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1.
J Ayurveda Integr Med ; 14(3): 100735, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37336118

RESUMO

OBJECTIVE: Flatulence is one of the main post-operative Ileus-related complications, especially in abdominal surgeries, which can be largely due to the effects of anesthesia. There are various kinds of therapeutic methods used for their treatment though sometimes their effects are limited. Thus, it is essential to find alternative treatments to decrease the implications of the disease. The present study is aimed to investigate the effect of Chamomilla recutita on flatulence after Laparoscopic cholecystectomy. METHODS: This randomized controlled trial was carried out in 2020 at Isfahan in Iran. Patients randomly fell into either chamomile (n = 32) or placebo groups (n = 32). The intervention was performed 1 h before the operation. The severity and the frequency of flatulence were recorded using a visual analog scale in both groups in three stages before the operation, after the operation in recovery, and 2 h after the operation. RESULTS: The flatulence was not observed before the operation and on arrival in the recovery room. Before leaving the recovery room, the frequency of flatulence was the same in both the groups. However, in the surgical ward, the frequency of flatulence in the chamomile group was significantly lower than in the placebo group. The mean of flatulence severity has significantly increased in both groups over time but in the chamomile group, this increase was significantly lower than in the placebo group. CONCLUSION: These results suggest that chamomile has a potential therapeutic effect on the gastrointestinal and can reduce flatulence. In laparoscopic surgeries, using chamomile drops as a preventive drug seems to be effective in reducing the incidence of postoperative flatulence.

2.
J Ovarian Res ; 11(1): 62, 2018 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-30041667

RESUMO

BACKGROUND: In the recent years, vitamin D has become a topical subject and a focus of research not only in reproductive medicine but across many medical disciplines. In reproductive medicine, studies have identified an association between vitamin D status in women and ovarian reserve. In humans, exposure of the skin to sunlight is the main important source of vitamin D. A dress code of wearing concealing clothing is a risk factor for vitamin D deficiency. The objective of this prospective observational study was to evaluate the correlation between vitamin D deficiency and ovarian reserve in a population of infertile women in Iran. As part of the basic fertility assessment of study participants, blood tests were taken to measure vitamin D concentration and transvaginal ultrasound scans were performed on day 2-5 of the cycle to determine antral follicle count (AFC). All study participants were assessed by a reproductive medicine specialist and consultant dermatologist to classify their skin types according to the Fitzpatrick classification. In addition, the dress code of each study participant was recorded noting the percentage of exposed skin not covered by concealing clothing. RESULTS: 189 infertility patients were included in this study. The mean concentration of vitamin D in this study population was 15.46 ng/ml, indicating severe vitamin D deficiency. A statistically significant negative correlation between age and vitamin D (p = 0.008) and age and AFC (p = 0.001) was identified. This study revealed a highly significant correlation between vitamin D concentrations and AFC (p < 0.001). CONCLUSIONS: A concealing dress code is an independent risk factor for vitamin D deficiency due to a lack of skin exposure to sunlight. Our study suggests that the so caused severe vitamin D deficiency may play a crucial role in reduced ovarian reserve in the herein described group of an infertile female Iranian population.


Assuntos
Vestuário/efeitos adversos , Infertilidade Feminina/sangue , Reserva Ovariana/fisiologia , Deficiência de Vitamina D/sangue , Adulto , Fatores Etários , Contagem de Células , Feminino , Humanos , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/etiologia , Irã (Geográfico) , Folículo Ovariano/citologia , Estudos Prospectivos , Fatores de Risco , Ultrassonografia , Deficiência de Vitamina D/etiologia , Adulto Jovem
3.
J Res Pharm Pract ; 5(4): 264-271, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27843963

