Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 Supp. 1 2023 07 19 375 379 Mehrdad Mokarram Dori Department of Anesthesiology and critical care medicine, Imam Reza Hospital, Mashhad University of Medical Science, Mashad, Iran. Fateme Dehghan Tafti Department of Anesthesiology and Critical Care Medicine, Imam Reza Hospital, Mashhad University of Medical Science, Mashad, Iran. Alireza Bameshki Department of Anesthesiology and Critical Care Medicine, Imam Reza Hospital, Mashhad University of Medical Science, Mashad, Iran. Maliheh Ziaee Department of Community Medicine, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran. 2022 10 25 2023 01 15 Background: The aim of this study was to evaluate the effect of combined lumbar plexus – para sacral nerve block (LP/NB) and spinal anaesthesia (SA) on the duration and intensity of postoperative pain in patients with Tibia fracture requiring surgery. Methods: In this clinical trial, 40 patients with tibial fractures requiring surgery, who were admitted to a referral hospital in north-eastern Iran from 2020 to 2021, and randomly subjected to LP/NB or spinal anaesthesia. Pain intensity and duration of anaesthesia in the two groups were compared based on a numerical rating scale within 4, 6 and 12 hours from the induction of anaesthesia. Clinical demand for analgesics following surgery was also recorded. Data were statistically analysed with IBM SPSS. Results: The mean age of participants was 37.4 ±14.4, with 29 (72.5%) and 11 (27.5%) male and female patients, respectively. There were no significant differences in age and sex ratio between the two groups. The mean pain intensity within 4 hours from surgery was lower in the LP/NB group, however, this difference was not statistically significant (p-value: 0.054). Likewise, there were also no significant differences between the values reported for 6 (p-value: 0.303) and 12-hour (p-value: 0.523) post-surgery pain intensity for each group. Overall, the mean pain intensity at any given time was not significantly different between the two groups of LP/NB and SA (p-value: 0.671). Conclusion: There was no significant difference between the two groups in terms of mean pain intensity at 4, 6 and 12 hours after the onset of the block. No side effects were observed in any of the patients. https://aacc.tums.ac.ir/index.php/aacc/article/view/657

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 Supp. 1 2023 08 24 450 456 Seyed Majid Haghighat-Shoar Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Mehrdad Mokaram Dori Department of Anesthesiology and pain medicine, Emam Reza Hospital, Mashhad University of medical Science, Mashhad, Iran. Azita Farzaneh Farzaneh Shahid Beheshti University of Medical Science, Tehran, Iran. 2022 12 01 2023 01 09 Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy syndrome, is a situation specified by persistent regional pain. The aberrant functioning of the neurological system is believed to be the root cause of an exaggerated reactivity to pain signals that are unable to switch off the sensation of pain. It is characterized by such symptoms as swelling, alterations in the color of the skin and tissues, along with edema. Although it most commonly affects the limbs, such as the arm, leg, hand, or foot, these symptoms can manifest themselves in any part of the body. The existence or nonexistence of nerve injury is used to classify patients into one of two subgroups, I or II, when referring to this illness. Since many medical professionals are unfamiliar with the diagnosis of CRPS and its etiology is not fully elucidated, the condition is frequently incorrectly diagnosed. The treatments available for CRPS focus on alleviating symptoms, regaining organ function, and cosseting a person's quality of life, despite the fact that no cure for the condition has been identified. https://aacc.tums.ac.ir/index.php/aacc/article/view/687

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 Supp. 1 2023 07 25 457 459 Bhavya Krishna Department of Anesthesia, Critical Care and Pain Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. Kavita Sharma Department of Anesthesia, Critical Care and Pain Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. Ranju Gandhi Department of Anesthesia, Critical Care and Pain Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. Siddharth Yadav Department of Urology and Renal Transplant, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. 2022 08 21 2022 09 10 Pheochromocytoma is a challenging case for any anesthesiologist and a team approach is required throughout the perioperative period to prevent anticipated difficulties and best manage any unforeseen complications that develop. We discuss successful management of certain unique challenges, like multifocal arrhythmias and surgical rebleed during transport, during pheochromocytoma surgery in an adult, in addition to the usual perioperative problems. https://aacc.tums.ac.ir/index.php/aacc/article/view/627

