Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 8 Supp. 1 2022 11 07 348 353 Shikhar Verma Department of Anesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India. Ranvinder Kaur Department of Critical Care Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India. Usha Yadav Department of Obstetrics & Gynaecology, Deen Dayal Upadhyay Hospital, New Delhi, India. Rupesh Yadav Department of Anesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India. Nisha Kachru Department of Anesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India. 2022 02 18 2022 04 04 Background: Spinal anaesthesia is the most common technique used for lower segment caesarean sections(LSCS). but it has own disadvantages too. Maternal haemodynamic changes is more profound in pregnant population. Aim of the study was to compare the maternal haemodynamic changes with crystalloid preloading and co-loading in patients undergoing elective lower segment caesarean section under spinal anaesthesia. Methods: 80 obstetric patients with period of gestation (POG) more than 37 weeks, in the age between 18 to 35 years, belonging to ASA class I and II and scheduled for elective LSCS were randomized into two groups. Group P - Patient receiving preloading with Ringer Lactate at a dose of 15ml/kg. Group C – Patient receiving Co-loading with Ringer Lactate at a dose of 15ml/kg. Primary objectives of the study were haemodynamic changes like Heart rate (HR), Systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) and these parameters were recorded baseline, at 1 min interval for first 10 minutes, after that at 5 minutes till 20 minutes and then every 15 min till completion of procedure. Results: The demographic data were comparable in group P and group C. The mean (SD) HR was significantly higher in group P as compared to group C at 5,6,7,8 and 9 minutes (p <0.05). The mean (SD) SBP, DBP and MBP was significantly lower in group P as compared to group C at 5,6 and 7 minutes (p <0.05). Significant difference was seen in the distribution of nausea/vomiting score between group P and C. (p value<.05). Conclusion: We conclude that co-loading with crystalloids is provide more Maternal Hemodynamics stability after subarachnoid block rather than preloading with crystalloids. https://aacc.tums.ac.ir/index.php/aacc/article/view/488

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 8 Supp. 1 2022 11 07 354 357 Seyed Mohammad Mireskandari Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Jalil Makarem Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Kaveh Hedayati Emami Department of Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Afshin Jafarzadeh Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Kasra Karvandian Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Shahram Samadi Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Babak Eslami Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Ali Movafegh Department of Anesthesiology and Critical Care and Pain Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2022 06 08 2022 07 02 Background: The change in patients' positions has a bold effect on the ventilation and hemodynamic parameters during surgery. In this study, we evaluated the changes in hemodynamic and ventilator values resulting from conversions in the position of patients under the thoracotomy from supine to lateral position and vice versa, to determine the most favourable position with the best hemodynamic stability and ventilation conditions. Methods: In this pre and that post interventional clinical trial, 50 patients scheduled for thoracotomy were included. Following general anesthesia induction and 5 minutes later, hemodynamic data before thoracotomy and after the surgical intervention was measured, the patient was placed in the supine position and all hemodynamic data were recorded. Then, the position of the patient was slightly changed to the lateral recumbent position. Then, at the end of the surgery, the position was changed to supine. Results: Regarding the change in study indices (including HR, SBP, DBP, MAP, SVV, CO, and PVI), changes in supine to lateral status led to only a decrease in systolic blood pressure, diastolic blood pressure, and mean blood pressure and other indicators did not show a statistically significant change. Similarly, the change in the above indices by changing the lateral to the supine state was only an increase in systolic blood pressure, diastolic blood pressure, mean blood pressure, and other data remained unchanged. Conclusion: Changing the position of patients during surgical thoracotomy from supine to lateral position or vice versa is associated only with significant changes in patient's blood pressure and has no significant effect on other ventilatory and cardiovascular parameters. https://aacc.tums.ac.ir/index.php/aacc/article/view/575

