Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 1 2023 02 08 1 3 Ali Jabbari Ischemic Disorder research Center, Golestan University of Medical Sciences, Gorgan, Iran. & Department of Anesthesiology and Intensive Care, Golestan University of Medical Sciences, Gorgan, Iran. Atabak Najafi Department of Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Vahid Khori Ischemic Disorder research Center, Golestan University of Medical Sciences, Gorgan, Iran. & Department of Pharmacology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. Zahid Hussain Khan Department of Anesthesiology and Critical Care, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2022 03 25 2022 04 24 No Abstract   No Abstract   No Abstract https://aacc.tums.ac.ir/index.php/aacc/article/view/511

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 1 2022 11 24 4 8 Rameesa Batul Department of anesthesiology and critical care, SKIMS Soura, Srinagar, J&K, India. Uzma Gulzar Department of anesthesiology and critical care, SKIMS Soura, Srinagar, J&K, India. Ouber Qayoom Department of Cardiology, GMC, Jammu, J&K, India. 2022 03 16 2022 04 24 Background: One of the most prevalent regional methods in paediatric anaesthesia is the caudal epidural block. It is a safe, simple procedure that has proven to be quite beneficial in children following infra-umbilical surgery. Ropivacaine causes differential neuraxial blockade, which is associated with less motor block and lower cardiovascular damage. To extend the duration of action of local anaesthetics, several adjuvants are administered. Our goal was to see how fentanyl affected the duration of postoperative analgesia when used in conjunction with ropivacaine in a paediatric population of children aged 3 to 8 years following infraumbilical operations. Methods: On 100 paediatric patients receiving elective infraumbilical operations, a prospective, comparative, and randomised investigation was done. Patients were randomised into two 50-person groups at random. Caudal anaesthesia was administered once the airway was secured. 0.2 percent ropivacaine 0.5ml/kg was given to Group R, while 0.2 percent ropivacaine 0.5ml/kg with fentanyl 0.5mcg/kg was given to Group RF. Face, legs, activity, cry, and consolability pain rating scales were used to measure postoperative pain for 24 hours. The length of the motor blockage and any negative effects were recorded. Hemodynamics, post-operative analgesia duration, and the number of rescue analgesics required were all recorded and statistically evaluated. Results: The mean duration of analgesia in ropivacaine group was 440.60±101.29 minutes (7.25hrs) and in ropivacaine fentanyl group was 891±312.84 (14.76hrs). Statistically, the difference was highly significant. Conclusion: In children having infraumbilical surgery, using fentanyl as an adjuvant to ropivacaine for caudal block enhanced analgesic effectiveness and extended post-operative analgesia. https://aacc.tums.ac.ir/index.php/aacc/article/view/504

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 1 2023 02 08 64 66 Jyoti Deshpande Department of Anaesthesiology and Critical Care, Smt Kashibai Navale Medical College and General Hospital Narhe-Pune, MUHS University, Nashik, India. Merlin Jacob Department of Anaesthesiology and Critical Care, Smt Kashibai Navale Medical College and General Hospital Narhe-Pune, MUHS University, Nashik, India. 2022 04 26 2022 05 28 Situs inversus totalis is a rare congenital positional anomaly with a predicted incidence of 1: 10,000 amongst the general population described by the transposition of the abdominal and thoracic visceral structures. Local infiltration of the breast is a common technique for fibroadenoma of small sizes. However, its efficacy, including duration of action as well as the extent, can be unreliable and surgeon dependent. Unless otherwise contraindicated, the regional technique of thoracic segmental spinal anesthesia has been proven to be a safe and effective method for even major surgeries including laparoscopic cholecystectomy, breast lumpectomy and abdominal surgeries. Multiple regional anesthetic techniques are available and should be used according to the requirement of the surgery as well as the skill and knowledge of the performing anesthetist. We discuss here, a case of fibroadenoma in a patient with isolated situs inversus totalis, operated under thoracic segmental spinal anesthesia. https://aacc.tums.ac.ir/index.php/aacc/article/view/532

