[Comparison of blood loss in femoral shaft surgeries between tranexamic acid and controlled hypotension]

Blood loss reducing approaches improve surgery outcomes through producing an appropriate operation field and reducing transfusion need. In this study two blood loss reducing techniques were compared. In a randomized clinical trial study 60 patients candidate for elective femoral shaft operation were devided in two groups. The first group went under induced hypotensionand the second group received tranexamic acid. Anesthesia technique and surgeon were the same in both groups. Bleeding amountwas measured based on site operation site and reservoir observing, pads counting. Traputic interventions such as crystalloids or colloids and blood transfusion were done as needed. Results were evaluated by Mann-witney U test. Dry field and surgeons satisfaction was good in 23 patinets of the hypotention group [76%] and was moderate in the rest of the group. In the tranexamic group the results were good in 21 patients [70%]. There was no significant difference in reducing blood loss between the groups. Both of the studied techniques can reduce bleeding and improve operation field and surgeon satisfaction, meanwhile there was no significant difference in two approaches

[Comparison of sedative effect of remifentanil with propofol in senile cataract surgery under retrobulbar block]

As general anesthesia is not a suitable choice in elderly ASA>II patients candidate for cataract surgery performored by ophthalmology Residents and lack of cooperation in these patients, sedative effect and hemodynamic status and side effects of two drugs, Remifentanil and propofol are compared in this study. In a Randomized clinical trial 60 patient candidates for cataract surgery were divided in two groups each containing 30 patients. In group A [remifentanil group], patients were sedated with a bolus dose of 0.5 micro g/kg within 1 minute, and maintenance dose of 0.05 micro g/kg/min. In group B [propofol group], patients were sedated with a bolus dose of 0.25 micro g/kg, and maintenance dose of 25 micro g/kg/min. After retrobulbar blockage was performored on all the patients by residents, Hemodynamic responses, including HR, DBP, SBP and O2Sat and sedation level according to MOAA/SS were measured. Modified Observers Assessment of Awareness/Sedation Scale = MOAA/SS. Sedation was deeper in group A [Remifentanil] were statistically meaningful during the measured times after blockage .The heart rate was reduced in group A 20 minutes after blockage and were statistically meaningful [p<0.05]. 7 patients in group A [Remifentanil] had nausea after drug administration [P=0.011]. Remifentanil can induce high level of sedation for patients compare to propofol. But Nausea could be troublesome and in this point propofol has less adverse effect