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 8 Supp. 1 2022 11 07 358 363 Saeideh Sadat Mousavi Department of Curriculum Studies and Instruction, Ferdowsi University of Mashhad, Mashhad, Iran. Morteza Karami Department of Curriculum Studies and Instruction, Ferdowsi University of Mashhad, Mashhad, Iran. Seyed Mohammad Mireskandari Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Shahram Samadi Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2022 02 22 2022 04 04 Background: This study aimed to assess the effect of virtual reality technology on knowledge, attitude, and skills of first-year anesthesia residents in spinal anesthesia procedure training. Methods: 25 anesthesia residents were enrolled in this experimental study. They were randomly divided into two groups of virtual reality (n =11) and conventional training (n = 14). The virtual reality (VR) group received a combined virtual and clinical training environment while the conventional group received only a clinical training environment for one month. A Similar content (herein, spinal anesthesia procedure) was trained to the both groups. The participants were the anesthesia residents in the academic year 2020-2021. Similar exams assessed knowledge, attitudes, and skills in both groups and data were analyzed using t-test and ANCOVA. Results: The mean knowledge score acquired by residents in the VR group was higher than the conventional learning group (16.45 ± 2.5 vs 13.57 ± 2.1). The method of training had also a significant effect on the post-test score; F (1) = 6.16, P = 0.02. In addition, the mean attitude score acquired by residents in the VR group was higher than the conventional learning group (110.63 ± 14.7 vs 107.64 ± 12.3), although the method of training had not a significant effect on residents’ attitude score; T (23) = 0.55, P = 0.58). The mean skills score acquired by residents in the VR group was higher than the conventional learning group (100.4 ± 3.17 vs 88.14± 11.8); While the method of training had a significant effect on residents’ skill score. T (23) = 3.34, P < 0.05), too. Conclusion: The combined virtual and clinical training environment was superior to a conventional method for enhancement of knowledge and skill in spinal anesthesia procedure training in anesthesiologist residents. This study can help the educational designers of the University of Medical Sciences to improve the competence of residents by using a combined learning environment. https://aacc.tums.ac.ir/index.php/aacc/article/view/490

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 8 Supp. 1 2022 11 07 364 369 EN Swarnamba U Nagappa Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubballi, India. Shashidhar Kallappa Department of Oncosurgery, Karnataka Institute of Medical Sciences, Hubballi, India. Mallikarjun Policepatil Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubballi, India. Veena Katappa Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubballi, India. 2022 02 23 2022 04 04 Background: Despite advances in anaesthesia care postoperative nausea and vomiting (PONV) remains a vexing problem. Objectives to determine the efficacy of Granisetron and Granisetron plus dexamethasone in preventing the incidence of PONV, also assess the requirement of rescue antiemetic and adverse effects in the postoperative period AIM: To determine the efficacy of Granisetron and Granisetron plus dexamethasone in preventing the incidence of Nausea and Vomiting in 70 patients undergoing Laparoscopic Surgeries. Methods: Prospective, Randomized, Double Blind Study among 70 Patients aged between 18 to 50 years, ASA class Grade I and II was conducted. 35 patients were recruited in two groups using randomization method. Post operatively data was collected using a questionnaire at 4 hrs and 24 hrs. Episodes of PONV were recorded by three points ordinal scale (TPOS). Intensity of nausea graded verbally with an eleven-point score (0-10). Results: In group G, at 0-4 hours 11.4% patients had nausea and 25.7% had vomiting/retching. In group G+D, 8.6% had nausea and 2.9% had vomiting/ retching. There was significant difference (p =0.018) on Three point ordinal scale (TPOS) between the two groups.      In group G, at 4-24 hours 5.7% patients had nausea and 20.0% had vomiting and retching. In group G+D 11.4% had nausea and there was no vomiting / retching.  There was significant difference (p =0.017) on Three point ordinal scale (TPOS) between the two groups. Conclusion: We concluded that Granisetron + Dexamethasone had lower incidence of PONV compared to Granisetron group alone in Laparoscopic surgeries. https://aacc.tums.ac.ir/index.php/aacc/article/view/491

