ABSTRACT
There are several studies about the correlation of blood glucose level and prognosis in traumatic patients. To determine the relationship between the on-admission plasma glucose [G] level with the type and severity of trauma. In this analytical study, 270 patients who were admitted to the trauma center of Alzahra general hospital in 2006, evaluated for plasma G level, GCS, TS, and the type of trauma upon admission. In cases with plasma G [BS1] grater than 140 mg/dl on admission, the plasma G [BS2] was re-checked the next 24 hours. Data were analyzed using t-test and correlation ratio. Findings: The incidence of different types of trauma and their mean BS1 were as follows: head and neck trauma [45%, BS1=238 +/- 104 mg/dl], multiple trauma [28%, BS1=193 +/- 82 mg/dl], extremities trauma [16.1%, BS1=140 +/- 12 mg/dl], abdominal and chest trauma [7.4%, BS1=200 +/- 89 mg/dl], and pelvis trauma [2%, BS1= 152 +/- 10 mg/dl]. The Mean plasma G level in patients with TS=11-16, TS=6-10, and TS=1-5 was 130.74, 273.78, and 340 mg/dl, respectively. In the emergency stage of trauma, hyperglycemia is common. In addition, an increase in plasma G level has a direct correlation with severity of trauma and head injury
ABSTRACT
Spinal anesthesia due to its simplicity, rapid onset of its effect and low dose of drug administration, is a desirable procedure to anesthetics particularly for lower extremity and lower abdomen operations. Lidocaine is widely used in this method of anesthesia for prolongation of the sensory block. In the method, different drugs are used to prolong the duration of sensory block. Fentanyl and epinephrine are being used widely for this purpose and so far, the effects of these drugs were not compared. Therefore, in this study, the effect of the two drugs, alone or together, with and without lidocaine, on the duration and intensity of sensory and motor block has been investigated. In this double-blinded clinical trial, 60 c and idates for elective surgery of lower abdomen were randomly divided into three equal groups. For spinal anesthesia, the first group was subjected to 50 mg lidocaine plus 0.2 mg epinephrine, the second one to 50 mg lidocaine plus 0.2 mg epinephrine and 20-micro g fentanyl and the third group to 50 mg lidocaine plus 20-micro g fentanyl. Subsequently, the patients in the 3 groups were evaluated and compared for the duration of sensory and motor block and their hemodynamic variations. The data was analyzed using ANOVA and Chi-square tests. Age and sex distribution among the three groups was not significantly different. The mean of sensory block duration in the first, second and third groups were 130.25 +/- 9.05, 133 +/- 32.7 and 116 +/- 14.58 min, respectively with no significant difference. The mean of motor block duration in the first, second and third groups were 120.95 +/- 14.63, 118.75 +/- 25.74 and 107 +/- 18.23 min, respectively. ANOVA test showed no significant difference among the three groups as well. Also, with respect to hemodynamic variation, there was no significant difference among the three groups. Our findings showed that addition of epinephrine and fentanyl and combination of them to the lidocaine had no effect on the duration of sensory and motor block and hemodynamic variations. Therefore, combined use of these drugs is not necessary