1 2228-6659 Iranian Society Of Regional Anesthesia And Pain Medicine 88 General Tracheal intubation without muscle relaxant with propofol or sevoflurane in children Hassani Valiollah Taghipour-Anvari Zahra Mirabi Nazanin Deljo Atousa 1 1 2011 1 4 1 8 16 11 2010 26 12 2010 Background and aims: To compare intubating conditions and cardiovascular changes followinduction of anesthesia and tracheal intubation in patients receiving either lidocaine-remifentanilpropofolor lidocaine-remifentanil-sevoflurane prior to induction.Methods and materials: In a randomized, double-blind study 75 healthy children patientswere assigned to one of two groups: lidocaine 1.5 mg·kg-1, remifentanil 2 μg·kg-1 and propofol2 mg·kg-1 (Group P) or lidocaine 1.5 mg·kg-1, remifentanil 2 μg·kg-1 and sevoflurane (GroupS). Then laryngoscopy and tracheal intubation were attempted at BIS 40-50. Intubating conditionswere assessed as excellent, good or poor on the basis of ease of ventilation, position of the vocalcords, and patient's response to intubation and slow inflation of the tracheal cuff. The meanarterial pressure (MAP) and heart rate (HR) were measured before anesthetic agentadministration, immediately after tracheal intubation, and five minutes after intubation.Results: Excellent intubating conditions were obtained in 76% of Group P patients and 84% ofGroup S patients and were not significantly different between the two groups (p<0.356).Cardiovascular changes following induction of anesthesia and tracheal intubation were notsignificantly different between the two groups.Conclusion: Lidocaine-remifentanil-sevoflurane is similar and safe like lidocaine-remifentanilpropofolfor tracheal intubation without muscle relaxants in children.
89 General The effect of low dose ketamine on sore throat after tonsillectomy Marzban Shideh Hadadi Sudabe 1 1 2011 1 4 9 16 01 12 2010 10 01 2011 Background and aims: Ketamine efficacy as an analgesic adjuvant has been studied inseveral clinical settings with conflicting results. Sore throat and pain after swallowingfollowing tonsillectomy is significant. The aim of this study was to investigate the effect of lowdose ketamine on sore throat (pain) after tonsillectomy.Materials and methods: In this double blind clinical trial, fifty children were, divided intotwo equal groups of Ketamine and control. The subjects aged 4-14 years old and physical ASAclass I-II were randomized to receive pemedication with either ketamine 0.lmg/kg I.V. orplacebo, 5 minutes before induction of a standard general anesthesia.Results: The ketamine group showed significantly lower pain scores with less totalpethidine consumption (P<0.005) during 6h after surgery. The mean pain score in ketaminegroup was 1.32±1.02 and in control group was 2.4±1.25. There were no differences in theincidence of vomiting between the groups.Conclusion: Premedication with a small dose of ketamine reduces pain after tonsillectomyin children who received an analgesic regimen combined with an opioid. 90 General Comparison of pain relief after heel spur treatment with local corton injection and Ultrasound waves ESWL Yeganeh Ali Olamaiyan Faranak Moghtadai Mehdi Shah-Hoseini Gholam-Reza 1 1 2011 1 4 17 24 27 10 2010 11 12 2010 Background and aims: Plantar calcaneal spurs are common however their pathophysiology ispoorly understood. This study aimed to evaluate the outcome of corticosteroid injection andultrasound usage.Methods and materials: We chose124 subjects, divided into two groups. One treated bycorton and the other received ultrasound waves. Pain levels after treatment were comparedbetween these two groups.Results: We had no significant differences between pain level of these two group but detectedmajor differences among before and after position. BMI more than 30 also could increase painlevel.Conclusion: Both of the methods could be used as non surgical treatments. But more studyneeded to evaluate more about these methods. 