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 8 Supp. 1 2022 11 07 370 376 Poonam Ghodki Department of Anaesthesiology, Deenanath Mangeshkar Hospital, Pune, India. Priyanka Kulkarni Department of Anaesthesiology, SKNMC&GH, Pune, India. Aakruti Prabhu Department of Anaesthesiology, SKNMC&GH, Pune, India. Akshay Dhamdhere Department of Anaesthesiology, SKNMC&GH, Pune, India. 2022 02 23 2022 04 04 Background: Exaggerated hemodynamic response has been linked to laryngoscopy and intubation. This reaction might have negative consequences on the respiratory system, the nervous system, and the heart. It might show up as tachycardia, hypertension, and dysrhythmias. The oral, pharyngeal, and laryngeal axes, all need to be aligned, which is largely responsible for the laryngoscopy reaction. Hence video laryngoscope was developed to overcome this response which does not require the alignment of these three axes. Thus, it can provide this ameliorating effect with less suspension and distension force, which will probably result in less hemodynamic changes during laryngoscopy. Comparing the hemodynamic response during laryngoscopy and intubation using the conventional McIntosh direct laryngoscope and the Truview® video laryngoscope was the primary objective of this study. Intubation time and glottic opening using Cormack Lehane grade were the secondary objectives. Methods: This randomized controlled trial was conducted in 60 patients who were scheduled to undergo elective surgeries requiring conventional GA. Random allocation into two groups was done. Patients in Group ML (n=30) underwent laryngoscopy and intubation using a conventional McIntosh laryngoscope. Patients in Group VL (n=30) underwent laryngoscopy and intubation using a Truview video laryngoscope. Before and after endotracheal intubation, as well as 2, 5, and 10 minutes later, both groups were monitored for changes in hemodynamic parameters such as heart rate, systolic and diastolic pressure, and mean arterial pressure. Intubation time and glottic view was also assessed using the Cormack Lehane grade. Results: Heart rate, systolic blood pressure, mean arterial blood pressure, and intubation time were significantly different between the two groups (p=0.00). The diastolic blood pressure did not significantly differ between the two groups (p=0.203). There was no statistically significant correlation between the type of laryngoscopy and the glottic view with Cormack Lehane Grade favouring certain groups (p=1). Conclusion: We conclude that tracheal intubation with Truview video laryngoscope is advantageous in preventing cardiovascular stress response but with longer intubation time. https://aacc.tums.ac.ir/index.php/aacc/article/view/492

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 8 Supp. 1 2022 11 07 377 382 Indu Verma Department of Anaesthesia, SMS Medical College and Hospital, Jaipur, India. Priyanka Beelwal Department of Anaesthesia, SMS Medical College and Hospital, Jaipur, India. Chandan Verma Department of Pharmacology, SMS Medical College and Hospital, Jaipur, India. Chand Vyas Department of Anaesthesia, SMS Medical College and Hospital, Jaipur, India. 2022 02 25 2022 04 04 Background: Off-pump coronary artery bypass grafting (OPCABG) is associated with hemodynamic fluctuations which usually require the use of various vasoactive drugs like norepinephrine and phenylephrine The aim of this study was to evaluate the effect of low dose vasopressin on hemodynamics in patients undergoing Off-pump Coronary Artery Bypass Graft Surgery (OPCABG). Methods: Sixty patients undergoing elective Off pump coronary artery bypass grafting (CABG) having triple vessel coronary artery disease (CAD). were randomly divided into two groups: group A (n=30), patients received Vasopressin 0.03 IU/min via infusion pump (diluted in 50 ml syringe) during the LIMA extraction and continued till the end of surgery; group B (n==30), patients received normal saline infusion pump during the LIMA extraction and continued till the end of surgery. The anessherName> Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 2 2024 06 21 638 640 Jyoti Deshpande Department of Anaesthesia, SMCW and SUHRC,SIU,Pune,India. Harsha Singhi Department of Anaesthesia, SKNMC & GH, MUHS, Pune, India. 2024 01 16 2024 02 07 Gestational trophoblastic disease (GTD) is a cluster of tumors which often had a lethal outcome in the past. As the years have passed, with better understanding of the pathophysiology fatalities have reduced and patients have been cured. On an anesthetic stand point these cases can be challenging to manage due to the emergency nature of the surgery and various systemic complications they may present with. We present to you a case of a 29-year-old female with molar pregnancy managed by spinal anesthesia. https://aacc.tums.ac.ir/index.php/aacc/article/view/935

