Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2024 01 30 1 2 Zahid Khan Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, Iran. 2024 01 30 No Abstract    No Abstract    No Abstract https://aacc.tums.ac.ir/index.php/aacc/article/view/938

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 08 3 8 Komal Garg Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. Samridhi Nanda Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. Usha Bafna Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. Chandan Mali Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. Sumaila Naaz Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. Nelwin Sabu Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. 2023 03 28 2023 05 29 Background: FESS has its share of complications which can be a challenge for both the surgeon as well the anesthetist and achieving a bloodless surgical field is essential So the principle of controlled hypotension can be used to combat this issue. Methods: A hospital-based randomized comparative interventional study was conducted on 60 patients to compare Clonidine (2mcg/kg in 10 ml of saline over 10 minutes before induction followed by an infusion of 1mcg/kg/hr during maintenance) and Esmolol (1mg/kg in 10 ml of saline over 10 minutes before induction followed by an infusion of 1mg/kg/hr during maintenance) to assess and compare the hypotensive properties of both the drugs. Results: After the induction of anesthesia, there was a significant difference in the mean heart rate, and mean arterial pressure between the two groups throughout the intraoperative period (p-value < 0.05). Both groups achieved a target mean arterial pressure (MAP) of 65-70 mmHg and improved surgical field quality. Conclusion: This study concluded that clonidine and esmolol both provide hemodynamic stability and a better surgical field in functional endoscopic sinus surgery (FESS). Clonidine also helps in achieving postoperative sedation and analgesia. https://aacc.tums.ac.ir/index.php/aacc/article/view/729

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 09 09 91 93 Selvamani Subramanian Department of Anesthesiology, ACS Medical College and Hospital, MGR Educational and Research Institute (Deemed to be university), Chennai, India. Vasanthakumar Murugesan Department of Anesthesiology, ACS Medical College and Hospital, MGR Educational and Research Institute (Deemed to be university), Chennai, India. Gayathri Santhanam Department of Anesthesiology, ACS Medical College and Hospital, MGR Educational and Research Institute (Deemed to be university), Chennai, India. 2022 12 18 2023 02 06 Injury to the Recurrent Laryngeal Nerve is uncommon, but one of the complications of thyroidectomy We report a case of 40 years old female, who underwent total thyroidectomy, following which developed recurrent laryngeal nerve injury and vocal cord palsy, which was diagnosed immediately and managed successfully. https://aacc.tums.ac.ir/index.php/aacc/article/view/691

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 09 26 105 106 Mahtab Poor Zamany Nejat Kermany Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2023 04 13 2023 06 25    No Abstract    No Abstract   No Abstract https://aacc.tums.ac.ir/index.php/aacc/article/view/738

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 09 05 9 14 Alireza Rahat Dahmardeh Department of Anesthesiology and Critical Care, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. Masoum Khoshfetrat Department of Anesthesiology and Critical Care, Khatam-Al-Anbiya Hospital, Zahedan University of Medical Sciences, Zahedan, Iran. Mehdi Heidari Department of Anesthesiology and Critical Care, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. & Clinical Immunology Research Center, Ali IbneAbitaleb 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. 2023 01 16 2023 04 25 Background: Disorders of consciousness, including the vegetative state (VS) and the minimally conscious state (MCS) following brain damage and various complications for the patient, also have economic and social consequences. However, there is still no definitive or effective treatment for this condition. However, there is still no definitive or effective treatment for this condition. Therefore, this study aims to investigate the effectiveness of zolpidem in improving consciousness in patients with acute brain injury. Methods: The present quasi-experimental study was performed from 2020 to 2021 after obtaining the necessary permissions from Zahedan University of Medical Sciences, Iran. Eighty patients with acute brain injury who met the study inclusion criteria were recruited and randomized into zolpidem and placebo groups. In the zolpidem group, 10 mg zolpidem tablets were gavage twice daily. In the placebo group, a placebo tablet with the same appearance as zolpidem was gavage twice daily for 14 days. The consciousness level of patients was measured daily until the outcome (ICU discharge or expiration) was established. Eventually, a comparative data analysis was conducted to determine zolpidem's efficacy in enhancing consciousness, reducing mechanical ventilation duration, and improving patient outcomes. Results: The mean GCS score in the zolpidem group was 6.1±2.4 on admission and 11.6±3.8 at the end of the study, compared to 5.9±1.7 on admission and 11.3±2.8 at the end of the study, for the placebo group (p=0.154 and p=0.211, respectively). The mean duration of mechanical ventilation was 24.41±9.14 days in the zolpidem group and 23.16±10.72 days in the placebo group (P=0.529). Twenty-eight patients in the zolpidem group were discharged from ICU, and 12 expired. For the placebo group, 26 patients were discharged from ICU, while 14 were expired (p=0.87). No statistically significant difference was found in any of the measured variables between the two groups. Conclusion: The results have shown that zolpidem administration had no statistically significant effect on improving the level of consciousness and reducing mechanical ventilation duration and clinical outcomes in acute brain injury patients. https://aacc.tums.ac.ir/index.php/aacc/article/view/700

