Clinical analysis of EEG parameters in prediction of the depth of anesthesia in different stages: a comparative study

Evaluation of depth of anesthesia is especially important in adequate and efficient management of patients. Clinical assessment of EEG in the operating room is one of the major difficulties in this field. This study aims to find the most valuable EEG parameters in prediction of the depth of anesthesia in different stages. EEG data of 30 patients with same anesthesia protocol [total intravenous anesthesia] were recorded in all anesthetic stages in Shohada-e-Tajrish Hospital. Quantitative EEG characteristics are classified into 4 categories of time, frequency, bispectral and entropy-based characteristics. Their sensitivity, specificity and accuracy in determination of depth of anesthesia were yielded by comparing them with the recorded reference signals in awake, light anesthesia, deep anesthesia and brain dead patients. Time parameters had low accuracy in prediction of the depth of anesthesia. The accuracy rate was 75% for burst suppression response. This value was higher for frequency- based characteristics and the best results were obtained in beta spectral power [accuracy: 88.9%]. The accuracy rate was 89.9% for synch fast slow bispectral characteristics. The best results were obtained from entropy-based characteristics with the accuracy of 99.8%. Analysis of the entropy-based characteristics had a great value in predicting the depth of anesthesia. Generally, due to the low accuracy of each single parameter in prediction of the depth of anesthesia, we recommend multiple characteristics analysis with greater focus on entropy-based characteristics

Acquaintance of patients with the aims of pre-operative anesthesia evaluation clinics

Anesthesia is peri-operative medicine. The role of anesthesiologist in the quality of care rendered to patients during the pre-operative period is well known. The role of pre-operative anesthesia clinics in providing better conditions for patients undergoing anesthesia is now well documented. This study was performed to evaluate the familiarity of Iranian patients with the aims of anesthesia clinics 10 years after the establishment of such clinics in Iran. All patients referred to anesthesia clinics in two university medical centers were evaluated during a 2-week period. A questionnaire was given to them and answers were analyzed and interpreted by statistical methods. Of the 286 patients who participated in this study, 56% were males and 44% were females; 43% of them were familiar with the goals of pre-op anesthesia, 83% of the patients mentioned that pre-op evaluation was the reason of their referral and 67% gave a positive feed-back on the clinic. The need for creating more motivation in patients and physicians was mentioned by 83% of the patients. Considering the statistical results, it seems that there is a great need to familiarize patients with the goals of these clinics and to create some motivation in them. By doing so, we can hope to offer better services to patients and reduce the anesthesia complications and anxiety

Effect of partial parenteral versus enteral nutritional therapy on serum indices in multiple trauma patients

Malnutrition is a common complication in multiple trauma patients because of the metabolic and catabolic increase and negative nitrogen balance. It may deteriorate patients' outcome. Some clinical and paraclinical parameters are used for nutritional assessment. In this study our goal was evaluation of nutritional parameters in enteral and partial parenteral methods for detecting the better method of nutritional support. This prospective study had done during 30 months on 80 multiple trauma patients with 4[th] to 10[th] GCS [Glascow Coma Scale] at the end of the first day of admission. They divided into 2 groups randomly: we used partial parenteral nutrition in the first group [41 patients] and enteral nutrition in the second one [39 patients]. We studied serum total protein, albumin, transferrin and total lymphocyte count during their first two weeks of hospitalization. In the first group, they received more protein and calorie during 14 days. Serum total protein, Albumin and transferrin were more statistically significant in this group [P < 0.05]. In partial parenteral nutrition patients will receive more protein and calorie, and they will have more total serum protein. It seems that parenteral-enteral nutrition prepares better paraclinical nutritional parameters