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 2 2024 06 22 557 564 Aidin Zeinaly Department of Anesthesiology and Critical Care, Urmia University of Medical Sciences, Urmia, Iran. Afsaneh Mouseli Kelvanagh Students Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. Maryam Soleimanpour Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. Robab Mehdizadeh Esfanjani Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Hassan Soleimanpour Emergency and Trauma Care Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 2024 02 05 2024 02 09 Background: The aim of the present study was to compare the effectiveness of two teaching models (e-learning and discussion-based learning) on the learning process of emergency department interns in relation to the use of the sedatives. Methods: In this study, 129 interns introduced to the emergency medicine department were included in the study. These interns were randomly divided into two groups, I and II. For both groups, a pre-test based on standard parallel multiple-choice questions (MCQs) was prepared. Then, the electronic software which was prepared was distributed to the first group. For people of group II, six hours of discussion-based training was conducted for 3 consecutive weeks. At the end of the course (after 1 month), a post-test, which was the same questions as the pre-test, was obtained from interns in both groups. Results: At the end of the study, we found a significant improvement in the learning rate of both groups all aspects of the knowledge including: science related to the use of narcotics in sedation (P=0.01 for e-learning group and P<0.001 for discussion based group), knowledge related to the use of intravenous anesthetics for sedation(P=0.025 for e-learning group P<0.001 for discussion based group), Knowledge related to definition and clinical judgments in sedation and Knowledge related to the use of Neuromuscular blocking agents (NMBAs) for sedation (P<0.001 for both groups). However, for all the investigated results, the learning rate was significantly better in the discussion-based learning group compared to the e-learning group (P<0.001). Conclusion: According to the results of this study, we found using either e-learning or discussion-based learning methods increase the acquisition of sedation knowledge for emergency department students. However, the discussion-based method have better results on the learning process of the interns. https://aacc.tums.ac.ir/index.php/aacc/article/view/944

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 2 2024 05 02 641 643 Alireza Babajani Department of Anesthesia, Allied Medical School, Iran University of Medical Sciences, Tehran, Iran. Nafiseh Feizollahzadeh Department of Operating Room, Zahra Mardani Azar Medical Education Center, Tabriz University of Medical Sciences, Iran. Hamed Koohsoltani Department of Anesthesiology and Critical Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 2024 02 04 2024 02 12 A 2-month and 13-day-old boy underwent surgery for a right inguinal hernia. During the procedure, a caudal block was performed using 4 mL of 0.25% bupivacaine injected with an epinephrine-soaked syringe. Before the injection, we confirmed that there was no blood or cerebrospinal fluid present. However, shortly after the injection, the patient experienced respiratory apnea and a slow heart rate. The medical team provided respiratory and cardiac support and closely monitored the patient. After a day and a half, the patient was discharged with no further complications. https://aacc.tums.ac.ir/index.php/aacc/article/view/941

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 2 2024 08 27 565 570 Hamed Abdollahi Department of Anesthesiology, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Hassan Tavakoli Department of Surgery, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Yousef Mojtahedi Department of Pediatric Nephrology, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran. & Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mohsen Sedighiyan Department of Clinical Nutrition, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mina Abdolahi Department of Clinical Nutrition, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Sadegh Jamshidi Department of Internal Medicine, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Boshra Rezvankhah Department of Internal Medicine, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Leila Soleymani Department of Nursing, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Hossein Gandomkar Department of Surgery, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Nader Ali Nazemian Department of Anesthesiology, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Behzad Asanjarani Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran Masoumeh Manouchehri Department of Nursing, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Shirin Ilkhani Department of Nursing, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Aram Ghaniuon Department of Nursing, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. Khosro Shakeri Tehran Emergency Center, Tehran, Iran. Amir Sobhrakhshan Khah Sepehr Heart Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran. Abolghasem Yousefi Department of Anesthesiology, Amir Alam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran. 2024 02 06 2024 02 13 Background: The COVID-19 pandemic is a traumatic event with a global impact, predicted to increase depression, anxiety, substance use, sadness, and loneliness. This study was conducted to evaluate the scale of depression, anxiety, and stress among patients infected with the COVID-19 virus. Methods: This cross-sectional study was conducted between April 2019 and April 2022. According to the conditions of the study space, available sampling was selected. In addition to demographic characteristics, a questionnaire related to stress, anxiety, and depression (DASS-21) was used to collect data. Then, the collected data were entered into SPSS software for analysis, and Pearson's correlation was used to check the relationship between the variables, with the significance level (P-value) reported.| Results: Out of a total of 714 participants, 26.1% had higher scores in depression, 37.5% in anxiety, and 15.7% in stress. In this way, two-thirds of the studied population on the depression and anxiety scale and almost half of the studied population on the stress scale experienced degrees of these disorders from mild to very severe during the period of COVID-19 infection. The scores of each subcategory of depression, anxiety, and stress are significantly correlated with each other, which shows that people who have a higher score in one subcategory also have a higher score in two subcategories. Conclusion: It seems that COVID-19 has an obvious effect on the mental health of people. Thus, more policies and attention are needed in this field to manage the disease. https://aacc.tums.ac.ir/index.php/aacc/article/view/945