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 Supp. 1 2023 07 25 467 468 Kajal Shrestha Department of Anaesthesiology, All India Institute of Medical Sciences,Rishikesh, Uttarakhand, India. Pankaj Singh Department of Anaesthesiology, All India Institute of Medical Sciences,Rishikesh, Uttarakhand, India. Loveneesh Dagar Department of Anaesthesiology, All India Institute of Medical Sciences,Rishikesh, Uttarakhand, India. 2022 11 12 2023 01 09 No Abstract   No Abstract   No Abstract https://aacc.tums.ac.ir/index.php/aacc/article/view/669

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 Supp. 1 2023 08 01 380 385 Swati Taneja Department of Anesthesia, and Critical Care, VMMC and Safdarjung hospital, New Delhi, India. Amardeep Kaur Department of Anesthesia, and Critical Care, Fortis hospital, Mohali, India. Shalvi Mahajan Department of Anesthesia, and critical care, PGIMER, Chandigarh, India. Ankit Kansal Department of Anesthesia, and critical care, ESIC hospital, Ludhiana, India. 2022 09 30 2023 01 09 Background: Neuromuscular blocking drugs (NMBD) have paved the way for the conduct of every known surgical procedure. However, the hunt for optimum NMD with appropriate intubating circumstances is continuous. Rocuronium and cisatracurium are amongst the newer NMBDs. We aim to compare the onset of action, intubating conditions, duration of action, and recovery features in a dose twice the ED95 in patients having abdominal surgery. Methods: A total 60 American Society of Anesthesiology (ASA) I and II adult patients were randomized equally into Group A and Group B. Group A received Inj. Rocuronium 0.6 mg/kg and Group B received Inj. Cisatracurium 0.10 mg/kg. We assessed the intubating conditions after ensuring jaw relaxation using both the clinical criteria and neuromuscular monitoring whereas onset time, duration of action and recovery time were assessed using neuromuscular monitoring only. Results: In Group A, a significant rapid onset of action of muscle relaxant was seen compared to Group B (2.4±0.30 mins versus 4.0±0.09 mins, p= 0.00). 93% patients had excellent intubating conditions in Group A compared to 73% patients in Group B (p= 0.038). The duration of action in Group A was 36.73±1.05 mins and in Group B was 47.40 ±1.33mins (p=0.00). Similarly, early mean duration of recovery was found in Group A-45.30±1.29mins versus Group B -57.77±1.19 mins, p= 0.00). Conclusion: Rocuronium provides rapid onset of action with excellent intubating conditions, and shorter duration of action with an early recovery time compared to cisatracurium. https://aacc.tums.ac.ir/index.php/aacc/article/view/647

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 Supp. 1 2023 08 04 460 462 EN Krunal Suryavanshi Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, India. Neha Panse Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, India. 2022 08 08 2022 08 27 Paediatric spine surgeries are quite frequently performed these days on patients with congenital spinal anomalies. Correction of congenital spinal deformities, at this early age of life can cause lifestyle modifying changes in young patients, which will help them to live a comparative healthy and disease free life. Spine surgeries are often performed in prone position with aid of Total Intra-Venous Anaesthesia which are better supplemented with Intra-Operative Neuro-Monitoring as they help in improving the desirable outcome of surgeries in children. Here, we report a case of Total Intra-Venous Anaesthesia for release of tethered cord aided with Intra-Operative Neuro-Monitoring, which was managed meticulously without any detrimental complications. https://aacc.tums.ac.ir/index.php/aacc/article/view/621

