فصلنامه آنستزیولوژی و مراقبتهای ویژه ایران
سال چهل و یکم شماره 1 (پیاپی 105، بهار 1398)

During and after cardiac surgery, bleeding occurs that resulting postoperative anemia. If patients have anemia before operation, the rate of blood transfusions increase that make several complications.

In this study, patients entered to the operating room prior to the anesthesia induction an arterial catheter was placed and hemoglobin and hematocrit level was detected.so anemia level is determined as: Hb less than 8 g/dl: Severe anemia; Hb between 8 to 10 g/dl: moderate anemia and Hb 10-12( for women) and 10-13 (for men):Mild anemia; and according to hematocrit, less than 45% for men and less 37% for women include anemia. The study also looked at the age, sex, and weight of patients and for the association of anemia with the above mentioned variables. Also, during surgery amount of blood transfusion to the patients was evaluated. The need for transfusion was evaluated according to Hb level.

In this study, 526 patients were studied in one year period. The mean hemoglobin level of patients was 13.1 g/dl and the mean hematocrit was 39.3%.In this study, 30.2% of patients were anemic. According to the anemia classification, 62.9% of anemic patients had Mild anemia, 36.4% moderate anemia and0.5% severe anemia. Of 526 patients,342(60.9%) did not need to receive packed red blood cells (PC).In this study, of 220 patients were received PC due to surgical bleeding. Of this group 114 patients have normal hemoglobin and 106 patient were anemic.

Patients with anemia needed to receive more blood, as well as female patients, older patients, patients with a lower BMI, patients with longer duration of operation, needed to receive more blood. According to the studies, blood transfusion is associated with side effects and increases the length of hospital stay and hospital costs. Therefore, performing diagnostic evaluation and therapeutic before elective surgery can reduce the need for transfusion and thereby reducing the complications that leads to redu

Pulmonary edema is the main reason behind the pregnancy of a pregnant mother in the intensive care unit and the timely diagnosis of these harmful effects on the mother and the fetus, we decided to study the present study with the aim of Determine the frequency, Predisposing Factors and Outcome of Acute Pulmonary Edema in Pregnant Women Referred to Hospitals in Tabriz: 1392- 1393.

This study was a cohort study in which 22,250 patients were evaluated in Tabriz Educational Centers in May 1392 in Tabriz. A total of 2750 patients were selected based on a checklist of the researcher-made checklist. Data were analyzed by ANOVA for quantitative variables and chi-square test for qualitative variables.

The prevalence of acute pulmonary edema in high-risk pregnancies is 1.2% and in the total population of pregnant women is 0.15%. The most common causes of acute pulmonary edema in pregnancy are preeclampsia (52.9- 18%), heart disease (26.5% -9) and infection (23.5% -8).In terms of neonatal outcomes, the weight of newborns in the acute lung group was lower and the Apgar score of 1 minute and 5 minutes was lower, and IUGR in the acute pulmonary edema group was 1.9 times more than the control group (RR=1.9; 95%CI[1.1-3.5]) and cases of fetal death in the group of lung edema, 2.5 times the control group (RR=2.5; 95%CI[1.1-5.9]).

Knowledge of the underlying factors and the implications of acute pulmonary edema in pregnancy can lead to their timely diagnosis in suspected

Oxycodone is a μ-opioid receptor agonist and is generally indicated for the relief of moderate to severe pain. The aim of this study was to compare the analgesic efficacy of oral oxycodone and intravenous ketorolac for postoperative pain in patients undergoing laparoscopic cholecystectomy.

In this double blinded study 60 patients underwent laparoscopic cholecystectomy classified into 2 groups Ketorolac (n=30) and Oxycodone (n=30) randomly. Anesthesia induction and intubation was the same in both groups. Postoperative pain, blood pressure and heart rate was measured 1, 2, 4, 6 and 12 hours after surgery in both groups. Post-operative nausea and vomiting and shivering also was compared between two groups.

there was no significant differences between two groups considering age, gender and ASA class. Also, no significant difference between two groups comparing systolic and diastolic blood pressure and heart rate in mentioned hours (P>0.05). Mean NRS was significantly lower in Oxycodone in compare with Ketorolac group, except in sixth hour (p<0.05). Need for morphine consumption in ketorolac group was meaningfully higher than the other group (p<0.001). Incidence of postoperative nausea and vomiting was a little higher in oxycodone group.

oral oxycodone is a good choice in controlling postoperative pain considering efficacy, easily consumption and low incidence of adverse effect.

Drug abuse is a widespread and increasing phenomenon throughout the world that, as the most important social harm, invades human society and causes many to become seriously impaired in individual and social action. The aim of this study was to investigate the prevalence and underlying factors of substance abuse among students of North Khorasan University of Medical Sciences.

This study was descriptive. 169 students participated in the study by stratified random sampling. The data collection tool was a researcher-made questionnaire that was developed by the presenters and reviewed by existing studies. The questionnaire included demographic information and drug use information including cigarettes, hookah, alcohol and drugs. Data on substance abuse were collected using 23 variables including substance use during the past year and month, age of first use, place and time, and people using them, using descriptive statistics (Frequency, percentage, mean) were analyzed by SPSS 20.

