Shideh Marzban - Academia.edu (original) (raw)

Papers by Shideh Marzban

Anesthesiology and Pain Medicine, 2019

Background: Myocardial dysfunction is frequently described as an underlying cause of mortality in... more Background: Myocardial dysfunction is frequently described as an underlying cause of mortality in traumatic brain injury (TBI) known as brain-cardiac link. However the impact on prognosis of a disease remains uncertain. Objectives: The current study aimed at investigating the correlation between TBI and cardiac troponin I (cTnI) rise and in-hospital mortality rate among patients with TBI. Methods: In the current prospective study TBI patients with abbreviated injury scale score (AIS) > 3 and Glasgow coma scale (GCS) score ≤ 8 with cTnI measurement within the first 24 hours of admission were evaluated. Chi-square, Kruskal-Wallis, Mann-Whitney U and Logistic Regression tests were used for data analysis. Results: A total of 166 eligible patients were studied .The mean age of the cases was 37.64 ± 17.21 years, largely under 65 (93.4%) and male (86.7%).The most common injuries were cerebral contusion (35.1%), while motor vehicle crash (MVC) was the most common cause of injuries (83.73%); 59 % of the patients showed detectable cTnI concentrations within 24 hours of admission; 65.7% of the patients expired; they showed higher levels of cTnI compared to survivors that showed lower levels, 0.148 ± 0.074 vs 0.057 ± 0.055, respectively (P < 0.001). Moreover, a significant association was observed between mortality rate and lower admission GCS 3.49 ± 1.08 vs 6.79 ± 1.66, respectively (P < 0.001). Conclusions: Increased cTnI levels could be a predictor of mortality among patients with TBI. Its measurement and investigation for therapeutic strategies could lead to better management of these cases.

Anesthesiology and Pain Medicine, Apr 28, 2019

Background: Myocardial dysfunction is frequently described as an underlying cause of mortality in... more Background: Myocardial dysfunction is frequently described as an underlying cause of mortality in traumatic brain injury (TBI) known as brain-cardiac link. However the impact on prognosis of a disease remains uncertain. Objectives: The current study aimed at investigating the correlation between TBI and cardiac troponin I (cTnI) rise and in-hospital mortality rate among patients with TBI. Methods: In the current prospective study TBI patients with abbreviated injury scale score (AIS) > 3 and Glasgow coma scale (GCS) score ≤ 8 with cTnI measurement within the first 24 hours of admission were evaluated. Chi-square, Kruskal-Wallis, Mann-Whitney U and Logistic Regression tests were used for data analysis. Results: A total of 166 eligible patients were studied .The mean age of the cases was 37.64 ± 17.21 years, largely under 65 (93.4%) and male (86.7%).The most common injuries were cerebral contusion (35.1%), while motor vehicle crash (MVC) was the most common cause of injuries (83.73%); 59 % of the patients showed detectable cTnI concentrations within 24 hours of admission; 65.7% of the patients expired; they showed higher levels of cTnI compared to survivors that showed lower levels, 0.148 ± 0.074 vs 0.057 ± 0.055, respectively (P < 0.001). Moreover, a significant association was observed between mortality rate and lower admission GCS 3.49 ± 1.08 vs 6.79 ± 1.66, respectively (P < 0.001). Conclusions: Increased cTnI levels could be a predictor of mortality among patients with TBI. Its measurement and investigation for therapeutic strategies could lead to better management of these cases.

Anesthesiology and Pain Medicine, 2019

Introduction: Several pathological conditions can reduce blood supply to the organs, among which ... more Introduction: Several pathological conditions can reduce blood supply to the organs, among which burns can be mentioned. By developing the volume depletion and reducing the cardiac contractility, burns can cause hypoperfusion. Further, in ICUs, since the finger pulse oximetryis commonly used instead of the measurement of the nasal alar oxygen saturation, the use of finger probe restricts pulse oximetry, especially in the cases of burns in four limbs. The present study is aimed to investigate the consistency between the nasal ala pulse Oximetry and arterial blood analysis in the patients with burns in 4 limbs and ears. Materials and Methods: This study was conducted by evaluating diagnostic tests on all of the 18to 60-year-old patients (N=51) with burns in four limbs and ears hospitalized in ICU. In the first 24h of the hospitalization, nasal alar pulse oximetry was performed and, simultaneously, an arterial blood specimen was sent to the laboratory to determine the oxygen saturation...