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 1 2022 10 15 80 83 EN Ali Jabbari Ischemic Disorders Research Center of Golestan University of Medical Sciences, Gorgan, Iran. & Department of Anesthesiology and Intensive Care Medicine, Golestan University of Medical sciences, Gorgan, Iran. Behrang Nooralishahi Department of Anesthesiology and critical care Medicine, Tehran University of Medical Sciences, Tehran, Iran. Saeid Amirkhanlou Department of Internal Medicine, School of Medicine, Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran. Vahid Khori Ischemic Disorders Research Center of Golestan University of Medical Sciences, Gorgan, Iran 2022 04 23 2022 05 28      No Abstract   No Abstract   No Abstract   https://aacc.tums.ac.ir/index.php/aacc/article/view/526

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 1 2023 02 08 9 12 Ravikanth Pula Department of Anesthesiology,ESIC Medical College and Superspeciality Hospital,Sanath Nagar,Hyderabad, India. Swapna Katakam Department of Anesthesiology, ESIC Medical College and Superspeciality Hospital, Sanath Nagar, Hyderabad, India. Sunanda Gooty Department of Anesthesiology, ESIC Medical College and Superspeciality Hospital, Sanath Nagar, Hyderabad, India. Nagarjuna Thakur Department of Anesthesiology, ESIC Medical College and Superspeciality Hospital, Sanath Nagar, Hyderabad, India. 2022 04 23 2022 05 28 Background: The current study is aimed to compare the effect of fixed cuff volume and fixed cuff pressure technique on hemodynamic parameters and on postoperative complications. Methods: The prospective, randomised, controlled study was conducted in a tertiary care hospital with 100 patients aged between 18 to 60 yrs. The patients who are undergoing for elective surgeries under general anaesthesia were enrolled after obtaining ethical committee approval. Patients were randomized based on computer generated random numbers into two groups, fixed volume (7ml) group (group V, n-50) and fixed cuff pressure group (group P, n-50). The ETT cuff was filled with 7 ml of air in the fixed volume technique, and in the fixed cuff pressure group -cuff pressure was maintained at 20 cmH2O, after intubation. Tracheal tube cuff pressures were measured by AMBU cuff pressure gauge manometer. Hemodynamic parameters SBP, DBP, MAP and PR were noted at the time of cuff inflation, after extubation in the both the groups. Post-operative sore throat, hoarseness and cough was assessed at the time of extubation in the both the groups. Results: Mean age in both the groups was 41 years. Statistical significance (P< 0.0001) was observed in Group P in systolic blood pressure (SBP), diastolic blood pressure (DBP), MAP, HR whereas no significance was seen in group V. The percentage of post-operative complications like hoarseness, cough, sore throat, and dysphagia were seen to be less in group P when compared to group V. Conclusion: With present data we could conclude that the fixed minimal cuff pressure (20 mm H2O) is an ideal and reliable technique in reducing the post-operative complications along with maintenance of hemodynamic parameters. https://aacc.tums.ac.ir/index.php/aacc/article/view/527

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 1 2023 02 08 67 69 Ahmed Uslu Başkent University, Anesthesiology and Reanimation, Ankara Hospital, Başkent University, Ankara, Turkey. Nedim Çekmen Başkent University, Anesthesiology and Reanimation, Ankara Hospital, Başkent University, Ankara, Turkey. Figen Leblebici Başkent University, Anesthesiology and Reanimation, Ankara Hospital, Başkent University, Ankara, Turkey. 2022 04 07 2022 05 11 The use of arthroscopic shoulder surgery for diagnosis and treatment is increasing. Although some complications may occur during the operation, subcutaneous emphysema, pneumomediastinum and pneumothorax are rare complications. In this case, we present a patient who developed subcutaneous emphysema, pneumomediastinum and pneumothorax. A 53-year-old female patient presented with right shoulder pain for 8 months. The patient's body mass index is 20. Additional diseases are rheumatoid arthritis (RA) and vertigo. There was no other systemic disease or comorbidity. She was assigned an American Society of Anesthesiologists (ASA) score of 2. Arthroscopic rotator cuff repair was planned. She was operated under general anesthesia (GA). Subcutaneous emphysema, pneumothorax and pneumomediastinum developed at 6 hours after this surgery. The patient was discharged without any complaints on the 6th day of follow-up. No problem was detected in the follow-up of the patient. After shoulder arthroscopy under GA, subcutaneous emphysema, pneumothorax and pneumomediastinum can occur due to the procedure itself, the pleural and alveolar trauma, the endotracheal intubation or extravasation of irrigation fluid during shoulder arthroscopy. In our case, it was not possible to determine the exact cause. However, it is important to keep in mind that subcutaneous emphysema, pneumothorax and pneumomediastinum can occur after arthroscopic shoulder surgery. Although shoulder arthroscopy is a safe procedure, surgeon familiarity with the risk factors for this complication and close monitoring can aid in its identification and allow for appropriate treatment. https://aacc.tums.ac.ir/index.php/aacc/article/view/517

