Showing 9 results for Intravenous
Hasani M, Ebrahi Soltani A R,
Volume 61, Issue 4 (7-2003)
Abstract
The induction characteristic of halothane in nitrous oxide and oxygen were compared with halothane in oxygen alone and intravenous induction with thiopentum and succinylcholine.
Materials and Methods: A vital capacity technique was used for the gaseous induction groups using a mapleson F system and a 1-litre reservoir bag. four end points of anesthesia were recorded: time to cessation of hand grip, time to loss of eyelash reflex, time to jaw relaxation, and time to settled breathing after tracheal tube insertion .we also recorded sequential blood pressure and pulse rate , the incidence of adverse airway events and the acceptability of the induction technique .
Results: Induction with thiopentum and succinylcholine had a faster time to cessation of hand grip (p, 0.05) and jaw relaxation (p, 0.01). These differences disappeared with the final induction stage and halothane in nitrous oxide and oxygen had the faster time to regular settled breathing though this did not reach statistical significance. Cardiac stability was good and comparable in all groups.
Conclusion: These were few adverse airway events in any group and none caused oxygen saturation to fall below 96%. There was more excitation in the gaseous induction groups.
Shoeibi G, Akbari Nejad M, Hosein Gholizadeh A,
Volume 62, Issue 2 (5-2004)
Abstract
Background: Total Intravenous Anesthesia (TIVA) compared to general anesthesia has some pits and falls. Many drugs have been employed for this anesthesia. Propofol is accounted as the last advent anesthetic drug. It belongs to alkyl phenol families and has been accounted one of the best choices for the continuous infusion. Invention of midazolam as the first water soluble benzodiazepine was also an important event in anesthesia and it can be used as continuous infusion for the anesthesia.
Materials and Methods: In this randomized controlled clinical trial, alfentanyl plus propofol or midazolam were used for TIVA anesthesia in 60 female patients undergoing Dilatation and Curettage (D&C) in Dr.Shariati hospital in March 2002 till March 2003. They were allocated reandomly in two group of alfentanyl plus propofol (propofol group) or alfentanyl plus midazolam (midazolam group)
Results: There was no significant difference in mean of age between propofol group and midazolam group (P>0.05), also There was no significant difference in preanesthesia condition such as blood pressure and heart rate between propofol group and midazolam group (p>0.05). After induction of anesthesia there was a gross blood pressure decrease in both group that it was greater in midazolam group (85 mmHg versus 73 mmHg, P<0.05 ) following this, there was an increase in heart rate in both groups that it was modest in propofol group (98 Beat/Sec versus 118 Beat/Sec, P<0.05). There was no significant difference in mean infused alfentanyl (P>0.05) also there was just one naloxane injection in midazolam group that have no significant difference between groups (P>0.05). Recovery room stay was significantly lower in propofol group (25 minutes versus 39 minutes, P<0.05).
Conclusion: The results of this study was similar to Vuyk et.al.In their study there was a significant lower recovery time estimated by psychomotor reflexes and there was significant lower drowsiness, place and time orientation time compared to midazolam group. Finally according to the results of this study it can be resulted that TIVA with propofol is more suitable than midazolam and it can lower hospitalization time and cost. In future studies using other narcotics and other narcotics-anesthetic compounds with various dose can be mentioned.
Salimi J, Taghavi M, Shojaeefar A, Shadman F,
Volume 64, Issue 8 (8-2006)
Abstract
Background: A plan for management of infected arterial pseudoaneurysm has evolved from our experience with forty two cases of such aneurysms treated between 1378 and 1382.
Methods: Clinical data of 42 patients with femoral pseudoaneurysm resulting from addictive drug injection who presented in emergency department of Sina Hospital between 1378 and 1383 were retrospectively reviewed.
