Omolbanin Taziki, Nadia Jamal,
Volume 83, Issue 1 (4-2025)
Abstract
Background: Asymptomatic hypotension is a common complication in patients undergoing hemodialysis, which can lead to serious consequences. Troponin I, as a biochemical marker for myocardial injury, may play a role in the diagnosis and management of this complication. This study aimed to investigate the relationship between serum troponin I level changes and asymptomatic hypotension in patients with advanced kidney failure undergoing hemodialysis.
Methods: In this cross-sectional study, 120 adult ESRD patients (aged 30–80 years) with an ejection fraction (EF) >50% who attended the hemodialysis unit of Shohada Tajrish Hospital over a 6-month period starting 15 January 2024 were enrolled. Demographic and clinical data were collected using a checklist. Serum troponin I levels were measured before and after dialysis, and patients' blood pressure was recorded throughout dialysis sessions. For quantitative variables, mean and standard deviation were reported; for qualitative variables, absolute and relative frequencies were presented. Statistical analysis was performed using the Paired t-test, Independent t-test, Pearson correlation coefficient, and their non-parametric equivalents as appropriate. A significance level of p < 0.05 was considered statistically significant.
.Results: A total of 120 patients were examined, with a mean age of 57.6 ± 7.1 years. The gender distribution was 67 males (55.8%) and 53 females (44.2%). The mean body mass index was 20.73 ± 0.98. Significant differences were found in mean blood pressure, heart rate, body weight, and changes before and after dialysis (P<0.05). These differences included a decrease in blood pressure, and body weight, an increase in heart rate, and an increase in troponin levels. No significant relationship was found between troponin changes before and after dialysis with age, gender, height, weight, body mass index, heart rate, average duration of dialysis, and other laboratory variables (P>0.05). However, a significant correlation was found between troponin changes and blood pressure changes, indicating that as troponin levels increased, the mean blood pressure of patients decreased.
Conclusion: The findings of this study indicate a significant relationship between increased serum troponin I levels and asymptomatic hypotension in patients with advanced kidney failure undergoing hemodialysis. These results may be useful in identifying at-risk patients and improving therapeutic management. Further research is needed to confirm this relationship and explore its underlying mechanisms.
Masoome Pourmokhtari , Shahram Shafa, Nasim Nabizadeh, Reza Sahraei, Hasan Zabetian, Mansour Deylami, Navid Kalani,
Volume 83, Issue 3 (6-2025)
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.