Zahedan Journal of Research in Medical Sciences, 2009

يدادح هبادوس رتكد * نابزرم هديش رتكد ، * يللاج دمحم ريم رتكد ، ** ، گنرشوخ نيسح رتكد * مرخ ديعس ر... more يدادح هبادوس رتكد * نابزرم هديش رتكد ، * يللاج دمحم ريم رتكد ، ** ، گنرشوخ نيسح رتكد * مرخ ديعس رتكد اين *** ، هداز نسح دماح رتكد * ** * يشوهيب هورگ رايداتسا ، يكشزپ مولع هاگشناد ينامرد يتشادهب تامدخ و نلايگ ، هدكشناد يكشزپ ** ينيب و قلح ،شوگ هورگ رايشناد ، يكشزپ مولع هاگشناد ينامرد يتشادهب تامدخ و ،نلايگ هدكشناد يكشزپ *** يشوهيب هتشر رايتسد ، يكشزپ مولع هاگشناد ينامرد يتشادهب تامدخ و گ ،نلاي هدكشناد يكشزپ

Background and aims: Ketamine efficacy as an analgesic adjuvant has been studied in several clini... more Background and aims: Ketamine efficacy as an analgesic adjuvant has been studied in several clinical settings with conflicting results. Sore throat and pain after swallowing following tonsillectomy is significant. The aim of this study was to investigate the effect of low dose ketamine on sore throat (pain) after tonsillectomy. Materials and methods: In this double blind clinical trial, fifty children were, divided into two equal groups of Ketamine and control. The subjects aged 4-14 years old and physical ASA class I-II were randomized to receive pemedication with either ketamine 0.lmg/kg I.V. or placebo, 5 minutes before induction of a standard general anesthesia. Results: The ketamine group showed significantly lower pain scores with less total pethidine consumption (P<0.005) during 6h after surgery. The mean pain score in ketamine group was 1.32±1.02 and in control group was 2.4±1.25. There were no differences in the incidence of vomiting between the groups. Conclusion: Preme...

American Journal of Case Reports, 2009

Introduction: Adenotonsillectomy is the main treatment for symptomatic tonsillar hypertrophy with... more Introduction: Adenotonsillectomy is the main treatment for symptomatic tonsillar hypertrophy with postoperative pain as the most common associated complication. The present study aimed to compare the efficacy of gabapentin with that reported for acetaminophen on the postoperative pain of adenotonsillectomy in children. Materials and Methods: In this double-blind clinical trial, a total of 60 children within the age range of 7-15 years undergoing adenotonsillectomy were randomly allocated to two groups of gabapentin (n=30) and acetaminophen (n=30). The first group received a 10 mg/kg dose of gabapentin suspension preoperatively and placebo (suppository) after the intubation. The second group received a 40 mg/kg dose of acetaminophen suppository and placebo suspension simultaneous with that in the case group. Using the pain scale (based on the score of visual analog scale, prescribed drugs, dosage as well as incidence of postoperative nausea and vomiting were recorded 0, 2, 4, 6, 12, ...

Introduction: Controlled hypotension is a technique to decrease intra-operative bleeding. Magnesi... more Introduction: Controlled hypotension is a technique to decrease intra-operative bleeding. Magnesium sulfate would be a compatible choice for this target. Aim: This study was conducted to evaluate effect of magnesium sulfate on controlling blood pressure during septorhinoplasty. Materials and methods: In this double-blind randomized clinical trial study, 60 patients aged 18-50 years with ASA class I and II, underwent septorhinoplasty. They were randomly divided into two groups: magnesium sulfate (M) and control (C). In Group M, diluted magnesium sulfate (50%) (40 mg/kg in 100 ml of normal saline) was infused intravenously in 10 minutes, prior to the induction of general anesthesia then followed by 15 mg/kg/hr administration during surgery. In Group C, same volume of normal saline 0.9% was infused. Anesthesia was conducted through intravenous infusion of propofol (50 μg/kg/min) and remifentanil (0.1 μg/kg/min) for all. The mean arterial pressure was maintained 60-65 mm Hg mm Hg by inj...