Results: All patients were men with the mean age of 36.9 years. Twenty eight patients were referred from other medical centers. The mean time of delay in presentation was 17.3 days. The mean duration of drug injection was 14 months. Primary repair and emergent vascular bypass were performed in 3(7.1%) and 2(4.8%) patients, respectively. 5(11.9%) patients undergone delayed revascularization. Thirty two (76.2%) patients returned to their normal lifestyle without any vascular bypass. One patient required amputation and one patient died due to sepsis and acute renal insufficiency.
Conclusion: Management of infected femoral pseudoaneurysms is simple ligation of the external iliac or femoral artery. When Doppler is not available “Operation Room and postoperative Direct Observation” is recommended in such patients to avoid unnecessary revascularization surgery.
Alemohammad M,
Volume 70, Issue 11 (2-2013)
Abstract
Insertion of central venous catheter is an accepted method for hemodynamic monitor-ring, drug and fluid administration, intravenous access, hemodialysis and applying cardiac pace-maker in hospitalized patients. This procedure can be associated with severe complications. The aim of this article is to provide a practical approach to prevent catheter malposition in states that the guide wire will not pass freely.
During central venous insertion in internal jugular vein using modified seldinger technique, when after venous insertion, the passage of the guide wire shows difficulties and don’t pass freely, insertion of an intravenous cannula over the wire and re-insertion of the wire can help to prevent malposition of the wire and the catheter. Use of an intravenous cannula over the guide, in situations that the guide wire cannot pass freely among the needle inserted in internal jugular vein, and re-insertion of the guide can probably prevent or reduce the tissue or vascular trauma and the associated complica-tions. This simple maneuver can be helpful in difficult cases especially in cardiac surgery patients who receive high dose heparin and it is necessary to avoid traumatize-tion of carotid artery.
Semira Mehralizadeh, Majid Mirmohammmadkhani, Aylin Kalantarzade ,
Volume 77, Issue 8 (11-2019)
Abstract
Background: Previous studies have considered patent ductus arteriosus (PDA) a common finding in premature infants, leading to complications such as intracranial hemorrhage, necrotizing enterocolitis and pulmonary dysplasia. The aim of this study was to assess and compare the efficacy of oral ibuprofen and intravenous acetaminophen in the closure of arterial duct in premature newborns. We also evaluated the complications of each drug.
Methods: A cross-sectional and analytical study was conducted at Amiralmomenin Hospital, Semnan City in Iran from April 2012 to December 2017. Subjects were selected through convenient sampling and consisted of all premature infants with patent arterial duct. All of the infants with the diagnosis of PDA were treated with either intravenous acetaminophen or oral ibuprofen. Cardiac echocardiographic findings were assessed in two study groups before and after each treatment course. The complications associated with the two treatment approaches were evaluated in two groups after treatment of each drug.
Results: In general, twenty-four neonates (62.5% females) with the average gestational age of 31.46±3.43 weeks were studied. There was no significant difference in the echocardiographic characteristics in the two treatment groups at the pre and post-treatment periods as well as the side effects of the medications. The average number of treatment cycles in newborns treated with oral ibuprofen (1.06±0.25) was not significantly different compared to those with intravenous acetaminophen (1.25±0.46) (P=0.190). There was no significant difference concerning closure status of the arterial duct in the two treatment groups at the end of the first period (P=0.112) as well as after the second period of treatment (P=0.386).
Conclusion: Our study indicated similar efficacy of oral ibuprofen and intravenous acetaminophen in the closure of the arterial duct. The incidence of complications was not significantly different between the two groups. The results of this study suggest the use of intravenous acetaminophen as a suitable drug for PDA closure, particularly in cases of ibuprofen contraindications.
Samaneh Assarzadeh, Shirin Sadat Badri, Sakinah Haddad , Marjan Mansourian, Shadi Farsaei, Saeed Abbasi,
Volume 78, Issue 8 (11-2020)
Abstract
Background: Intravenous (IV) injection of drugs is one of the most common methods of drug prescription in hospitals, which is a complex, potentially hazardous and erroneous method; accordingly, it requires control methods to reduce the potential risks. This study focused on determining the frequency and types of different medication errors while preparing and administering mostly used IV drugs in three intensive care units (ICU) and one general department in AL-Zahra hospital, Isfahan, Iran.
