Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 4 2023 08 30 277 278 Zahid Khan Department of Anesthesiology and Critical Care, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2023 08 30 No Abstract    No Abstract    No Abstract https://aacc.tums.ac.ir/index.php/aacc/article/view/852

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 4 2023 07 05 279 287 EN Charvi Mathur Department of Anesthesiology, ABVIMS and Dr. RML hospital, Guru Gobind Singh Indraprastha University, New Delhi, India. Jasvinder Kohli Department of Cardiac Anesthesiology, ABVIMS and Dr. RML hospital, Guru Gobind Singh Indraprastha University, New Delhi, India. Tina Khurana Department of Anesthesiology, ABVIMS and Dr. RML hospital, Guru Gobind Singh Indraprastha University, New Delhi, India. Mohandeep Kaur Department of Anesthesiology, ABVIMS and Dr. RML hospital, Guru Gobind Singh Indraprastha University, New Delhi, India. Himanshu Bhasin Department of Anesthesiology, ABVIMS and Dr. RML hospital, Guru Gobind Singh Indraprastha University, New Delhi, India. 2022 08 21 2022 09 10 Background: Postoperative nausea and vomiting (PONV), an unpleasant complication following anaesthesia and surgery has various components such as nausea, retching and vomiting. Although PONV is usually self-limiting and non-fatal, it often causes substantial patient distress and dissatisfaction, augmenting healthcare costs by delaying discharge from post anaesthesia care units and causing unexpected hospital re-admissions. Different pharmacological and non-pharmacological approaches have been used for preventing PONV. Nonetheless, the most effective prophylactic regime has not been determined. Methods: We conducted a prospective randomised study for evaluation of effect of preoperative oral carbohydrate fluid (GROUP- C) and placebo drink (clear water) (GROUP-P) on PONV in 90 adult patients undergoing laparoscopic cholecystectomy surgery under general anaesthesia. The number of episodes of nausea, retching and vomiting, total requirement of antiemetic dose in 24 hours, pre and postoperative blood glucose levels, patient satisfaction score, VAS score and haemodynamic parameters were recorded in the two groups and statistical analysis was done. Results: Demographic data was comparable between the two groups with respect to age, gender and BMI. The surgical time and intra-abdominal pressures throughout the surgery were similar in the two groups. In our study the pre-induction blood glucose levels were found to be higher in group C and preoperative thirst was found to be less in group P. Both the groups were comparable in terms of number of episodes of PONV, total requirement of anti-emetic dose in 24 hours, patient satisfaction and well-being. VAS score for pain and requirement of analgesic dose was also similar in the two groups. Conclusion: Pre-operative oral monosaccharide carbohydrate fluid does not prevent PONV, alter requirement of antiemetic, patient satisfaction and well-being, VAS score for pain, requirement of analgesic dose in patients undergoing laparoscopic cholecystectomy under general anaesthesia, as compared to placebo drink.   https://aacc.tums.ac.ir/index.php/aacc/article/view/622

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 4 2023 08 02 343 356 EN Fatemeh Mohammadyari School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Morteza Biabani Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Behrad Nematollahi Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran. Maryam Soleimani Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran. Morteza Sohbatzadeh School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Sarvin Sadreddini Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. Reyhaneh Shoorizadeh School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Sepideh Shavysi Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran. Sepehr Olangian-Tehrani School of Medicine, Iran University of Medical Sciences, Tehran, Iran. & Avicennet, Tehran, Iran. 2023 01 19 2023 03 26 Background: A burn tissue injury is one of the most severe forms of trauma which results in severe life-threatening disturbances. Burn injury has many morbid complications, so it needs a multi-disciplinary care team according to the burn center to reduce its mortality and morbidity. Methods: This article aims to review drawbacks and complications associated with the burning injury including Acute Kidney Injury (AKI), Acute lung injury, Heart Failure, Electrolyte imbalance, intra-abdominal hypertension in children and adult burn patients, and recent challenging treatments. Results: Improved understanding of the pathophysiology of burn-induced complications can contribute to organizing a well-treatment plan, which leads to improved outcomes. Conclusions: Herein, the evidence available on the management of all burn induced-complications is summarized. https://aacc.tums.ac.ir/index.php/aacc/article/view/699

