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  • 1
    Online Resource
    Online Resource
    A Comparative Study of the Effect of Dexmedetomidine-Fentanyl and Midazolam-Ketamine Combination on the Level of Sedation in Children undergoing Bone Marrow Biopsy
    Knowledge E DMCC ; 2023
    In:  Archives of Anesthesia and Critical Care ( 2023-02-13)
    Details
    In: Archives of Anesthesia and Critical Care, Knowledge E DMCC, ( 2023-02-13)
    Abstract: Background: This study aimed to compare the effect of dexmedetomidine-fentanyl (DF) and midazolam-ketamine (MK) combination on the level of sedation in children undergoing bone marrow biopsy. Methods: This study was a single-blind randomized clinical trial. The patients were divided into two groups of 35. Five minutes before undergoing bone marrow biopsy, the first group underwent sedation with a combination of 0.1 mg/kg midazolam with 1 mg/kg ketamine, and the second group underwent sedation with a combination of 2 μg/kg dexmedetomidine with 1 μg/kg fentanyl. The mean arterial pressure (MAP), heart rate, SpO2, the level of sedation, and the incidence rates of complications were recorded in both groups and compared to each other. Results: There was no significant difference between the two groups in terms of age (P= 0.687), gender (P= 1.00), and weight (P= 0.839). However, there was a significant difference in the average length of stay in recovery (P= 0.015) and surgeon satisfaction (P= 0.000), with a longer recovery period in the midazolam-ketamine (MK) group. The Repeated measures ANOVA showed significant differences in heart rate (P= 0.008), sedation score (P= 0.038), and the percentage of oxygen saturation (P= 0.00) during surgery. Conclusion: The combination of dexmedetomidine and fentanyl (DF) compared to the combination of midazolam and ketamine (MK) can provide more patient sedation and surgeon satisfaction along with more stable hemodynamics for patients undergoing bone marrow biopsy.
    Type of Medium: Online Resource
    ISSN: 2423-5849
    URL: Article
    DOI: 10.18502/aacc.v9i1.11946
    Language: Unknown
    Publisher: Knowledge E DMCC
    Publication Date: 2023
    detail.hit.zdb_id: 3045514-5
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  • 2
    Online Resource
    Online Resource
    A Comparative Study of Nasal Fiberoptic Intubation with Laryngeal Mask Airway Fiberoptic Intubation in Children with a Difficult Airway
    Knowledge E DMCC ; 2023
    In:  Archives of Anesthesia and Critical Care ( 2023-04-17)
    Details
    In: Archives of Anesthesia and Critical Care, Knowledge E DMCC, ( 2023-04-17)
    Abstract: Background: Considering that the gold standard for intubation in children with a difficult airway is the use of fiberoptic bronchoscopy, and few studies have evaluated its application in children, the present study aimed at comparing two bronchoscopic techniques of nasal fiberoptic tracheal intubation (FOI-Nasal) and fiberoptic intubation via laryngeal mask airway (FOI-LMA) in children with a difficult airway. Methods: A single-blind randomized clinical trial was performed on 40 six-month-old to six-year-old children that were divided into two groups each consisting of 20 patients.  The participants were all candidates for elective surgery with clinical criteria for the anticipated difficult intubation. FOI-Nasal and FOI-LMA were performed in the first and second groups, respectively. Mean arterial pressure (MAP), heart rate (HR), and blood oxygen saturation levels (SpO2) were assessed and recorded before anesthesia (T1), immediately before bronchoscopy (T2), and immediately after intubation with endotracheal tube (T3). Moreover, ETCO2, the first successful insertion attempt, and the intubation time were recorded, as well. Results: The results of the present study revealed that parameters including MAP, HR, and SpO2 at times T1, T2, and T3 were not significantly different between the two groups after adjusting for potential confounding factors (P 〉 0.05). However, ETCO2 in FOI-Nasal group with a mean of 38.40 ± 3.57 was significantly higher than that of the FOI-LMA group with a mean of 34.35 ± 3.15 (P = 0.001). In addition, the intubation time in the FOI-LMA group with a mean of 32.40 ± 7.45 was significantly shorter than that of the FOI-Nasal group with a mean of 51.75 ± 9.97 (P 〈 0.001). The success rate in the first attempt in the FOI-Nasal group with the value of 70% was lower than that of the FOI-LMA group with the value of 90%; however, this difference was not statistically significant (P 〉 0.05). Conclusion: According to the results of the present study, the intubation time in the FOI-LMA group was significantly shorter than that of the FOI-Nasal group. Moreover, the success rate of the first attempt in the FOI-LMA group was higher than that of the FOI-Nasal group. Therefore, it can be stated that FOI-LMA as compared to FOI-Nasal can be regarded as an easier technique, with a shorter intubation time, a higher success rate, and a greater stability of children’s hemodynamic parameters.