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 Supp. 1 2023 07 19 386 391 Sujata Chaudhary Department of Anesthesiology and Intensive Care, VMM College and SJ Hospital, IP University, Delhi, India. R C Ananth Department of Critical Care Medicine, Manipal Hospitals, Bengaluru, India. Swati Bharti Department of Anesthesiology, Pain Medicine and Critical Care, AIIMS, JPNATC, Delhi, India. Rashmi Salhotra Department of Anesthesiology and Critical Care, UCMS and GTB Hospital, Delhi University, Delhi, India. Mahendra Kumar Department of Anesthesiology and Critical Care, Sharda Medical School and Research (SMSR), Sharda University, Greater Noida, UP, India. 2022 08 14 2022 09 10 Background: The pre-requisites to a successful awake fiberoptic intubation (AFOI) include adequate psychological and pharmacological preparation of the patient. This study aims to compare two pharmacological agents, dexmedetomidine and nalbuphine, in addition to nebulization and airway topicalization, for intubating conditions during AFOI. Methods: Sixty consenting patients belonging to ASA I/II, MPC I/II, age-group of 18-60 years weighing between 40-70 kgs requiring general anaesthesia with endotracheal intubation were randomly allocated to one of the two groups. Patients received dexmedetomidine 1µg/kg i.v. (group D) or nalbuphine 0.2 mg/kg i.v. (group N) over 10 min before intubation. Fiberoptic intubation was attempted. Intubating conditions were assessed in terms of sedation score, cough score and post-intubation score. Hemodynamic responses, lignocaine and propofol requirement were also recorded. Repeated measure ANOVA, Tukey’s test, unpaired t test, Chi‑square test or Fisher’s exact test were used for data analysis. A P < 0.05 was considered significant. Results: Sedation score (P = 1.000), cough score (P = 0.165) and post‑intubation score (P = 0.157) were comparable among the two groups. Hemodynamic responses, propofol and lignocaine requirements were also comparable. Conclusion: Both intravenous dexmedetomidine and nalbuphine provide good intubating condition with minimal adverse effects on haemodynamic profile during awake fibreoptic intubation.   https://aacc.tums.ac.ir/index.php/aacc/article/view/624

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 Supp. 1 2023 08 12 463 466 EN Jyoti Deshpande Department of Anaesthesiology, SKNMC & GH, Pune, India. Merlin Jacob Department of Anaesthesiology, SKNMC & GH, Pune, India. Priyanka Gangthade Department of Anaesthesiology, SKNMC & GH, Pune, India. 2022 07 19 2022 08 13 Parathyroid adenomas are usually an incidental finding and present more commonly in women. The parathyroid gland releases parathyroid hormone(PTH), which is essential to maintain calcium homeostasis. Hence, the removal of parathyroid glands will result in hypocalcemia and if not treated could be life threatening. We present the case of a young female patient who presented with vague complaints and was evaluated and diagnosed with primary hyperparathyroidism. She was optimized and taken for surgical removal of parathyroid glands. The anesthetic considerations in the perioperative period and an intraoperative event during positioning are mentioned herewith. https://aacc.tums.ac.ir/index.php/aacc/article/view/608

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 9 Supp. 1 2023 07 27 392 396 Niyoosha Yoosefi 2025 04 05 783 785 Alireza Babajani Department of Anesthesiology, School of Allied Medical Sciences, Alborz University of Medical Sciences, Karaj, Iran. Pegah Arman Department of Anesthesiology, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran. Parastoo Rahmati Torkashvand Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran. Behrouz Karkhane Department of Anesthesiology, School of Medicine, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran. Kimia Khonakdar Department of Anesthesiology, Allied Medical School, Mazandaran University of Medical Sciences, Sari, Iran. 2024 12 22 2025 01 17 The patient was an 11-year-old girl, weighing 25 kg and measuring 125 cm in height, with a history of congenital cleft palate and previous surgeries (including cleft palate repair and cardiac procedures). She was referred for maxillary alveolar closure surgery. She experienced difficulty swallowing and dyspnea when consuming solids and liquids. During the preoperative evaluation, no significant comorbidities were identified, but anatomical changes in the nasopharynx suggested a defect in the previous repair. To ensure safe airway management and avoid nasopharyngeal injury during surgery, a modified intubation technique was employed. We used a flexible armored endotracheal tube that had been autoclaved at 45°C for 2 min. Anesthesia induction included propofol, fentanyl, and cis-atracurium. Intubation was successfully performed without complications. Postoperatively, the patient recovered well, showing no signs of trauma or airway distress. She was discharged on the first postoperative day with appropriate care recommendations. https://aacc.tums.ac.ir/index.php/aacc/article/view/1161

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 05 05 802 803 Anahita Babaei Department of Anesthesiology and Critical Care, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 2025 04 01 2025 04 07 No Abstract    No Abstract  No Abstract    No Abstract  https://aacc.tums.ac.ir/index.php/aacc/article/view/1254

