Seyedeh Roya Mousavi , Parvaneh Ebrahimzadeh, Sepideh Yazdanpanah , Nasim Alsadat Mousavi, Mansour Deylami ,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Today, addiction is a major problem in modern society, which affects the management of patients during anesthesia. In patients with long-term use of opioids, higher doses of opioids are needed to create analgesia and control pain during and after surgery. Also, addicted patients have more resistance to local anesthetic drugs when they are used to perform peripheral and central nerve blocks. Therefore, many drugs are added to local anesthetics to enhance their analgesic properties, one of the most common of which is narcotic compounds. Itching caused by opium may be generalized and often occurs shortly after injection. Therefore, this study aims to investigate the amount of itching caused by intrathecal injection of fentanyl in opium addicts who undergo elective orthopedic surgeries of the lower limbs with spinal anesthesia. have been taken, designed and established.
Methods: This study was a double-blind clinical trial conducted on 68 patients who were candidates for elective lower limb orthopedic surgeries under spinal anesthesia and referred to 5 Azar Hospital in Gorgan in 2023. Patients were divided into two groups using random numbers table, Intervention (a group of addicted patients who received intrathecal marcaine together with fentanyl for spinal anesthesia) and control (a group of addicted patients who received only intrathecal marcaine for spinal anesthesia). Pruritus, nausea and vomiting were measured in both groups. Data analysis was done using descriptive statistics and inferential statistical tests.
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Results: In terms of age, gender, and BMI, there was no statistically significant difference between the intervention and control groups. There was no statistically significant difference in the incidence of nausea and vomiting between the two groups. The incidence of itching was zero in the bupivacaine group and 17.6% in the fentanyl and bupivacaine group, of which 3% required anti-itch medication for treatment.
Conclusion: The results of this study showed that due to the low incidence of pruritus in the group using fentanyl along with bupivacaine, its use is beneficial in people with drug addiction.
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Kazem Kazemnejad, Parvaneh Ebrahimzadeh, Seyedeh Roya Mosavi, Mansour Deylami ,
Volume 82, Issue 6 (September 2024)
Abstract
Background: Shivering is one of the side effects of anesthesia that occurs both in general anesthesia and regional anesthesia. Ketamine, as an N-methyldiaspartate receptor antagonist, may prevent shivering after spinal anesthesia by reducing central heat distribution to the environment. Therefore, the purpose of this study is to investigate the effect of ketamine in preventing tremors after spinal anesthesia in lower limb orthopedic surgeries.
Methods: This randomized, single-blind clinical trial study was conducted on 60 patients who were candidates for orthopedic surgery of the lower limb referred to 5 Azar Hospital in Gorgan. Patients were randomly divided into two equal groups of ketamine (0.25 mg/kg) and control (placebo). The data collection tool includes a checklist containing information; Age, gender, mean arterial pressure, percentage of arterial oxygen saturation, heart rate, tremors and hallucinations. Data analysis was performed using descriptive statistics and inferential statistical tests at a significance level of P<0.05.
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Results: There was no statistically significant difference in gender between the control and intervention groups. The mean age of the study subjects in the control group was 36.13±12.53 and in the intervention group was 40.30±11.96. There was no statistically significant difference in age between the control and intervention groups. There is no statistically significant difference in mean arterial pressure (MAP) between the control and intervention groups. The incidence of shivering after spinal anesthesia was 13.33% in patients receiving prophylactic ketamine and 40% in patients receiving placebo. The incidence of hallucinations in the ketamine group was 26.67%. The rate of nausea and vomiting was similar in both groups. According to this study, between the two groups in terms of hemodynamic parameters, including mean arterial pressure, heart rate, percentage of arterial oxygen saturation; There was no significant difference.
Conclusion: The incidence of shivering in spinal anesthesia in the preventive use of ketamine has been more effective than placebo. Considering the effectiveness of ketamine in reducing the incidence of shivering, its use as a prevention is suggested to reduce the incidence of shivering.
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