RESUMO
Introduction: Now a days, the increased use of abdominal ultrasound and CT scanning has led to the frequent finding of unexpected adrenal masses, which named incideltaloma. Unsuspected adrenal masses have been detected in 0.6-1.3% of upper abdominal CT scan
Case report: The case was a 24 years old woman who had vauge pain in her right flank. In sonography one mass, 5 cm diameter, in retroperitoneoum and right kidney was observed which had shifted renal vein to anterior. In CT scan, one mass, sized 4.6chi 39 mm, in anatomic size of right adrenal with significant enhancement and central hypodensity was observed which had moved renal vein to anterior. The patient underwent transperitoneal laparoscopic adrenalectomy and in pathology, neurofibroma was reported
RESUMO
Post-operation shivering is very common and followed by many problems such as increased oxygen consumption, blood pressure, intracranial and intraocular pressure, and post-operation pain. Therefore, prevention of shivering is important especially in elderly and ischemic heart disease patients. The goal of this study was comparing the effect of Pethedine [Meperidin], Dexanethasione and Placebo on prevention of shivering. This double blind clinical trial study was carried out on 114 patients of ASA class I and II who were candidates for elective abdominal surgery under general anesthesia. The patients were randomly divided into three groups including those who received Pethedine [P], Dexamethasone [D] and Placebo [N]. Induction and maintenance of anesthesia for all patients were similar. Temperature of patients was measured in 4 steps: before induction, before extubation, in the beginning of recovery and the end of recovery. Five minutes before the ending of the surgery 0.3mg/kg of Pethedine, 0.1mg/kg of Dexamethasone and 3ml of saline 0.9% were injected to groups P, D and N respectively. N recovery all patients were controlled for visible shivering. 25 mg of Pethedine was injected intravenously while shivering. All data were statistically analyzed by SPSS software and ANOVA and chi square tests. There were no significant differences among three mentioned groups regarding of gender, age and duration of surgery. 18 cases [47.4%] in group N had post-op shivering. Whereas, in group D only 7 cases [18.4%] had shivering and the difference was significant [P value=0.0001]. Also in group P just 3 cases [7.9%] had shivering that the difference from Placebo group was significant [P value=0.0001]. But the difference between group P and D was not significant too [P value= 0.155]. The present study showed that Pethedine and Dexamethasone are effective drugs for preventing the post-op shivering in elective abdominal surgery