Acta medica Iranica
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Acta medica Iranica · Jan 2012
Randomized Controlled Trial Comparative StudyComparison of effects of ephedrine, lidocaine and ketamine with placebo on injection pain, hypotension and bradycardia due to propofol injection: a randomized placebo controlled clinical trial.
Propofol is a widely used anesthetic drug because of its minor complication and also its fast effect. One of most popular complication in using this drug is pain during injection that is more sever in new generation of its components (lipid-free microemulsion). Other complications of propofol are bradycardia and hypotension. ⋯ Our data shows that in pain management all tested drugs can decrease pain significantly comparing with placebo (P=0.017). In control of hemodynamic parameters ephedrine could efficiently control SBP, DBP, MAP at the time 1 min after intubation. Based on our study ephedrine can be an appropriate suggestion for control of both pain and hemodynamic changes induced by propofol, although because of inconsistent result in other studies it is recommended to design a systematic review to draw a broader view on this issue.
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Acta medica Iranica · Jan 2012
Randomized Controlled Trial Comparative StudyOndansetron pretreatment reduces pain on injection of propofol.
To assess the effectiveness of ondansetron pretreatment in alleviating propofol injection pain, 135 patients were randomly assigned to one of following three groups. Group 1 who received up to 2 mL pretreatment 50 mg tramadol in the saline, group 2 cases who received up to 2 mL pretreatment 4 mg ondansetron in saline, and group 3 who received up to 2 mL solution saline. A 20 gauge cannula was placed into the largest vein on the dorsum of the hand. Tourniquet was closed to the arm above the cannula and inflates to 70 mmHg, and then drug was injected. After 20 seconds, the tourniquet deflated, and propofol 2mg/kg injected over 10 seconds and pain assessment was made. ⋯ Tramadol and ondansetron significantly reduced the incidence and severity of propofol injection pain more than placebo (P=0.001). The efficacy of ondansetron in alleviating the pain on injection of propofol was no different from tramadol (P=0.330). Ondansetron pretreatment may be used to reduce the incidence of pain on injection of propofol, an advantage added to the useful prevention of postoperative nausea and vomiting.
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Acta medica Iranica · Jan 2012
Medication errors in an internal intensive care unit of a large teaching hospital: a direct observation study.
Medication errors account for about 78% of serious medical errors in intensive care unit (ICU). So far no study has been performed in Iran to evaluate all type of possible medication errors in ICU. Therefore the objective of this study was to reveal the frequency, type and consequences of all type of errors in an ICU of a large teaching hospital. ⋯ According to our results, the rate of errors is alarming and requires implementation of a serious solution. Since our system lacks a well-organize detection and reporting mechanism, there is no means for preventing errors in the first place. Hence, as the first step we must implement a system where errors are routinely detected and reported.
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Acta medica Iranica · Jan 2012
Preservation of thoracic kyphosis is critical to maintain lumbar lordosis in the surgical treatment of adolescent idiopathic scoliosis.
Restoration of the sagittal alignment is one of the fundamental goals in scoliosis correction surgery. Having an increase in popularity of segmental spinal instrumentation, thoracic kyphosis (TK) is often sacrificed to achieve frontal and axial plane correction. Patients with a Lenke type 1 deformity underwent selective thoracic fusion (lowest instrumented vertebra of T12 or L1) using corrective segmental spinal instrumentation (Hook-Rod) and were followed up for 2 years. ⋯ There were 63 patients (21 male, 42 female) with a mean age of 15.8 ± 2.1 years included to this study. TK reduction had significant correlation (P≤0.001) with lumbar lordosis (LL) decrease at preoperative (r=0.47), immediately postoperative (r=0.37) and at 2-year follow-up (r=0.5). The decrease in LL after 2-years was less than decrease in TK (4.5 ± 8.5 vs 6 ± 10, respectively).
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Burns are injuries which may require long hospitalization and may result in important impairment and disability. Burn injuries are still common especially in developing countries. Assessment of the epidemiology of burns is very important for introduction of preventive methods. ⋯ Mean total body surface area burned (TBSA) was 6.16% (±9.93). This study showed a high incidence of burn injuries at home and in the workplace. The burns were mostly preventive and many of them can be prevented by education.