]. Increase IAP was related to the type of respiratory mode with the more increased IAP observed in SIMV mode, followed by BIPAP and CPAP modes [P = 0.01]. There were significant correlations between increased IAP and respiratory variables including respiratory rate, pressure support ventilation, and inspiratory pressure [P < 0.05]. Tube feeding tolerance through NG-tube was lower in SIMV group, followed by BIPAP and CPAP groups [P < 0.05]. There is a significant relationship between respiratory modes and IAP; therefore, it is better to utilize those types of mechanical ventilation like CPAP and BIPAP mode in patients who are prone to Intra-abdominal hypertension