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 09 26 94 96 EN Naeemeh Dini Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Zahra Jahangard- Rafsanjani Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Mamak Tahmasebi Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran. 2023 01 17 2023 03 26 Pain is an unpleasant experience and a subjective term that is associated with tissue damage. Cancer patients experience pain for a myriad of reasons, from disease related to treatment causes and unrelated to both of these categories. Opioids are the mainstay in the treatment of moderate to severe cancer pain. Progressive opioid dose increases can cause opioid-induced hyperalgesia (OIH). OIH has no definite management, here we present a 47-year-old cancer patient with OIH and her management. https://aacc.tums.ac.ir/index.php/aacc/article/view/701

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 08 15 23 Vinay Sharmal Department of Anesthesiology, Dr S N Medical College, Jodhpur, India. Pratima Yadav Department of Anesthesiology, SMS Medical College, Jaipur, India. Mathura Tak Department of Anesthesiology, Dr S N Medical College, Jodhpur, India. 2023 01 18 2023 04 18 Background: Although nerve block facilitatory effects of dexmedetomidine when used as a perineural adjunct to local anesthetics in supraclavicular brachial plexus blocks are well recognized in multiple studies, but whether this action is at directly on peripheral nerve fibers or is at central level after systemic absorption is unclear. Aim of this study was to evaluate the effect of adding dexmedetomidine 1 microgram/kg to ropivacaine 0.5% in supraclavicular brachial plexus block in terms of duration of analgesia and 24hour cumulative analgesic requirement and to test the hypothesis whether the effect of dexmedetomidine, is due to direct local action on nerve plexus or is centrally mediated after systemic absorption. Methods: 105 patients of ASA grade I and II of either sex undergoing upper limb orthopedic surgeries were divided in 3 groups of 35 patients in each group. Group Rc (control group) received supraclavicular block with 30ml of 0.5% ropivacaine and intravenous infusion of 30ml of normal saline; group RDexP received supraclavicular block with 30ml solution of 0.5% ropivacaine+ dexmedetomidine 1mcg/kg and intravenous infusion of 30ml of normal saline; and group RDexIV received supraclavicular block with 30ml of 0.5% ropivacaine and intravenous infusion of 30ml of normal saline solution containing dexmedetomidine 1mcg/kg. Primary outcome was duration of analgesia and 24hour cumulative analgesic requirement. Results: The demographic data were comparable in all three groups. Duration of analgesia was longest in group RDexP followed by group RDexIV and least in control group. 24hour cumulative analgesic requirement was least in group RDexP and maximum in group R. 2 patients, one from each group RDexP and group RDexIV reported bradycardia and 6 patients from group RDexIV reported hypotension. Conclusion: We conclude that action of dexmedetomidine is most probably peripheral on brachial plexus nerve fibers directly rather than centrally mediated after systemic absorption. https://aacc.tums.ac.ir/index.php/aacc/article/view/703

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 27 97 100 Manjunatha Munivenkatappa Department of Anesthesiology, Bangalore Medical Colllege and Research Institute, Bengaluru, India. Sudha Kondi Department of Anesthesiology, Bangalore Medical Colllege and Research Institute, Bengaluru, India. Bhaskar Bhaskar Department of Anesthesiology, Bangalore Medical Colllege and Research Institute, Bengaluru, India. Dayanand Parvathamma Department of Anesthesiology, Bangalore Medical Colllege and Research Institute, Bengaluru, India. 2023 01 21 2023 03 26 Huge head and neck tumors are known to cause difficult ventilation and difficult intubation. Edentulous mouth can result in difficult mask ventilation. Head and neck tumor resections can also present hemodynamic challenge, due to their proximity to large vessels. We herein report a clinical case of difficult ventilation due to large parotid tumor in an edentulous patient. https://aacc.tums.ac.ir/index.php/aacc/article/view/705