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 4 2023 07 03 357 359 Krunal Suryavanshi Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, India. Jyoti Deshpande Department of Anaesthesiology,Symbiosis Medical College for Women, Symbiosis International University, Pune, India. 2022 05 30 2022 06 25 Atrial Septal Defect is most common congenital developmental acyanotic cardiac anomaly. There is left to right shunt of blood in normal compensated state. In decompensated state, the shunt is reversed and flow is from right to left side causing heart failure and thrombo-embolic event. Here, we report a case of Humerus fracture with large ASD, managed under General Anaesthesia with Interscalene block without any deleterious effects like Venous Air Embolism, Spontaneous Reversal of Shunt etc. As patient was in Beach chair position. https://aacc.tums.ac.ir/index.php/aacc/article/view/567

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 4 2023 06 30 288 293 Kavita Adate Department of Anesthesiology, Smt.Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India. Neha Panse Department of Anesthesiology, Smt.Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India. Pooja Mhaske Department of Anesthesiology, Smt.Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India. Asmita Shinde Department of Anesthesiology, Smt.Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India. 2022 07 09 2022 08 13 Background: Levobupivacaine because of its longer duration of action and better safety profile has gained popularity in regional anaesthesia. Intrathecal opioids synergise with Local anaesthetics and potentiate subarachnoid block.  We conducted this study with the primary aim to compare analgesic efficacy of two different doses of buprenorphine as adjuvant to isobaric Levobupivacaine and the secondary aim to compare the onset and duration of sensory and motor blockade, hemodynamic variability and adverse effects if any. Methods: One hundred and twenty patients of American society of anaesthesiologist (ASA) I and II were divided in 3 groups of 40 each. Group A :0.5%levobupivacaine, group B: 0.5%levobupivacaine with 60 mcg buprenorphine Group C:0.5 %levobupivacaine with 90mcg buprenorphine. Duration of analgesia, onset of sensory and motor block, VAS scores, haemodyanamic parameters and adverse effects were noted. Results: The duration of analgesia was significantly prolonged in group C (11±0.41) h than group B (8.5±0.61) hour and Group A (4.8 ±40) hour (p < 0.001). Onset and duration of Sensory and motor blockade was not significantly different. VAS score was significantly lower in group C (p<0.001), hemodynamic parameters were well preserved with higher incidence of PONV in group C (10%). Conclusion: Addition of buprenorphine to intrathecal Isobaric Levobupivacaine prolonged the duration and quality of postoperative analgesia after lower abdominal surgery. Increasing the dose of buprenorphine from 60mcg to 90mcg provided longer duration of analgesia with minimal adverse effects like dizziness and PONV which were not significant to hinder recovery. https://aacc.tums.ac.ir/index.php/aacc/article/view/601

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 4 2023 07 03 360 365 Richa Chauhan Department of Anesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India. Abhirup Bose Department of Anesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India. Lakshmi R Department of Anesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India. 2022 05 30 2022 06 25 Several formulations of vaccines against novel coronavirus have been launched. Thereby, increasing the plausibility of having one or more successful vaccines. India put in place the world’s largest Covid-19 vaccination drive in January 2021. However, the side effects of these vaccines are slowly unfolding. Each new vaccine has potential adverse events of special interest (AESI) that warrant a focused evaluation. We report a very rare neurological complication Guillain-Barré syndrome, immediately following the first dose of COVID vaccination in a young female. An apparently healthy 35 years old female presented with acute onset lower backache, weakness of bilateral lower limbs 11 days after receiving the first dose of Covishield vaccine, which rapidly ascended to upper limbs over 5 days with symmetric motor weakness, power 1/5 in bilateral lower limbs, 3/5 in bilateral upper limbs, with absent deep tendon reflexes. Mild sensory involvement was seen. Evolving dysphagia and hoarseness of voice. Bladder/bowel function, respiratory pattern, and hemodynamics were unaffected. A provisional diagnosis of Guillain-Barre Syndrome was made on basis of clinical presentation, neurological examination, and nerve conduction studies suggesting axonal polyneuropathy. Gradual improvement of the muscle power over the next 2 weeks following Human Intravenous immunoglobulin was seen. The risk-benefit analysis for an individual should be considered prior to Covid-19 vaccination, including the implementation of a pre-vaccination screening checklist to ensure vaccine safety for every vaccine recipient. The vaccine continues to be far more beneficial than detrimental for the public at large. Nonetheless, increased awareness amongst healthcare professionals and the public regarding the potential adverse effects of the vaccine is warranted. https://aacc.tums.ac.ir/index.php/aacc/article/view/568