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 05 25 627 634 Arezou Ashari Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Dariush Abtahi Department of Anesthesiology, Clinical Research and Development Unit, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2025 02 21 2025 02 23 Background: Bimalleolar fractures, which often necessitate surgery due to instability, are linked to considerable postoperative pain. Selective cyclooxygenase-2 (COX-2) inhibitors, like celecoxib, have demonstrated potential in alleviating pain and decreasing the need for opioids. However, the optimal dosing regimen remains unclear. This study compares the efficacy of two celecoxib regimens in reducing postoperative pain after ankle fracture surgery. Methods: A double-blind, randomized controlled trial was carried out with 240 patients undergoing bimalleolar fracture surgery under spinal anesthesia. The participants were split into three groups: a placebo group, a group receiving 400 mg of celecoxib (Group 400), and a group receiving 600 mg of celecoxib (Group 600). Pain levels were evaluated using the Visual Analog Scale (VAS) at specific time points (0, 6, 24, and 72 hours after surgery). Additionally, total morphine consumption, the time until first analgesic use, patient satisfaction, and side effects were documented. Results: Patients in Group 600 experienced significantly lower pain scores and delayed morphine use compared to the placebo group (P < 0.05). Both celecoxib groups consumed less morphine overall, with higher patient satisfaction scores reported in Group 600. Adverse events were minimal and comparable across all groups. Conclusion: The preemptive use of celecoxib, particularly at a 600 mg dose, significantly reduces postoperative pain and opioid use while enhancing patient satisfaction with minimal side effects. These results suggest that COX-2 inhibitors are a practical alternative to opioids for managing pain after ankle fracture surgery. https://aacc.tums.ac.ir/index.php/aacc/article/view/1214

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 04 11 767 773 EN Bahare Firouzbakht Department of Anesthesiology, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. Bahareh Hakiminia Department of Clinical Pharmacy, School of Pharmacy, Semnan University of Medical Sciences, Semnan, Iran. Laleh Dehghanpisheh Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 2024 12 30 2025 01 04 Background: In cardiopulmonary bypass (CPB), there is a need to better maintain appropriate anesthesia due to the physiological and hemodynamic alterations induced by CPB. This review aimed to explore the effects of sevoflurane versus propofol in the management of patients undergoing cardiac surgeries with CPB. Methods: The literature search was conducted in the international databases, including Cochrane, Science-Direct, Scopus, PubMed, and Google Scholar, from January 2012 to July 2024. Results: According to the studies, sevoflurane was associated with a significantly shorter time to extubation, eye-opening, and command compliance with better intraoperative hemodynamic stability. It was superior in reducing oxygen demand and may be associated with less hypoxia in the aortic cross-clamp phase. In addition, sevoflurane produces more prominent myocardial protection, attenuates inflammatory response, and has a lower impact on cognitive function. On the other hand, propofol decreased the incidence and intensity of acute kidney injury and may be preferred over sevoflurane in patients at risk of postoperative nausea. Conclusion: It seems in adults undergoing cardiac surgery with CPB, the class of sevoflurane is superior to propofol with regard to many perioperative and postoperative outcomes. However, more studies with larger sample sizes are needed to clarify this issue. https://aacc.tums.ac.ir/index.php/aacc/article/view/1169

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 04 07 786 789 Reza Tahmasabi Department of Anesthesia, Hamadan University of Medical Sciences, Hamedan, Iran. Ibrahim mouhamad Department of Anesthesiology, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran. Pegah Arman Department of Anesthesiology, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran. Afshin Farhanchi Department of Anesthesia, Hamadan University of Medical Sciences, Hamedan, Iran. 2024 12 24 2025 01 08 A 68-year-old female patient referred for mandibular reconstruction surgery. He was treated for cancer in the mandible last month. Due to the extent of the mass in the lower jaw area, this patient underwent Mandibulectomy 9 months ago. The patient was admitted to Ba'ath Hospital in Hamadan, his vital signs were stable. Before the surgery, according to his underlying diseases, a cardiovascular consultation was done and no complications affecting anesthesia were reported. The challenge of the anesthesia team in this patient was to establish a safe airway for him. According to the physical condition of the patient's neck and mandible, the patient was intubated using a Fireoptic bronchoscope. The patient's surgery lasted 2 hours and 45 minutes. During the entire period of anesthesia, the patient was under strict respiratory monitoring. After the end of the surgery, the patient was transferred to the recovery room without removing the endotracheal tube, and after ensuring that the patient's condition was stable, he was transferred to the intensive care unit. https://aacc.tums.ac.ir/index.php/aacc/article/view/1164