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 2 2024 06 19 571 577 Mohammad Golparvar Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Aman Allah Mansoori Borooojeni Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 2024 02 23 2024 03 04 Background: Brachial plexus block, particularly the supraclavicular approach. The choice of local anesthetic and the addition of adjuvants can significantly impact the quality and duration of the block. This study aimed to compare the effects of three different additives dexmedetomidine, dexamethasone, and sodium bicarbonate when combined with ropivacaine in ultrasound-guided supraclavicular blocks. Methods: A double-blind randomized clinical trial was conducted with 103 patients undergoing upper limb orthopedic surgery. Patients were divided into four groups, and each group received one of the following combinations: ropivacaine with dexmedetomidine, ropivacaine with dexamethasone, ropivacaine with sodium bicarbonate, or ropivacaine alone (control). The onset and duration of motor and sensory blocks, complications, patient and surgeon satisfaction, and vital signs were assessed. Results: The study revealed that all additives, particularly dexmedetomidine, significantly influenced the onset and duration of motor and sensory blocks compared to the control group. Dexmedetomidine demonstrated the fastest onset and prolonged the block, while dexamethasone and sodium bicarbonate also had substantial effects. Importantly, the additives did not lead to an increase in complications, and patient and surgeon satisfaction remained consistent across all groups. Conclusion: The findings of this study suggest that dexmedetomidine is a promising adjuvant for enhancing the quality and duration of supraclavicular blocks. https://aacc.tums.ac.ir/index.php/aacc/article/view/951

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 2 2024 07 06 578 581 Arman Taheri Department of Anesthesiology and Pain Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Foad Fouladi Pain Research Center, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. & Department of Anesthesiology, Intensive Care and Pain Medicine, Tehran University of Medical Sciences, Tehran, Iran. Alireza Khajenasiri Department of Anesthesiology, Intensive Care and Pain Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Reza Atef-Yekta Department of Anesthesiology, Intensive Care and Pain Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nader-Ali Nazemian-Yazdi Department of Anesthesiology and Pain Medicine, Amir Alam hospital, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Arjmandnia Department of Anesthesiology, Intensive Care and Pain Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2024 03 05 2024 03 17 Background: Shoulder impingement syndrome is a clinical situation that presenting with shoulder pain, difficultly and weakness. Present study designed for evaluating the effect of radiofrequency and corticosteroid injection in longterm treatment follow up for pain reduction and functional evaluation of shoulder joint. Methods: Sixty patients were analyzed equally in two treatment groups. Post-treatment follow up at one, four and twelve weeks after procedures were carried out using Visual Analog Scale (VAS) for pain relief, Shoulder Pain and Disability Index (SPADI) for shoulder function and Beck Depression Inventory (BDI). Results: Both treatment groups showed significantly pain reduction (P-value<0.001 for both) in 4 weeks after procedures. In time point comparison between 4 to 12 weeks postoperatively, there were significantly reduced pain in R group (P=0.03), but not significant in C group (P=0.1). Total SPADI score was significantly lower in RF group in time points 1 and 4 weeks (P<0.001), but not significant in 12 weeks of follow up. Conclusion: Radiofrequency could not be sufficient alone for retrieving function of the shoulder at the long periods of time after procedure, unless good and effective results for first 1 and 4 weeks of follow up. https://aacc.tums.ac.ir/index.php/aacc/article/view/956

