[Effect of metoclopramide and ondansetrone plus dexamethason on postoperative nausea and vomiting in cholecystectomy laparoscopic surgery]

Nausea and vomiting are common complications after surgery which creates spasm, hypoxia and pulmonary aspiration. This study was done to determine the effect of ondansetrone, metoclopramide associated with dexamethasone on postoperative nausea and vomiting in cholecystectomy surgery using Laparoscopic method. In this double blind clinical trial study, 100 patients with ASA class I and II undergoing laparoscopic cholecystectomy divided randomly into two groups. The patients in the first group were received metoclopramide [10mg/kg/bw] with dexamethasone [8mg/kg/bw] and the second group were received ondansetron [4mg/kg/bw] with dexamethasone [8mg/kg/bw] intravenously 5 min before the final stage of surgery. Premedication and induction of anesthesia in patients were equal 5 minutes to 4 hours after surgery, postoperative nausea and vomiting were recorded for each patient. The rate of nausea in the first and the second groups were recorded 38% and 28%, respectively. The rate of vomiting in the first and the second groups were recorded 30% and 16%, respectively. These values were not significant. Ondansetron with dexamethasone non significantly reduced postoperative nausea and vomiting after laparoscopic cholecystectomy in comparison with metoclopramide with dexamethasone

Comparison of the effect of metoclopramide and droperidol associated with dexamethasone on nausea and vomiting after operation

One of the most common complications after general anesthesia is nausea and vomiting that can cause spasm, hypoxia and pulmonary aspiration. Metoclopramide and dropridol are two common drugs to prevent nausea and vomiting after operation. On the other hand adding dexamethasone to these drugs is effective in decreasing nausea and vomiting. The purpose of this study was to compare the effect of metoclopramide and dropridol on prevention of nausea and vomiting after operation. In this study, 160 patients were randomly divided into two groups of 80 patients. Patients in both groups were equally administered with premedication and induction of anesthesia according to their weight. The first group was injected with metoclopramide associated with dexamethasone and the second group was injected with dropridol associated with dexamethasone. After removing tracheal tube, nausea and vomiting in both groups were assessed for two hours and then data was compared to each other. Postoperative nausea and vomiting in first group was 24% and in second one was 8%. Nausea and vomiting in females was more than males [p=0.049]. According to the results, dropridol associated with dexamethasone can cause decreasing of nausea and vomiting in patients after general anesthesia

Comparison of Lidocaine and magnesium sulfate on hemodynamic changes in response to endotracheal intubation

Laryngoscopy and endotracheal intubation may produce adverse hemodynamic effects such as hypertension and tachycardia. To attenuate these stimulating responses, various methods and drugs were recommended. The objective of this study was to compare the effect of lidocaine and magnesium sulfate on hemodynamic changes in response to endotracheal intubation. In this study, 100 patients [ASA class I-II] were selected and divided randomly into two groups [50 patients in each group]. Premedication and induction drugs were the same in both groups according to weight. In case group, magnesium sulfates 40mg/kg [50%] and in control group, lidocaine lmg/kg [1%] was used before induction of anesthesia. In both groups, BP and HR checked in all patients and recorded before and after premedication after induction and in the 1st, 3rd, 5th minutes after endotracheal intubation. Data were analyzed by SPSS. T-test was used to compare the mean heart rate and systolic and diastolic blood pressure in different time and p<0.05 was considered significant. Two groups were equal in ASA class, frequency distribution of gender and age, HR, systolic and diastolic BP before and after premedication. But decrease in BP and HR after inducation of anesthesia in control group was more than study group [p<0.05]. There were no significant differences between two groups in mean BP and HR in the 1st, 3rd, 5th minutes after endotracheal intubation. Magnesium sulfate and lidocaine have the same effect on attenuating cardiovascular responses to endotracheal intubation

[Comparison of recovery duration of Propofol and Thiopental Sodium in ECT]