Methods: This cross-sectional observational study was conducted for 6 months from September 2017 to March 2018. To determine the frequency of different medication errors, a quoting sampling method was applied to select and observe 400 cases of IV drug administrations. All nurses from any studied department were included in this study. Different stages of preparation and administration of the observed drugs were compared to an instructed checklist prepared by the clinical pharmacist.
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Results: Totally, 75 nurses were recruited from ICU-1 (N=29), ICU-2 (N=18), ICU-3 (N=19), and nephrology (N=9) departments. Type of department and occupation were the influential factors on nursing errors; also, a significant relationship was found between different work shifts and the occurrence of nurses’ errors, mostly seen in the evening work shift (P=0.037). The mean of nurses’ errors in IV drug administration was not correlated with other factors including age, work history, and the number of patients managed by each one. Also, a positive correlation was found between the number of nurses in each work shift and the number of errors (P=0.008).
Conclusion: Medication errors in each stage of drug administration may lead to the hazardous clinical outcome or serious side effects such as thrombosis, infection or eventually lead to morbidity or mortality. Therefore, being aware of these errors and establishing observational policies can prevent unpleasant events related to drug administration.
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Hamidreza Shetabi, Khosrow Naghibi , Alireza Peyman, Shima Taghizadeh,
Volume 79, Issue 6 (9-2021)
Abstract
Background: The risk of anesthesia increases with age, so it is necessary to choose a safe and effective method. In this study, we compared the effectiveness of intranasal fentanyl with intravenous fentanyl in patients undergoing cataract surgery.
Methods: This study was a triple-blind prospective randomized clinical trial (The patient, physician, and data analyzer were unaware of the patient grouping). The study was performed from April 2017 to March 2019 in Feyz Hospital, Isfahan, Iran. 90 patients over 18 years of age who were candidates for cataract surgery were included in the study and were divided in two groups receiving intravenous fentanyl (IVF) or intranasal fentanyl (INF). The dose of fentanyl in both groups was 1.5 μg/kg with a maximum of 100 μg. In the IVF group, 1 ml of normal saline was dripped into each nasal passage 10 minutes before surgery and intravenously fentanyl was injected 2 minutes before surgery. In the INF group, 1 ml of fentanyl was administered into each nostril 10 minutes before surgery and 2 ml of saline was administered intravenously two minutes before surgery.
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Results: In this study, there was no significant difference between the two groups in terms of mean heart rate (P=0.762), mean arterial blood oxygen saturation (P=0.262), mean systolic blood pressure (P=0.264), mean arterial blood pressure (0.462), satisfaction rate Patient (P=0.231), duration of surgery (P=0.612) and pain intensity (P=0.87). But in the intravenous fentanyl group (IVF), the level of sedation (P=0.002) and the level of surgeon satisfaction (P<0.001) were higher than intranasal fentanyl group (INF). There was no significant difference between the two groups in terms of side effects (P=0.171) and surgery time (P=0.612). The mean VAS was not significantly different between the two groups.
Conclusion: The study showed that intranasal administration of fentanyl compared with intravenous administration of fentanyl provided similar sedation and cardiovascular response. Intranasal administration of fentanyl is a non-invasive, safe and effective method, that is easy to use and can be a viable alternative to intravenous administration.
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Kambiz Javadzadeh Siahkelrodi , Shahpour Shoja, Karim Naseri, Farzad Sarshivi, Shahrokh Ebnerasouli, Mohamad Aziz Rasouli , Shaho Shoja ,
Volume 79, Issue 7 (10-2021)
Abstract
Background: Bier block is a reliable technique used in extremity surgeries. Typically, angiocatheters are palced in the distal portion of the extremity that is going to be operated. Although, it is not the case in every operation. Therefore, determining the effectiveness of the local anesthetic injection site on the quality of the upper-extremity block can be helpful.