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 09 28 24 29 Chake Maria Josiane Bekoin-Abhe Multipurpose Intensive Care Unit of Cocody University Hospital, Cocody, Abidjan, Côte d'Ivoire. Goulai Bi You Etienne Bazago Multipurpose Intensive Care Unit of Cocody University Hospital, Cocody, Abidjan, Côte d'Ivoire. Coulibaly Klinna Théodore Multipurpose Intensive Care Unit of Cocody University Hospital, Cocody, Abidjan, Côte d'Ivoire. Mobio Michael Paterne Multipurpose Intensive Care Unit of Cocody University Hospital, Cocody, Abidjan, Côte d'Ivoire. Bedié Yao Vianney Multipurpose Intensive Care Unit of Cocody University Hospital, Cocody, Abidjan, Côte d'Ivoire. 2023 01 21 2023 03 26 Background: Cardiac arrest in the operating room (CAO) is a serious accident of often rare epidemiology. Methods: Retrospective, descriptive aFirstName>Mohammad Hossein Hajali Student Research Committee, AJA University of Medical Sciences, Tehran, Iran‎. Hamidreza Karbalaei-Musa Student Research Committee, AJA University of Medical Sciences, Tehran, Iran‎. Reza Mourtami Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. & School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Reza Pourfallah Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. Atabak Najafi Department of Anesthesia and Intensive Care‎, Sina Hospital‎, Tehran University of Medical Sciences, Tehran, ‎Iran. Mojtaba Mojtahedzadeh Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. Samrand Fattah Ghazi Department of Anesthesiology and Critical Care‎, Imam Khomeini Hospital Complex‎, Tehran University of Medical Sciences, Tehran, ‎Iran. Arezoo Ahmadi Department of Anesthesia and Intensive Care‎, Sina Hospital‎, Tehran University of Medical Sciences, Tehran, ‎Iran. Nasibe Ashouri Department of Critical Care, Imam Khomeini Hospital Complex‎, Tehran University of Medical Sciences, Tehran, ‎Iran. Babak Jahangirifard Department of Anesthesia and Intensive Care‎, School of Medicine‎, Aja University of Medical Sciences, Tehran, ‎Iran. 2024 10 13 2024 11 12 Background: This study aimed to investigate mortality risk factors among severe COVID-19 patients admitted to the intensive care unit (ICU) to inform better management strategies and reduce mortality rates. Methods: A descriptive-analytical, cross-sectional, and retrospective study was conducted between March 2022 and April 2023 at the intensive care unit of Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. The study included patients admitted to the ICU with severe COVID-19. The main variables were demographic factors (age, gender), pre-existing medical conditions (smoking, diabetes, hypertension), disease severity markers (CT-scan scores, inflammatory and coagulation parameters), and mortality outcomes. Results: The study included 395 eligible patients. The mortality rate was 57.72%, with no significant difference in hospital stay duration between deceased and survived patients. Smoking, diabetes mellitus, and hypertension were significantly associated with higher mortality. Males exhibited a higher mortality rate, although not statistically significant. Patients over 65 years old had significantly higher mortality. Winter showed a significant increase in mortality, likely due to the Omicron subvariant. Higher CT scan scores and elevated inflammatory/coagulation markers correlated with increased mortality risk. Conclusion: Pre-existing conditions, demographic factors, and disease severity markers are crucial predictors of mortality in severe COVID-19 patients. Tailored interventions targeting these risk factors are essential to improve outcomes. https://aacc.tums.ac.ir/index.php/aacc/article/view/1108