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 04 23 635 639 Majid Razavi Lung Diseases Research Center, Imam-Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Hamideh Zarezadeh Lung Diseases Research Center, Imam-Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Ahmad Bagherimoghaddam Lung Diseases Research Center, Imam-Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Mehryar Taghavi Gilani Lung Diseases Research Center, Imam-Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. 2025 03 01 2025 03 06 Background: Postoperative emergence agitation in children is so common. Isoflurane and propofol are evaluated for agitation, but results were contradictory. This study aimed to compare the effect of isoflurane and propofol for emergence agitation in children under three years old. Methods: This double-blinded, randomized clinical trial was performed on 104 children under three years’ old who were candidates for nasolacrimal probing. The children were anesthetized by sevoflurane and then were divided into isoflurane and propofol groups. After transfer to the recovery room, at first, 4 and 8 minutes, the degree of agitation of the child was measured according to the Watcha sedation criteria. Results: The demographic parameters were not different. The mean duration of anesthesia (from LMA insertion to extubation) in isoflurane was significantly shorter than in propofol (p = 0.001). Also, the recovery time in the isoflurane group was significantly shorter than that of the propofol group (P=0.02). The prevalence of agitation was 7.69% in the propofol and 59.61% in the isoflurane, and the difference was significant (P = 0.001). Agitation scores at first, 4 and 8 minutes in the recovery room, showed less agitation in the propofol group (P=0.001). Conclusion: Our study showed that propofol in children reduces the incidence of emergence agitation compared to isoflurane. But emergence and recovery time in the isoflurane group was less than in the propofol group. https://aacc.tums.ac.ir/index.php/aacc/article/view/1220

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 04 18 774 779 Zachary Merhavy Ross University School of Medicine, Bridgetown, Barbados, USA. Colton Zeitler Arizona College of Osteopathic Medicine at Midwestern University, Glendale, AZ, USA. Thomas Varkey Department of Neurology, University of Arizona College of Medicine, Phoenix, AZ, USA. Marc Brandon Arizona Anesthesia Consultants, Glendale, AZ, USA. 2025 03 09 2025 03 31 Anesthesia in patient care, both in the perioperative period and in the pain clinic, is a challenging field to engage with - this is secondary to the fact that patients are individuals who are influenced by numerous factors, including the bacterial makeup of their microbiome and its parts. With the focus on personalized medicine as the next frontier, this narrative literature review looks at the current trend in individualized medicine, specifically regarding the use of the microbiome and artificial intelligence in the choice of different drugs for the induction and continuation of surgery as well as the management of pain syndromes in patients. This review also includes a summary of the different research directions that can take place based on the most recent data, including microbiome composition testing, therapeutic alterations, and the use of artificial intelligence to select the best drugs for treating the patient. https://aacc.tums.ac.ir/index.php/aacc/article/view/1229

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 04 06 790 794 Ibnu Samdani Department of Anesthesiology and Intensive Care, Padjadjaran University, Bandung, Indonesia. Iwan Fuadi Department of Anesthesiology and Intensive Care, Padjadjaran University, Bandung, Indonesia. Iwan Rachman Department of Anesthesiology and Intensive Care, Padjadjaran University, Bandung, Indonesia. 2025 01 05 2025 02 03 Intraoperative Neurophysiological Monitoring (IONM) refers to the use of various electrophysiological methods to monitor the function of the brain, spinal cord, and related nerves during surgical procedures. IONM involves the use of neurophysiological recordings to detect changes in nervous system function during surgery, allowing doctors to identify potential nerve damage before it occurs. Reported is a 65-year-old male patient with a diagnosis of unruptured aneurysm of the Posterior Communicating Artery (PcomA) and left ophthalmic segment of C5 whose aneurysm was planned to be clipped. The patient was planned to have the aneurysm clipped under general anesthesia. The challenge in the anesthesia process for aneurysm cases is maintaining the pressure in the aneurysm and cerebral perfusion pressure (CPP), protecting the brain during periods of ischemia, and providing as wide an operating field as possible. Post-operatively, the patient showed stable neurological function with no new deficits, highlighting the importance of intraoperative neurophysiological monitoring in achieving a favorable outcome. https://aacc.tums.ac.ir/index.php/aacc/article/view/1173