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 1 2022 10 24 13 20 Sonal Goyal Department of Anesthesia, All India Institute of Medical Sciences, Rishikesh, India. Bhavna Gupta Department of Anesthesia, All India Institute of Medical Sciences, Rishikesh, India. 2022 04 06 2022 05 11 Background: The utility of Neuromuscular monitoring (NMT) has not been studied in Indian scenario till date. We did a survey to evaluate the knowledge, attitude, practices of NMT among Indian anesthesiologists. Methods: A questionnaire-based google form was sent to 350 anesthesiologists over 3-months. Demographic data was collected in initial questions, followed by data on their concepts, practices, and knowledge of NMT and postoperative residual nerve block (PRNB). Data were descriptively analysed using frequencies and percentages. Descriptive statistical testing was done using software package IBM SPSS 23. Results: 88.9% of participants reported the use of clinical assessment. Though majority used clinical parameters, they were well-versed about Train-of-Four criteria. 75.9% stated the use of objective NMT in < 25 % of patients. The reasons for not using objective monitoring were scarcity of neuromuscular monitors, non-familiarity, and complexity of monitors. In regards to PRNB, 79.6 % participants considered PRNB to be an important clinical issue. Although in their clinical practice they rarely encountered PRNB, 74% responded that routine NMT can decrease PRNB.  The cross-tabulation table reflected that the use of objective tools (P= 0.014), knowledge about the essentiality of NMT (p=0.003), correctly stating PRNB as an important clinical issue (p=0.006), and their understanding about unreliability of clinical tests (p=0.001) showed significant improvement with increasing anesthesia experience. Conclusion: Participants showed great understanding of clinical and qualitative tests but not of quantitative tests, with low rate of usage of objective NMT. A lacuna in understanding of quantitative parameters must be addressed considering high incidence of PRNB and lack of sensitivity of clinical parameters. https://aacc.tums.ac.ir/index.php/aacc/article/view/515

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 1 2023 02 08 70 73 Deniz Kaya Department of Anesthesiology, Başkent University, Ankara, Turkey. Nedim Çekmen Department of Anesthesiology, Başkent University, Ankara, Turkey. Asude Ayhan Department of Anesthesiology, Başkent University, Ankara, Turkey. 2022 04 04 2022 05 11 The incidence of postpartum hemorrhage (PPH) is increased in multiple pregnancies and is an important cause of maternal death. Controlling bleeding and correct anesthesia management during this period are essential. In our 35-year-old patient with triple pregnancy, hemorrhage due to uterine atony developed during C/S surgery. We aimed to discuss the anesthesia management of PPH in our patient who underwent a total abdominal hysterectomy and bilateral salpingectomy (TAH BS) due to continued bleeding during and after C/S, with literature. We think that morbidity and mortality rates can be reduced in the perioperative period for PPHs with the help of multidisciplinary approach, rapid action, and close follow-up. https://aacc.tums.ac.ir/index.php/aacc/article/view/514

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care https://aacc.tums.ac.ir/index.php/aacc/article/view/831