Background: Postoperative pain control (especially, after adenotonsillectomy) has a very importan... more Background: Postoperative pain control (especially, after adenotonsillectomy) has a very important effect on recovery time, hospitalization duration, hemodynamic disorders, bleeding, nausea, vomiting and medical costs. Objectives: The aim of this study was to investigate and compare the effects of intravenous and rectal acetaminophen on controlling postadenotonsillectomy pain in children, and duration of their analgesic effects. Patients and Methods: In this randomized double-blinded clinical trial, 96 children aged 4 -10 years old with ASA physical status I or II who were candidates for adenotonsillectomy surgery in Amir-al-Momenin Hospital, Rasht, Iran were entered into the study and randomly divided into two equal groups. Anesthesia in both groups was induced injecting fentanyl-thiopental and at racurium; afterwards is of lurane was used to maintain anesthesia. After anesthesia induction, one group received intravenous and the other one, rectal acetaminophen, and were later compared based on CHIPPS criteria. Results: Data analysis indicated a significant relationship between reduction of postoperative pain and the use of intravenous or rectal acetaminophen (P = 0.0001); in group receiving IV acetaminophen, only 10.4% of patients had no pain whereas in group receiving rectal acetaminophen, this number reached 43.8%. Also, on 4 and 6 hour time intervals, pain in rectal acetaminophen receiving group was less than that in IV acetaminophen receiving group (P < 0.05). Demand for additional analgesic medication in rectal acetaminophen receiving group was less than that in IV group (P = 0.0001). Conclusions: Post-operative pain in rectal acetaminophen group was less than that in intravenous acetaminophen group, and rectal acetaminophen group demanded their first additional analgesic medication later.

Anesthesiology and Pain Medicine, 2014

Background: Laryngospasm is the protective reflex of tracheobronchial tree against secretions and... more Background: Laryngospasm is the protective reflex of tracheobronchial tree against secretions and hemorrhage. This reflex is more prevalent in adenotonsillectomy in the presence of light anesthesia, which can lead to obstruction of airway, complications, and mortality. Different methods have been studied for preventing this complication; however, none of them could reliably prevent it. Objectives: The objective was to assess the effect of magnesium sulfate on laryngospasm and coughing after adenotonsillectomy. Patients and Methods: Seventy children with three to 12 years of age and ASA classes I and II, who were candidates for adenotonsillectomy, were recruited in this randomized clinical trial. The study group received 15 mg/kg intravenous magnesium sulfate and the control group received 0.9% normal saline with the same volume, 2 minutes after tracheal intubation via intravenous infusion for 20 minutes. After removing the endotracheal tube in the recovery room, the patients were assessed at minutes zero, 15, and 30in terms of laryngospasm and coughing. The assessment was based on four-point scale of severity of these complications and saturation percentage of arterial oxygen in operating and recovery room. After collecting the data, results were analyzed with the SPSS 16 software anda P value < 0.05 was considered statistically significant. Results: Laryngospasm was not found in the magnesium sulfate group; however, its incidencewas5.7% in the control group. The incidence rates of coughs were 17.1% and 40% in the magnesium sulfate group and in the control group, respectively, which had no statistically significant differences. Conclusions: Intravenous magnesium sulfate with dose of 15 mg/kg could not prevent laryngospasm and coughing after removal of the endotracheal tube in patients undergoing adenotonsillectomy; however, it reduced coughing and laryngospasm in the magnesium sulfate group compared with the control group.

