فصلنامه آنستزیولوژی و مراقبتهای ویژه ایران
سال سی و نهم شماره 3 (پیاپی 99، پاییز 1396)

Pain is an unpleasant sensory and emotional experience that is associated with actual or potential damage to the tissues or resulting from it. Human have always tried to find a means to heal their physical and psychological suffering and relieve their pain. In this study, the effect of acupuncture on pain relief in patients undergoing open cholecystectomy was studied
Material and In this double-blind clinical trial, a total of 40 patients were randomly selected into intervention and control groups. In the intervention group, after an intubation, and before leaving from the operating room, acupuncture was performed by one anesthetist who had passed acupuncture course or familiar with principles of acupuncture and allowed to perform this activity, at two points LI4 and LV3 on both sides, a total of four points were pinpointed manually. At the end of the operation, the needles were removed before the extubation and the patient's be alert. In the control group, before entering the recovery room and when the patient was not alert, in the same areas of the puncture in intervention group, only dressed and the patient dispatched to the recovery room. Patient's pain score was evaluated by the recovery technicians who were unaware of the type of intervention and by the VAS and recorded in the questionnaire. Data were collected by SPSS software version 16 and analyzed statistically. The significance level in this study was considered to be less than 0.05.
In the intervention and control groups, the mean age of participants was 58.8±5.8 and 57.11±9.49 years, the mean score of pain in recovery room was 5.11±1.45 and 5.50±1.50, induction anesthesia using Propofol 55% and 60%, the percentage of using bullous retainer was 66.7% and 33.3%, and the correlation coefficient between age and pain score was 0.138 and 0.238. Respectively. There was no significant difference in pain intensity between the intervention and control groups (P> 0.05). But the percentage of use of bullous retainer in the control group was significantly higher than the intervention group (P = 0.027)
The use of acupuncture in patients undergoing open cholecystectomy does not have a significant effect on reducing their pain intensity in recovery room.

One of the important duties of nurses in ICUs is to take of skin problems in patients and to cooperate in the healing of bedsores (also called pressure sores or ulcer sores). Despite recent advances in the treatment of bedsores, they are still one of the major problems ICU patients face, and an important cause of death in these patients, in addition to putting a heavy financial burden on patients and hospitals. In fact, about 7-8 percent of cases of death in ICU patients are related to pressure sores.
This double-blind clinical trial was conducted on 80 trauma ICU patients with stage 3 bedsores. The control group received regular care including daily washing with normal saline followed by Comfeel ulcer dressing, while the intervention group received two 20-minute humidified oxygen treatment at 10 liters per minute every day in addition to the regular care. The wounds were assessed at the end of the first and second weeks with respect to granulation tissue formation, surface area of the wounds, and the extent of exudation. The data was analyzed using SPSS version 19 and repeated measures ANOVA.
Findings: The average age of the patients in the two groups was 41.27±12.3 years. At the end of the second week, the following results (which were all significantly different between the intervention and control groups at the 0.0001 level) were observed: the surface areas of the wounds were 3.56±2.47 in the intervention group and 5.7±2.1 in the control group, the degrees of exudation were 1.07 ± 0.27 in the intervention group and 1.55±0.61 in the control group, the extents of granulation tissue formation were 0.99±1.24 in the intervention group and 1.65±1.04 in the control group, and the PUSH scores were 5.59 ± 3.6 in the intervention group and 8.90 ± 3.2 in the control group.
The present research indicated that topical oxygen could reduce exudation and surface area of wounds and increase granulation tissue formation significantly.

Potassium disturbances are common, hyperkalemia is less common but hypokalemia is one of the most common electrolyte disorder in hospitalized patients, its prevalence in the ICU according to present findings is unknown, although studies have shown different levels of it.
After ethic committee of Urmia university approval this retrospective cross sectional study was conducted during 2015 in Emam hospital. During this period, clinical records of patients admitted to intensive care unit with mechanical ventilation were studied. Demographic characteristics (age, gender), duration of mechanical ventilation, length of stay in the ICU, medication intake, potassium intake, potassium level of admission time, mortality rate extracted and entered in the questionnaire. After completion of the study results were analyzed with SPSS software version 20 .P In this study, 400 patients were enrolled. The mean age of patients was 57.99±22.57 years old and 69% male and the rest were females. Potassium level of admission time was 4.11±0.72 meq/l. The separation of potassium level in patients showed 15% hypokalemia, 4% hyperkalemic and 81% were normokalemic. 25% of patients intake pulmonary inhaler drugs, 42% had received furosemide and corticosteroids 72.2%. 32.5% of patient intake supplementary potassium and further rate was 87.7 percent. 40% of patients with hypokalemia and 62.5% with hyperkalemia during the study were died, there was significant difference between mortality and mechanical ventilation and intensive care unit length of stay with and without hypokalemia and hyperkalemia versus normokalemia (P The frequency of hypokalemia in patients in our study was 15% and hyperkalemia 4%. and the expected outcomes in patients with hypo and hyperkalemia was statistically significant difference versus normokalemic patients.

Intubation is the first and most important step in the recovery of basic life support and the best way to learn of intubation training is necessary. Therefore, we decided to study with aim of comparison of simulated training of intubation on mannequins and normal patient in medical students.
In this interventional study, forty medical students after theoretical education was divided into two groups: A (training on mannequins) and B (training on a normal patient). The study was conducted as pre-test and post-test with the DOPS checklist. Data were analyzed by ANOVA and SPSS 16 software.
There was no significant difference between two groups in pre-test stage, but after intervention and in post-test, the mean of group A was significantly higher than the group B.
Discussion and It seems that after theoretical training and before training on patients, practical skills training on mannequins is the best way to learn clinical skills.

Tracheal intubation is an essential procedure during general anesthesia which may cons hemodynamic conditions to become unstable (high blood pressure, tachycardia increased pulmonary capillary wedge pressure & etc…) Magnesium sulfate could decrease catechol amine release from adrenal gland therefore could potentially decrease the side effects of tracheal intubation.
In this double blinded RCT, 50 patients candidate for non obstetric gynecologic abdominal surgery were randomly allocated into two groups of each 25 patients in case group, patients recieve 20mg/kg magnesium sulfate derag imin before infusion and control group recieve iv saline as some volume. Hemodynamic values were scored before induction and 1,5,10 and 15 minutes after intubation for all patients collected data were analyzed using SPSS ver. 18 and proper statistical tests.
Mean recovery time was 4f.92±6.7 min and 51.64±5.2 in control & case groups respectively study showed that mean hr before induction mean systolic BP before induction, on 1st minute and is minutes after intubation, mean diastolic BP in 1st minute, and mean arterial pressure (MAP) in all times except intubation time, mean spo2 in 5th minute and mean recovery time was statistically meaningful.
The mean of three values of systolic, diastolic & mean BP were statistically meaning in all times. Based on the findings of the study, low dose infusion of magnesium sulfate could increase cardiovascular response and recovery time after tracheal intubation

concerning the high prevalence of post dural puncture headache and nausea & vomiting among parthurient we deaided to study the effects of different doses of ondansetron of preventing of the PDPH.
In this double blinded randomized clinical trial patients allocated to three groups randomly. Patients reciewed 8mg ondansetron and placebo in first second & third (couliol) respectively. Patients were evaluated concerning both in the first week of postoperative period
PDPH was more prevalent in third (control) group in every house comparing to other groups and was less in first group in comparison with the second one but was not statistically meaning.
based on our finding, 8mg/iv ondansetron could be effective in reduction of pdph among partients.