91 General Percutaneus nephrolithotripsy bleeding in the spinal anesthesia versus general anesthesia Movassaghi Gholam-reza Mohaghegh-Dolat-Abadi Mahmoud-Reza Shirkhani Gholam-hossain 1 1 2011 1 4 25 32 27 10 2010 11 12 2010 Background and aims: Percutaneus nephrolithotrips is commonly used for the removal ofstones. This procedure can be performed under general or spinal anesthesia. In this study weevaluated amount of Bleeding and transfusion needs between two mentioned anesthesia routes.Methods and materials: A total of 80 ASA I-II patients undergoing PCNL were randomlyallocated to receive spinal anesthesia (3 ml bupivacain % 0. 5) or general anesthesia which wasinduced with Thiopentone and maintained with propofol. Estimated blood loss and transfusionrates, postoperative pain (scored from 0 to 10 on a visual analog scale), in two groups wererecorded separately then collected data were analyzed by SPSS13 software.Results: Mean blood loss was 262±113.8 ml & 148.1±55.8 ml in general & spinal group,respectively. There is meaningful difference between two groups (p<0.001).Rate of transfusion was 7.5 % in general group & no one in spinal group .The spinal group hadbetter patient satisfaction and lower pain scores (p<0.001). Post operative pain after 1 hr (VAS)was 4.2± 1.0.1 & 2.3± 0.9 in general group & in spinal group respectively.Conclusion: Spinal anesthesia decreased blood loss versus general anesthesia up to 50%, andhad less postoperative pain score and is an attractive alternative to general anesthesia in thesepatients 92 General Comparison of effect of ringer lacatated vs hetastarch solutions on cardiac output during spinal anesthesia Fathi Mehdi Imani Farnad Goudarzi Vahid Judi Marjan 1 1 2011 1 4 33 42 01 11 2010 16 12 2010 Background and aims: Spinal anesthesia induced hypotension is common and it could beserious and life threatening. Occasionally many types of solutions use for prevention. Wecompared ringer lacatated (RL) vs Hetastarch (HS) about cardiac output reductions.Methods and materials: This is a randomized clinical trial which has done on 60 lowerextremity orthopedic patients who went under surgery whereas spinal anesthesia has done forthem. We used from electrovelosimetery for our evaluations.Results: Base line heart rate, systolic and diastolic blood pressure and cardiac output weresimilar in both groups. whereas they were apparently reduced in ringer lactated group.Conclusion: This study showed effectiveness of hetastarch 6% in preventing of hemodynamicparameters changes in patients undergoing spinal anesthesia in comparison with ringer lactatedsolutions. 93 General Effect of adding magnesium to bupivacaine and fentanyl for spinal anesthesia in lower limb orthopaedic surgeries Alebouyeh Mahmoud-reza Iman Farnad Entazary Saeid-reza Yusefvand-Mansuri Tiam Rahimzaheh Poupak 1 1 2011 1 4 43 51 22 12 2010 30 01 2011 Background and aim: In recent years spinal anesthesia using a local anesthetic incombination with an opioid has gained popularity for lower limb operations due to the highsuccess rate and patient satisfaction, and the decreased resource utilization compared withgeneral anesthesia. In experimental studies, intrathecal administration of magnesium sulphate(MgSO4) significantly potentiated antinociception during spinal anesthesia however availabledata are scarce. This study aimed at evaluating the effect of adding MgSO4 to bupivacaine andfentanyl for spinal anesthesia in lower limb orthopaedic surgeries.Methods & materials: In this double-blind randomized clinical trial, 100 candidates ofspinal anesthesia for lower limp orthopaedic surgeries (ASA class I-II) were recruited in HazratRasoul Akram Medical Complrx in a 10-month period. They randomized in two equal age- andsex-matched groups receiving 1.0 ml of preservative-free 0.9% sodium chloride (group S) or 50mg of MgSO4 5% (1.0 ml) (group M) following 12.5 mg of bupivacaine 0.5% plus 25 μg offentanyl intrathecally. Date were collected regarding the time to reach the highest level ofsensory blockade, time to L2 regression, times to reach the highest level of motor blockade andits full regression, time to