Anesthesiology and Pain Medicine, 2015

Cataract is one of the most common surgical procedures in the elderly. In most cases, the elderly... more Cataract is one of the most common surgical procedures in the elderly. In most cases, the elderly have cardiac ischemia or chronic coronary diseases, which would lead to more ischemic events during general anesthesia. Therefore, surgeons and anesthetists prefer regional aesthesia to the general one owing to its more advantages and less complications. Therefore, this study aimed to compare topical method and retrobulbar block for pain intensity, patient&amp;amp;amp;amp;#39;s satisfaction, hemodynamic changes and intra and postoperative complications. In a single-blinded clinical trial, 114 patients scheduled for cataract surgery, aged 50 to 90 years with ASA physical status of I-III, were randomly assigned to two groups under monitored anesthesia care as topical anesthesia and retrobulbar block. After the injection of intravenous sedation, which was the combination of midazolam 0.5-1 mg with fentanyl 0.5-1 µ/kg, patients received retro bulbar block or topical anesthesia. During the operation, heart rate, systolic and diastolic blood pressure, mean arterial blood pressure and arterial saturation of O2were measured every five minutes. In addition, pain (VAS) and satisfaction (ISAS) scores were recorded every 15 minutes, then at recovery and one hour after the ending of operation in the ward. Findings were statistically analyzed using SPSS 16. In this study, no significant association was found between age, gender, education and physical condition of patients in both topical and retro bulbar block groups. Comparison of pain based on VAS, satisfaction based on ISAS score and MAP in the studied periods had no significant differences between the two groups of patients undergoing cataract surgery. However, significant differences were found between the two groups (P = 0.045, 0.02, 0.042 and P &amp;amp;amp;amp;lt; 0.05) regarding heart rate, systolic and diastolic blood pressure and arterial oxygen saturation percentage after 20-30 minutes of the operation. Both methods, topical and retro bulbar block had similar impression in cataract surgery regarding analgesia and patient satisfaction. However, in non-complicated cataract surgeries with short duration, topical anesthesia may be the preferable method, because of non-invasiveness, appropriate analgesia, patient satisfaction and hemodynamic stability.

Iranian journal of otorhinolaryngology, 2015

Foreign-body aspiration is still considered one of the most important diagnostic and therapeutic ... more Foreign-body aspiration is still considered one of the most important diagnostic and therapeutic issues for physicians. Mortality rates and the prevalence of diseases caused by foreign bodies in the airway are higher in children because of the relatively narrow airway and immature protective mechanisms. The aim of this study was to study the pattern of foreign-body aspiration in the tracheobronchial tree as well as the success rate of rigid bronchoscopy in children admitted to the Amir-al-Momenin Hospital, Rasht during 2007-2014. In this cross-sectional descriptive study, the required data were collected from the medical reports of all children under the age of 14 years with suspected foreign-body aspiration who were admitted and underwent explorative rigid bronchoscopy from 2007-2014. The data recorded in the checklists were analyzed using SPSS V16. Out of 103 children with suspected foreign-body aspiration, a foreign body was seen in 74 children (71.8%) during bronchoscopy. Among ...

Anesthesiology and Pain Medicine, 2019

Background: Myocardial dysfunction is frequently described as an underlying cause of mortality in... more Background: Myocardial dysfunction is frequently described as an underlying cause of mortality in traumatic brain injury (TBI) known as brain-cardiac link. However the impact on prognosis of a disease remains uncertain. Objectives: The current study aimed at investigating the correlation between TBI and cardiac troponin I (cTnI) rise and in-hospital mortality rate among patients with TBI. Methods: In the current prospective study TBI patients with abbreviated injury scale score (AIS) > 3 and Glasgow coma scale (GCS) score ≤ 8 with cTnI measurement within the first 24 hours of admission were evaluated. Chi-square, Kruskal-Wallis, Mann-Whitney U and Logistic Regression tests were used for data analysis. Results: A total of 166 eligible patients were studied .The mean age of the cases was 37.64 ± 17.21 years, largely under 65 (93.4%) and male (86.7%).The most common injuries were cerebral contusion (35.1%), while motor vehicle crash (MVC) was the most common cause of injuries (83.73%); 59 % of the patients showed detectable cTnI concentrations within 24 hours of admission; 65.7% of the patients expired; they showed higher levels of cTnI compared to survivors that showed lower levels, 0.148 ± 0.074 vs 0.057 ± 0.055, respectively (P < 0.001). Moreover, a significant association was observed between mortality rate and lower admission GCS 3.49 ± 1.08 vs 6.79 ± 1.66, respectively (P < 0.001). Conclusions: Increased cTnI levels could be a predictor of mortality among patients with TBI. Its measurement and investigation for therapeutic strategies could lead to better management of these cases.