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 4 2023 06 30 294 303 Masoum Khoshfetrat Department of Anesthesiology and Critical Care, Khatam-Al-Anbiya Hospital, Zahedan University of Medical Sciences, Zahedan, Iran. Alireza Rahat Dahmardeh Department of Anesthesiology and Critical Care, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. Bibi Mahdie Khodadadi Hosseini Department of Nursing, Alzahra eye Hospital, Zahedan University of Medical Sciences, Zahedan, Iran. Aliakbar Keykha Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. & Department of Medical-Surgical Nursing, School of Nursing and Midwifery Zahedan University of Medical Sciences, Zahedan, Iran. 2022 08 16 2022 10 26 Background: The intensive care unit is one of the most specialized hospital units that need nurses with a high level of skill and experience. The leave of experienced nurses from this unit reduces the quality of nursing care and imposes heavy costs on the health care system. This study aimed to investigate the reasons for nurses' intention to leave the ICU. Methods: This cross-sectional study was performed on 247 nurses in the ICU affiliated with Zahedan, Tehran, and Mashhad University of Medical Sciences, Iran, from 2018 to 2021. Nurses were included in the study by Census sampling method based on inclusion criteria. They completed a four-part questionnaire including demographic variables, Job Satisfaction Survey (JSS), intention to leave, and reasons for intention to leave the ICU. Data were analyzed with SPSS software using descriptive-analytic statistics, Chi-square, independent t-test, one-way ANOVA, and Pearson correlation. The significance level was considered less than 0.05. Results: Out of 247 nurses studied, 183 (74.1%) were female and 64 (25.9%) were male. The mean age of participants was 32.47± 6.68 years. The mean score of job satisfaction was 115.45±58.20 and the mean score of intention to leave was 15.98±3.76. The mean score of the three areas of reasons for intention to leave had a negative correlation with job satisfaction and a positive correlation with the intention to leave the ICU, which was statistically significant in all cases (p= 0/001). The mismatch between the workload and legal benefits, shortage of nurses, forced overtime, the disproportion of nurse-patient ratio, and lack of welfare facilities had the greatest effect on nurses' intention to leave the ICU. Conclusion: The results of the study showed that the most common reasons for the increase the intention to leave of nurses are related to the mismanagement of nursing managers and authorities of ICU. Therefore, reforming old management styles, observing justice among employees, involving nurses in decisions and the process of patient's treatment are among the things that can increase nurses' self-esteem, job satisfaction and reduce the leave of ICU without providing additional funding for the organization. https://aacc.tums.ac.ir/index.php/aacc/article/view/625

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 4 2023 06 3 2023 11 19 305 306 Masoud Tarbiat Department of Anesthesiology, School of Medicine, Basat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran. Mohammad Hossein Bakhshaei Department of Anesthesiology, School of Medicine, Basat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran. Hamid Reza Khorshidi Department of Surgery, School of Medicine, Basat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran. Sayed Ahmadreza Salimbahrami Department of Anesthesiology, School of Medicine, Basat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran. 2023 05 10 2023 06 28 No Abstract No Abstract  No Abstract https://aacc.tums.ac.ir/index.php/aacc/article/view/762

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 3 2023 11 19 216 220 Nazli Karami Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran. Alireza Mahoori Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran. Tohid Karami Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran. Alireza Shakeri Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Dariush Abtahi Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2023 05 16 2023 06 25 Background: Endotracheal intubation is a potentially high-risk aerosol-generating procedure. So, an intubation box (I-Box) is designed for personal protection during intubation. This study aimed to compare the outcomes of endotracheal intubation with and without an I-box in COVID-19 patients. Methods: In this study, 60 COVID-19 patients (30 patients in each group) with and without I-box groups were included. outcomes of intubation including duration of intubation, first-pass success intubation, suitable visibility of airways, restriction of movement in the neck, the need to surface maneuvering of the airway, and the number of attempts for successful intubation were compared between the two groups. Results: The time of intubation was significantly longer in the I-box group (15.27±2.6 seconds) than without the I-box group (8.37±1.3 seconds) (p<0.001). All patients (100%) were intubated in the first attempt in the without I-box group while the rate of first-pass success intubation was 50% in the I-box group (p <0.001). The visibility of the airway was significantly better in the without I-box group than the I-box group (without I-box: 23 patients (76.7%), I-box: 15 patients (50%), p= 0.032). The frequency of need to optimizing maneuver of the airway was in without and with I-box was 23.3% and 50% respectively (p=0.032). Conclusion: However, the I-box as a physical barrier can protect healthcare workers but its use increased the time to intubation and the number of attempts for successful intubation and reduced the rate of first-pass success intubation and visibility. https://aacc.tums.ac.ir/index.php/aacc/article/view/773