RESUMO

OBJECTIVE: This study aimed to compare two methods of controlled hypotension using labetalol and remifentanil in terms of capability to create controlled hypotension and to investigate the obtained complications, and satisfaction rate of surgeon and patient during functional endoscopic sinus surgery. METHODS: In this prospective clinical trial, 62 patients underwent endoscopic sinus surgery in Al-Zahra and Ayatollah Kashani Hospitals of Isfahan were divided into two groups: in the first group, 20 mg bolus dose of labetalol and then infusion of it, at a rate of 0.5-2.0 mg/min and in the second group, remifentanil with dose of 0.5-1 µg/kg started and then 0.25-0.5 µg/kg/min were prescribed. Hemodynamic parameters during anesthesia and recovery time, surgeon and patient satisfaction, and recovery time were measured and recorded. FINDINGS: Hemodynamics variable were comparable between two groups at different times of the study. The mean of bleeding and the frequency of side effects were higher in labetalol group (P = 0.033 and P < 0.0001, respectively). The median of surgeon satisfaction score in remifentanil group was statistically higher in labetalol group (P < 0.0001). Recovery time, fluid requirement, and pain score in labetalol group reported significantly more than remifentanil group. Richmond Agitation-Sedation Scale status at time points in the postanesthetic care unit showed differences between groups. CONCLUSION: With infusion of labetalol and remifentanil after a bolus dose we can induce effective controlled hypotension under general anesthesia. Remifentanil is a short-acting narcotic drug; then, patient satisfaction was better and recovery time was shorter. From the economic aspect, labetalol prefers to remifentanil.

4.
Adv Biomed Res ; 5: 114, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27403409

RESUMO

BACKGROUND: Therapeutic superiority of a combination of Paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) over either drug alone remains controversial. We evaluated the efficiency of a combination of Paracetamol and Piroxicam versus each drug alone and also placebo in the management of postoperative pain, in patients who had undergone elective upper limb orthopedic surgery under general anesthesia. MATERIALS AND METHODS: A total of 100 patients were randomly divided into four groups to receive either intravenous (IV) infusion of Paracetamol, 15 mg/kg., intramuscular (IM) injection of Piroxicam 0.4 mg/kg., their combination or placebo. The pain scores were recorded at the first; second, fourth, sixth, twelfth, and 24 hours after Post Anesthesia Care Unit (PACU) admission. After the operation 0.1 mg/kg of morphine was administered, if the patient needed. RESULT: The means of the pain scores were 5.26 ± 1.53, 4.09 ± 0.88, 4.36 ± 1.48, and 4.11 ± 1.29, in groups A, B, C, and D, respectively, (Group A: received placebo; Group B: received both Paracetamol and Piroxicam; Group C received Piroxicam; Group D received Paracetamol). Except for differences between the mean pain scores in Groups B and D, the other differences were statistically significant (P value < 0.05). No adverse effect was reported in the four groups. CONCLUSION: IV infusion of 15 mg/kg Paracetamol used as a preventive may provide effective analgesia in comparison with IM 0.4 mg/kg Piroxicam or placebo. Addition of Piroxicam to Paracetamol has not much more benefit than Paracetamol alone, in reducing pain after upper limb orthopedic surgery.

5.
Artigo em Inglês | LILACS | ID: lil-785235

RESUMO

ABSTRACT Objective The aim of the present study was to determine the prevalence of metabolic syndrome (MS) in infertile Iranian women with polycystic ovary syndrome (PCOS) using the ATPIII criteria. Subjects and methods In this cross-sectional study, 624 women with PCOS were enrolled at a tertiary referral center in Tehran, Iran, between April, 2012 and March, 2013. Diagnosis of MS was according to ATPIII criteria. Also, we divided PCOS patients into following two main groups: (i) with MS (n = 123) and (ii) without MS (n = 501), and then compared variables between two groups. Results The mean age, body mass index (BMI) and waist circumference were 28.6 ± 4.3 years, 26.7 ± 3.7 kg/m2 and 85.2 ± 8.7 cm, respectively. The prevalence of MS was 19.7%. Our findings showed that age, BMI, waist circumference and all metabolic parameters were higher in PCOS women with MS than related values in those without MS. The most and least prevalent forms of MS were low level of high density lipoprotein-cholesterol (HDL-C) and hypertension, respectively. Conclusion It seems the prevalence of metabolic syndrome in our country isn’t as high as western countries. The prevalence rate of MS increased with age and BMI. One of the major cardiovascular risk factors, low level of HDL-C, is the most prevalent metabolic abnormality in our participants.


