[Bacterial colaonization of endotracheal tube connectors after 24, 48 and 72 hours of repeated intubation]

Colonization of bacteria on the equipments in touch with airway and respiratory mucosa may cause respiratory infections. According to available protocols, endotracheal tube connectors should be disposable, but because of financial issues many hospitals use it more than once. In the present study, the colonization rate of endotracheal tube connectors after 24, 48 and 72 hours of administration in multiple patients on mechanical ventilation in the operating room was assessed. In this study, 150 endotracheal tube connectors after repeated use in different patients have been sampled and cultured using standard microbiological methods. Samples were categorized in three groups based on the duration of administration [24, 48 or 72 hours]. Colony counts were identified and compared among the three groups. Colonization rate after 24, 48 and 72 hours of usage was 2%, 18% and 30%, respectively [p<0.05]. Separated bacteria usually were in kinds of Streptococci, Bacillus SP, Coagulate negative staphylococci, Klebsiella SP and Mold. Using endotracheal tube connector for more than 24 hours significantly increases the colonization rate. In hospitals with limited financial resources, repeated use of endotracheal tube connector up to twenty four hours maybe acceptable

[ effect of patient-selected music on early postoperative pain, anxiety, and hemodynamic profile in cesarean section surgery]

After cesarean section surgery, routine pharmacologic methods of analgesia, opioids and benzodiazepines may impair the immediate close contact of mother and neonate for their sedative and emetic effects. The aim of this study was to explore the effect of patient-selected music on postoperative pain, anxiety, opioid requirement, and hemodynamic profile. A total of 80 patients, American Society of Anesthesiologists [ASA] physical status I-II, scheduled to undergo general anesthesia and elective cesarean section surgery were enrolled. Patients were randomly allocated to receive 30 minutes of music or silence via headphones postoperatively. Pain and anxiety were measured with a visual analogue scale. Total postoperative morphine requirement as well as blood pressure and heart rate were recorded after the intervention period. Pain score and postoperative cumulative opioid consumption were significantly lower among patients in the music group [p< 0.05], while there were no group differences in terms of anxiety score, blood pressure, or heart rate [p > 0.05]. Postoperative use of patient-selected music in cesarean section surgery would alleviate the pain and reduce the need for other analgesics, thus improving the recovery and early contact of mothers with their children

[ effect of oral clonidine premedication on blood loss and the quality of the surgical field during endoscopic sinus surgery: a placebo-controlled clinical trial]

Bleeding during functional endoscopic sinus surgery [FESS] remains a challenge for both surgeons and anesthesiologists despite several modalities available for improving the surgical field. This study was conducted to evaluate the effect of oral clonidine premedication on blood loss and the quality of the surgical field in FESS. In a placebo-controlled clinical trial, a total of 84 American Society of Anesthesiologists [ASA] physical status I-II patients undergoing endoscopic sinus surgery for chronic sinusitis were randomly allocated to receive either oral clonidine 0.2 mg or identical looking placebo tablets 90 min before arrival at the operating room. Blood loss in the clonidine group was 214 +/- 67 ml on average and that in the placebo group was 276 +/- 78 ml [mean +/- SD, p 0.01]. The median [range] bleeding score in the clonidine group was significantly lower than that in the placebo group [2 [1-3] vs. 2.5 [2-4], p<0.0001]. Accordingly, the surgeon was more satisfied with the surgical field in the clonidine group than with that in the placebo group [median score, 4 [3-5] vs. 3 [1-5], p<0.001]. Premedication with oral clonidine 0.2 mg can effectively reduce bleeding during FESS