جستجوی مقالات مرتبط با کلیدواژه « بیهوشی استنشاقی » در نشریات گروه « پزشکی »

For hernia surgery and to induce general anesthesia in children, pediatric venipuncture is needed. The venipuncture process in the children can lead to damage (destroy) of the vein due to many reasons, including fear, restlessness and the child's excessive movements. The aim of this study was to compare the results of inhalation anesthesia in children undergoing inguinal hernia repair surgery under general anesthesia.

In this randomized, single-blinded, prospective clinical trial study, 70 children aged 2 to 6 years who volunteered for inguinal herniorrhaphy were divided into two groups of 35 people in the children's operating room of Shahid Motahari Medical Training Center in Urmia. In the intervention group, peripheral venous catheterization was performed with induction of inhalation anesthesia by 8% soflurane along with oxygen and nitrous oxide, but in the control group, peripheral venous catheterization was performed without induction of inhalation anesthesia and awake. Randomization of intervention and control groups was done with Random Allocation software. Chi-square test was used to compare the frequency of studied variables between two groups. Independent t-test was used to compare the average intensity of restlessness between the two groups. Data analysis was done using SPSS 20 software and the significance level was considered less than 0.05.

The average time of intravenous insertion in the group receiving soflurane was 25.03 ± 21.996 and in the group not receiving soflurane was 254.21 ± 154.913. The difference in the average time of intravenous insertion of the patients in the study between the two groups receiving soflurane and not receiving soflurane was statistically significant, and this average value was much higher in the group not receiving soflurane than in the group receiving soflurane. There was a significant difference between the two groups in the variable of intravenous insertion time (P=0.0001).

Children induced with soflurane need more sedative drugs such as midazolam or combination of midazolam with other drugs. In terms of nausea and vomiting, soflurane has little nausea-causing properties, although is more common in soflurane compared to some drugs such as propofol.

Direct laryngoscopy and biopsy are important procedures in otorhynolaryngology .There would be severe consequences due to the extensive manipulations during these procedures. Ideal condition for this type of surgery requires adequate depth of anesthesia to prevent hemodynamic changes and short-term recovery. The effects of inhaled and intravenous anesthesia (TIVA) on the hemodynamic changes and recovery time, is investigated in this study.
sixty four patients entered the study and divided into two groups of inhaled and intravenous (TIVA) anesthesia, thirty two patients each. Heart rate and blood pressure were recorded before induction and in defined intervals in both groups. At the end of surgery, recovery time recorded in both groups.
Average heart rate in 1st, 3rd, 5th, 10th, 15th, 20th and 30th minute post induction was 77.87, 74.38, 72.23, 68.83, 68.92, 69.03 and 69.55 beats/min in TIVA group respectively and 94.73, 93.26, 91.56, 86.97, 87.83, 87.12 and 87.75 beats/min in inhaled anesthesia group respectively, which was statistically meaningful. Average Systolic BP in 1st, 3rd, 5th, 10th, 15th, 20th and 30th minute post induction was 118.83, 113.17, 108.33, 105.50, 102, 97 and 101.33 mmHg in TIVA group respectively and 127.50, 133.83, 131, 135.12, 127.83, 123.83 and 120.83 in inhaled anesthesia group respectively, which was statistically meaningful. Average recovery time to respond to verbal stimulation was 12.13 minute and 22.43 minute in TIVA and inhalation group respectively which was statistically meaningful.
Intravenous anesthesia is a wise choice for direct laryngoscopy and biopsy surgery, since exerts better control on hemodynamics and causes a short-term recovery.

Emergence agitation is a common clinical phenomenon in children undergoing general anesthesia. A possible predisposing factor is the type of general anesthetic technique used. The aim of the present study was to evaluate the effect of two intravenous and inhalational general anesthetic methods on emergence agitation of children in the recovery room. In this prospective single-blind clinical trial, 56 children aged less than 6 years were randomly divided into two groups of 28. The first group received IV general anesthesia with propofol and alfentanyl and the second group received inhalation anesthesia with isoflorance and nitrous oxide. After awakening in the recovery room the children's emergence agitation was measured every ten minutes for 60 minutes by PAED scale. Data was analyzed with t-test, chi-squared test and ANOVA with SPSS software (α = 0.05). Emergence agitation in the intravenous and inhalational groups at 10-minute interval were 12.85 and 10.51 on PAED scale, respectively, demonstrating a significantly higher rate in the intravenous group. However, in general, there were no significant differences between the two groups (p value = 0.241). There was an inverse relationship between age and agitation, with higher rates in younger children. Based on the results it was concluded that decision-making on the type of anesthesia should not be based on emergence agitation. Other factors involved in emergence agitation should be considered.

