[Comparison the effect of sofentanil and lidocaine versus lidocaine alone in hemodynamic changes and spinal anesthesia duration after surgery]

Spinal anesthesia is a route for anesthesia. In this route some drugs like Lidocaine, Procaine, Ropivacaine used. For decreasing the side effects and increasing the quality also duration of anesthesia added to the others drugs like Morphine, Sufentanil, Fentanyl and Epinephrine. This study was compared the effect of sufentanil and lidocaine to anesthesia in surgery. We selected randomly 90 patients who referred to Amir-Al-Momenin Hospital, Semnan, Iran from 21 June to 20 August 2008. The patients divided into two groups [S and L]. The S group received Lidocaine and Sufentanil and L group received Lidocaine alone. We recorded the initiation of spinal anesthesia and its duration. Also the changes in the heart rate, systolic and diastolic blood pressure [at zero, 5, 10 and 20 minute after injection] were recorded. There were significant differences in both studied groups about some variables including; duration of spinal anesthesia [37/7 + 11/86][P< 0.001], initiation of anesthesia effect [82/7+55/64] [P=0.001], systolic blood pressure [P=0.014] and diastolic blood pressure [P=0.008]. But the other variables such as age, sex and heart rate have not any difference in two studied groups [P>0.05]. This study shows that adding of Sufentanil to Lidocaine result the increase of spinal anesthesia quality and decrease the homodynamic changes

[Study of the prevalence of hepatitis C in type II diabetic patients]

Considering the increasing prevalence of HCV in diabetes type 2 and chronic and progressive nature of HCV infection to cirrhosis and hepato_cellular tumors, we aimed to determine the frequency of HCV infection in diabetes type 2 in order to diagnose and treat these patients as soon as possible. Essential information gathered by prepared check list from diabetic type two patients admitted at endocrinology institute of Firuzgar hospital in a year [from June 2007 to June 2008]. From patients agreed to enroll in this study, blood samples got for detecting HCV Ab and FBS, lipid profile and HCV infection risk factors, also Blood pressure measured in all as well. Results analyzed by the SPSS. Totally 235 diabetes type 2 enrolled in our study with mean age of 60.8 +/- 10 [42-78] years old, most of them were females 146[62.1%]. The mean duration of diabetes was 9.5 +/- 7.7 years. The prevalence of HCV infection risk factors were as follow: surgery history 139 [59.1%], blood transfusion 39 [16.6%], dentistry procedures 175 [74.5%], positive family for HCV infection 30 [12.8%]. Finally, no HCV infection found among our patients, so as expected no association is observed between HCV infection and diabetes duration and various levels of HbA1C. In the present study, no HCV infection reported among our patients which is congruent with another study in Iran. It seems that geographical distribution of various HLA and prevalence of HCV infection in a region are important factors for finding any relationships between HCV infection and diabetes incidence

Effect of IV dexamethasone on incidence of nausea and vomiting and beginning of oral intake in adenotonsillectomy

Tonsillectomy and adenotonsillectomy are two of the most common surgical procedures performed in children. Although new surgical technique has reduced immediate postoperative hemorrhage, other complications such as postoperative nausea and vomiting [PONV], pain, poor oral intake, dehydration and fever, however, continues to be a concern in children undergoing tonsillectomy. The purpose of the present study was to determine whether one single, large dose of IV dexamethasone administered before surgery could decrease PONV and improve oral intake after surgery, This study was performed on 50 children, 2-12 yr of age undergoing adenotonsillectomy. To specifically delineate the contribution of dexamethasone, all anesthetic and nonanesthetic factors that could influence the incidence of PONV were standardized. Each child received dexamethasone 1 mg/kg [maximal dose 25 mg] [steroid group] or an equal volume of saline [control group] before initiation of surgery. Twenty seven children were in steroid group and 23 children were in control group. There were no significant differences between two groups with respect to age, weight and sex but the incidence of PONV was lower in steroid group in both in the recovery [0.00 vs. 0.30 +/- 0.5 in control group] [p= 0.007] and in the ward [0.22 +/- 0.6 vs. 0.82 +/- 0.9 in control group] [p= 0.010]. Oral intake begins after 1.64 +/- 0.74 hr vs. 1.96 +/- 1.1 in control group. Compared with placebo, dexamethasone significantly decreased the incidence of PONV in the immediate and late post operative period [6 hr and 6-24 hr respectively] but it didn't influence oral intake