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 3 2023 12 19 293 295 Shalvi Mahajan Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India. Kirandeep Kaur Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India. Priya Thappa Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India. Aparna Deperu Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India. Vinitha Narayan Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India. 2023 05 15 2023 06 28 Acute lymphoblastic leukemia (ALL) is the most common hematological malignancy in the pediatric age group. Anesthesia in such patients necessitates special considerations, in terms of disease progression and its respective treatment as well. We present a case of a 2-year-old child, a known case of ALL posted for drainage of multifocal brain abscess under general anesthesia. Anesthetic management of children with ALL presenting for neurosurgical procedures should focus on disease and its various systemic manifestations, treatment-related side effects, and anesthetic interactions which sometimes may be disastrous. https://aacc.tums.ac.ir/index.php/aacc/article/view/771

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 3 2023 11 13 221 226 Mohammadreza Safavi Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Azim Honarmand Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Behzad Nazemroaya Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Negar Maleky Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 2023 05 27 2023 06 28 Background: Nausea and vomiting after operation has high prevalence and cause adverse effect. The aim of this study was to compare the effect of dexmedetomidine with ondansetron in prevention of post-operative nausea and vomiting (PONV) after middle ear surgery under general anesthesia.and saliva gas in traumatic patients under mechanical ventilation. Methods: This in this double-blinded clinical trial study, one hundred and sixty-two patients undergoing middle ear surgery under general anesthesia were randomly divided into three groups of 55 each: ondansetron (O), dexmedetomidine (D) and control (C). Group O received 0.1 mg/kg of ondansetron, Group D received 1 μg/kg/min of dexmedetomidine and Group C received 10 cc of normal saline 15 to 20 minutes before surgical incision. After that, the patients were examined in post-anesthesia care unit (PACU) and up to 24 hours after the operation in terms of PONV and other study variables. Results: The severity of nausea after operation based on VAS (visual analog scale) was significantly different between Group O (2.2±0.7) and Group D (3.9± 0.7) and Group C (5.15±1.3) (P= 0.04). The incidence of vomiting in the first 24h postoperatively was 14.8% in Group O, 46.3% in Group D and 88.8% in Group C (P= 0.003). Conclusion: Our study showed that ondansetron was better than dexmedetomidine for prevention of PONV after middle ear surgery. https://aacc.tums.ac.ir/index.php/aacc/article/view/778

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 3 2023 11 11 296 302 Mahmoud Ganjifard Pain Research Center, Neuroscience Institute, Imam Khomeini Hospital Complex, Department of Anesthesiology and Pain Medicine,Tehran University of Medical Sciences, Tehran, Iran. Ebrahim Espahbodi Pain Research Center, Neuroscience Institute, Imam Khomeini Hospital Complex, Department of Anesthesiology and Pain Medicine,Tehran University of Medical Sciences, Tehran, Iran. Abbas Tafakhori Department of Neurology, School of Medicine, Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital Complx, Tehran University of Medical Sciences, Tehran, Iran 2023 04 29 2023 06 25 Spontaneous intracranial hypotension (SIH) is an orthostatic headache syndrome with variable symptoms and complications which is often misdiagnosed at initial manifestations. SIH results from spontaneous CSF leakage leading to brain sag. The typical findings on cranial MR imaging consist of subdural fluid collections, enhancement of the pachymeninges, engorgement of venous structures, pituitary hyperemia, and sagging of the brain. Subdural hematoma may occur as a result of tearing of bridging veins and usually develop into chronic subdural hematoma. The majority of patients with SDH due to SIH have chronic DSH and, therefore, rarely present with neurological deficits. Evacuation of SDH may be performed for large SDH with ME (mass effects), or when dilated or asymmetric pupil is present. However in most cases, evacuation of the hematoma is not necessary and may result in worsened outcomes. The epidural blood patch (EBP) is a treatment of choice. Fortunately, most of these subdural hematomas can be handled with treatment directed at the underlying spinal CSF leak without the need for surgery. We report the case of 42-year-old man with the chief complaint of orthostatic headache. He was admitted to neurology ward and after imaging studies, it was found that he has bilateral subdural hematoma. Due to the lack of history of trauma, underlying disease, and coagulation disorder, and considering the imaging findings, the patient was referred to the pain department to perform an epidural blood patch. After performing the epidural blood patch, the patient's pain was relieved immediately, and during a three-month follow-up period, the epidural hematoma was completely absorbed. Spontaneous intracranial hypotension (SIH) is a highly misdiagnosed and underdiagnosed disorder and requires a high index of suspicion for diagnosis. During the last decades, a much larger number of spontaneous cases are identified. Literature is a bit confusing, with some authors recommending evacuation of subdural fluid in cases of deteriorating consciousness and few others recommending EBP first even in patients with comatose state but epidural patch is often an important part of treatment. https://aacc.tums.ac.ir/index.php/aacc/article/view/752

