[Surgical tracheostomy versus percutaneous tracheostomy in the intensive care unit]

Prolonged intubation and need to mechanical ventilation is an indication for tracheostomy. This procedure can be done, surgical or percutaneous. In this study, we compare surgical and percutaneous dilated tracheostomy. In this retrospective study, which was conducted in ICU wards of Rasool Akram Hospital from Mehr 1387 to Mehr 1390. We compared complication of tracheostomized patients in two groups. In this study, early postoperative bleeding, in 11 cases, 1 case [4.2%] in PDT group and 10 cases [17.5%] in surgical group was shown [with a significant difference]. Surgical site infection in 1 case, 2 cases [7.4%] in PDT group and 1 case [4.2%] in surgical group was shown [with a non-significant difference]. Subcutaneous emphysema in 11 cases, 2 case [8.3%] in PDT group and 1 case [1.7%] in surgical group with a significant difference, was shown. Other complications such as tracheal posterior wall were not shown in both groups. Because of lower complications rate and bedside PDT doing, percutaneous tracheostomy is a safe and suitable alternative for surgical tracheostomy

[Comparing the analgesic effect pregabalin and gabapentin as premedication in laparoscopic procedures]

Laparoscopic surgery is associated with post operative pain . Optimal pain treatment with minimal side effects is essential for early recovery and mobility in patients undergoing laparoscopic surgery . We compared the analgesic effect Pregabalin and Gabapentin with different doses in these surgical procedures. In a randomized, double blind, ninety patients were allocated to either Group A Pregabalin 300mg, Group B Gabapentin 600mg and Group C Gabapentin 900mg. These were administered 1 h before operation .General anesthesia was performed . We collected data on pain intensity through Visual Analogue Scale [VAS] in recovery, 6, 24 h after operation. Consumption of supp Diclofenac was recorded. p<0.05 was considered statistically significant. Pregabalin 300 mg was significantly more effective in reducing post operative pain up to 24 hours following the surgery [p<0.001] . Furthermore, the amount of analgesic consumption was less in the Pregabalin group [p<0.001]. Consumption analgesic and VAS were more than the other groups in patient who receive Gabapentin 600 mg. Our finding showed that single dose of pregabalin 300mg oral is more effective than Gabapatin on the management of postoperative pain following abdominal laparoscopic surgery. And Pregabalin resulted in reduction in 24 h postoperative analgesic requirements. Gabapentin 900mg decrease VAS and consumption of analgesic significantly

[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