t. ahere parsa

The laryngeal mask airway (LMA) is a supraglotic airway device that can be used as a substitute for the standard endotracheal tube in emergency and difficult airway management. However, the use of LMA for elective surgical procedures is still controversial. In the most of published studies, ETCO2 and SpO2 monitoring were for assessment of adequacy of LMA placement. However, the most reliable method of evaluating ventilation and oxygenation is measurement of arterial oxygen partial pressure (PaO2) and arterial carbon dioxide partial pressure (PaCO2) directly from an arterial blood sample. The purpose of this descriptive cross-sectional study was to evaluate ventilation and oxygenation with ProSeal laryngeal mask airway (PLMA) during short-term elective gynecologic surgery in paralyzed anesthetized patients. 15 ASA class I-II women undergoing short-term elective gynecologic operations under general anesthsia were included to the study. After induction of standard general anesthesia an appropriate size of ProSeal LMA was inserted and controlled ventilation was established. Position of LMA was detected with ausculation of lungs and epigastric area. Before the end of surgery, arterial blood sample was withdrawn for blood gas analysis. First attempted insertion of PLMA was successful in all of the patients. The position of PLMA was good in 11, acceptable in 2 and suspected in 2 patients. PaO2, PaCO2 and SaO2 were in normal limits in all situations. Duration of anesthesia (>30 min and <30 min) had no effect on PaO2. We concluded that ventilation and oxygenation can be maintained through a PLMA during short-term gynecologic surgery under general anesthesia.

History and Considering the significance of analgesia and lower complications following surgical operations and the existence various and sometimes reports controversial reports on the efficacy of addition of fentanyl and for comparison of its effect, this study was carried out on patients under thoracotomy in Masih Daneshvari hospital. The clinical trial, two-blind strategy of this study was performed on 74 patients and cases with contraindication for drugs were excluded from the study. Control group received morphine (0.5 mg/kg) and experimental group received a mixture of morphine and fentanyl. The intensity of pain was measured using verbal pain scoring and they were followed up for post-operative complications for 48h and data were statistically analyzed. From each group, 7 cases were excluded and study was carried out on 60 cases. In this regard, 31 cases were in control group and 29 cases were in experimental group. Both groups were similar regarding age and gender. Complications rate was 71% (22) in control group and 48.3% (14) in experimental group (P<0.07). There was a complication rate of 92.3% and 55.5% in female cases of control group and experimental group respectively. Meanwhile, duration of unexpected analgesia in control group was 8±4.8 and in experimental group was 9.03±4.5 h. in addition, duration of unexpected analgesia for control and experimental groups were 2±4.8 and 5±4.5 h respectively. Conclusion and Recommendations: Simultaneous use of fentanyl and morphine could reduce the complications and extension of analgesia. Therefore, it is recommended to carry out further studies using fentanyl.