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 3 2024 12 15 407 416 Siavash Sangi Anesthesia and Operating Room Department, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mehrdad Mesbah Kiaei Department of Anesthesiology and Pain Medicine, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Maryam Aligholizadeh Anesthesia and Operating Room Department, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Alireza Babajani Department of Anesthesia Technology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran. Parisa Akbarpour Department of Anesthesia Technology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran. Maryam Sarkhosh Department of Anesthesia Technology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran. Elnaz Jalalkamali Department of Anesthesia Technology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran. Zahra Karimian Anesthesia and Operating Room Department, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2024 09 03 2024 09 17 Background: Shivering is prevalent in 65% of patients undergoing spinal anesthesia, resulting in adverse outcomes and increased healthcare expenses. Ketamine, an N-methyl-D-aspartate receptor antagonist, and tramadol exhibit analgesic properties, potentially mitigating post-spinal shivering. This scoping review aims to explore the existing literature on the intravenously administered ketamine and tramadol in reducing the incidence of shivering subsequent to spinal anesthesia. Methods: This scoping review, conducted from April to June 2024, examined studies on intravenous ketamine and tramadol for shivering post-spinal anesthesia. Using MeSH terms, researchers searched Scopus, Web of Science, PubMed, Cochrane, Google Scholar, Iran SID, and Iran ISC. After excluding duplicates and irrelevant studies, six pertinent studies were included. Results: The search strategy identified 1316 articles, with 1258 remaining after removing 58 duplicates. Title and abstract screening excluded 6 conference papers, 42 systematic reviews, 94 book chapters or animal studies, and 2 theses. A full-text review of 97 studies resulted in excluding 78 unrelated cases, 1 language discrepancy, and 11 without full-text availability. Ultimately, 6 studies (5 randomized controlled trials and 1 prospective cohort) from Iran, Pakistan, India, Egypt, and Ethiopia found ketamine more effective than tramadol in preventing shivering. Conclusion: Ketamine is more effective than tramadol in preventing post-spinal anesthesia shivering, with fewer adverse effects like nausea, vomiting, and bradycardia. These findings support its use for shivering management. Future research should optimize dosing to reduce hallucinations, explore other side effects, and prioritize diverse study parameters and safety evaluations. https://aacc.tums.ac.ir/index.php/aacc/article/view/1081

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 3 2025 02 11 429 431 Firoozeh Madadi Department of Anesthesiology, Ayatollah Taleghani Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Faranak Behnaz Department of Anesthesiology, Shohada-e-Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2024 10 13 2024 10 29 Maternal morbidity and morbidity are among the most important concerns of the World Health Organization and every country’s healthcare system. Anesthetic management of parturients with a history of acute myocardial infarction (MI) presents unique challenges, particularly in the 3rd trimester when the pregnancy is approaching its end. Herein we will present anesthetic management of a parturient who underwent a cesarean section one week after acute myocardial infarction. https://aacc.tums.ac.ir/index.php/aacc/article/view/1107

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 3 2025 01 17 285 290 Pooya Mohamadali Zade Department of Anesthesiology, School of Para-Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Pegah Arman Department of Anesthesiology, School of Para-Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Nasrin Shirmohammadi-Khoram Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan,Iran. Ibrahim Kareem Muhammad Department of Anesthesiology, School of Para-Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Siavash Sangi Department of Anesthesia Technology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran. Mobin Arian Department of Anesthesiology, School of Para-Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. 2024 10 20 2024 11 02 Background: The skill of intubation is one of the most important technical skills for anesthesia nurses, as it can be a lifesaver in times of crisis. Learning by observation (a method in which the learner observes the teacher and learns the skill through watching) and self-directed learning (the learner identifies their needs using their creativity, sets goals, and learns the desired skill through trial and error) are effective methods for learning technical skills. This semi-experimental study aimed to compare two methods, observational learning and self-directed learning, in improving technical skills in nurse anesthetists. Methods: Nurse anesthesia students (n=60) were divided into two groups: Group A (n=30) and Group B (n=30). Group A experienced learning through the self-directed method, while Group B learned through observation and attempted to acquire skills by observing the instructor. All students were then evaluated and scored using the intubation checklist. The collected data were analyzed using SPSS version 16.0 software and presented as mean ± standard deviation (P value< 0.05). Results: The data showed that there was no significant difference between the two groups in terms of demographic indicators. According to the results, both observational learning and self-directed learning can improve the learning of intubation skills in students. Self-directed learning led to a greater improvement in intubation scores for students (P value=0.001). But there was no significant difference between the two methods in terms of the need for frequent intubation. Conclusion: Both observational and self-directed learning methods can be useful in improving students' technical skills, but the use of self-directed methods may be more effective. https://aacc.tums.ac.ir/index.php/aacc/article/view/1110

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 3 2025 04 06 417 421 Mohamad Ali Roozegar Oral and Dental Health Research Center, Ilam University of Medical Sciences, Ilam, Iran. & Department of Dentistry, Ilam University of Medical Sciences, Ilam, Iran. Aminollah Vasigh Department of Anesthesiology, Ilam University of Medical Sciences, Ilam, Iran. 2024 11 30 2024 12 17 Background: Ventilator-associated pneumonia (VAP) is a highly prevalent complication of ICU admission. the aim study This systematic review and meta-analysis aimed to determine the effect of an oral care program on oral health (OH) status and prevention of VAP in ICUs in Iran. Methods: This systematic review and meta-analysis were conducted on the group of articles published on patients hospitalized in ICUs in Iran in 2024. This review included published articles that aimed to assess the effectiveness of care programs or educational interventions in preventing VAP in patients hospitalized in ICUs in Iran. Data search and extraction were performed by two independent researchers in Persian and English between 2004 and 2024. The extracted articles were entered into EndNote software and analyzed using CMA software. Results: The results showed that, at the beginning of the search, 92 articles were found, and after the final conclusion, five articles entered the meta-analysis stage. Also, VAP prevalence in intervention group was 15% (CI: 6.2-31.9%), and VAP prevalence in control group was 39.5% (CI: 21.1-61.4%). Conclusion: It is recommended for preventing VAP that OH programs and interventions be carried out in an ICU. https://aacc.tums.ac.ir/index.php/aacc/article/view/1148

