[Effects of laryngeal mask airway comparing to tracheal tube on the recovery time]

Patients' staying in recovery unit is associated with risk and complications and is expensive. Decreasing the duration of staying can both increase patients' safety and decrease hospital costs. Laryngeal mask airway [LMA] as a new instrument has been widely used for airway management and in this study, its effect on recovery time is investigated. In a double blind randomized controlled clinical trial, 62 ASAI and II patients were divided into two equal groups. In one group laryngeal mask and in the other, tracheal tube was used. The anesthetic drugs were similar in both groups. Patients with upper airway infections, as well as patients undergoing thoracic and upper abdominal surgeries were excluded. Those with more than one hour duration of anesthesia and more than 30 seconds need for intubations were also excluded. Duration of anesthesia was measured in minutes. Duration of recovery staying [in minutes] and complications were also recorded. Data was analyzed using Chi Square and Mann Whitney U tests. There were no significant differences in age, sex and mean time of anesthesia between the two groups. But mean recovery time in LMA group with 10.65 minutes and tracheal tube group with 16.71 minutes was significantly different [P=0.007]. Two patients [6.45%] in LMA and 11 patients [35.48%] in tracheal tube group developed complications during recovery period which was a statisyically significant difference [P=0.004]. Laryngeal ,mask airway, decreased recovery time and the number and severity of respiratory complications. Complications such as cough, laryngospasm, bronchosam, and arterial hypoxemia were significantly less in patients with laryngeal mask airway compared to patients with tracheal tube, so the use of LMA is recommended

[ comparison of Dexamethasone and Metoclopramide effects on postoperative nausea and vomiting]

Postoperative nausea and vomiting is one of the most common problems in postoperative period. Patients' who are at high risk of PONV, may receive antinausea and vomiting drugs. The most common drug is Metoclopramide, but it's extrapiramidal signs and side effects such as lethargy, dizziness and headache especially in children lead us to perform this study, in order to compare Dexamethasone and Metoclopramide effects in PONV prevention. This study was a double-blind randomized controlled clinical trial. 262 patients [2-25 years] in ASA class I, II which were candidates for ENT, eye and laparatomy surgeries, divided into two groups randomly. One group received 0.1 mg/kg Dexamethasone IV and the other group received 0.1mg/kg Metoclopramide IV, 10-15 minutes before operation ending time. During recovery, the frequency of PONV was assessed. Data was analysed by Pearson test. PONV frequency in the two groups had no significant difference. Also PONV rate in the two groups had no significant difference in male and female. In prevention and treatment of PONV, Dexamethasone effect was same as Metoclopramide. Considering low expense, avalibility and low side effects Dexamethasone is a proper substitute for Metoclopramide in surgeries with high risk of PONV

[Study of tramadol and pethidin effects on post operativeshivering]

Post operative shivering is a common and unpleasant problem with relatively 40% incidence that has a lot of cardiovascular and pulmonary effects. It's main cause is hypothermia during operation, but there are also other causes. There are some recommendations to resolve this problem. In this survey we compared Tramadol and Pethidin effects in treatment of postoperative shivering.This is a clinical trial study, performed on 324 patient with ASA I and n classes. When shivering occurred, 1mg/kg Tramadol was administered to 162 patients and the others received 0.5 mg/kg Pethidin. After injection, the shiver-end time was recorded. Patients' vital sign such as blood pressure, pulse rate and respiratory rate were measured and recorded before and after injection [vital sign was checked and recorded every 10 minutes for 1 hours after injection]. Data was analyzed with two independent t-test by SPSS software.61.7% of samples were male. The average of shiver-end time in group receiving Tramadol and group receiving Pethidin was134.96 +/- 18 and 161.3 +/- 22 seconds respectively, that was significantly lower in Tramadol group[p=0.007]. The minimum of shiver-end time was 55 seconds in patients receiving Tramadol and the maximum time was 320. The minimum of this time in patients receiving Pethidin was 70 seconds and the maximum time was 395.Results of this study showed that using Tramadol in treating post operative shivering is more useful than Pethidin. Also it has better therapeutic effects and lesser side effects

comparison of intravenous and intrathecal Fentanyl injections effects in elective Cesarian

To improve painlessness quality and increasing the time of block and also for more painlessness after Cesarian surgery opiates are used in spinal anesthesia with blocker drugs in two ways: intravenous and intrathecal. The main goal of this research is to make a comparison between effects of intravenous and intrathecal fentanyl injections in elective Cesarian. In this double blind clinical trial study, 50 patients who were selected for elective Cesarian surgery were divided into two equal groups, and each group received 75-100mg lidocain as a blocker agent. Then 12.5 microgram fentanyl was injected intravenously for one group and equal dose intrathecaly for the second group. Then vital signs and some side effects such as nausia, vomiting, itching and shivering were recorded for 6hours and blood pressure under 90 mmHg for 30 minutes. Results were analyzed with T test and SPSS soft ware. In this study, the time of painlessness for intrathecal fentanyl was 135.4 minutes and in intravenous group was 106.2. It was also found that in intrathecal fentanyl group and intravenous fentanyl group, blood pressure under 90mmHg was 72% and 56%, nausea 52% and 32%, vomiting 20% and 12%, and shivering 12% and 16% respectively. Itching was not seen. The average time of analgesic effect of fentanyl in intrathecal group was significantly more than the other group. Nausea, vomiting, low blood pressure and shivering were more prevalent in intrathecal group but there was no meaningful difference between them