Assuntos
Humanos , Feminino , Adulto , Síndrome do Ovário Policístico/epidemiologia , Síndrome Metabólica/epidemiologia , Infertilidade Feminina/epidemiologia , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/diagnóstico , Resistência à Insulina , Índice de Massa Corporal , Prevalência , Estudos Transversais , Fatores de Risco , Fatores Etários , Guias de Prática Clínica como Assunto , Síndrome Metabólica/diagnóstico , Circunferência da Cintura , Infertilidade Feminina/etiologia , Irã (Geográfico)/epidemiologia , HDL-Colesterol/sangue
6.
Int J Fertil Steril ; 10(1): 36-41, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27123198

RESUMO

BACKGROUND: The endometrial hyperplasia measured by ultrasound in polycystic ovary syndrome (PCOS) women is strongly related to pathologic endometrial thickness, but there is no consensus on the relation between serum luteinizing hormone (LH) and either of these factors: pathologic endometrial hyperplasia and body mass index (BMI). MATERIALS AND METHODS: In this observational cross-sectional study, three hundred fifty infertile PCOS women were involved in this research. An endometrial biopsy was taken by using a pipelle instrument, regardless of menstrual cycle's day and all samples were reported by the same pathologist. Basal serum LH level was compared between two subgroups (hyperplasia and non-hyperplasia). The intended population was divided into three groups according to BMI and basal serum LH, later on the comparison was made in three groups. Chi-square test was applied to compare nominal variables between groups. Mann-Whitney U, and one way ANOVA tests were used to compare means on the basis of the result of normality test. RESULTS: The frequency of endometrial hyperplasia was 2.6%. Endometrial thickness in the patients with endometrial hyperplasia was significantly higher than that of a normal endometrium (10.78 ± 3.70 vs. 7.90 ± 2.86 respectively, P=0.020). There was no relation between endometrial hyperplasia and serum LH (P=0.600). The ANOVA test showed serum LH levels were not the same among three BMI groups (P=0.007). Post hoc test was also performed. It showed that the LH level in normal BMI group was significantly higher than those of other groups (P=0.005 and P=0.004), but there was no statistical difference between overweight and obese groups (P=0.8). We found no relationship between BMI and endometrial thickness in PCOS patients (P=0.6). CONCLUSION: Sonographic endometrial stripe thickness is predictive for endometrial hyperplasia in PCOS women. We could not find out any relationship between serum LH level and BMI with endometrial thickness in PCOS patients. However, our study confirmed a diverse relationship between serum LH level and BMI in PCOS patients.

7.
Arch Endocrinol Metab ; 60(3): 199-204, 2016 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-26910626

RESUMO

OBJECTIVE: The aim of the present study was to determine the prevalence of metabolic syndrome (MS) in infertile Iranian women with polycystic ovary syndrome (PCOS) using the ATPIII criteria. SUBJECTS AND METHODS: In this cross-sectional study, 624 women with PCOS were enrolled at a tertiary referral center in Tehran, Iran, between April, 2012 and March, 2013. Diagnosis of MS was according to ATPIII criteria. Also, we divided PCOS patients into following two main groups: (i) with MS (n = 123) and (ii) without MS (n = 501), and then compared variables between two groups. RESULTS: The mean age, body mass index (BMI) and waist circumference were 28.6 ± 4.3 years, 26.7 ± 3.7 kg/m2 and 85.2 ± 8.7 cm, respectively. The prevalence of MS was 19.7%. Our findings showed that age, BMI, waist circumference and all metabolic parameters were higher in PCOS women with MS than related values in those without MS. The most and least prevalent forms of MS were low level of high density lipoprotein-cholesterol (HDL-C) and hypertension, respectively. CONCLUSION: It seems the prevalence of metabolic syndrome in our country isn't as high as western countries. The prevalence rate of MS increased with age and BMI. One of the major cardiovascular risk factors, low level of HDL-C, is the most prevalent metabolic abnormality in our participants.