Anesthesiology and Pain Medicine, Apr 28, 2019

Background: Myocardial dysfunction is frequently described as an underlying cause of mortality in... more Background: Myocardial dysfunction is frequently described as an underlying cause of mortality in traumatic brain injury (TBI) known as brain-cardiac link. However the impact on prognosis of a disease remains uncertain. Objectives: The current study aimed at investigating the correlation between TBI and cardiac troponin I (cTnI) rise and in-hospital mortality rate among patients with TBI. Methods: In the current prospective study TBI patients with abbreviated injury scale score (AIS) > 3 and Glasgow coma scale (GCS) score ≤ 8 with cTnI measurement within the first 24 hours of admission were evaluated. Chi-square, Kruskal-Wallis, Mann-Whitney U and Logistic Regression tests were used for data analysis. Results: A total of 166 eligible patients were studied .The mean age of the cases was 37.64 ± 17.21 years, largely under 65 (93.4%) and male (86.7%).The most common injuries were cerebral contusion (35.1%), while motor vehicle crash (MVC) was the most common cause of injuries (83.73%); 59 % of the patients showed detectable cTnI concentrations within 24 hours of admission; 65.7% of the patients expired; they showed higher levels of cTnI compared to survivors that showed lower levels, 0.148 ± 0.074 vs 0.057 ± 0.055, respectively (P < 0.001). Moreover, a significant association was observed between mortality rate and lower admission GCS 3.49 ± 1.08 vs 6.79 ± 1.66, respectively (P < 0.001). Conclusions: Increased cTnI levels could be a predictor of mortality among patients with TBI. Its measurement and investigation for therapeutic strategies could lead to better management of these cases.

Anesthesiology and Pain Medicine, 2019

Introduction: Several pathological conditions can reduce blood supply to the organs, among which ... more Introduction: Several pathological conditions can reduce blood supply to the organs, among which burns can be mentioned. By developing the volume depletion and reducing the cardiac contractility, burns can cause hypoperfusion. Further, in ICUs, since the finger pulse oximetryis commonly used instead of the measurement of the nasal alar oxygen saturation, the use of finger probe restricts pulse oximetry, especially in the cases of burns in four limbs. The present study is aimed to investigate the consistency between the nasal ala pulse Oximetry and arterial blood analysis in the patients with burns in 4 limbs and ears. Materials and Methods: This study was conducted by evaluating diagnostic tests on all of the 18to 60-year-old patients (N=51) with burns in four limbs and ears hospitalized in ICU. In the first 24h of the hospitalization, nasal alar pulse oximetry was performed and, simultaneously, an arterial blood specimen was sent to the laboratory to determine the oxygen saturation...

Zahedan Journal of Research in Medical Sciences, 2009

يدادح هبادوس رتكد * نابزرم هديش رتكد ، * يللاج دمحم ريم رتكد ، ** ، گنرشوخ نيسح رتكد * مرخ ديعس ر... more يدادح هبادوس رتكد * نابزرم هديش رتكد ، * يللاج دمحم ريم رتكد ، ** ، گنرشوخ نيسح رتكد * مرخ ديعس رتكد اين *** ، هداز نسح دماح رتكد * ** * يشوهيب هورگ رايداتسا ، يكشزپ مولع هاگشناد ينامرد يتشادهب تامدخ و نلايگ ، هدكشناد يكشزپ ** ينيب و قلح ،شوگ هورگ رايشناد ، يكشزپ مولع هاگشناد ينامرد يتشادهب تامدخ و ،نلايگ هدكشناد يكشزپ *** يشوهيب هتشر رايتسد ، يكشزپ مولع هاگشناد ينامرد يتشادهب تامدخ و گ ،نلاي هدكشناد يكشزپ

Background and aims: Ketamine efficacy as an analgesic adjuvant has been studied in several clini... more Background and aims: Ketamine efficacy as an analgesic adjuvant has been studied in several clinical settings with conflicting results. Sore throat and pain after swallowing following tonsillectomy is significant. The aim of this study was to investigate the effect of low dose ketamine on sore throat (pain) after tonsillectomy. Materials and methods: In this double blind clinical trial, fifty children were, divided into two equal groups of Ketamine and control. The subjects aged 4-14 years old and physical ASA class I-II were randomized to receive pemedication with either ketamine 0.lmg/kg I.V. or placebo, 5 minutes before induction of a standard general anesthesia. Results: The ketamine group showed significantly lower pain scores with less total pethidine consumption (P<0.005) during 6h after surgery. The mean pain score in ketamine group was 1.32±1.02 and in control group was 2.4±1.25. There were no differences in the incidence of vomiting between the groups. Conclusion: Preme...