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 3 2025 02 11 432 436 Seyyed Masoud Hashemi Department of Anesthesiology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Faranak Behnaz Department of Anesthesiology, Shohada-e-Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sina Hassannasab Department of Anesthesiology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sogol Asgari Department of Anesthesiology, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2024 10 16 2024 10 29 Trigeminal neuralgia (TN) is one of the most severe painful conditions known to man. Contradictory results regarding the effectiveness of pulsed radiofrequency (PRF) treatment of the trigeminal ganglion have been published in the literature. In the past few years, reports in support of prolonged (extended duration) radiofrequency treatment of the trigeminal ganglion have been emerging. Unlike most other interventional procedures that include nerve or ganglion destruction and its resultant potential complications, PRF treatment is believed to be much safer. Working toward the establishment of effective PRF protocols proves highly valuable in the management of TNs refractory to medical treatment. This article showcases the successful control of two cases of refractory trigeminal neuralgia (TN) through extended duration pulsed radiofrequency treatment. Recent studies, however, suggest prolonged PRF ablation may provide a more durable solution. PRF offers a potentially safer alternative to traditional interventions by minimizing nerve destruction. https://aacc.tums.ac.ir/index.php/aacc/article/view/1109

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 3 2025 01 11 291 297 Piroozeh Taheri Rajaie Cardiovascular Medical and Research Institute, Tehran, Iran. Mohammad Taghi Beig Mohammadi Department of Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Mostafa Mohammadi Department of Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Atabak Najafi Anesthesia, Critical Care, and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. Samrand Fattah Ghazi Critical Care, and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. Hesam Aldin Varpaei College of Nursing, Michigan State University, East Laning, MI, USA. 2024 10 22 2024 11 12 Background: Exploring risk factors for the development of COVID-19 in vital organs of the body is necessary to improve patient survival and reduce disability and morbidity due to disease progression. By identifying these underlying risk factors and controlling them, it is possible to prevent extra-pulmonary involvement and even alleviate pulmonary involvement in patients, resulting in a significant reduction in mortality and morbidity rates. This study aimed to identify the underlying risk factors associated with pulmonary and extrapulmonary organ complications of COVID-19. Methods: This study was a cross-sectional descriptive-analytical study. Patients with a definitive diagnosis of COVID-19 who were admitted to the intensive care unit of Imam Khomeini Hospital in Tehran due to respiratory distress and poor clinical condition were included in the study population and were clinically followed up on. Patients' information was collected by reviewing patients' records and the hospital information system. Results: A total of 123 patients were included in the study (63.4% were male, mean age = 58.87 ± 12.37). Using ROC curve analysis, the calculated risk score is considered statistically significant for diagnostic accuracy (AUC = 0.862 [0.797–0.927], P value < value<0.001). A risk score cutoff greater than 1.5 (sensitivity 89.9%, specificity 38.9%) favors an increased likelihood of in-hospital mortality. According to multiple linear regression (F (9,93).369, P value=0.001), chronic obstructive pulmonary disease, asthma, diabetes, SOFA score on days 2 & 3, and ventilation support were predictors of ICU length of stay. Conclusion: A history of chronic heart failure with renal impairment, liver cirrhosis with liver complication, and any underlying disease are associated with pulmonary complications in COVID-19 patients. https://aacc.tums.ac.ir/index.php/aacc/article/view/1116