Assuntos
Infertilidade Feminina/epidemiologia , Síndrome Metabólica/epidemiologia , Síndrome do Ovário Policístico/epidemiologia , Adulto , Fatores Etários , Índice de Massa Corporal , HDL-Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Infertilidade Feminina/etiologia , Resistência à Insulina , Irã (Geográfico)/epidemiologia , Síndrome Metabólica/diagnóstico , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/diagnóstico , Guias de Prática Clínica como Assunto , Prevalência , Fatores de Risco , Circunferência da Cintura
8.
Int J Fertil Steril ; 9(1): 55-64, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25918593

RESUMO

BACKGROUND: Establishment of viable pregnancy requires embryo implantation and placentation. Ectopic pregnancy (EP) is a pregnancy complication which occurs when an embryo implants outside of the uterine cavity, most often in a fallopian tube. On the other hand, an important aspect of successful implantation is angiogenesis. Vascular endothelial growth factor (VEGF) is a potent angiogenic factor responsible for vascular development that acts through its receptors, VEGF receptor 1 (VEGFR1) and VEGFR2. This study aims to investigate mRNA expression of VEGF and its receptors in fallopian tubes of women who have EP compared with fallopian tubes of pseudo-pregnant women. We hypothesize that expression of VEGF and its receptors in human fallopian tubes may change during EP. MATERIALS AND METHODS: This was a case-control study. The case group consisted of women who underwent salpingectomy because of EP. The control group consisted of women with normal fallopian tubes that underwent hysterectomy. Prior to tubal sampling, each control subject received an injection of human chorionic gonadotropin (hCG) to produce a state of pseudo-pregnancy. Fallopian tubes from both groups were procured. We investigated VEGF, VEGFR1 and VEGFR2 mRNA expressions in different sections of these tubes (infundibulum, ampulla and isthmus) by reverse transcription polymerase chain reaction (RT-PCR) and quantitative PCR (Q-PCR). RESULTS: RT-PCR showed expressions of these genes in all sections of the fallopian tubes in both groups. Q-PCR analysis revealed that expressions of VEGF, VEGFR1 and VEGFR2 were lower in all sections of the fallopian tubes from the case group compared to the controls. Only VEGFR2 had higher expression in the ampulla of the case group. CONCLUSION: Decreased expressions of VEGF, VEGFR1 and VEGFR2 in the EP group may have a role in the pathogenesis of embryo implantation in fallopian tubes.

9.
Iran J Reprod Med ; 12(8): 547-54, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25408704

RESUMO

BACKGROUND: Traditionally, septate uterus was diagnosed with invasive method like hysterosalpingography and hysteroscopy. Nowadays transvaginal ultrasonography was reported to be a sensitive tool for detection of septate uterus too. OBJECTIVE: The objective of the present study was to evaluate the application of two dimensional ultrasound (2-DUS) and real time three dimensional ultrasound (3-DUS) in differentiating various type of septated uterus. Hysteroscopy confirmation was assigned as the gold standard. MATERIALS AND METHODS: This retrospective study was performed among 215 infertile women with suspected septate uterus from October 2008 to July 2012. An inclusion criterion was septated uterus based on HSG or experiencing abortion, preterm labor, or recurrent IVF failure. Fusion anomalies were excluded from the study (unicornuate, bicornuate and didelphys anomalies). The results of 3D and 2D sonographies were compared, while they were confirmed by hysteroscopy result in detection of septated uterus. Kappa index for agreement between 2DUS and hysteroscopy, as well as 3-DUS and hysteroscopy in detection of septate uterus was carried out. By receiver operating characteristic (ROC) curve, cut off points for predicting the kind of anomalies were proposed. RESULTS: The women were evaluated by 2-DUS (n=89) and (II) 3-DUS (n=126). All women underwent hysteroscopy, following 2-DUS and 3-DUS at the same or subsequent cycle. The results of kappa (K) index were 0.575 and 0.291 for 3-DUS and hysteroscopy, as well as 2-DUS and hysteroscopy, respectively. Also, the cutoff points were 27% for arcuate and subseptate, and 35% for differentiating septate and subseptate. CONCLUSION: Real time 3-DUS has better ability for visualization both uterine cavity and the fundal uterine, so it has higher agreement in detection of septate uterus than 2-DUS.