American Journal of Case Reports, 2009

Introduction: Adenotonsillectomy is the main treatment for symptomatic tonsillar hypertrophy with... more Introduction: Adenotonsillectomy is the main treatment for symptomatic tonsillar hypertrophy with postoperative pain as the most common associated complication. The present study aimed to compare the efficacy of gabapentin with that reported for acetaminophen on the postoperative pain of adenotonsillectomy in children. Materials and Methods: In this double-blind clinical trial, a total of 60 children within the age range of 7-15 years undergoing adenotonsillectomy were randomly allocated to two groups of gabapentin (n=30) and acetaminophen (n=30). The first group received a 10 mg/kg dose of gabapentin suspension preoperatively and placebo (suppository) after the intubation. The second group received a 40 mg/kg dose of acetaminophen suppository and placebo suspension simultaneous with that in the case group. Using the pain scale (based on the score of visual analog scale, prescribed drugs, dosage as well as incidence of postoperative nausea and vomiting were recorded 0, 2, 4, 6, 12, ...

Introduction: Controlled hypotension is a technique to decrease intra-operative bleeding. Magnesi... more Introduction: Controlled hypotension is a technique to decrease intra-operative bleeding. Magnesium sulfate would be a compatible choice for this target. Aim: This study was conducted to evaluate effect of magnesium sulfate on controlling blood pressure during septorhinoplasty. Materials and methods: In this double-blind randomized clinical trial study, 60 patients aged 18-50 years with ASA class I and II, underwent septorhinoplasty. They were randomly divided into two groups: magnesium sulfate (M) and control (C). In Group M, diluted magnesium sulfate (50%) (40 mg/kg in 100 ml of normal saline) was infused intravenously in 10 minutes, prior to the induction of general anesthesia then followed by 15 mg/kg/hr administration during surgery. In Group C, same volume of normal saline 0.9% was infused. Anesthesia was conducted through intravenous infusion of propofol (50 μg/kg/min) and remifentanil (0.1 μg/kg/min) for all. The mean arterial pressure was maintained 60-65 mm Hg mm Hg by inj...

Background: Postoperative pain control (especially, after adenotonsillectomy) has a very importan... more Background: Postoperative pain control (especially, after adenotonsillectomy) has a very important effect on recovery time, hospitalization duration, hemodynamic disorders, bleeding, nausea, vomiting and medical costs. Objectives: The aim of this study was to investigate and compare the effects of intravenous and rectal acetaminophen on controlling postadenotonsillectomy pain in children, and duration of their analgesic effects. Patients and Methods: In this randomized double-blinded clinical trial, 96 children aged 4 -10 years old with ASA physical status I or II who were candidates for adenotonsillectomy surgery in Amir-al-Momenin Hospital, Rasht, Iran were entered into the study and randomly divided into two equal groups. Anesthesia in both groups was induced injecting fentanyl-thiopental and at racurium; afterwards is of lurane was used to maintain anesthesia. After anesthesia induction, one group received intravenous and the other one, rectal acetaminophen, and were later compared based on CHIPPS criteria. Results: Data analysis indicated a significant relationship between reduction of postoperative pain and the use of intravenous or rectal acetaminophen (P = 0.0001); in group receiving IV acetaminophen, only 10.4% of patients had no pain whereas in group receiving rectal acetaminophen, this number reached 43.8%. Also, on 4 and 6 hour time intervals, pain in rectal acetaminophen receiving group was less than that in IV acetaminophen receiving group (P < 0.05). Demand for additional analgesic medication in rectal acetaminophen receiving group was less than that in IV group (P = 0.0001). Conclusions: Post-operative pain in rectal acetaminophen group was less than that in intravenous acetaminophen group, and rectal acetaminophen group demanded their first additional analgesic medication later.

