Showing 6 results for Malekshoar
Pourya Adibi , Mehrdad Sayadinia, Parnia Dabiri , Majid Vatankhah, Mehrdad Malekshoar, Tayyebeh Zarei , Bibi Mona Razavi,
Volume 82, Issue 9 (December 2024)
Abstract
Background: Preoperative anxiety assessment allows for better analgesia in the postoperative period and a better experience for the patient. Previous studies have investigated anxiety factors specific to cataract surgery, reporting vision problems, particularly blindness, among the main preoperative fears. However, there is little research that fully and accurately investigates the causes and factors of anxiety in this population. Therefore, in this study, the factors related to anxiety in the elective eye patients.
Methods: In this descriptive-analytical study, the comparison of the level of anxiety in elective eye patients of Shahid Mohammadi Bandar Abbas Hospital in the spring and summer of 2023 was investigated. Patients referred to Bandar Abbas Shahid Mohammadi Hospital were included in the study according to the entry criteria and obtaining informed consent. In this study, after the approval of the research committee of the university, the necessary information was made by the researcher's checklist, which includes gender, age, causes of anxiety, patient's level of education, previous history of eye surgery, previous history of non-eye surgery and other underlying diseases. Was collected and the level of anxiety was measured in 2 stages before and after eye surgery based on VAS criteria.
Results: In this study, 85 (47.2%) patients were male and 95 (52.8%) were female. Also, most of the patients had a diploma-level education. Most patients mentioned a non-ocular surgery history (18.3%). Also, most of the patients (52.8%) noted an unknown cause as an anxiety-causing factor, and the least frequent among the anxiety-causing causes mentioned by the patients was the fear of death due to surgery. The level of anxiety in patients who had a history of non-ocular surgery was significantly lower. Patients who mentioned the unknown cause, the surgery itself, and financial problems as the cause of their anxiety experienced significantly higher preoperative anxiety and postoperative anxiety.
Conclusion: The level of anxiety in patients who have a history of eye and non-eye surgery is significantly lower. Preoperative anxiety and postoperative anxiety are significantly higher in patients who mention the unknown cause, the surgery itself, and financial problems as the cause of their anxiety.
Mehrdad Malekshoar, Bibi Mona Razavi, Mehrdad Sayadinia, Saeed Kashani, Nadia Mohammadi, Majid Vatankhah,
Volume 82, Issue 10 (January 2025)
Abstract
Background: This study was designed to compare the effects of using a laryngeal mask airway (LMA) and endotracheal intubation on airway resistance and compliance in patients undergoing orthopedic surgery under general anesthesia. Evaluating these two methods is crucial for improving respiratory quality and reducing complications related to airway management in patients.
Methods: This analytical cross-sectional study was conducted on 50 patients undergoing orthopedic surgery under general anesthesia at Hospital in Bandar Abbas between May and September 2024. The patients were equally divided into two groups: the first group received a laryngeal mask airway (LMA), while the second group underwent endotracheal intubation under general anesthesia. The primary variables, including airway resistance and compliance, were measured at 0, 15, 30, and 60 minutes after anesthesia induction. Demographic characteristics such as age, gender, and ASA class were also recorded. Data analysis was performed using SPSS version 21, with descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistical tests (Mann-Whitney U test and Chi-square test), considering a significance level of P<0.05.
Results: The findings of the present study showed no statistically significant differences between the two groups regarding age distribution and ASA class. A comparison of airway resistance and compliance between genders revealed no significant differences at 0, 15, 30, and 60 minutes. There was no significant difference between the two anesthesia groups (laryngeal mask airway and endotracheal tube) in terms of age distribution. There was no statistically significant difference in ASA classification between the two anesthesia groups. At minute 0 of anesthesia, airway resistance was significantly higher in the endotracheal intubation group compared to the LMA group (P<0.001). At 30 and 60 minutes of anesthesia, airway resistance remained significantly higher in the endotracheal intubation group (P<0.001). Airway compliance was significantly higher in the LMA group at all measured time points (0, 15, 30, and 60 minutes) compared to the endotracheal intubation group (P<0.001).
Conclusion: The results of this study demonstrated that using a laryngeal mask airway (LMA) compared to endotracheal intubation leads to improved airway compliance and reduced airway resistance during anesthesia. These findings may influence the selection of anesthesia methods and enhance postoperative care quality.