10.
Adv Biomed Res ; 3: 89, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24761397

RESUMO

BACKGROUND: Post-operative shivering is an unpleasant complication that various drugs are used to prevent and treat. It is tried to advice a suitable drug with the least side-effects. This study was carried out to examine the effect of intravenous Apotel on the post-operative shivering and core and peripheral body temperature. MATERIALS AND METHODS: This clinical trial conducted in Al Zahra and Kashani Hospitals in Isfahan in 2012 on 64 patients undergoing upper limbs surgery with general anesthesia, which divided in two equal groups. In the first group, before induction, 15 mg/kg and up to 1 g paracetamol was infused in 100 cc normal saline within 20 min and control group was infused 100 cc normal saline during 20 min. Post-operative shivering and pain were recorded in the same time in addition to the core and peripheral temperature. The results were analyzed by SPSS ve.20 software. RESULTS: In patients receiving Apotel, the core and peripheral temperature were significantly lower (P < 0.05). At 10 min after entering in recovery, 10 patients in the control group and 2 in the intervention group suffered from shivering (31.2% vs. 6.2%), which was significantly different (P = 0.02). Nineteen patients (29.7%) suffered from shivering in recovery (14 patients in the control group and 5 patients in the intervention group (43.8% vs. 15.6%)). In Apotel receiving group, the incidence of shivering in recovery was significantly lower (P = 0.014). CONCLUSION: Given the beneficial effects of Apotel in post-operative shivering and pain reduction, using the drug as a pre-drug is recommended in patients undergoing surgery with general anesthesia.

11.
Urology ; 83(1): 107-10, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24210565

RESUMO

OBJECTIVE: To evaluate microsurgical testicular sperm extraction (micro-TESE) and intracytoplasmic sperm injection (ICSI) treatment in patients with non-mosaic Klinefelter syndrome (KS). METHODS: We retrospectively evaluated the micro-TESE/ICSI performance in 134 patients with classic KS and 537 men with nonobstructive azoospermia (NOA) and normal karyotype referred to Royan Institute between 2009 and 2011. The patients were divided into 2 groups according to micro-TESE outcome. Several factors, including patients' age, level of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone, were compared between the 2 groups. RESULTS: Sperm retrieval rate by micro-TESE in the KS and control groups were 28.4% (38/134) and 22.2% (119/537), respectively. In the KS group, the mean age of patients with successful sperm retrieval of spermatozoa was significantly lower than those with negative results (30.0 ± 0.65 vs 33.68 ± 0.6 year, P = .001) and comparison of laboratory parameters between the 2 groups showed that the level of testosterone was significantly higher in patients with successful sperm retrieval (3.4 ± 0.48 vs 2.33 ± 0.23 ng/mL, P <.001). The fertilization rate was significantly higher in the KS group than the control group (28% vs 21%, P = .038). Also, live birth rate per embryo transfer was higher in the KS group, but it was not significant (13% vs 3%, P = .05). CONCLUSION: This study of sperm recovery and ICSI outcome in men with and without KS shows that micro-TESE/ICSI is a successful intervention for the majority of men with KS.


Assuntos
Infertilidade Masculina , Síndrome de Klinefelter , Injeções de Esperma Intracitoplásmicas , Recuperação Espermática , Adulto , Humanos , Infertilidade Masculina/etiologia , Síndrome de Klinefelter/complicações , Masculino , Estudos Retrospectivos , Resultado do Tratamento
12.
J Clin Anesth ; 25(3): 188-92, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23567482

RESUMO

STUDY OBJECTIVE: To compare postoperative pain scores and rescue analgesic use in patients who received acetaminophen preoperatively or during skin closure versus those who received a placebo. DESIGN: Randomized, double-blind clinical trial. SETTING: University-based, tertiary-care hospital. PATIENTS: 75 adult, ASA physical status 1 and 2 undergoing lower extremity orthopedic surgery. INTERVENTIONS: Patients were randomized to three groups. The control group received 100 mL of intravenous (IV) normal saline as a placebo. The preventive acetaminophen group received 100 mL of IV normal saline plus 15 mg/kg of acetaminophen prior to skin closure. The preemptive acetaminophen group received 15 mg/kg of IV acetaminophen combined with 100 mL of normal saline half an hour preoperatively. MEASUREMENTS: Pain was scored with the verbal rating scale and assessed 5 minutes before spinal anesthesia, and 6, 12, 18, and 24 hours after surgery. Total rescue meperidine consumption by each patient during the first 24 hours after surgery was also recorded. MAIN RESULTS: Pain scores were lower in both preemptive and preventive acetaminophen groups at 6 hours after surgery than in the placebo group (P < 0.001). There were no differences in pain scores after 6 hours between the preemptive and preventive groups. Total analgesic consumption 24 hours after surgery was lowest in the preemptive acetaminophen group (P < 0.01). Average time to initial analgesic requirement was slightly longer in the preemptive and preventive acetaminophen groups than the control group (P < 0.01). CONCLUSION: In patients undergoing lower extremity surgery with spinal anesthesia, both preventive and preemptive acetaminophen may enhance analgesia and decrease postoperative analgesic consumption.