Anesthesiology and Pain Medicine, 2014

Background: Laryngospasm is the protective reflex of tracheobronchial tree against secretions and... more Background: Laryngospasm is the protective reflex of tracheobronchial tree against secretions and hemorrhage. This reflex is more prevalent in adenotonsillectomy in the presence of light anesthesia, which can lead to obstruction of airway, complications, and mortality. Different methods have been studied for preventing this complication; however, none of them could reliably prevent it. Objectives: The objective was to assess the effect of magnesium sulfate on laryngospasm and coughing after adenotonsillectomy. Patients and Methods: Seventy children with three to 12 years of age and ASA classes I and II, who were candidates for adenotonsillectomy, were recruited in this randomized clinical trial. The study group received 15 mg/kg intravenous magnesium sulfate and the control group received 0.9% normal saline with the same volume, 2 minutes after tracheal intubation via intravenous infusion for 20 minutes. After removing the endotracheal tube in the recovery room, the patients were assessed at minutes zero, 15, and 30in terms of laryngospasm and coughing. The assessment was based on four-point scale of severity of these complications and saturation percentage of arterial oxygen in operating and recovery room. After collecting the data, results were analyzed with the SPSS 16 software anda P value < 0.05 was considered statistically significant. Results: Laryngospasm was not found in the magnesium sulfate group; however, its incidencewas5.7% in the control group. The incidence rates of coughs were 17.1% and 40% in the magnesium sulfate group and in the control group, respectively, which had no statistically significant differences. Conclusions: Intravenous magnesium sulfate with dose of 15 mg/kg could not prevent laryngospasm and coughing after removal of the endotracheal tube in patients undergoing adenotonsillectomy; however, it reduced coughing and laryngospasm in the magnesium sulfate group compared with the control group.

Anesthesiology and Pain Medicine, 2015

Cataract is one of the most common surgical procedures in the elderly. In most cases, the elderly... more Cataract is one of the most common surgical procedures in the elderly. In most cases, the elderly have cardiac ischemia or chronic coronary diseases, which would lead to more ischemic events during general anesthesia. Therefore, surgeons and anesthetists prefer regional aesthesia to the general one owing to its more advantages and less complications. Therefore, this study aimed to compare topical method and retrobulbar block for pain intensity, patient&amp;amp;amp;amp;#39;s satisfaction, hemodynamic changes and intra and postoperative complications. In a single-blinded clinical trial, 114 patients scheduled for cataract surgery, aged 50 to 90 years with ASA physical status of I-III, were randomly assigned to two groups under monitored anesthesia care as topical anesthesia and retrobulbar block. After the injection of intravenous sedation, which was the combination of midazolam 0.5-1 mg with fentanyl 0.5-1 µ/kg, patients received retro bulbar block or topical anesthesia. During the operation, heart rate, systolic and diastolic blood pressure, mean arterial blood pressure and arterial saturation of O2were measured every five minutes. In addition, pain (VAS) and satisfaction (ISAS) scores were recorded every 15 minutes, then at recovery and one hour after the ending of operation in the ward. Findings were statistically analyzed using SPSS 16. In this study, no significant association was found between age, gender, education and physical condition of patients in both topical and retro bulbar block groups. Comparison of pain based on VAS, satisfaction based on ISAS score and MAP in the studied periods had no significant differences between the two groups of patients undergoing cataract surgery. However, significant differences were found between the two groups (P = 0.045, 0.02, 0.042 and P &amp;amp;amp;amp;lt; 0.05) regarding heart rate, systolic and diastolic blood pressure and arterial oxygen saturation percentage after 20-30 minutes of the operation. Both methods, topical and retro bulbar block had similar impression in cataract surgery regarding analgesia and patient satisfaction. However, in non-complicated cataract surgeries with short duration, topical anesthesia may be the preferable method, because of non-invasiveness, appropriate analgesia, patient satisfaction and hemodynamic stability.

Iranian journal of otorhinolaryngology, 2015

Foreign-body aspiration is still considered one of the most important diagnostic and therapeutic ... more Foreign-body aspiration is still considered one of the most important diagnostic and therapeutic issues for physicians. Mortality rates and the prevalence of diseases caused by foreign bodies in the airway are higher in children because of the relatively narrow airway and immature protective mechanisms. The aim of this study was to study the pattern of foreign-body aspiration in the tracheobronchial tree as well as the success rate of rigid bronchoscopy in children admitted to the Amir-al-Momenin Hospital, Rasht during 2007-2014. In this cross-sectional descriptive study, the required data were collected from the medical reports of all children under the age of 14 years with suspected foreign-body aspiration who were admitted and underwent explorative rigid bronchoscopy from 2007-2014. The data recorded in the checklists were analyzed using SPSS V16. Out of 103 children with suspected foreign-body aspiration, a foreign body was seen in 74 children (71.8%) during bronchoscopy. Among ...