Bispectral index (BIS) is a new method for determination depth of anesthesia. In most of our operating rooms depth of anesthesia is measured according to clinical features; however, it has not enough accuracy. The aim of this study was to compare BIS numbers between inhalation and intravenous anesthesia at different times of anesthesia. This was a prospective descriptive study. One hundred and fourteen patients divided between two groups; inhalation anesthesia and intravenous anesthesia. The patients in each group randomly were divided among three subgroups. BIS was measured in one phase of anesthesia in each group: Immediately after intubation, surgical incision, and wound closer. Then, the data was analyzed by t-test, chi-square and analysis of variance (ANOVA) tests in SPSS software. There was no significant differences in any phases of study for frequency of desired BIS between inhalation and intravenous anesthesia groups. However, mean of BIS in the inhalation anesthesia group was significantly more than other group (p0.05). Ordinary used clinical findings are not enough to evaluate desired depth of anesthesia. When we use BIS monitoring, we can produce enough depth of anesthesia; also, sometimes we can decline dose of anesthetic drugs.

Every surgery is followed by some changes in postoperative pulmonary function tests which can dramatically influence this period. Although the type of the surgery and its vicinity to diaphragm are the main determinants of these changes, anesthetic techniques are also responsible. Among different probable factors through which anesthesia could influence postoperative pulmonary function tests, we planned to evaluate the effects of drugs used during the maintenance stage of anesthesia on postoperative pulmonary function tests. Patients & This is a single blind randomized clinical trial in which the patients ranged in age from 15 to 35 and presented with ASA I(American Society of Anesthesiology). All the operations were elective extremity or lower abdominal surgeries and their length was between one and two hours. All the patients had normal preoperative pulmonary function tests. The total number of the subjects was sixty and they were randomly divided into two equal groups(n=30). For the maintenance stage of anesthesia, inhalational agents(N2O 50%, Halothane 0.5-1%) were used in one group and intravenous drugs in the other one (Midazolam 0.1mg/kg/h, Alfentanil 0.5µg/kg/min). 24 hours postoperatively, pulmonary function tests(PFT) were performed and the deviations of three indices(FEV1=Forced Expiratory Volume in 1 sec, FVC=Forced Vital Capacity, VC=Vital Capacity) from their preoperative values were measured and compared. Students’ t-test was used for statistical analysis. FEV1, FVC and VC decreased by 16.3%, 13.5% and 12.5% in the inhalational group and by 12%, 12.9% and 12% in the intravenous group respectively. Comparing the results showed no significant difference between the two groups. Among the factors which are related to anesthesia and can affect postoperative pulmonary indices, the above-mentioned drugs that we used for the maintenance stage, whether inhalational or intravenous, exert no significant influence on postoperative pulmonary function tests.

For evaluating the safety of pediatric anesthesia in an outpatient setting, 100 cases were selected by covenient sampling method in Mofid children hospital. Informations about postoperative complications (during 24h) were gathered by telephone interview. Most of patients were in the 1-4years age group(55%), 4-8years, 1 month to 1 year, above 8years and below 1 month. were situated respectively. Four surgical procedures of inguinal hernia, hydrocele, circumcision and ectopy of testis consist 73% of all the surgeries. Ninety eight Percent of the surgeries were performed under general anesthesia. In these patients, 25% received narcotics, and in 42% regional block were combined with general anesthesia. Fifteen Percent of the patients were intubated. Complications that occurred at home were pain and restlessness (29%, most common), Nausea and vomiting (17%), sleep disturbances (11%), fever (7%), Anorexia (6%), Urinary retension (5.3%), hoarsness 4% and cough 3%.