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 https://aacc.tums.ac.ir/index.php/aacc/article/view/704

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 08 101 104 EN Man Mahajan Department of Anesthesiology, Sawai Man Singh Medical College, Jaipur, India. Mamta sharma Department of Anesthesiology, Sawai Man Singh Medical College, Jaipur, India. Rupali Mahajan Department of Anesthesiology, Civil Hospital, Fazilka, India. 2023 02 02 2023 03 25 Parapharyngeal tumors often distort the airway anatomy leading to obstruction and hinderance for intubation thus posing a challenge for the anesthetist at securing airway with least damage to the nearby structures. We present our experience through a series of 5 such cases in children managed successfully using video laryngoscope. Working in places where availability of advanced airway equipment such as pediatric size fiberoptic is unavailable, a video laryngoscope can help to appropriately assess the airway and prevent disastrous outcomes. https://aacc.tums.ac.ir/index.php/aacc/article/view/670

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 09 22 30 35 Anjane Sree Surendran 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. Rupesh Yadav Department of Anesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India. 2023 03 31 2023 05 29 Background: Accurate assessment of intravascular volume status is a vital aspect of management of intensive care unit (ICU) patients. Inferior vena cava (IVC) diameter and IVC collapsibility index have surfaced as promising methods to accurately predict hypovolemia. But no such study has evaluated it’s their utility in postoperative patients. Methods: The study aimed to assess the correlation between ultrasound guided IVC collapsibility index (IVC CI) and CVP for volume status in intensive care unit patients. Hundred spontaneously breathing patients receiving postoperative care in our surgical ICU between November 2019 to march 2021were enrolled into the study. Maximum IVC diameter (IVCdmax) at end-expiration, minimum IVC diameter at end-inspiration (IVCdmin) and IVC CI were measured. Simultaneous CVP recordings were obtained. Results: A positive correlation was noted between IVC maximum diameter and CVP (p = <0.001) and between IVC Minimum Diameter and CVP. (p = <0.001) A negative correlation between IVC CI and CVP was seen (p = <0.001). Mean IVC CI was highest in the hypovolemic group. The area under the ROC curve (AUROC) for IVC CI predicting hypovolemia was 0.943 (95% CI: 0.9 - 0.986), thus demonstrating excellent diagnostic performance. At a cut off of ≥58.416%, IVC CI predicts hypovolemia with a sensitivity of 93.8%, and a specificity of 84%. Conclusion: IVC CI can be used to guide fluid therapy due to its excellent diagnostic accuracy in predicting hypovolemia in postoperative patients in ICU. https://aacc.tums.ac.ir/index.php/aacc/article/view/731

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 12 36 42 Priya Nair Department of Anaesthesiology, Shri B.M.Patil Hospital(B.L.D.E.U), Vijayapura, Bharat, India. Sridevi Mulimani Department of Anaesthesiology, Shri B.M.Patil Hospital(B.L.D.E.U), Vijayapura, Bharat, India. Jyoti Mantur Department of Anaesthesiology, Shri B.M.Patil Hospital(B.L.D.E.U), Vijayapura, Bharat, India. Anusha Suntan Department of Anaesthesiology, Shri B.M.Patil Hospital(B.L.D.E.U), Vijayapura, Bharat, India. 2023 01 30 2023 03 25 Background: Unanticipated difficult intubation poses a challenge in routine practice for anaesthesiologists. A preoperative airway evaluation helps in the identification of a difficult airway. Airway assessment with ultrasound is a modality recently being used to predict difficult airway. In this study we evaluate ultrasonography parameters with conventional clinical parameters for predicting difficult airway in adults undergoing elective surgeries. Methods: This cross sectional randomised clinical trial analyses ASA class 1 and 2 adults requiring endotracheal intubation for surgeries under general anaesthesia were enrolled following which Modified Mallampatti score and thyromental distance as well as ultrasound distance to epiglottis (DSE) and distance to hyoid bone (DSHB) were measured and based on Cormack Lehane grading they were categorised into easy and difficult airway groups. Results: DSE had the highest sensitivity of 90.48% whereas Modified Mallampatti grading had least sensitivity of 66.67%. Conclusion: The results of this study showed that ultrasonographic measurements at the thyrohyoid and hyoid level have higher sensitivity and specificity than the clinical parameters for airway assessment. https://aacc.tums.ac.ir/index.php/aacc/article/view/708