Assuntos
Acetaminofen/administração & dosagem , Analgésicos não Narcóticos/administração & dosagem , Perna (Membro)/cirurgia , Dor Pós-Operatória/prevenção & controle , Acetaminofen/efeitos adversos , Acetaminofen/uso terapêutico , Adulto , Idoso , Analgésicos não Narcóticos/efeitos adversos , Analgésicos não Narcóticos/uso terapêutico , Analgésicos Opioides/administração & dosagem , Raquianestesia/métodos , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Masculino , Meperidina/administração & dosagem , Pessoa de Meia-Idade , Medição da Dor/métodos , Medicação Pré-Anestésica/métodos
13.
Saudi J Anaesth ; 6(2): 145-51, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22754441

RESUMO

AIMS: The efficacy of using midazolam or haloperidol for prevention of postoperative nausea and vomiting (PONV) has been investigated before. The main object of the present study was to evaluate the anti-emetic effects of combining administration of intravenous haloperidol with intravenous midazolam on PONV in patients underwent middle ear surgery in comparison with using each drug alone. METHODS: Study design was randomized, double-blind, placebo-controlled. 80 patients, aged 18-60 years, scheduled for middle ear surgery in Kashani Hospital Medical Center under general anesthesia were enrolled in this randomized, double-blind, placebo-controlled study. Patients were divided into 4 groups of 20 each and received haloperidol 2 mg i.v. (Group H); midazolam 2 mg i.v. (Group M); haloperidol 2 mg plus midazolam 2 mg i.v. (Group HM); saline i.v. (Group C). The incidences of PONV and complete response were evaluated at 0-2 hours after arrival to the PACU and 2-24 hours after arrival to the ward in 4 groups. RESULTS: Patients in group HM had significantly lower incidence of PONV compared with groups H, M, and C throughout 0-24 h (P<00.5). The HM group had the lowest incidence of PONV (0-2, 2-24, and 0-24 h) and the highest incidence of complete response. Postoperative anti-emetic requirement was significantly less in group HM compared with group M or H (P<0.05). CONCLUSION: Combine administration of haloperidol 2 mg plus midazolam 2 mg significantly reduced PONV better than using each drug alone in patients underwent middle ear surgery under general anesthesia.

14.
Middle East J Anaesthesiol ; 21(4): 499-504, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23327021

RESUMO

BACKGROUND: Adenotonsillectomy is the most frequently performed ambulatory surgical procedure in children. Post operative agitation and inadequate pain control, for children undergoing adenotonsillectomy, can be a challenge. The aim of this study was to assess the effect of intravenous dexamethasone and oral acetaminophen codeine on emergence agitation and pain after adenotonsillectomy in children. METHODS: One hundred and five pediatric patients (3-7 years old), scheduled to undergo adenotonsillectomy under general anesthesia, were enrolled in the study. Thirty minutes before induction, patients were randomized to three groups. Group 1 received 0.2 mg/kg of intravenous dexamethasone and 0.25 ml/kg of oral placebo syrup. Group 2 received 20 mg/kg of oral acetaminophen codeine syrup and 0.05 ml/kg of intravenous saline. Group 3 received 0.25 ml/kg of oral placebo syrup and 0.05 ml/kg of intravenous saline. Emergence agitation and postoperative pain were assessed, recorded and compared. RESULT: Agitation was less frequent in dexamethasone and acetaminophen codeine groups in comparison with placebo group, but there were not significant differences between the two groups. The pain frequencies in the three groups were not significantly different. CONCLUSION: The results of this study suggest that the administration of intravenous dexamethasone (0.2 mg/kg) and oral acetaminophen codeine (20 mg/kg) thirty minutes before anesthesia can significantly decrease the incidence and severity of agitation but does not have an effect on postoperative pain.