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 3 2025 02 12 298 304 Masoud Nashibi Department of Anesthesiology, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Parisa Sezari Department of Anesthesiology, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Kamran Mottaghi Department of Anesthesiology, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Farhad Safari Department of Anesthesiology, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Faranak Behnaz Department of Anesthesiology, Shohada-e-Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Neshat Abdi Department of Anesthesiology, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sogol Asgari Department of Anesthesiology, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sara Nashibi School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2024 11 07 2024 11 30 Background: In this study, the effect of different doses of magnesium sulfate on the consumption of anesthetic drugs during surgery and pain after spine surgery has been investigated. In complex spine surgeries, a large amount of sedative and analgesic drugs is prescribed, which will have various systemic effects during and after the operation. Methods: This study was a double-blind clinical trial, and 80 patients who were candidates for posterior spinal fusion surgery at Luqman Hakim Hospital were included in the study. Patients were randomly divided into four groups (20 people in each group): Group M received magnesium sulfate in three doses (M1=10mg/kg/hr), (M2=15mg/kg/hr), and (M3=20mg/kg/hr). and group S received normal saline. Due to a drop in blood pressure and severe bradycardia in the M3 group, we had to stop the infusion, so the M3 group was excluded from the study, and 60 patients from the M1, M2, and S groups were studied. Results: The M2 group experienced a decrease in bleeding volume, intraoperative fentanyl consumption, and postoperative pain score compared to the M1 and S groups. Conclusion: In this study, we showed that the administration of magnesium sulfate during surgery can have positive and protective effects on the quality of anesthesia and the postoperative period. The recommended dose of magnesium was 15 mg/kg/hr because it has the lowest amount of narcotic consumption during the operation and the lowest amount of narcotic and analgesic consumption after the operation, and on the other hand, it has good hemodynamic stability. At the same time, doses higher than 15 mg/kg/hr are not recommended due to the drop in HR and MAP. https://aacc.tums.ac.ir/index.php/aacc/article/view/1124

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 3 2025 03 10 305 314 Seyed Babak Mojaver Aghili Department of Anesthesiology, Golestan University of Medical Sciences, Gorgan, Iran. Solmaz Halakou Department of Paramedical School, Golestan University of Medical Sciences, Gorgan, Iran. Fatemeh Talebi Department of Anesthesiology, Golestan University of Medical Sciences, Gorgan, Iran. Zahra Mehrbakhsh Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. & Department of Biostaticstics, School of Health, Golestan University of Medical Sciences, Gorgan, Iran. 2024 11 09 2024 11 25 Background: Spinal anesthesia in orthopedic surgeries presents challenges, especially concerning the choice of anesthetic agents and their adjuncts, which affect analgesia quality and potential side effects. This study was conducted with the aim of determining the effects of intrathecal bupivacaine, meperidine and magnesium sulfate on hemodynamic parameters, onset and duration of sensory/motor block in spinal anesthesia in patients with lower limb fractures. Methods: This double-blind, randomized clinical trial included 130 patients who were candidates for planned lower limb orthopaedic surgery. They were divided into four groups: 1: bupivacaine 10 mg, 2: meperidine (1 mg/kg), 3: bupivacaine 10 mg + magnesium sulfate of 100 mg, and 4: meperidine (1 mg/kg) + magnesium sulfate with (100 mg). Parameters measured included hemodynamic status and sensory and motor block onset and duration. The level of sensory block was assessed via the pinprick sensation method, while the Bromage scale was used to evaluate motor block. Results: No clinically significant differences in hemodynamic parameters were observed across the groups. The onset of sensory block (P value= 0.235), onset of motor block (P value= 0.097), and duration of motor block (P value= 0.135) were statistically similar across the groups. However, significant differences were found in the duration of the sensory block (P value= 0.035). Magnesium sulfate increased the duration of motor block in the meperidine group (80.93 ± 30.28 minutes). However, it reduced the duration in the bupivacaine group (75.23 ± 38.56 minutes) Motor block onset was prolonged in groups receiving magnesium sulfate, with a significant difference between the meperidine and meperidine with magnesium sulfate groups (CI = 1.10 to 12.52, P value = 0.04). Conclusion: The intrathecal drugs used did not produce significant side effects, suggesting that they can be used interchangeably... However, magnesium sulfate, as an adjuvant, did not enhance the length or quality of the block in spinal anesthesia when used with meperidine and bupivacaine. https://aacc.tums.ac.ir/index.php/aacc/article/view/1125

Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 3 2025 02 21 315 318 Afzal Shamsi Department of Anesthesia, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. Sozyar Ahmed Department of Anesthesia, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. Masoomeh Nataj Majd Department of Anesthesiology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahroo Rezaeinejad Department of Obstetrics and Gynecology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2024 11 11 2024 11 14 Background: The fetal head station plays a crucial role in determining its location in the birth canal, estimating the time and manner of delivery, and detecting the upcoming steps in both the fetus and mother. This informatio