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 4 2024 01 29 415 417 EN Ehsan Yousefi-Mazhin Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Hossein Karballaei-Mirzahosseini Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Hamidreza Sharifnia Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Atabak Najafi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farhad Najmeddin Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Tofighi-Mohammadi Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Rezvan Hassanpour Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Mojtaba Mojtahedzadeh Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2023 09 14 2023 11 03 Familial hypokalemic periodic paralysis is a rare disorder that manifests manifests with the sudden onset of flaccid paralysis that is triggered by low levels of blood potassium, which can be caused by various factors such as, rest after intense exercise, or high-carbohydrate foods. This report presents cases of hypokalemic periodic paralysis attack triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A 29-year-old male patient was admitted with quadriparesis, fever, shortness of breath, and sever hypokalemia. The patient had a history of three episodes of Familial hypokalemic periodic paralysis (HPP). Diagnostic tests, such as chest computed tomography scan and polymerase chain reaction test, confirmed SARS-CoV-2 infection. The patient was treated with potassium chloride infusion, spironolactone, and remdesivir, and was eventually discharged from the hospital.in conclusion, SARS-CoV-2 infection can potentially exacerbate HPP and should be considered a risk factor for its occurrence. https://aacc.tums.ac.ir/index.php/aacc/article/view/866

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 4 2023 09 28 323 326 Nima Nazari Department of Anesthesiology and Critical Care,Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mehrdad Goudarzi Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Ashkan Taghizadeh Department of Anesthesiology and Critical Care,Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Hojatollah Raji Department of Pediatric Surgery, Tehran Unversity of Medical Sciences, Tehran, Iran. Bita Malekianzadeh Department of Anesthesiology and Critical Care, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2023 08 13 2023 08 29 Background: Herniorrhaphy is the most common inguinal surgery in children. Several methods such as caudal block, ilioinguinal iliohypogastric block, and wound infiltration have been studied for postoperative pain management in these patients. Caudal block is common in pediatrics. However, ilioinguinal iliohypogastric block is effective and less invasive. Previous studies have shown different comparative results regarding these blocks. This study compares the analgesic effect of caudal and bilateral ilioinguinal iliohypogastric block with ropivacaine in children. Methods: This study is a randomized double-blind clinical trial. A total number of 66 patients aged between 1-7 years that volunteered for bilateral inguinal hernia repair were randomly assigned to two groups. After general anesthesia, caudal block with 1cc/kg ropivacaine 0.2% was performed for 33 patients and sonography-guided ilioinguinal iliohypogastric block with 0.1 cc/kg ropivacaine for each side was considered for another group. Hemodynamic parameters (systolic blood pressure, diastolic blood pressure, and heart rate) during anesthesia, pain score (CHEOPS), delirium score (PAED), nurses’ satisfaction score (RN), need for additional narcotic, recovery time, and complications were compared in these two groups. Results: There was no statistically significant difference between the two groups in terms of hemodynamic parameters during the anesthesia process. Furthermore, the two groups had no statistically significant difference in CHEOPS score (6.27 in ilioinguinal block and 5.70 in caudal block, P=0.061), PAED score (5.64 vs 5.30, P=0.144), and RN satisfaction score. However, the need for narcotics, mean recovery time, and block complications were comparable in two groups. Conclusion: Caudal block and ilioinguinal block are equally effective for post herniorrhaphy pain and emergence agitation management in pediatrics. Additionally, no differences were observed in complications. It is recommended that the study be performed with a larger sample size. https://aacc.tums.ac.ir/index.php/aacc/article/view/839

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 4 2024 03 05 418 421 Yasaman Esfahanian Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, Iran. Mostafa Mohammadi Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, Iran. Parsa Mohammadi Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, Iran. 2023 06 10 2023 08 15 Anemia, a common symptom in pregnancy, can lead to life-threatening cardiomyopathy. A 30-years old gravida 2 para 1 woman was admitted at 34 weeks of gestational age with asymptomatic pancytopenia and vitamin B12 deficiency in the laboratory tests. She also had a diet-controlled gestational diabetes, megaloblastic changes in Bone marrow aspiration and cardiomyopathy shown by echocardiography. The patient recovered from pancytopenia and cardiomyopathy after one week treatment with vitamin B12 and folate. In this case, cardiomyopathy worsened with anemia. By treating vitamin B12 deficiency, cardiomyopathy can be prevented or controlled during pregnancy. Careful consideration is needed when assessing anemia in pregnant women on vegetarian diet and at higher risk. https://aacc.tums.ac.ir/index.php/aacc/article/view/783