Mehrdad Sayadinia, Seyed Mohamad Seyed Mirzayi , Majid Vatankhah, Mehrdad Malekshoar, Tayyebeh Zarei, Bibi Mona Razavi,
Volume 82, Issue 11 (February 2025)
Abstract
Background: Endoscopy is a common medical procedure that often involves the administration of sedative agents to ensure patient comfort and cooperation. Midazolam, a short-acting benzodiazepine, is commonly used as a premedication for its anxiolytic and amnestic properties. Despite its widespread use, there is limited research specifically assessing the occurrence of anterograde amnesia, a potential side effect associated with midazolam administration during endoscopic procedures. Understanding the frequency of this adverse effect is crucial for optimizing patient safety and procedural outcomes.
Methods: In this prospective cohort study After obtaining approval and ethical clearance, patients eligible for endoscopy at Bandar Abbas Shahid Mohammadi Hospital were included in the study. They received 2mg midazolam intravenously before the procedure, followed by propofol for anesthesia maintenance. A memory test involving personal details was conducted before and after the procedure to assess progressive amnesia. Additionally, patients were asked about the procedure 5 minutes before discharge.
Results: 342 endoscopy candidates participated, with an average age of 46.77 years, over half being men. Less than a quarter had a diploma. Average endoscopy time was 2.96 minutes, mostly ASA class 2. Recall scores after midazolam injection and endoscopy were 5.22 and 2.87, respectively. Post-graduate education showed a significant difference in midazolam amnesia. No significant gender difference was observed. Longer endoscopy duration correlated with decreased recall scores. ASA class 2 patients had lower post-endoscopy recall scores than ASA class 1. Recall scores decreased with age, with the highest in the 19-29 age range, a statistically significant finding.
Conclusion: This study In conclusion, this study provided valuable insights into the factors influencing midazolam anterograde amnesia. Key findings include a significant association between higher education levels, particularly post-graduate education, and increased recall scores after midazolam injection. Gender did not show a significant impact on midazolam amnesia, but the duration of endoscopy played a crucial role. Additionally, patients in ASA class 2 exhibited lower recall scores than those in class 1, highlighting the influence of overall health status. Age also emerged as a factor, with the youngest age group showing the highest recall scores after endoscopy. These findings contribute to our understanding of factors affecting midazolam-induced amnesia during endoscopy procedures.
Pourya Adibi , Somayeh Mehrpour, Reza Sahraei , Samira Zanbagh, Majid Vatankhah, Mehrdad Malekshoar, Mansour Deylami, Bibi Mona Razavi, Tayyebeh Zarei ,
Volume 83, Issue 2 (May 2025)
Abstract
Background: Today, cesarean section is one of the most common surgeries performed in different countries. Shivering after surgery is one of the common complications of spinal anesthesia in cesarean surgery. Many drugs have been investigated to prevent or reduce shivering, but the ideal drug has not yet been finally approved. The purpose of this study is to investigate the effect of dexmedetomidine in preventing shivering after cesarean section surgery under spinal anesthesia in the form of a systematic review.
Methods: In this systematic review, the Persian keywords "dexmedetomidine", "spinal anesthesia", "caesarean" and dexmedetomidine" and the English keywords dexmedetomidine", "Caesarean section", "Spinal Anesthesia" "Dexmedetomidine and "C-Section" in databases PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Clinical Trials.gov and Scopus, SID, Magiran, Medlib and Google Scholar search engine, without time limit Done. Data extraction was performed independently by two authors. Study name, year of study, country, study groups, and incidence of shivering were extracted from the studies. Our primary outcome was the severity of shivering in patients. All disagreements in data extraction were resolved through discussion between the reviewers or, if not possible, by a third reviewer. Data were entered into an Excel file.
Results: In this systematic review, 19 studies were examined. The total number of patients included in the study was 2001 patients. The study range was from 2016 to 2022. The age group of most patients was between 18-45. The drugs studied in combination with dexmedetomidine in the studies included: pethidine, dexamethasone, nalbuphine, ondansetron, and morphine. The most studied drugs were pethidine and dexamethasone in three studies. In 13 studies, dexmedetomidine was more effective in controlling shivering than the other groups studied. Also, in five studies, dexmedetomidine, along with three drugs: pethidine, dexamethasone, and ondansetron, had similar effects in controlling shivering in patients. In one study, dexmedetomidine produced less anti-tremor effects than nalbuphine.
Conclusion: In the review of the studies, the results indicated that dexmedomedin is effective in preventing post-operative shivering in patients undergoing caesarean section. Therefore, it seems that the use of dexmedetomidine to prevent shivering after surgery is useful in these patients.