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 21 43 48 Pranab Kalita Department of Anaesthesiology and Critical Care, Gauhati medical College and Hospital, Srimanta Sankaradeva University of Health Sciences, Guwahati, India. Prishel Prasad Department of Anaesthesiology and Critical Care, Gauhati medical College and Hospital, Srimanta Sankaradeva University of Health Sciences, Guwahati, India. Biswajit Talukdar Department of Anaesthesiology and Critical Care, Gauhati medical College and Hospital, Srimanta Sankaradeva University of Health Sciences, Guwahati, India. Priyam Saikia Department of Anaesthesiology and Critical Care, Gauhati medical College and Hospital, Srimanta Sankaradeva University of Health Sciences, Guwahati, India. 2023 01 31 2023 04 18 Background: Both ketamine and dexmedetomidine have proven effective in relieving the pain resulting from propofol injection. However, studies comparing them directly are limited. The primary outcome was to compare the incidence of propofol injection pain after dexmedetomidine pretreatment with ketamine pretreatment. Secondary outcome was to study the changes of haemodynamic parameters that arise after the administration of the pretreatment drug till anaesthesia was induced with propofol. Methods: In this randomized, triple blinded, parallel arm single centre study, we compared pre-treatment with dexmedetomidine 0.5mcg/kg (Group A) and ketamine 0.5mg/kg (Group B). Our primary objective was to compare the incidence of propofol injection pain. The McCririck and Hunter scale was used to evaluate the pain. Secondarily, we compared the changes of haemodynamic parameters that arose after the administration of the pre-treatment drug till induction of anaesthesia with propofol. Results: Among 168 patients evaluated for eligibility, 140 were included for final analysis with 70 patients in each group. The incidence of propofol injection pain in Group A was 74.3% (52/70) and that in Group B was 42.9% (30/70) (p value <0.001). No pain was reported by 25.7% (18/70) and 57.1% (40/70) patients in Group A and B respectively. Mild and moderate to severe pain was experienced by 58.6% and 15.7% patients in Group A, where as it was 40% and 2.9% patients in Group B respectively. Conclusion: Ketamine leads to a greater reduction in both the frequency and intensity of pain resulting from propofol injection when compared to dexmedetomidine. https://aacc.tums.ac.ir/index.php/aacc/article/view/709

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 21 49 54 Jyoti Kale Department of Anesthesia, Smt. Kashibai Navale Medical College and General Hospital, Pune, India. Neha Panse Department of Anesthesia, Smt. Kashibai Navale Medical College and General Hospital, Pune, India. Priyanka Gangathade Department of Anesthesia, Smt. Kashibai Navale Medical College and General Hospital, Pune, India. Aniket Shete Department of Anesthesia, Smt. Kashibai Navale Medical College and General Hospital, Pune, India. 2023 02 11 2023 04 25 Background: Intraoperative stress response and ongoing bleeding at surgical site especially in areas like head and neck can cause serious adverse reactions and affect the postoperative outcome. This study compared the effect of intranasally administered dexmedetomidine (dexmed) in combination with local anesthesia (LA) and local anesthetic alone on quality of surgical field, surgical bleeding and haemodyanamic parameters during functional endoscopic sinus surgery (FESS). Methods: Roller gauge strips dipped in dexmedetomidine were used for nasal packing. Sixty patients undergoing FESS were randomly allocated to receive either intranasal Dexmedetomidine with LA (D group) or intranasal LA alone (L group) via nasal packing 15 min before surgery. The primary objective was to study the quality view of surgical field through the endoscope and the blood loss that occurred while raising the nasal mucosal flap. The secondary objective was to study the intraoperative hemodynamic profile and anesthetic and analgesic requirement during surgery. Results: Surgical field quality, Blood loss, hemodynamic profile and satisfaction scores of patients and surgeons were significantly better (P< 0.05) in dexmed group. Conclusion: Patients receiving intranasal dexmed with LA for FESS had better surgical field, surgeon’s satisfaction and minimal hemodynamic fluctuations with lesser blood loss as well as better postoperative comfort and analgesia. https://aacc.tums.ac.ir/index.php/aacc/article/view/713

