[Local anesthesia in vitreoretinal surgery]

To compare general anesthesia [GA] with local anesthesia [LA] in terms of safety and patient satisfaction. In this interventional case series, 928 consecutive patients who underwent vitreoretinal surgery were included. Data for analysis were type of anesthesia and operation, patient compliance, operating conditions and pain scores. General anesthesia was provided with a standard method and local anesthesia was performed through peribulbar or retrobulbar routes. Selection of the type of anesthesia was determined by patient age and co-morbidities based on the surgeon's opinion. Patients were operated under local anesthesia in 343 [36.9%] and general anesthesia in 585 [63.1%] cases. Mean age was 68.8 +/- 7.3 [range 51-78] years in the LA group and 55.9 +/- 6.5 [range 43-70] years in the GA group [P= 0.041]. ASA [American Society of Anesthetics] physical status score in the LA group was higher than GA group. Patients were in appropriate condition in 96.4% and operating conditions were good or excellent in 98.8%. The majority of patients [97%] said they would choose local anesthesia for their next vitreoretinal procedures. Local anesthesia is a useful and flexible method of anesthesia for vitreoretinal surgery, with excellent patient tolerance, especially in old patients and those who suffer from concurrent diseases

Fingerprint study of Thyrnus spp.aby TLC

Thymus is a widely used medicinal plant in food and pharmaceutical industries. Among different species of Thymus, T. vulgaris is used more than other species in therapeutic dosage forms. This study was conducted to differentiate various Thymus species by TLC fingerprint. In order to identify and differentiate various species of Thymus, TLC fingerprints of essential oil, dichloromethane, ethylacetate and n-butanol extracts of four available species named T. vulgaris, T. pubescens, T. citriodorus and T. daenensis were obtained and compared with each other. The results showed that the TLC chromatograms of essential oil and n-butanol extract cannot be used as differential identification for the above-mentioned species; while the ethylacetate and dichloromethane extracts are more reliable to be used for TLC fingerprints. TLC-chromatogram of ethylacetate extract is specific for identification of T. pubescens and T. vulgaris while T. citriodorus and T. daenensis can be best identified by their TLC fingerprints obtained from dichloromethane extract. For best differentiation of various Thymus species, different extracts of the plants should be used

Investigation of a and beta - thujone content in common wormwood from Iran

Artemisia absinthium L. [common wormwood] has been widely used in traditional medicine. The plant contains toxic components: a and beta-thujone, therefore, it should be used with caution. Since common wormwood is considered to be a toxic plant, we decided to evaluate toxic compounds quantities in those used in Iranian folk market. Five samples were purchased from Tehran markets. Essential oil of the flowers was obtained by water distillation. Essential oils were injected to gas chromatograph and their thujone content were determined according to the calibration curve. The results showed that alpha-thujone is absent in all samples and p-thujone content in the essential oils is much less than its amount reported from other countries. Since the quantity of toxic compounds are low in the plant growing in Iran, it is proposed that Artemisia absinthium L. can be studied for its some medical uses

Comparative and differential study of Passiflora incarnata L. and Passiflora caerulea L. in raw plants and pharmaceutical dosage forms

Passiflora has several species that two of them named P. incarnata and P. caerulea are cultivated in Iran. Many investigations have been carried out on therapeutic effects of the genus but only P. incarnata is approved for use in pharmaceutical dosage forms for anxiety and insomnia. The purpose of this study is differential determination of P. incarnata and P. caerulea in medicinal plants and related herbal drugs. In this investigation, microscopic properties, total ash, acid-insoluble ash and total flavonoids calculated as hyperoside of P. incarnata and P. caerulea were determined. In addition, TLC chromatogram regarding flavonoids and HPLC chromatograms of P. incarnata and P. caerulea ethanol extract, Passipay tablet and drop [Iran Darouk Co.], Passiflora drop and dry extract [Vogel Co.] and Passiflora drop [Curarina Co.] were also compared. No significant difference between total ash, acid-insoluble ash and total flavonoids in two species were found. But they were very different in microscopic properties. TLC and HPLC chromatograms are very different as well. The aerial parts of the two plant species can be well distinguished by microscopic method. The plant extract either itself or in pharmaceutical dosage forms, can be determined by HPLC or TLC methods. Since sample preparation is very simple and doesn't require complex procedures, the above-mentioned methods seem to be efficient

survey on the changes of oil compounds of medicinal and edible plants sterilized with gamma radiation