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 04 23 640 647 EN Behzad Nazemroaya Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Zahra Rahimi Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Mojtaba Rahimi Varposhti Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Movahed Dehghani Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 2025 03 01 2025 03 10 Background: This study was conducted with the aim of comparing the sedation rate of Propofol and Lidocaine -Propofol combination in patients undergoing bronchoscopy. Methods: In this clinical trial study, 60 patients undergoing bronchoscopy were divided into two groups of 30 people, in the first group 1 mg/kg of Propofol and in the second group 1 mg/kg of Propofol together with 1.5 mg/kg of Lidocaine were injected. And the hemodynamic parameters, depth of sedation, consumption of Propofol and midazolam, and pain intensity after the operation were evaluated and compared between two groups. Results: Patients in the propofol-Lidocaine group had better hemodynamic stability and the trend of sedation score changes was significantly different between the two groups (P=0.042). In terms of pain intensity during recovery, propofol-Lidocaine recipients had less pain intensity (P<0.001). Patients receiving propofol-Lidocaine received less Propofol (P=0.028) and midazolam (P=0.01). Conclusion: The results of the present study show that the use of injectable Lidocaine with Propofol is associated with more favorable hemodynamic stability, reduction of Propofol consumption, better sedation, and less postoperative pain, so it seems that the use of Lidocaine with Propofol is beneficial. It is preferable to Propofol alone. https://aacc.tums.ac.ir/index.php/aacc/article/view/1221

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 03 31 795 798 EN Hossein Karballaei Mirzahosseini School of Pharmacy, Semnan University of Medical Sciences, Semnan, Iran. Leili Manafi School of Pharmacy, Semnan University of Medical Sciences, Semnan, Iran. 2025 01 14 2025 01 19 Baclofen functions as a GABA-B receptor agonist and is utilized as a muscle relaxant. Acute baclofen poisoning can lead to significant central nervous system depression, which may occasionally be challenging to distinguish from brain death. Because of the complexities associated with the diagnosis and treatment of baclofen poisoning, we decided to document this case. We present the case of an 18-year-old female who experienced acute poisoning due to an intentional overdose of baclofen. He was intubated and in a deep coma with no brainstem reflexes. Initial evaluations indicated brain death due to the lack of neurological responses. The patient received intensive supportive care and continuous monitoring. Over the following days, she showed gradual neurological improvement, eventually regaining consciousness and autonomic stability. After an extended hospital stay and a careful reduction of ventilation support, she achieved a full neurological recovery. Baclofen toxicity may show severe symptoms of brain death, but with the support of the intensive care unit, the symptom may be completely reversible. https://aacc.tums.ac.ir/index.php/aacc/article/view/1178