Methods: In this double-blinded randomized clinical trial that took place in Kowsar Hospital (Sanandaj, Iran) at 2020, 60 patients after complete monitoring and sedation were assigned randomly into proximal bier block (32 in experimental) and distal bier block (28 in control) groups. 10ml/kg Ringer serum was prescribed for patients in both groups on the non-surgical hand. Depending on the patients’ placement in either group, an angiocatheter (22 or 24) was attached to the ante-cubital area (proximal bier block group) or on the back of the patient's hand (distal bier block group). Respectively, after blood was drained by a Smarch band from the extremity that was to be operated, the tourniquet was inflated up to 150mmHg above the patient’s systolic pressure and the smarch band is untied from the hand. For every patient regarding the group they were assigned, 3mg/kg lidocaine 0.5% was administered through an angiocatheter. After 5 minutes, the depth of patient's anesthesia and pain intensity were measured. Sensory and motor recovery was assessed every 10 minutes after surgery. Patient satisfaction with anesthesia was measured after the surgery and characterized by excellent, good, moderate (pain relief), and unsuccessful (need for pain medications) indicators. In case insufficient depth was reached, intravenous Remifentanil was injected.
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Results: According to the results of the chi-squared test, there were no significant differences in gender distribution (p=0.063), anesthesia class type (p=0.964), type of surgery (p=0.694), anesthesia satisfaction (p=0.578), sensory block of hand (p=0.529), motor block of hand (p=0.059), pain intensity (p= 0.634), pain relief medication requesting (p=0.755) and also body mass index (T-test used P=0.099) variables comparing both groups together. Additionally; according to the T-test results no significant differences were reported in the mean systolic pressure, mean diastolic pressure and mean heart rate variable in designated times.
Conclusion: There is no significant difference between the two groups. Therefore, using a distal Bier block can be an alternative if needed.
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Hamidreza Shetabi , Khosro Naghibi, Alireza Peyman, Hamed Norouzi,
Volume 80, Issue 8 (11-2022)
Abstract
Background: To improve the quality of sedation in procedures, different medications are used alone or in combination with each other, but so far, no administration method that is agreed upon by anesthesiologists has been presented. This study aimed to investigate the effectiveness and safety of intranasal ketamine in comparison with intravenous ketamine in cataract surgery.
Methods: This clinical trial was performed from December 2016 to March 2017 in Feyz Hospital, Isfahan. Ninety patients over the age of 18 who were candidates for cataracts surgery were randomly assigned to receive 1 mg/kg ketamine through the nasal route (INk) or intravenously (IVK). Ten minutes before the surgery, ketamine was administered in the INK group and intranasal saline in the IVK group. Two minutes before the start of surgery, normal saline was administered in the INK group and ketamine was administered intravenously in the IVK group. Patients received intravenous midazolam 0.04 mg/kg during prep and drape. The quality of sedation and analgesia, vital signs, patient and doctor satisfaction, and side effects were recorded during the study period. Data were analyzed using of SPSS software, version 23 (IBM SPSS, Armonk, NY, USA).
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Results: In this study, 90 people were included in the study, 53 of whom (58.9%) were men. The mean age of the patients was 61.5±10.6. Two groups had a significant difference in terms of gender (P=0.696), age (P=0.960), weight (P=0.212), height (P=0.632), underlying disease (P=0.094), and type of disease (P=0.090). Two groups were not significantly different in terms of mean heart rate (P=0.77), mean arterial blood pressure (P=0.13), mean blood oxygen saturation (P=0.58), patient satisfaction (P=0.470) and surgeon satisfaction (P=0.115), pain intensity (P=0.506), level of sedation level (P=0.477) and side effects (P=0.221).
Conclusion: Intranasal administration of ketamine provides similar sedation and cardiovascular response compared to intravenous administration of ketamine. Administering ketamine intranasally is a non-invasive, safe and effective method with easy application and can be a suitable alternative to intravenous administration.
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