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 2 2024 09 08 582 589 Surabhi Sandill Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A.I.R.C.H., AIIMS, New Delhi, India. Mhonchumi Khuvung Department of Anaesthesia, CIHSR, Dimapur, Nagaland, India. Rajpal Singh Department of Anaesthesia and Critical Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. Udismita Baruah Department of Anaesthesia and Critical Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. 2024 02 18 2024 03 13 Background: The laryngoscopy and tracheal intubation is a noxious stimuli resulting in transient but marked sympathetic response. This response is exaggerated in patients with hypertension. This study evaluated the role of oral pregabalin premedication in attenuation of haemodynamic response during tracheal intubation in adult patients with controlled hypertension posted for elective surgery. Methods: A prospective double blinded randomized study was carried out in a total of 60 adult patients (aged 18-65 years, either gender) with controlled hypertension after being randomized into two groups with 30 patients in each. Prior to induction, Group PL received Placebo (multivitamin) and Group PB received pregabalin 75mg tablet 1 hour. The anaesthesia technique was standardized as per department protocols. Both groups were evaluated for pre-operative sedation, haemodynamic changes after premedication, before and after induction, after the laryngoscopy and tracheal intubation and post-operative side effects. Results: There was attenuation of haemodynamic responses without significant side effects with pregabalin. Statistically significant increase in post intubation systolic, diastolic and mean blood pressure was seen in group PL as compared to group PB. In both groups, a reduction in heart rate was observed and was statistically significant 1 minute after intubation in group PB. Pre-operative sedation levels were higher in PB group in comparison to PL group. No post-operative side effects observed in both the groups. Conclusion: In controlled hypertensive patients, oral pregabalin 75 mg attenuated the haemodynamic responses to laryngoscopy and tracheal intubation. It produced effective pre-operative sedation without any post-operative side effects. https://aacc.tums.ac.ir/index.php/aacc/article/view/949

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 2 2024 06 19 590 593 EN Maryam Shakiba Department of Anesthesiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Mahmood Hosseinzadeh Maleki Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Ghazaleh Khademian Department of Critical Care, Razavi Hospital, Mashhad, Iran. Amene Ghanbari Department of Extra-Corporeal Circulation (ECC), Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Fatemeh Hajipour Department of Extra-Corporeal Circulation (ECC), Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Mohamad Amin Younessi Heravi Department of Radiology and Medical Physics, North Khorasan University of Medical Sciences, Bojnurd, Iran. Saeideh Imani Moghaddam Department of Critical Care, Razavi Hospital, Mashhad, Iran. Mohsen Yaghubi Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Mashhad, Iran. 2024 03 20 2024 04 24 Background: The importance of cerebral perfusion during congenital cardiac surgery, especially after hypothermic cardiopulmonary bypass (CPB) strategy, has remained a debate. In this study, we evaluated the effect of mild hypothermic CPB strategy on cerebral oximetry near-infrared spectroscopy in congenital heart defects surgery. Methods: In a randomized prospective study, the pediatrics aged two months and six years with RACHS categories I-Ⅱ for congenital heart defects surgery were randomly divided into normothermic and mild hypothermic CPB groups. The NIRS was measured in all patients via the INVOS ™ cerebral oximetry system. The perfusion and anesthesia strategies during the study were followed as standard methods. A p-value below 0.05 is considered to be a significant level. Results: Regarding cerebral oximetry, the results showed no significant difference between normothermic and mild hypothermic CPB groups. Conclusion: It can be concluded that optimizing cerebral oxygen saturation monitoring during congenital cardiac surgery can improve patient outcomes as a protective strategy. https://aacc.tums.ac.ir/index.php/aacc/article/view/961

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 2 2024 07 06 594 598 Arash Peyvandi Yazdi Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Ebrahim Golmakani Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Veghar Hejazi Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Andia Peivandi Yazdi School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Mehryar