Hadaegh F, Zabetian A, Tohidi M, Azizi F,
Volume 66, Issue 8 (5 2008)
Abstract
Background: Although metabolic syndrome (METs) is receiving attention from physicians, data on the syndrome's association with coronary heart disease (CHD) in the Iranian population are limited. This study was designed to determine the association of different definitions of METs and its components with CHD.
Methods: Logistic regression analysis was used to analyze data from 5981 subjects aged ≥30 years. METs definitions by the International Diabetes Federation (IDF), the Adult Treatment Panel (ATP III) and the WHO for CHD were used in three models: model 1 an age adjusted model, model 2 adjusted for age, smoking status, premature history of CHD and LDL-cholesterol and model 3 adjusted for the mentioned variables plus the METs components.
Results: METs as delineated by all three definitions was associated with CHD in models 1 and 2. In model 2, METs was most closely associated with CHD in men, as defined by the WHO [2.3 (1.8-3)] and in women by the ATP III definition [1.6 (1.3-2)]. In model 3, METs lost its association with CHD. However, in men high fasting plasma glucose and high blood pressure plus obesity (by the WHO definition) and in women high blood pressure plus high waist circumference (by the ATP III definition), obesity and glucose domain (by the WHO definition) remained associated with CHD.
Conclusions: In Iranian men and women, all three definitions of METs were associated with CHD when considering the conventional risk factors. After further adjustments for the components of METs, none of these definitions showed an association with CHD and only high blood pressure correlated with CHD in both sexes for all definitions.
Navid Kalani , Hasan Zabetian, Shahram Shafa, Erfaneh Alirezai, Fatemeh Eftekharian, Reza Sahraei ,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Recently, epinephrine is used to increase the depth and duration of local anesthetic pain, and it is widely used topically to reduce local anesthetic release and reduce bleeding caused by surgery.
Methods: This study was a randomized, double-blind clinical trial on 30 patients aged 18 to 85 years undergoing lower limb orthopedic surgery referred to Peymaniyeh Hospital in Jahrom from September to December 2022. Patients were randomly assigned to two groups, A (epinephrine+fentanyl+bupivacaine) and B (bupivacaine+fentanyl). Systolic blood pressure, diastolic pressure, mean arterial pressure, arterial blood oxygen saturation percentage, and pulse rate were measured and recorded before drug administration, before spinal anesthesia, after anesthesia, and then every half hour until the end of surgery (15, 45, 30, 60, 75, 90, 120) and during recovery. Data analysis was performed using SPSS version 21 software and descriptive (mean, standard deviation) and inferential statistics (t-test, chi-square, Mann-Whitney, Friedman) at a significance level of P<0.05.
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Results: Thirty patients aged 18 to 85 years (in two groups of 15) with anesthesia class I and II undergoing lower limb orthopedic surgery were evaluated. The study groups are matched in terms of age and gender variables. There was no significant difference in mean systolic, diastolic, mean arterial blood pressure, and heart rate before and after anesthesia, 15, 45, 30, 60, 75, 90, and 120 minutes after drug injection, and at entry and exit from recovery between the Epinephrine+Fentanyl+Bupivacaine and Fentanyl+Bupivacaine groups. There was a significant difference in mean O2SAT before anesthesia, 15, 30, and 75 minutes after drug injection between the epinephrine+fentanyl+bupivacaine and fentanyl+ bupivacaine groups (P<0.05).
Conclusion: The use of the combination of epinephrine+fentanyl+intrathecal bupivacaine compared to the combination of fentanyl+bupivacaine did not have a significant difference in the studied variables of patients' vital signs.
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Reza Sahraei, Anahita Haghjoo , Hasan Zabetian, Mansour Deylami, Rahil Haghjoo, Fatemeh Khadempir, Navid Kalani ,
Volume 83, Issue 1 (April 2025)
Abstract
Background: Spinal anesthesia is a common method for elective cesarean sections; however, complications such as shivering and nausea may affect postoperative recovery quality. Bupivacaine is a standard drug used in this procedure, but its combination with opioids like sufentanil may have beneficial effects in reducing these complications. This study aimed to compare the incidence of shivering and nausea in women undergoing elective cesarean section who received either bupivacaine alone or a bupivacaine-sufentanil combination.