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 3 2023 10 16 227 231 EN Faranak Behnaz Department of Anesthesiology, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Atiyeh Tizghadam Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Gholamreza Mohseni Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Leila Nazari Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2023 06 22 2023 07 25 Background: One of the most important treatments used in women with infertility is IVF, and improving its results can affect the success of assisted reproductive techniques. It was previously shown that anesthetics can enter the follicular fluid (FF), so there is concern about the accumulation of anesthetics in the FF and their negative effects on fertilization and fetal growth under general anesthesia. The use of drugs that have both analgesic and sedative effects but do not have hemodynamic side effects is of particular importance and dexmedetomidine is one of the drugs introduced in this field. On the other hand, the use of sedatives such as midazolam and propofol may cause hemodynamic disturbances and severe hypotension in these patients, which limits the use of such drugs. Accordingly, and considering the importance of the issue, in this study, we decided to evaluate and compare the effect of propofol and dexmedetomidine on fertility in IVF candidates. Methods: In this clinical trial study, 78 infertile patients who underwent IVF were randomly examined. After dividing the patients into two groups receiving dexmedetomidine and propofol or standard recording doses, the fertility rate of the patients in the two groups was evaluated using chi-square and Fisher tests at a significance level of 0.05. Results: The use of dexmedetomidine for (P = 0.0348) Pressure_After_Dia, HR_Before (P = 0.0204), Injection_Time (P =0.000) and Recovery Time (P =0.000) indices caused a significant increase compared to the propofol group. Conclusion: The results of the present study did not show a significant difference in the use of these two drugs on fertility. https://aacc.tums.ac.ir/index.php/aacc/article/view/796

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 3 2023 10 14 232 238 Faranak Behnaz Department of Anesthesiology, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Seyed Ebrahim Sadeghzadeh Sadat Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Gholamreza Mohseni Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mahshid Ghasemi Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2023 06 25 2023 07 25 Background: Today, the COVID19 pandemic is one of the most important health system challenges in the world, which doesn’t have specific treatment yet. It includes a wide range of respiratory and non-respiratory signs and symptoms, that lead to hospitalization and intensive care units. Methods: In this study, 78 patients in two groups of 39 patients were included. The case group included 39 COVID19 patients who had specified sign in CT scans and factors of viral infection, high serum ferritin, increased inflammatory factor in the blood. There were two intervention groups (receiving deferoxamine and vitamin C) and the control group (receiving only official protocol drugs of the country). All patients were admitted to the ICU of Shohada-e-Tajrish Hospital and underwent complete cardiorespiratory monitoring. All changes in Spo2, hemodynamics, serum ferritin and CRP were recorded before the study. Results: This study presented that improved patient had lower ferritin levels than those who were still ill. In addition, prescribing deferoxamine as an adjunct to vitamin C can prevent cytokine storms that was effective for improving the patients with COVID19. Conclusion: In conclusion. According to the role of deferoxamine and vitamin C in significantly reducing inflammatory factors of ferritin and CRP, they can be used as an adjunctive therapy in patients with COVID19. https://aacc.tums.ac.ir/index.php/aacc/article/view/798