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 4 2024 02 08 327 333 Asghar Hajipour Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Razieh Erfani Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Maziar Maghsoudloo Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Amir Keshvari Departments of Surgery, Tehran University of Medical Sciences, Tehran, Iran. Mojgan Rahimi Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2023 09 04 2023 09 09 Background: Due to the associated hypertension and cardiovascular disease in patients with ESRD hemodynamic changes during operations are detrimental and may be life-threatening. Therefore, hemodynamic stability is an important criterion in selecting the anesthetic approach. Methods: 72 ASA class III/IV, ESRD Patients were studied in randomized double blind clinical trial. They were divided into two groups by four-block randomization. A group of patients were induced and maintained by etomidate and second of patients were induced by Na thiopental and maintained by isoflurane. Systolic, diastolic and mean arterial blood pressure and heart rate were measured at interval of pre and post induction, postintubation, pre and post abdominal insufflation during and at the end of surgery and in recovery. The total BP modulators were recorded and postoperative nausea and vomiting was registered in the recovery. Data were analyzed by STATA version 12. Results: There was no significant difference in physical characteristics between two groups. There was no statistical difference between the groups in SBP and HR (P>0.05), although DBP fluctuation>20% at interval postinduction and prior to abdominal insufflation during surgery and at the end of surgery, was significantly higher in the isoflurane group of patients. (P=0.004, 0.001, 0.003 and 0.009, respectively). Also, the MAP fluctuation at interval of post induction, preinsufflation and at the end of surgery was significantly higher in isoflurane of patients. (P=0.04, 0.001, and 0.02, respectively). Conclusion: The group anesthetized with isoflurane had a higher hemodynamic fluctuation, compared to the group anesthetized with etomidate. As hemodynamic changes are critical in patients with ESRD, etomidate is a more appropriate anesthetic choice for implantation of peritoneal dialysis catheter by laparoscopic approach. https://aacc.tums.ac.ir/index.php/aacc/article/view/857

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 4 2024 03 05 334 342 Ali Reza Montaseri Department of Anesthesiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Abdul Jammoul School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mohammad Mireskandari Department of Anesthesiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Nima Nazari Department of Anesthesiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Babak Eslami Department of Anesthesiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Ali Jammoul School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. 2023 09 07 2023 09 11 Background: Whether in a hospital setting or in the community, medical students are exposed to cardiac arrests. Fast response and effective resuscitation are main determinants for decreasing mortality and morbidity due to cardiac arrests. We assessed the effectiveness of anesthesiology rotation in acquiring cardiopulmonary and cerebral resuscitation for medical students. Methods: A pre-test/post-test quasi experimental design was undertaken, comprising A fortuitious sample of medical students who were undergoing anesthesiology rotation at Tehran University of Medical Sciences hospital complexes during the academic year 2021-2022 using a self-administered questionnaire to evaluate their theoretical comprehension, knowledge, skills and before and after the rotation. Results: The study revealed an increase in theoretical scores (mean dif +2.6/20), increased in self-assessment knowledge scores (mean dif + 0.84/5), as well as an increased in self-assessment skill scores (mean dif +0.96/5). The highest scored were witness in students with previous cardiopulmonary resuscitation (CPR) experience. Conclusion: It is of extreme importance for medical students to participate in anesthesiology rotations. It is essential for possessing the appropriate knowledge and skills to provide effective resuscitation care and gain confidence to perform CPR. https://aacc.tums.ac.ir/index.php/aacc/article/view/860

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 4 2024 01 16 343 352 Maryam Sadat Mirenayat Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Narjes Jalali Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Somayeh Sadeghi Infectious Disease and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Acquired Immunodeficiency Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. Reyhaneh Zahiri Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mitra Lotfalipour Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Amraei Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Faculty of Sport Sciences and Health, University of Shahid Beheshti, Tehran, Iran. Atefeh Fakharian Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2023 08 23 2023 09 13 Background: The effect of using high flow oxygen delivery through the nasal cannula (HFNC) in COVID-19 patients has been associated with different results. This study aimed to evaluate the effect of different HFNC temperatures in COVID-19 patients. Methods: Patients were randomly divided into three groups under high current oxygenation with temperatures of 31, 34, and 37. Except for the temperature, other device settings were set equally. After 24 hours, clinical conditions were on the agenda and compared with the conditions before the intervention. Results: Fever, sore throat, malaise, diarrhea in patients of 31 degree group and indicators of nausea, cough, body pain, headache have changed the most in 37 degree group. Abdominal pain has shown the greatest change in the 34 degree group. PR, DBP, and SpO2 indices changed the most at 31 degrees and RR and SBP at 37 degrees. PR, RR, SBP and SPO2 indices showed significant values in intra-group comparison, and in inter-group comparison, only PR, RR indices had significant differences. In intra-group analysis, PaCO2, WBC, CRP, ESR and ferritin had significant changes, and in inter-group comparison, none of the indicators had significant differences. Conclusion: Based on the results of the present study, reducing the temperature in the use of HFNC can improve the clinical conditions of patients with COVID-19. https://aacc.tums.ac.ir/index.php/aacc/article/view/845