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 04 29 648 654 Mehdi Dehghani Firoozabadi Department of Anesthesiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Afzal Shamsi Department of Anesthesia, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Hosseini Neonatal Intensive Care Unit, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2025 03 03 2025 03 06 Background: Delivery and assuming the parental role, especially for mothers, are often accompanied by anxiety and stress, conditions that are significantly aggravated by the birth of a premature infant. The aim of our study is to "determine the effect of COVID-19 prevention training on the stress levels of mothers with premature infants admitted to the NICU." Methods: This is a quasi-experimental study. The sample consisted of 100 mothers (50 in the experimental group and 50 in the control group) of premature infants hospitalized in the Neonatal Intensive Care Unit (NICU). Participants were randomly assigned to the two groups. The experimental group received an educational program on preventing respiratory infection transmission, with a focus on the coronavirus, delivered through individual face-to-face sesa Moradimajd Department of Anesthesia, Faculty of Paramedicine, Iran University of Medical Sciences, Tehran, Iran. Azam Saei Department of Anesthesia, Faculty of Paramedicine, Iran University of Medical Sciences, Tehran, Iran. & Research Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran. jamile Abolghasemi Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. 2024 07 17 2024 08 03 Background: Blood transfusion is a critical procedure where any error in the transmission chain can jeopardize patient safety. To ensure safe blood transfusions, it is essential to evaluate the performance of all personnel involved in the transfusion process, including anesthesia technologists, whose role has often been overlooked. This study was conducted with the aim of investigating the performance of in com anesthesia technologist plying with safe blood transfusion procedures during anesthesia. Methods: This cross-sectional study was conducted on 80 Anesthesia technologist s working in Rasoul Akram and Firouzgar hospitals in Tehran. The purpose of this study was to investigate the level of adherence to safe blood transfusion standards by Anesthesia technologist s. The data was collected using a comprehensive and standard questionnaire including two parts: the first part demographic information and the second part focusing on the standards of safe blood transfusion. All completed questionnaires were entered into SPSS software version 27. Descriptive and inferential statistics were used for statistical analysis. Results: The average age of the participants was 34 ± 10 years. Of the participants, 70% were women and 30% were men. The average score on the 36-question questionnaire was 27.32, corresponding to 73% of the maximum possible score. Performance levels were categorized as follows: good (75–100%), representing 41.25% of participants; moderate (50–75%), representing 58.75% of participants; and poor (<50%), with no participants falling into this category. Overall, the performance of anesthesia technologist in adhering to safe blood transfusion standards was considered average. Conclusion: Anesthesia technologist performance in safe blood transfusion procedures during anesthesia was evaluated at a moderate level. Addressing these gaps and considering educational programs in health care systems can improve patient safety and improve clinical outcomes during anesthesia and surgical procedures. https://aacc.tums.ac.ir/index.php/aacc/article/view/1044

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 2 2024 11 20 168 172 Ravikanth Pula Department of Anaesthesia, ESIC Medical college & Super Speciality Hospital Sanathnagar, Hyderabad, India. Suneetha Dadi Department of Anaesthesia, ESIC Medical college & Super Speciality Hospital Sanathnagar, Hyderabad, India. Nagarjuna Thakur Department of Anaesthesia, ESIC Medical college & Super Speciality Hospital Sanathnagar, Hyderabad, India. 2024 07 30 2024 08 17 Background: An optimal anaesthesia protocol is critical for paediatric patients undergoing surgery to ensure smooth recovery and minimize complications. This study compares the impact of Bispectral Index (BIS) and End-Tidal Anaesthetic Gas (ETAG) concentration-guided protocols on tracheal extubation time in paediatric patients. Methods: A prospective randomized controlled study was conducted on 60 paediatric patients (4-12 years) undergoing general anaesthesia. Patients were divided into BIS-guided (Group B) and ETAG-guided (Group E) protocols. Various parameters, including age, gender, duration of surgery, duration of anaesthesia, and time to extubation, were analyzed using statistical methods such as Chi-Square Test, Analysis of Variance (ANOVA), and Logistic Regression. Results: No significant differences were found in demographic characteristics, surgery duration, anaesthesia duration, or time for extubation between the two groups. Both monitoring techniques demonstrated comparable efficacy in maintaining appropriate anaesthesia levels and ensuring a smooth recovery process. Conclusion: The study concludes that BIS and ETAG-guided protocols are equally effective in maintaining optimal anaesthesia levels and facilitating a seamless recovery for paediatric patients. While the monitoring techniques are not interchangeable in all clinical scenarios, this research provides valuable insights for anaesthesia management. https://aacc.tums.ac.ir/index.php/aacc/article/view/1060

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 2 2024 12 15 173 177 Parisa Akbarpour Department of Anesthesia, Faculty of Paramedicine, Iran University of Medical Sciences, Tehran, Iran. Parisa Moradimajd Department of Anesthesia, Faculty of Paramedicine, Iran University of Medical Sciences, Tehran, Iran. Azam Saei Department of Anesthesia, Faculty of Paramedicine, Iran University of Medical Sciences, Tehran, Iran. & Research Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran. Maryam Aligholizadeh Department of Anesthesia, Faculty of Paramedicine, Iran University of Medical Sciences, Tehran, Iran. Siavash Sangi Departmen