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 06 55 59 Mahima Balakrishnaiah Department of Anaesthesiology, MVJ Medical College & Research Hospital, Hoskote, Karnataka, India. Karthik Sheshadri Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India. Sudheer Ramegowda Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India. Rahul Srinivasan Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India. Raghavendra Ullas Lolakrishna Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India. Monisha T Sambandam Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India. 2023 02 15 2023 04 18 Background: Ropivacaine is an amino-amide local anesthetic, extensively used for peripheral nerve blocks, numerous adjuvants have been added to Ropivacaine to prolong the duration of analgesia. Aim: To compare the effectiveness of adding Dexamethasone to Ropivacaine versus adding Clonidine to Ropivacaine in ultrasound guided supraclavicular brachial plexus block in terms of analgesic duration, onset & duration of sensory and motor blockade. Methods: A prospective randomized single blinded study carried out in 70 patients of ASA grade I and II, aged 20 to 60 years scheduled for elective upper limb orthopedic surgeries. Patients were randomly allocated into two groups, Group RC - patients received 20ml of 0.75% ropivacaine along with 1mcg/kg of clonidine diluted to 2ml of normal saline, Group RD - patients received 20ml of 0.75% ropivacaine along with 8mg of dexamethasone (2ml). Statistical Analysis: Onset & duration of sensorimotor blockade, duration of analgesia was assessed by Unpaired t-test. If p-value <0.05, results were statistically significant & p-value <0.001 were highly significant. Results: Duration of analgesia is superior and statistically significant in Group RD (1,172.57± 18.37 vs 931.09± 16.3). Onset time for sensory (3.14 ± 1.00 vs 9.71± 1.23) and motor (7.60 ± 1.54 vs 13.66± 1.03) block is rapid in Group RD. Duration of sensory (1,106.57± 20.28 vs 786.26± 31.43) and motor (997.74 ± 24.9 vs 674.57 ± 2.18) block is enhanced in Group RD Conclusion: Dexamethasone as an adjuvant to ropivacaine provided superior post-operative analgesia, faster onset and longer duration of sensory and motor blockade. https://aacc.tums.ac.ir/index.php/aacc/article/view/716

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 11 03 60 65 Mohsen Mousavi Department of Anesthesiology and Critical Care, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Reza Atef Yekta Department of Anesthesiology and Critical Care, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Arash Heroabadi Department of Anesthesiology, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2023 02 28 2023 04 18 Background: Propofol is one of the most widely used medications in anesthesia and intensive care. Propofol Intravenous injection is painful for patients at the injection site. The aim of this study was to determine the effect of premedication with oral acetaminophen in prevention of local pain caused by intravenous injection of propofol. Methods: This study was a double-blind randomized controlled trial. Data were collected from July 2020 to July 2021 in Shariati Hospital. All stages of premedication and induction of anesthesia were the same in all three groups of patients. Pb, P500 and P1000 groups (patients with oral placebo, 500 or 1000 mg of oral paracetamol, respectively) received the medication 1 hour before transfer to the operating room. Results: In this study, 150 patients were included. 44.7% were men, 55.3% women, and mean age of patients was 36.82 ± 10.24. The highest severity of reported pain was in the group of patients receiving placebo. Patients receiving 1 gram of acetaminophen had the lowest reported pain. Patients receiving 500 mg of acetaminophen reported significantly less pain than patients receiving placebo and more pain than patients in the group receiving 1 g of acetaminophen. Age, gender and weight did not have any significant effect on the pain severity. Conclusion: When compared to placebo, the use of oral acetaminophen as a premedication considerably lowers discomfort induced by intravenous propofol infusion. A dosage of 1 g of oral acetaminophen is more effective than 500 mg in decreasing pain. The level of pain and acetaminophen's pain-relieving effects were not affected by age, gender or weight. https://aacc.tums.ac.ir/index.php/aacc/article/view/719