Methods: The present study was a double-blind randomized clinical trial conducted over a 6-month period from April 2021 to October 2021 on 30 patients undergoing elective cesarean section with spinal anesthesia at Motahari Hospital in Jahrom city. Patients were randomly assigned using a random number table into two groups: bupivacaine alone and bupivacaine-sufentanil combination. The frequency of nausea, vomiting, and shivering was recorded at different time points: before spinal anesthesia, after spinal anesthesia, 3 minutes before delivery, immediately after delivery, at 15, 30, and 45 minutes, upon recovery room admission, and upon discharge from recovery. The data analysis was performed using descriptive statistics indicators (frequency, percentage, mean, and standard deviation) and inferential statistical tests (t-test, Mann-Whitney, chi-square and Friedman) using SPSS software version 21. A significance level of p < 0.05 was considered.
Results: In the bupivacaine-sufentanil group, the highest frequency of shivering occurred at 30 minutes post-spinal anesthesia (20%) and upon recovery room admission (26.7%). In the bupivacaine-alone group, the highest frequency was observed upon recovery room admission (33.3%) and at discharge from recovery (26.7%). The highest nausea frequency was 33.3% in the bupivacaine-sufentanil group and 40% in the bupivacaine group at 3 minutes before delivery. However, no statistically significant difference was found between the two groups at different time points.
Conclusion: The present study showed that adding low-dose sufentanil to bupivacaine in spinal anesthesia protocols, while potentially having minor clinical effects on certain complications, did not lead to a significant difference in the incidence of shivering and nausea. Therefore, for more precise clinical decision-making regarding drug combinations in regional anesthesia, further studies with larger sample sizes and different drug dosages are recommended.
Masoome Pourmokhtari , Shahram Shafa, Nasim Nabizadeh, Reza Sahraei, Hasan Zabetian, Mansour Deylami, Navid Kalani,
Volume 83, Issue 3 (June 2025)
Abstract
Background: Spinal anesthesia is an effective method for providing analgesia in surgery and a safe alternative to general analgesia; But despite its benefits, in many cases it is not free of side effects, including unwanted cardiovascular events such as hypotension and bradycardia. Ondansetron effectively reduces the incidence of nausea, vomiting, and bradycardia associated with spinal anesthesia Thus, the present study aimed to assess intravenous ondansetron's efficacy in preventing post-spinal hypotension among patients scheduled for lower extremity orthopedic surgery at Peymanieh Hospital in Jahrom, Iran.
Methods: This randomized double-blind clinical trial included 60 patients undergoing lower limb orthopedic surgery at Peymanieh Hospital, Jahrom, Iran, from March 2021 to February 2022. Patients were randomly allocated into two groups: the intervention group (receiving 8 mg intravenous ondansetron) and the control group (receiving distilled water). Systolic and diastolic blood pressure (SBP, DBP) and heart rate (HR) were measured before pre-spinal anesthesia, after spinal anesthesia and then every two minutes for the first ten minutes and at 15, 30, 45, 60 and 90 minutes after surgery. After spinal anesthesia, the patient was asked about pruritus every 10 minutes. Nausea and vomiting during surgery in case of incidence, recording and nausea after spinal anesthesia, the patient was asked every 10 minutes.
Results: The chi-square test indicated no significant differences between the study groups regarding age and sex distribution(P>0.05). Time before anesthesia, immediately after anesthesia, 10 minutes, 15 minutes, 30 minutes, 45 minutes, 60 minutes, 75 minutes, and 90 minutes after anesthesia, significant difference between ondansetron and placebo groups from There was no mean SBP and DBP and HR (P <0.05). No significant difference between ondansetron and placebo groups in the incidence of pruritus and nausea and vomiting at different times (p <0.05).
Conclusion: Dose of 8 mg of ondansetron in lower limb orthopedic surgery has no significant effect on hemodynamic symptoms as well as the prevention of postoperative nausea, vomiting and pruritus in these patients. Therefore, to achieve more results regarding the transient effect of this drug, it can be compared with other drugs in the class of HT3-5 receptor antagonists.