Most of the students were female (62.5%). The mean age of students was 21.08 ± 2.03. The mean score of students was 16.431 1.45. The prevalence of cigarette, hookah, alcohol and drug abuse were 8.4%, 18.9%, 7.7% and 3.6%, respectively. The mean age of substance abuse students was 17.15±2.57 years. Most students with non-academic friends had hookah abuse (18.5%), alcohol abuse (2.2%) and drugs (2.4%). Abuse of hookah, alcohol and drugs were more frequent in leisure  time and were (12.4%), (1.8%) and (4.7%), respectively. The most prevalent areas of abuse were cigarettes, hookahs and narcotics in parks and green spaces, and single and family-run alcoholic beverages.

The highest abuse among students was related to hookah smoking. Drug abuse was often done in groups and with non-academic friends, in green spaces and parks and in leisure time. In order to reduce the prevalence and areas of substance abuse, it is suggested that more specialized training courses be held to increase students' awareness and understanding of the causes of substance abuse. In addition, further studies are recommended to identify more precisely the underlying causes of substance abuse.

The role of the non-technical skills in reducing undesired errors is significant and
there are a few methods that improve the effectiveness of CPR's non-technical skills. The aim of this
study was to determine the effect of Seven-Stage Response Plan of cardiopulmonary resuscitation
(SSRP-CPR) on non- technical skills of nursing and anesthesiology students.

The current quasi-experimental study included forty-two undergraduate
nursing and anesthesiology students that divided in stratified sampling and random allocation into
the experimental (SSRP-CPR) and traditional groups. All participants completed a course of CPR
technical skills, and then participated in a 4-hour workshop. The trainings included routine

of CPR and Seven-Stage Response Plan in traditional and experimental groups, respectively. Data
were collected by using the Team Emergency Assessment Measure (TEAM) Tool and were
analyzed by SPSS 20.

The mean total scores of team's performance in SSRP-CPR group (35.08±9.63) were
significant and higher than the traditional group (23.46±5.68), (p<0.002). Furthermore, the mean
score of non- technical skills categories including leadership (p<o.oo1), teamwork (p<o.oo2) and
task management (p<o.o24) were significant and higher in SSRP-CPR group, than the traditional
group. In addition, the results showed that there was no significant difference between the two
groups in a number of subcategories of teamwork, including working together, team superiority and
team morale, respectively. (p<o.310, p<0.292 p<0.187).

The SSRP-CPR, as a teamwork and leadership model, can improve the non-technical
skills of resuscitation. Therefore, it’s suggested that the model of SSRP-CPR could be used to train
the non-technical skills of resuscitation in a simulation and real resuscitation environment in hospital
resuscitation teams.

Awareness during anesthesia is a side effect associated with general anesthesia and refers to a condition in which brain awakens by a stimulus during a period of general anesthesia. The experiences are stored in explicit memory and patient might recall a few things after recovering from anesthesia. The experiences are sometimes in the form of pain perception, but the patient is not able to show a reaction due to the administration of muscle relaxants, the feeling of weakness and helplessness caused by intraoperative awareness might cause some patients to develop lasting and significant psychological issues. Given the importance of monitoring and maintaining the depth of anesthesia, this study aimed to determine the incidence of awareness and recall during general anesthesia.

A total of 400 patients who were referred to Besat Hospital and underwent various surgical procedures in 2016 were involved in this study. Data collection was performed using a questionnaire previously utilized by other researchers to study the same topic. Patients were visited 24 to 36 hours after recovery and interviewed about their experiences before, after and during operation. The data collected from each patient were then recorded in the patients questionnaire form.

data were obtained from patients indicates that out of 400 patients, 249 patients were men (62.3%) and 151 patients were women (37.7%). In order to induce, propofol was used in 71.8%, thiopental sodium in 27.3% and ketamine in 0.9% of patients. Benzodiazepines were used as 1 . نویسنده مسوول: dsmbszolhavarieh@gmail.com 53 preanesthetic agents in 87.8% of cases. Ten patients (2.5%) had pointed to issues that suggested consciousness during anesthesia. The only significant connection in this study was found to be the lack of use of benzodiazepines and awakening during anesthesia.

Given the increased risk of awakening during anesthesia without use of benzodiazepines as preanesthetic drugs, we suggest administration of these agents as far as possible in general anesthetics. Also, our findings indicate that the prevalence of consciousness during anesthesia is higher in our country compared to other countries.

Wegener's granulomatosis is a systemic autoimmune vasculitis that is associated with vascular involvement and can affect any organ. The most important organs of involvement are kidneys, upper and lower respiratory tract. Because Wagner is a rare and dangerous disease, it can lead to death if not treated at the right time with medication and sometimes surgery with special anesthesia considerations. We report a 17-year-old female patient with Wegener's granulomatosis who scheduled thoracotomy surgery under general anesthesia with a diagnosis of bronchopulmonary fistula.