Thiopental sodium is not and ideal intravenous drug for inducing general anesthesia and compared to intravenous anesthetic drugs like propofol has a long standing recovery time. The aim of this study was to compare the recovery duration of propofol and thiopental sodium in ECT [Electroconvulsive therapy]. Methods: In a clinical trial, 70 patients aged between 15-40 years old in ASA class I and II were selected for ECT. They were randomly divided into two groups of 35 patients. After patient monitoring, 2-3 mg/kg thiopental sodium or 1-1.5 mg/kg propofol [Randomly in each patient] and then 0.5 mg/kg succinylcholine were administered. Patients were ventilated with mask and oxygen [100%]. After ECT, seizure and recovery durations were recorded. During these procedures, blood pressure and heart rate were recorded before and after anesthetic induction and 1 and 5 min after ECT. Findings: Mean recovery duration of propofol and thiopental sodium were 5.49 +/- 2.57 min and 6.4 +/- 3.69 min, respectively [P=0.233]. Also, seizure duration of propofol and thiopental sodium were 32.06 +/- 13.78 sec and 35.06 +/- 10.08 sec [P=0.302]. Hemodynamic changes [Systolic blood pressure] in two groups were not significant except at 1 minute after seizure [P<0.05]. Conclusion: According to the results, there was not a significant difference between two groups in seizure and recovery duration. But propofol can prevent increasing hemodynamic response to ECT better than thiopental sodium. In patients with hypertension or restriction of thiopental sodium, propofol can be a suitable replacement

[Effect of alfentanil on the hemodynamic changes [heart rate, blood pressure] following laryngoscopy]

Hemodynamic changes following laryngoscopy and intubation of trachea is one of the main problems in anesthesia. Different methods and drugs are used to lower this problem. The aim of this study was to survey the effect of Alfentanil, which is a short acting opioid on hemodynamic changes. Methods: 100 patients with ASA class I were divided into 2 groups of 50 patients. Both groups received diazepam 0.1 mg/kg, morphine 0.1 mg/kg and faxedil 20 mg/kg as premedication. 3 minutes before induction, Alfentanil group received 10 mg/kg Alfentanil and control group received normal saline as placebo. Both groups received sodium thiopental and succinyl choline for induction. Blood pressure and heart rate were recorded before and after premedication, 1, 3 and 5 minutes after intubation of trachea. The data were compared together. Findings: Changes in heart rate and blood pressure [Systolic and diastolic] before and after premedication had no meaningful difference in both groups, but average of changes in heart rate and blood pressure in the patients in the Alfentanil group after laryngoscopy and intubations were less and there was statistically significant difference. Hemodynamic features in both groups after 5 minutes were stable. Conclusion: According to the results, Alfentanil is effective in reducing heart rate and blood pressure [Systolic and diastolic] after laryngoscopy and intubations of trachea. So, using Alfentanil before laryngoscopy in general anesthesia is recommended

[Comparison of halothane and propofol effect on blood pressure and heart rate changes in maintenance of anesthesia]

Background and Objective: Propofol is an intravenous anesthetic for induction and maintenance of anesthesia, which its usage is increasing owing to produce a general state of post operative well being, antiemetic effect, rapid onset and recovery. This study was done to compare the effect of halothane and propofol on blood pressure and heart rate in maintenance of anesthesia

Methods: One hundred patients in ASA class I and II [American Society of Anesthesiologists] 16-60 years old were randomly divided into two groups. Halothane and propofol with continuous IV infusion were used for maintenance of anesthesia in group 1 and 2, respectively. Hemodynamic changes were measured after premedication, 1 minute after intubation and then every 5 minutes but it was recorded to 30 minutes after beginning and end of surgery. In the end of surgery, the patients were taken to recovery room and observed for evaluating nausea and vomiting for one hour and duration of recovery was compared on the basis of visual and verbal response

Findings: Systolic blood pressure during maintenance of anesthesia was similar in two groups, but systolic blood pressure changes [0.037] and heart rate [P=0.009] were different in both groups. Relative frequency of nausea and vomiting was one in propofol group and four in halothane group. First and second recovery time in propofol group were 9.60, 10.52 min and in halothane group were 20.20, 22.90 min, respectively that there was significant difference between them [P=0.000]

Conclusion: With regard to cardiovascular changes in maintenance of anesthesia with propofol, halothane and recovery time, propofol is a better choice in cases that rapid recovery time is need or inhalational drug usage is contraindicated