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 09 26 66 74 Alireza Babajani Department of Anesthesia, Allied Medical School, Iran University of Medical Sciences, Tehran, Iran. Parisa Moradimajd Department of Anesthesia, Allied Medical School, Iran University of Medical Sciences, Tehran, Iran. Azam Saei Department of Anesthesia, Allied Medical School, Iran University of Medical Sciences, Tehran, Iran. Jamile Abolghasemi Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. 2023 03 13 2023 04 25 Background: Patient safety is one of the main elements of the quality of health services. Our aim of this study was to compile a complete checklist for the three stages of anesthesia. Methods: This research was a cross-sectional descriptive-analytical study. First, an internet search was conducted in databases to identify checklists related to safe Anesthesia. The WHO Safe Anesthesia Checklist was designated as the main checklist. Then, a brainstorming session was held with experts and according to the determined fields, the initial draft was compiled. Face and content validity were conducted. The reliability of the checklist was measured with Cronbach's alpha and intra class correlation index (ICC) methods. Results: The initial draft was compiled with 34 items. 29 items scored higher than 0.79 in terms of CVI (content validity index) The value of CVI of 5 items was less than the permissible limit and the edge of the border, which was revised and corrected by the research group. 2 items were returned to the research process according to the survey of experts and their necessity CVR (content validity ratio) (value >0/62) and 3 items were removed from the research process. Cronbach's alpha was calculated as 0.876 for the first evaluator and 0.870 for the second evaluator, and the percentage of agreement between the evaluators was 0.956 (P<0.001). Conclusion: We developed and evaluated a checklist for the three stages of anesthesia through an evidence-based study. We hope   this checklist can reduce and prevent clinical errors. https://aacc.tums.ac.ir/index.php/aacc/article/view/722

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 16 75 81 Lakshmi Pillai Department of Anaesthesiology, Sree Narayana Institute of Medical Science, Kerala, India. Sridevi Mulimani Department of Anaesthesiology, Shri B. M. Patil Medical College, BLDE, Vijayapura, Karnataka, India. Anusha Suntan Department of Anaesthesiology, Shri B. M. Patil Medical College, BLDE, Vijayapura, Karnataka, India. Deepa Dandoti Department of Anaesthesiology, Shri B. M. Patil Medical College, BLDE, Vijayapura, Karnataka, India. 2023 03 20 2023 04 18 Background: Direct laryngoscopy necessitates the alignment of the oropharyngeal-laryngeal axis whereas video laryngoscope is an optical vision which doesn’t require alignment. This study aimed to compare direct laryngoscopy with a Macintosh blade to King-Vision Video laryngoscope for endotracheal intubation in patients who were scheduled for elective laproscopic surgeries under general anaesthesia. Methods: In this prospective randomised clinical study,118 adults with ASA I and II requiring endotracheal intubation for laproscopic surgeries under general anaesthesia were enrolled and randomised into either of the two groups by envelope method, Group DL-direct laryngoscope and Group VL-video laryngoscope where they were intubated using direct laryngoscope with Macintosh blade or King Vision videolaryngoscope. The Primary objective was to compare Time to intubate(TTI), Visualization of the laryngeal view by Cormack-Lehane grade and Successful first attempt. Secondary objective was to record the Number of intubation failure, Number of attempts, Change of anaesthesiologist and use of adjunct equipment and the complications such as oropharyngeal trauma, neck pain, dysphagia and hoarseness. Results: In comparison to group DL (21.67±4.318s), group VL took longer time to intubate (26.21± 4.150s) but had superior glottic vision than DL group(p=0.0177). Compared to DL group (72.4%), the VL (84.5%) patients had their first successful attempt, inspite of 2 failures. Complications such as pharyngeal pain (8.6%vs29.3%), hoarseness (5.2%vs29.3%), Use of adjunct equipment like bougie (19%vs 3.4%) were significantly higher in DL compared to VL group, while oropharyngeal injury, dysphagia, number of attempts and change of anaesthetists were similar in both groups. Conclusion: In comparison to the Macintosh laryngoscope, the King-vision VideoLaryngoscope took longer to intubate but had clearer glottis visualisation and a higher first-time success rate and can be used as a good teaching tool. In King-vision video laryngoscope, there was less use of auxiliary equipment and fewer complications. https://aacc.tums.ac.ir/index.php/aacc/article/view/723

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 12 27 82 90 Shahram Samadi Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran. Alireza Montaseri Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mohamad Mireskandari Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran. Zahra Shahvari Department of Nursing and Midwifery, Gachsaran Branch, IslamicAzad University, Gachsaran, Iran. Afshin Jafarzadeh Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran. Zahid Khan Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran. Melika Arab Bafrani Students’ Scientific Research Center (SSRC), Tehran University of Medical sciences, Tehran, Iran. 2023 12 15 2023 12 20 Background: Burnout syndrome (BOS) is a c