RESUMO
Objective: To investigate the decrease in hemoglobin concentration and hematocrit during elective surgery
Methods: This was a prospective study being performed in Nemazee Hospital of Shiraz University of Medical Sciences. We included a total of 50 American Society of Anesthesiology [ASA] I and II patients undergoing elective minor surgeries. Perioperative fluid administration was performed for all the patients and hemoglobin and hematocrit levels were measured three times: Once before the operation, once one hour after start of operation and once in the recovery room. Values were compared using paired sample t-test
Results: The mean age of the patients and controls was 39.66 +/- 8.27 years. Hemoglobin level decreases significantly after one hour [p<0.001] and after the end of operation [p<0.00l]. In the same way hematocrit level was decreased significantly after one hour [p<0.001] and after the end of operation [p<0.001]
Conclusion: In this patient population undergoing elective minor operations, there was significant decrease in the hemoglobin and hematocrit levels in response to the IV fluids administration
RESUMO
Laryngoscopy and endotracheal intubation is usually associated with hemodynamic changes increases in blood pressure and heart rate. We aimed to compare the hemodynamic effects of combined use of low dose thiopentone and propofol during induction of anesthesia with conventional dose of thiopentone and propofol separately. This trial was conducted prospectively among 90 candidates, American Society of Anaesthesiologists grade-l [ASA-I], scheduled for elective surgery, with an age range of 20-50 years. Selected patients were randomly assigned to three equal groups. Thiopentone was used in group 1, propofol in group 2, and a combination of low dose thiopentone and propofol in group 3 as an induction agent. Heart rate and blood pressures were measured non-invasively at five different times: prior to the injection of study drugs, three minutes after the last injection of induction drug and immediately before the laryngoscopy and endotracheal intubation, as well as at the first, third and fifth minutes after endotracheal intubation. The adjusted mean values of systolic blood pressure, diastolic blood pressure, and heart rate were assessed by paired comparisons, by considering the variable of time; all changes were significantly different between Groups 1 and 2. Moreover, changes in systolic and diastolic blood pressures were significantly different between Groups 1 and 3. They were not significant for heart rate. No significant difference was documented between Groups 2 and 3; showing that in these groups the hemodynamic changes were small during drug injection, laryngoscopy, and intubation as well as until five minutes after endotracheal intubation. The combined use of low dose thiopentone and propofol for anesthetic induction caused less hemodynamic changes than the higher dose of either alone. This modality of anesthesia induction may have clinical importance for the elderly patients as well as those with high blood pressure and heart diseases
RESUMO
A number of pharmacological methods are being used for preserving the function of the transplanted kidney; however, their effects on the future performance of these kidneys remain controversial. We aimed to compare the effects of different methods of induced diuresis on the function of transplanted kidneys. This randomized, controlled, double-blind trial was conducted among 140 candidates of renal transplantation. They were randomly assigned into four equal groups of 35 patients each: control group [receiving furosemide and mannitol], group receiving dopamine, group receiving aminophylline, and group receiving a hyperosmolar solution containing dextrose and sodium bicarbonate [forced diuresis group]. To assess renal function, urine volume, creatinine clearance, urinary sodium excretion, and serum creatinine were measured. Data were analyzed using SPSS software. Pearson correlation and analysis of variance [ANOVA] tests were used as appropriate. Age and gender distribution of kidney graft recipients and donors of transplanted kidneys had no statistically significant difference among the four studied groups. During the first postoperative day, creatinine clearance was significantly higher in the groups receiving either dopamine or forced diuresis compared with other groups. Likewise, in the first 2 hours after surgery the mean urinary output and creatinine clearance were significantly higher in the groups receiving either dopamine or forced diuresis. The stimulation of transplanted kidneys by dopamine and using forced diuresis were the best methods in increasing the surrogate markers of renal function, i.e. urinary output, and creatinine clearance. They may be suggested as methods of choice for supporting the function of transplanted kidneys