Majid Vatankhah, Saeed Kashani, Mohsen Sarafikhah, Bibi Mona Razavi, Mehrdad Sayadinia, Mehrdad Malekshoar,
Volume 83, Issue 2 (May 2025)
Abstract
Background: Aspiration pneumonia is a significant and potentially preventable cause of morbidity and mortality in critically ill ICU patients. Prophylactic pharmacological interventions, particularly antiemetics like metoclopramide (a prokinetic agent) and ondansetron (a 5-HT3 receptor antagonist), are commonly employed to reduce gastric aspiration and subsequent pneumonia. Despite their widespread use, comparative efficacy data remains limited. This randomized controlled trial was specifically designed to rigorously compare the effectiveness of these two distinct antiemetic strategies in preventing aspiration pneumonia among high-risk, mechanically ventilated patients, aiming to provide evidence-based guidance for clinical practice.
Methods: This double-blind randomized clinical trial involved 116 individuals admitted to the ICU at Shahid Mohammadi Hospital, Bandar Abbas from March 2024 to March 2025. Subjects were randomly assigned to metoclopramide or ondansetron groups. Enrollment criteria consisted of patients between 17 and 70 years old in the ICU requiring intubation and mechanical ventilation. Monitoring continued for 72 hours, with evaluation utilizing the Clinical Pulmonary Infection Score (CPIS), chest X-ray (CXR) results, and physical assessments. Data were analyzed with SPSS version 21 employing descriptive statistics (mean, standard deviation, percentage, frequency) and inferential tests with significance set at P<0.05.
Results: Chi-square analysis indicated no statistically significant gender difference between groups (P=0.947). Mean age was 30.6±10.5 years for metoclopramide recipients and 32.9±6.12 years for ondansetron recipients. Further analysis revealed no significant differences in age or BMI between cohorts. No significant difference emerged between metoclopramide and ondansetron groups regarding aspiration pneumonia occurrence, with similar incidence rates in both arms. Multiple logistic regression demonstrated that statistically, no variables influenced aspiration pneumonia development.
Conclusion: The results of this randomized trial clearly demonstrate no statistically significant difference in efficacy between metoclopramide and ondansetron for preventing aspiration pneumonia in intubated ICU patients. Both agents showed comparable effectiveness in our study population, suggesting that either drug represents a clinically acceptable prophylactic option. This finding provides clinicians with valuable therapeutic flexibility based on individual patient characteristics, drug availability, and cost considerations. However, further multicenter studies with larger sample sizes are recommended to confirm these findings across diverse patient populations and settings.
Majid Vatankhah Tarbebar , Saeid Kashani, Milad Mohammadi , Zohreh Nik Eghbali, Mehrdad Malekshoar,
Volume 83, Issue 6 (September 2025)
Abstract
Background: Laparoscopic cholecystectomy is the gold standard for treating gallbladder diseases; however, it is associated with physiological challenges from pneumoperitoneum and specific patient positioning. Positive end-expiratory pressure (PEEP) may mitigate these effects, but the optimal level remains uncertain. This study compared the impact of three PEEP levels on respiratory performance and hemodynamic stability during laparoscopic cholecystectomy.
Methods: This randomized double-blind clinical trial was conducted at Shahid Mohammadi Hospital, Bandar Abbas, Iran, from August 2023 to February 2024. A total of 75 adult patients aged 18-70 years with ASA class I-II scheduled for elective laparoscopic cholecystectomy were assigned to three groups (n=25 each): PEEP 0 cmH₂O (control), PEEP 5 cmH₂O, and PEEP 7 cmH₂O. Standardized general anesthesia and mechanical ventilation with tidal volumes of 6-8 mL/kg were applied. Hemodynamic variables (mean arterial pressure, heart rate) and respiratory parameters (SpO₂, EtCO₂) were recorded before intubation, during intubation, and at 15, 30, and 60 minutes post-intubation, as well as in the recovery room. Arterial blood gas analysis was performed 30 minutes after intubation. Data were analyzed using ANOVA and chi-square tests with a significance level of 0.05.
Results: The mean age of patients was 41.89±11.39 years, and baseline demographic variables showed no significant differences among groups. Oxygen saturation remained above 94% across all time points without intergroup differences. EtCO₂ values differed significantly at 30 minutes (P=0.04) and 60 minutes (P=0.01), with the highest levels observed in the PEEP 7 group and the lowest in the PEEP 5 group. Although mean arterial pressure and heart rate did not show statistically significant variation among groups, the PEEP 7 group demonstrated the smallest postoperative decline in blood pressure.
Conclusion: A PEEP level of 5 cmH₂O offers the most favorable balance between maintaining oxygenation, supporting effective ventilation, and preserving hemodynamic stability during laparoscopic cholecystectomy. This level can be recommended as a safe and optimal ventilation strategy.
