The role of local injection of Bupivacaine in the management of pain after tonsillectomy surgery

Pain relief after tonsillectomy is an important part of post-operative management. There are some common drugs and local anesthetics such as bupivacaine used to treat postoperative pain. This research was aimed to assess the role of local injection of bupivacaine in the management of pain after tonsilectomy surgery 96patients aged 5–12 were included in a double-blind clinical trial prospective study. Patients in treatment group received an injection 3cc of 0.5% bupivacaine solution in side and upper peritonsillar areas, and patients in group B were injected 3cc of normal saline in the same area. Patients were asked to Visual Analog Score, After tracheal extubation, 1st, 2th, 4th, 8th,12th, and 24th hours after operation. The first request for analgesic and the total amount of analgesic consumption was also recorded. Regarding to Visual Analog Score over a 24-h period, there was a significant difference between two groups (p&lt;0.05). Also demand for analgesic in 24 hours after surgery was significantly less in treatment group than in placebo (p&lt;0.001). preoperative local 0.5% bupivacaine injection in tonsillectomy patients was effective relieves the post-tonsillectomy pain and significantly reduces opioid consumption in kids.</jats:p

The effect of N-acetyl cysteine injection on renal function after coronary artery bypass graft surgery : A randomized clinical trial

Abstract Objective: This study aimed to compare the effects of N-acetyl cysteine on renal function after coronary artery bypass graft surgery.Method: In this randomized clinical trial conducted in Golestan Hospital, Ahvaz, Iran, 60 candidates for coronary artery bypass graft surgery were selected and divided into two N-acetyl cysteine and control groups (30 people each).Intervention: Patients received 3 (2 intraoperative and 1 postoperative) doses of IV N-acetyl cysteine (100 mg/kg) (n=30) or placebo (n=30) over 24 hour. Prescription times were as follows: after induction of anesthesia, in the Next 4 hours, and in the 16 hours after on. Primary outcomes were serum levels of BUN and Cr, at baseline,4 and 48 hours after surgery. And also need renal replacement therapy (RRT). Secondary outcomes included the hemodynamic variables, Blood products transfusionResults: There were significant differences in BUN between groups at 4 h (P= 0.02) and 48h after surgery (P=0.001) There were significant differences in Cr level between groups at 4 h (P &lt;0.001) and 48h after surgery (P=0.001). MAP at different times (at 4h p=0.002 and 48h after surgery P&lt;0.001) were significantly different between the two groups. There was a significant difference between the two groups in terms of the unit of Packed cell transfusion (P=0.002) and FFP transfusion (P&lt;0.001).Conclusion: In the present study, we found that administration of N-acetyl cysteine can reduce the incidence of acute kidney injury in patients undergoing coronary artery bypass graft surgery and improved kidney functions.Trial registry: IRCT20190506043492N3 Registered at 2020.06.07 </jats:p

Sequential compression pump effect on hypotension due to spinal anesthesia for cesarean section: A double blind clinical trial

Background: Spinal anesthesia (SA) is a standard technique for cesarean section. Hypotension presents an incident of 80-85% after SA in pregnant women. Objective: To determine the effect of intermittent pneumatic compression of lower limbs on declining spinal anesthesia induced hypotension during cesarean section. Methods: This double-blind clinical prospective study was conducted on 76 non-laboring parturient patients, aged 18-45 years, with the American Society of Anesthesiologist physical status I or II who were scheduled for elective cesarean section at Razi Hospital, Ahvaz, Iran from December 21, 2015 to January 20, 2016. Patients were divided into treatment mechanical pump (Group M) or control group (Group C) with simple random sampling. Fetal presentation, birth weight, Apgar at 1 and 5 min, time taken for pre-hydration (min), pre- hydration to the administration of spinal anesthesia (min), initiation of spinal to the delivery (min) and total volume of intravenous fluids, total dose of ephedrine and metoclopramide were recorded. Data were analyzed by SPSS version 19, using repeated measures of ANOVA and Chi square test. Results: Heart rate, MPA, DAP and SAP changes were significantly higher in off-pump group in the baseline and 1st-minute (p<0.05), and in the other times, this change was significantly different with control groups. Conclusion: This research showed the suitability of the use of Sequential Compression Device (SCD) in reducing hypotension after spinal anesthesia for cesarean section, also this method can cause reducing vasopressor dosage for increased blood pressure, but the approval of its effectiveness requires repetition of the study with a larger sample size. Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2015011217742N3. Funding: The authors received no financial support for the research, authorship, and/or publication of this article

Investigating the Effect of Near Infra-red Spectroscopy (NIRS) on Early Diagnosis of Cardiac Surgery Associated Acute Kidney Injury

Abstract Background. Cardiac surgery-associated acute kidney injury (CSA –AKI), is a major complication of cardiac surgery. Early detection of this complication can improve the quality of post-operative care and help to prevent this phenomenon.Materials and Methods: 148 patients were enrolled to study and 107 patients were selected for analysis between February and September 2019 in the cardiac surgery unit of Golestan Hospital. Ahvaz. Iran. Kidney tissue oxygen saturation was measured in multiple definite times during surgery. Hemoglobin, blood urea nitrogen, creatinine, and lactate were measured during and 48 hours after surgery.Results: Forty-one patients were diagnosed of CSA-AKI according to KDIGO criteria. Parametric and non-parametric analyzes significant difference was not detected between CSA-AKI and NON CSA-AKI group in the demographic parameter. Repeated measurement of ANOVA Analysis did not show any significant difference in parameters except for BUN. Repeated measurement of ANOVA showed a significant difference in both groups and time factors (p&lt;0.001, p=0.0006 respectively). ROC curve analyzes showed in a single point of time, difference the middle of CPB time from baseline high-value in the prediction of AKI 0.764 (0.57 to 0.951) (AUC-CI). Conclusion; Kidney saturation monitoring could be considered as routine monitoring in cardiac surgery for the rapid detection of CSA -AKI. Although kidney tissue saturation is not correlated directly to the arterial saturation of oxygen, physician and surgery team could predict the chance of acute kidney injury exposure.</jats:p