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 3 2023 11 19 239 246 EN Moloud Zolfaqari Department of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Mehrdad Mokaram Dori Department of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Seyed Hossein Khademi Department of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Mehryar Taghavi Gilani Lung Diseases Research Center. Mashhad University of Medical Sciences, Mashhad, Iran. Maliheh Ziaee Department of Community Medicine, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran. Tayyebe Ghanei Mashhad University of Medical Science, Mashhad, Iran. 2023 06 19 2023 07 25 Background: Perioperative pain management can improve surgery results and patient outcomes. Moreover, multimodal methods for pain control have been advised so this study was conducted to assess the beneficial impact of preoperative ultrasound-guided femoral nerve blocks in hip replacement surgery. Methods: This study is a double-blinded clinical trial including 60 individuals who were candidates for joint replacement surgery. The intervention group (n = 30) received a femoral nerve block prior to general anesthesia. Results: After surgery, patients received morphine, Apotel, and morphine + Apotel, all of which were administered at lower doses in the intervention group (femoral nerve block) than in the control group. Pain intensity in first hour (P= 0.01), 4 hours (P= 0.003), 8 hours (P= 0.01), 12 hours (P= 0.001), and 24 hours (P= 0.01) after surgery and average pain 4 hours (P= 0.01), 8 hours (P = 0.01), 12 hours (P = 0.02), and 24 hours (P= 0.01) after surgery was significantly less in the intervention group (femoral nerve block) than in the control group. Conclusion: The findings of our investigation demonstrated the efficacy of ultrasound-guided femoral nerve blocks in the improvement of pain control following hip replacement surgery.   https://aacc.tums.ac.ir/index.php/aacc/article/view/793

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 3 2023 10 21 247 251 Mohammad Reza Khajavi Anesthesia, Critical Care, and Pain Management Research Center,Tehran University of Medical Sciences, Tehran, Iran. Mohammad Maroofian Anesthesia, Critical Care, and Pain Management Research Center,Tehran University of Medical Sciences, Tehran, Iran. Hamed Akhavizadegan Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2023 06 30 2023 08 24 Background: We intend to evaluate the effect of intraoperative diphenhydramine administration on incidence and severity of catheter related bladder discomfort (CRBD) and pain after percutaneous nephrolithotomy. Methods: In a double blind randomized clinical trial, adult male patients undergoing percutaneous nephrolithotomy were enrolled. They were randomized into two groups by a computerized digital random allocation method. Before anesthesia induction, group D (Diphenhydramine group) (n = 48) received 5 ml normal saline containing 0.5 mg/kg of diphenhydramine intravenously. In group C (Control group) (n = 48), 5 ml of normal saline was injected in the same manner. Induction and maintenance of anesthesia were identical in both groups. The incidence and severity of CRBD and postoperative pain were assessed at recovery room. Results: The incidence of CRBD was significantly lower in group D than in group C (14% vs. 63%, P=0.001). The severity of CRBD was milder in group D in comparison to group C (P<0.05). Postoperative pain score was significantly lower in group D (P<0.05). Conclusion: Intraoperative administration of diphenhydramine is an effective practice for the prevention of CRBD after percutaneous nephrolithotomy in male patients and can reduce postoperative pain as well. https://aacc.tums.ac.ir/index.php/aacc/article/view/801

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 3 2024 06 09 252 259 Omid Nabavian Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Shahram Samadi Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran. Anesthesia, Critical Care and Pain Research Center, Tehran University of Medical Sciences, Tehran, Iran. Shabnam Beigi Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran. Leyla Sahebi Maternal, Fetal, and Neonatal Research Center & Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Babak Eslami Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Alireza Montaseri Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Seyedeh Azadeh Hosseini Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran. 2023 12 20 2024 01 14 Background: The Covid-19 disease was the most significant pandemic of the century. Health care providers showed great sacrifices in managing this disease and saving humanity, and they suffered many injuries. So, this study aimed to investigate the effect of Covid-19 on the resident’s quality of life and comparison with medical students. Methods: This cross-sectional study was performed on 223 Residents and 225 medical students. Using a random sampling method, WHOQOL-BREF 26 questionnaire was distributed among the participants. The collected data were analyzed with SPSS 21 software using T-test and ANCOVA. Results: The results showed that covid-19 had caused a decrease in the quality of life of residents compared to medical students (P value<0.001). In addition, more advanced statistical analyzes showed that high work and study hours, irregular sleep, work history in COVID-19 wards, and the experience of CPR and intubation conditions of covid-19 patients have independent effects on the quality of life. Conclusion: Covid-19 hurt all aspects of the quality of life of residents. Considering the essential role of residents in educational and treatment hospitals, it is necessary to make plans to improve the quality of life and psychological support of these people to prevent the decline in the quality of healthcare services. https://aacc.tums.ac.ir/index.php/aacc/article/view/916

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 3 2023 11 30 260 265 Dorna Kheirabadi Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA. Amir Shafa Anesthesiology and Critical Care Research Center, Department of Anesthesiology and Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran. Mohammadreza Rasouli Department of Anesthesiology, Perioperative and Pain Medicine, Stanford School of Medicine, Stanford, California, USA.