    Type of Medium: Online Resource
    ISSN: 2423-5849
    URL: Article
    DOI: 10.18502/aacc.v9i2.12504
    Language: Unknown
    Publisher: Knowledge E DMCC
    Publication Date: 2023
    detail.hit.zdb_id: 3045514-5
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  • 3
    Online Resource
    Online Resource
    Effects of Intraoperative Low Dose Ketamine on Hemodynamic Changes and Postoperative Opioid Consumption in Patients Undergoing Laparoscopic Cholecystectomy
    Knowledge E DMCC ; 2023
    In:  Archives of Anesthesia and Critical Care ( 2023-02-13)
    Details
    In: Archives of Anesthesia and Critical Care, Knowledge E DMCC, ( 2023-02-13)
    Abstract: Background: Laparoscopic Cholecystectomy (LC) as a minimally invasive surgery has become extremely common in recent decades. Despite being less invasive, these surgeries require postoperative analgesia. In this regard Ketamine, can reduce postoperative pain and opioid consumption. Owing to the wide heterogeneity of studies on efficacy of ketamine in pain management in different operations, anesthetics methods, and the way and dose of consumption, the present study sought to evaluate the effects of intraoperative low-dose ketamine on postoperative pain, opioid consumption, and hemodynamic changes of patients undergoing LC in the 5th Azar hospital of Gorgan in 2019. Methods: 66 patients with the need for LC were randomly selected. After induction of anesthesia and intubation, and before surgical incision, 0.5 mg/kg of Ketamine was injected as a bolus for target group (n=33), and the equivalent volume of normal saline for control group (n=33). Systolic, diastolic and mean arterial pressure were recorded before, during, after anesthesia and during surgery at 5-minute intervals. Postoperative pain was evaluated through Visual Analog Scale(VAS). We recorded the time of the first dose of opioid, total amounts of opioid consumption during the first 24 hours after surgery and doses of antihypertensive drug. Results: VAS score (opioid requirement) were lower in the intervention group only in the recovery period (p=0.049). There was no difference between two groups in total amounts of opioid consumption during 24 hours even in cases with increase of the length of surgery (p= 0.742). Blood pressure trend increased from the beginning of induction to the end of anesthesia (p-value 〈 0.001); however, there was no statistically significant difference between two groups (p=0.786). The need for labetalol was higher in control group (p 〈 0.0001). Conclusion: Although 0.5 mg/kg ketamine could not reduce overall opioid consumption within 24 hours after surgery, it had significant pain relief during awakening and recovery. Additionally, it reduced the need for further interventions, such as labetalol and other drugs and therefore was associated with lower costs.
    Type of Medium: Online Resource
    ISSN: 2423-5849
    URL: Article
    DOI: 10.18502/aacc.v9i1.11945
    Language: Unknown
    Publisher: Knowledge E DMCC
    Publication Date: 2023
    detail.hit.zdb_id: 3045514-5
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  • 4
    Online Resource
    Online Resource
    How Does Covid-19 Outbreak Affect Emergent Surgery in Neonates?
    Respub Journals ; 2020
    In:  Journal of Medical Research and Surgery Vol. 1, No. 4 ( 2020-06-27), p. 1-4
    Details
    In: Journal of Medical Research and Surgery, Respub Journals, Vol. 1, No. 4 ( 2020-06-27), p. 1-4
    Abstract: Background: Covid-19 virus infection is a pandemic disease. Incidence of COVID-19 infection in children and neonates is less than adults. Neonates may be contaminated by close contact with the infected family members or environment. However, infection via transplacental transmission and breast feeding has not been proved yet. Hospitals face shortages of resources in the outbreaks. This becomes more important in underdeveloped countries. Methods: We have studied the neonates who underwent surgical interventions in emergent or urgent conditions. No specific protection measures were applied in the operating room and neonatal intensive care unit for patients without symptoms or positive history of contact, in an attempt to save the resources of the hospital. All the neonates and their families were followed up for two weeks. Results: Forty patients and their families were studied. At admission, our patients neither demonstrated symptoms of the disease nor gave positive history of contact, hence received surgical intervention in the ordinary protection. One patient suffered from respiratory problems in the post-operative period and tested positive for the Covid-19 infection. Six patients and Five family members became symptomatic during the follow-up. All of them tested negative for the diseases and recovered. Conclusion: Based on the results of our study, surgical interventions for the critical neonates without positive symptoms or history neither should be postponed nor be necessarily dependent on the application of the corona specific personal protection. This gains most significance in the peak of outbreak, especially in underdeveloped countries.
    Type of Medium: Online Resource
    ISSN: 2582-9572
    URL: Journal
    URL: Article
    DOI: 10.52916/jmrs
    DOI: 10.52916/jmrs204017
    Language: Unknown
    Publisher: Respub Journals
    Publication Date: 2020
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