consumption the first dose of postoperative analgesic andcomplications.Results: Median time to reach the highest level of sensory blockade was significantly higherin the S group (16 vs. 14.5 min p=0.02). Median time to L2 regression (243 vs. 207 minp<0.001), as well as the median time to consumption the first dose of postoperative analgesic(345 vs. 232 min p<0.001) were significantly higher in the M group. Median times to reach thehighest level of motor blockade and its full regression were comparable between the two groups.Hypotension and bradycardia were recorded in 20% and 10% of the patients in group M and 30%and 14% of patients n group S, respectively (p=0. 35).Conclusion: Intrathecal MgSO4 along with the spinal anesthesia with bupivacaine andfentanyl in lower limb orthopaedic surgeries hasten the sensory blockade and prolongs the periodof anesthesia without additional side effects or influence on the motor blockade. 94 General Comparison of the effect of facia iliaca block and intravenousfentanyl in reduction the pain of broken femoral shaft duringpositioning patient for spinal anesthesia Mosaffa Faramarz Esmailijah Ali-Akbar Khoshnevis Seyyed-Hassan 1 1 2011 1 4 53 57 10 12 2018 Background and aims: The patients with fractures of femoral shafts have severe andvigorous pain which limit their lateral positioning to perform spinal anesthesia. To detect anappropriate resolve for decreasing their pain, we decided to compare facia iliaca block and ivfentanyl injection.Materials and Method: This study was performed as a randomized single blind sequentialclinical trial. Prior to spinal anesthesia, pain score evaluated through visual analogue scale (VAS)[from 0 to 10] after that, patients randomly divided in to two groups, 10 members in each group.In the first group patients received 1.5 mg/kg fentanyl intravenously. Once their condition wassuitable to achieve the position, VAS again assessed. In second group after facia iliaca block(20ml lidocaine 2%) VAS evaluated, and then the patients positioned laterally to perform spinalanesthesia.Results: This study showed that the time for painless lateral positioning in group fascia iliacablock was shorter than group iv fentanyl.VAS score for fascia iliaca block group was lower than iv fentanyl group. The entireinformation mentioned earlier was analytically significant (P<0.05) and showed satisfactoryconsequences.Conclusion: In respect to this study, fascia iliaca block is reliable and safe and it is feasible toperform in all stages of accidents. 95 General Preemptive pregabalin versus placebo for acute postoperative pain after total abdominal hysterectomy Entezary Saeid-reza Imani Farnad Khatibi Ali Rezaei Azadeh 1 1 2011 1 4 59 64 06 11 2010 11 12 2010 Background and aims: Although pregabalin is primarily an anticonvulsive drug and is alsoeffective on chronic neuropathic pain, there are limited data regarding its effect on acute pain. Inthis study we assessed the analgesic effect of pregabalin on acute post operative pain used aspreemptive analgesia in comparison to placebo and compared pain intensity and opiumrequirements among placebo and pregabalin group.Methods and materials: 60 females who scheduled for TAH in Rasoul -Akram hospital werechosen, aged between 30-70, and weighted between 60 - 80 kg. Thirty had taken oral pregabalin(300) mg one hour pre surgical procedure, the others received placebo. Pain level and doses ofopioid substance were compared between two groups at 4, 8, 12, 16, 20 and 24 hours aftersurgery. Agitation status, nausea, vomiting and dizziness were also recorded and compared.Results: Pain level at 12, 20, 24 hours were significantly lower in the pregabalin group.Meperidin needed dosage and agitation level was reduced in the pregabalin group (p < 0.0001).Nausea and vomiting had no difference between two groups. Dizziness was higher in pregabalingroup (p = 0.03).Conclusion: Pregabalin as a preemptive drug before surgery can reduce postoperative pain andagitation. However can increase some complications like dizziness.