One of the essential problems of using medicinal plants which are mostly collected from the wild is their fungus and microbial infections. Nowadays, exposing the plants to Gamma radiation apparently removes the problem. But, as the plants contain outstanding amount of chemical substances, the exposition can lead to a change in the composition of the plants chemicals and therefore a change in their medicinal effects. Making poisonous, carcinogen or stimulant substances in the plants could be examples of this change. The aim of this research was evaluating effect of Gamma radiation on chemical composition of ten medicinal plants essential oils; Mentha, Coriandrum, Foeniculum, Zingiber, Cuminum, Bunium, Melissa, Thymus and Zataria. Essential oil of the species before and after Gamma radiation were obtained over Clevenger apparatus, analyzed using GC and GC/MS and identified based on RT, KI and authentic references. Results showed that within ten species, the Coriander oil was affected with the 10 and 25 KG of Gamma radiation and changed to the another components. These results of experiment can alert the world, to the threatening consequences of using Gamma radiation concerning human health

Preemptive analgesia in elective cataract surgery [Phacoemulcification]

Preemptive analgesia is based on the idea that analgesia which initiates before a nociceptive even will be more effective than the analgesia commenced afterwards. This clinical trial compared postoperative analgesia and comfort in patients with general anesthesia combined with preoperative or postoperative local anesthesia. 90 patients who had been scheduled for phacoemulcification in Farabi Eye Hospital, 2002-3, were enrolled in the study. Sixty patients received general anesthesia: 15 received preoperative local anesthesia [GA+LA+OP], 15 received postoperative local anesthesia [GA+OP+LA], and 30 did not get local anesthesia [only GA]. Thirty patients only received local anesthesia [LA]. Subjective postoperative pain was determined by a visual analogue scale. Frequency of oculocardiac reflex, postoperative nausea and vomiting [PONV], and patient's comfort were assessed. Postoperative pain was less in local anesthesia [LA] compared to general anesthesia [GA] [p < 0.0001]. Additional preoperative application of local anesthesia [GA+LA+OP] resulted in less pain than additional postoperative application [GA+OP+LA] [p <0.05]. Additional postoperative peribulbar block did not differ from general anesthesia [Only GA]. The incidence of intraoperative oculocardiac reflex and postoperative nausea and vomiting was significantly less in patients with peribulbar block [P =.0001] and in GA+LA+OP group, as compared with others [P= 0.001]. We conclude that preoperative local anesthesia [Only LA] or in combination with general anesthesia provides the best comfort for the patient in eye surgery

[Comparing the prophylaxis effect of ondansetron and metoclopramide against intraoperative nausea and vomiting during spinal anesthesia for cesarean section]

Background and Objective: Nausea and vomiting are complications of cesarean section [C/S] during spinal anesthesia and different methods have been suggested to prevent it. The aim of this study was to compare incidence of intraoperative nausea and vomiting [IONV] during cesarean section [S/C] under spinal anesthesia

Methods: This double-blind and placebo-controlled study was performed on 150 ASA 1 and 2 women submitted for spinal anesthesia scheduled C/S. They were divided into three groups: 4mg ondansetron, 10mg metoclopramide or saline were administered I.V after clamping of umbilical cord, depending on their treatment group. After that treatment, if INOV appeared or the patients had no subside completely after 5 minutes, the subjects were treated with droperidol

Findings: Nausea and vomiting were not seen in 91.8% of the ondansetron group, 91.6% of the metoclopramide group and 60% of the placebo group [P<0.001]. There was no significant difference between the first and second groups. Emetic symptoms were more frequent after clamping the umbilical cord [25.9%] than prior to it [16.3%] [P<0.05]

Conclusion: According to the results, there was no significant difference between ondansetron and metoclopramide. For reducing IONV, it is recommended to use metoclopramide for preventing intraoperative nausea vomiting during spinal anesthesia for C/S

Comparison of tramadol and pethidine for postanesthetic shivering in elective cataract surgery

Background: postoperative shivering is a common event of unknown etiology with an incidence of 5-65%. This study intended to compare the efficacy of tramadol with that of pethidine in controlling postanesthetic shivering

Methods: this double-blind clinical trial was performed on 300 consecutive patients underwent general anesthesia for elective cataract surgery. Intravenous tramadol 1 mg/kg or pethidine 0.5 mg/kg was administered for alternate subjects who developed postanesthetic shivering. They were monitored in the recovery room for 1 hour and the cessation time of shivering, recurrence of the event, duration of recovery, respiratory depression, nausea, vomiting, and arterial O2 saturation were recorded

Results: one hundred and twenty patients [40%] had postanesthetic shivering. In the tramadol group, shivering terminated within 8 minutes after injection [mean 5 min]. They had not recurrence of shivering, respiratory depression, reduction in SpO2 and nausea or vomiting during recovery. In the pethidine group, shivering terminated within 13 minutes [mean 9 min] after injection, but in 10 patients it recurred after 30 minutes. In this group 28 patients had respiratory depression, reduction in SpO2, nausea and vomiting but none of them needed any medication

Conclusion: tramadol is superior to pethidine as it induced a faster termination of postanesthetic shivering and did not entail adverse effects on the respiratory system and SpO2, recurrence of shivering or nausea and vomiting. Easy availability and minimum monitoring requirements are other advantages of tramadol