Assuntos
Adenoidectomia/métodos , Dor Pós-Operatória/prevenção & controle , Agitação Psicomotora/prevenção & controle , Tonsilectomia/métodos , Acetaminofen/administração & dosagem , Acetaminofen/uso terapêutico , Administração Intravenosa , Administração Oral , Analgésicos não Narcóticos/administração & dosagem , Analgésicos não Narcóticos/uso terapêutico , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/uso terapêutico , Período de Recuperação da Anestesia , Criança , Pré-Escolar , Codeína/administração & dosagem , Codeína/uso terapêutico , Dexametasona/administração & dosagem , Dexametasona/uso terapêutico , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Humanos , Incidência , Masculino , Agitação Psicomotora/epidemiologia , Índice de Gravidade de Doença
15.
J Anesth ; 25(6): 892-7, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21928127

RESUMO

PURPOSE: The aim of this study was to evaluate the effect of additional magnesium sulfate (MgSO(4)) 100 mg to intrathecal (IT) isobaric 0.5% bupivacaine 3 ml on spinal anesthesia in patients undergoing lower extremity orthopedic surgery. METHODS: In a double-blind randomized clinical trial, 79 American Association of Anesthesiologists (ASA) I or II adult patients undergoing lower extremity orthopedic surgery were recruited. The patients were randomly allocated to receive 100 mg MgSO(4) 5% (0.2 ml) plus 15 mg of bupivacaine 0.5% (MgSO(4) group) or 15 mg bupivacaine 0.5% combined with 0.2 ml normal saline (control group) intrathecally. Response to treatment was assessed as onset and duration of sensory block, the highest level of sensory block, time to complete motor block recovery, duration of spinal anesthesia, and postoperative analgesic requirement. RESULTS: The onset of the sensory block was slower in the MgSO(4) group than in the control group (13.3 vs. 11.6 min, P = 0.04), and the duration of the sensory blockade was significantly longer in the MgSO(4) group than the control group (106.5 vs. 85.5 min, P = 0.001). Total analgesic requirements for 24 h following surgery were lower in the MgSO(4) group than in the control group (96.8 vs. 138.5 mg, P = 0.001). Mean duration of spinal anesthesia was not significantly different between two groups (178.0 vs. 167.4 min, P = 0.23). CONCLUSION: In patients undergoing lower extremity surgery with spinal anesthesia, the addition of 100 mg IT MgSO(4) to 15 mg bupivacaine without opioid supplement, prolonged the duration of the sensory block, decreased postoperative analgesic consumption, and significantly prolonged the onset of spinal anesthesia.


Assuntos
Analgésicos/administração & dosagem , Raquianestesia/métodos , Anestésicos Locais/administração & dosagem , Bupivacaína/administração & dosagem , Extremidade Inferior/cirurgia , Sulfato de Magnésio/administração & dosagem , Dor Pós-Operatória/tratamento farmacológico , Adulto , Método Duplo-Cego , Feminino , Humanos , Injeções Espinhais , Masculino , Procedimentos Ortopédicos , Medição da Dor/efeitos dos fármacos , Medição da Dor/métodos
16.
Iran J Nurs Midwifery Res ; 15(3): 125-9, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21589775

RESUMO

BACKGROUND: Tea consumption has been known mostly as a well-drink after water in the world. Tea drink can affect balance of fluids and renal function. In addition, it can cause loss of many viruses in the stomach and can increase or decrease gastrointestinal movements. This research was done to determine the effect of tea on increasing enteral feeding tolerance in ICU patients in Alzahra Hospital. METHODS: In this clinical trial study, 45 patients were enrolled in two groups, tea consumption group and the standard method of nutrition as control group. Tea gavage was performed two times in the morning; 100 cc tea used for the study group and the same volume of water was used for the control group. Residual volume was measured before gavage. Data collected for one week. Information sheet had two pages; the first page described how to complete the form and the method of tea gavage and the second page was for data collection. Data were analyzed by t-student test, chi-square, and analysis of variance. RESULTS: In two groups, 92% of patients tolerated liquid gavage. Their difference by chi-square test was not significant. Average urine volume after black tea gavage was 783.3 L in the study group and 802.2 L in the control group. ANOVA test showed no significant difference. CONCLUSIONS: Although the difference was not statistically significant between the two groups, but in study group consumption of tea was acceptable by patients.

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