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 4 2024 02 17 353 356 Alireza Montasseri Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Omid Nabavian 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. Enab Zehra Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2023 08 29 2023 09 12 Background: Anesthesia techniques significantly impact the long-term and short-term outcomes after cancer surgery such as cancer recurrence, post-discharge hospitalizations, and duration of hospitalization, probably by decreasing the neuroendocrine stress response during surgery, reducing opioid requirement, reducing post-operation nausea vomiting, and pain, and interacting with the immune system. Research in recent years has provided ample evidence that epidural anesthesia produces better post-operation outcomes compared to general anesthesia. The purpose of this study was to evaluate the effects of epidural anesthesia on cancer recurrence after surgery in gastrointestinal cancer patients. Methods: To perform this study medical records from the archive of gastrointestinal cancer patients who have undergone surgery at Imam Khomeini Hospital Complex (IKHC) from the years 1390 to 1400 were used. The variables required for the study were obtained from the records. The data obtained were analyzed by the SPSS software and the significance value of < 0.05 was considered. Results: Our study included 8987 patients out of which 1673 patients received epidural anesthesia. Cancer recurrence was reported after 90 days and 180 days and for the type of surgery (using or not using epidural anesthesia) B value for 90 days and 180 days was 0.079 and 0.018 respectively. Thus causality was not established for the type of surgery with recurrence of cancer. Conclusion: The findings of our study indicate that the rate of gastrointestinal cancer recurrence after surgery is not influenced by having or not having epidural anesthesia.   https://aacc.tums.ac.ir/index.php/aacc/article/view/850

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 4 2023 08 29 357 360 Shreedevi Yenni Department of Anesthesiology, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, India. Namburi Naveena Department of Anesthesiology, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, India. Rajesh Mane Department of Anesthesiology, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, India. Guruprasad Shetty Department of Anesthesiology, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, India. 2023 07 25 2023 08 21 Background: Flexible LMA offers the advantage of providing a better surgical field without being compressed compared to other LMAs in surgeries around the oral cavity. The insertion of flexible LMA is comparatively difficult as the shaft is flexible. The aim of this study is to compare the index-finger guided technique, two-finger guided technique, and 90° rotation technique for the success and time of insertion of flexible LMA in pediatric patients. Methods: After obtaining consent from parents,84 patients aged between 3 to 12 years of either gender were randomized into 3 groups. After administration of general anesthesia, flexible LMA of appropriate size as per manufacturer recommendations was inserted. In the index finger guided method (Group A), the LMA was held like a pen and the mask was pushed backward pressing against the palate. In the two-finger guided method (Group B), the anesthetist stood by the side facing the patient. LMA was fixed in between the index and middle fingers, held facing the lower jaw, and pushed along the palatopharyngeal curve. In the 90° rotation method (Group C), the LMA was rotated 90° anticlockwise in the oral cavity and was advanced through the right side of the tongue till resistance was felt and then turned back. The time from insertion of LMA and the number of attempts taken for successful insertion were noted. The data were analyzed using ANOVA. Results: The mean time of insertion was the least in Group B and highest in Group C. The first attempt success rate was highest in Group B and least in Group C. However, the mean time of insertion and the first attempt success rates were not significantly different between Group A and Group B. Conclusion: The LMA insertion by the two-finger guided method is the easiest and most efficient method and a good alternative to the standard method (index finger guided) for insertion of flexible LMA. https://aacc.tums.ac.ir/index.php/aacc/article/view/822

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 4 2024 05 10