فصلنامه آنستزیولوژی و مراقبتهای ویژه ایران
سال چهل و پنجم شماره 1 (پیاپی 117، بهار 1401)

There is a need for a meta-analysis of a study comparing post-surgery pain following general anesthesia with sevoflurane and propofol, which is of high quality and can compare the results of high-quality trial studies that have been conducted in the last few years. Therefore, the present study aimed to compare the effects of sevoflurane and propofol in children's general anesthesia on pain after surgery in the form of a systematic review and meta-analysis.

A systematic search (keywords: propofol or diprivan or propofol (for propofol) and sevoflurane or sevo (for sevoflurane), child, pain and anesthesia) in databases PubMed, Embase, Cochrane Library, CNKI, Scopus, Web of Science, MagIran and SID without time limit. The final aim was to compare the outcome of pain after surgery. Statistical analyzes were performed with RevMan 5.3 and Cochrane Collaboration's software.

There is a significant increase in the incidence of pain after surgery for the sevoflurane group compared to the propofol group (OR=1.72 - 95%CI (1.2-11.64) - Z Test =2.45 - P=0.01)

In pediatric general anesthesia, the use of propofol can be associated with less pain after surgery.

Several recent clinical trials have investigated the effect of prophylactic administration of dexamethasone after extubation on sore throat after surgery, and their results have not yet been presented in a coherent study. Therefore, we performed a systematic review and meta-analysis examining the effects of preoperative dexamethasone prophylactic administration on the prevalence of sore throat during the first 24 hours after anesthesia.

This study was a systematic review and meta-analysis; Based on this, Scopus, Web of Science, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Mag Iran and SID were used to search for eligible studies based on the keywords prevention, surgery, post-surgery, post-anesthesia, sore throat and dexamethasone.

A review of articles using a forest diagram for the incidence of sore throat after surgery in 24 hours after surgery or intubation showed a decrease in the incidence of sore throat in patients treated with intravenous dexamethasone compared to the control group (normal saline) (62/ 0=RR- 0.51-0.75: 95% CI- 0.001. P= df=7). (Figure 1)

Our study shows that administration of intravenous dexamethasone 15 minutes before extubation reduces postoperative sore throat more effectively.

The present study was conducted with the aim of identifying the effect of age and gender on the death of COVID-19 patients.

In this descriptive study, the files of 780 patients with COVID-19 referred to the hospital were examined, and demographic information including age, sex and possible mortality in both sexes in two separate groups in five age groups (>15, 15 up to 34, 35 to 54, 55 to 74 and < 75 years) were recorded from the hospital system.

Among the age groups, the highest mortality rate was related to the age groups over 75 years old (38.7%) and then the age group 55-74 years old (23.1%). Although the mortality rate was higher in men than in women. But this difference was not statistically significant (22.4% vs. 19.0%; P-value=0.255.

Infection with COVID-19 is associated with significant mortality, mainly in elderly and male patients. These findings can help to identify patients with COVID-19 who are at higher risk, and on the other hand, monitor these factors. It can help with early warnings for appropriate interventions.

Septorhinoplasty surgery is one of the most well-known cosmetic surgeries among ear, nose and throat surgeries. Postoperative pain is still one of the most important factors affecting patient satisfaction. These symptoms can be uncomfortable for the patient. The purpose of this study is to compare the intraoperative administration of ketorolac and morphine in controlling postoperative pain in septorhinoplasty patients.

The present study is a double-blind randomized clinical trial that was conducted during a six-month period from March 2022 to August 2022 in 180 patients referred to the operating room of Motahari Hospital in Jahrom city who underwent septorhinoplasty surgery. Patients were randomly divided into three groups of morphine 6 mg and ketorolac with doses of 30 and 60 mg. Information collection tools include; Age, gender and pain level after surgery. Pain intensity was measured by pain measurement scale (VAS). Data analysis was done using spss version 21 and descriptive statistics (mean and standard deviation) and inferential statistical test (Fisher).

In terms of gender, 67.22% of the participants were male and 32.77% were female. The distribution of the number of men and women in the study groups was not significantly different (P=0.80). There was no significant difference between the study groups in terms of age (P=0.14). In terms of felt pain, Fisher's statistical test showed that more people in the ketorolac 30 mg group had felt pain than the other two groups, which was statistically significant (P=0.003).

Due to the importance of reducing the pain of patients after surgery and minimizing the side effects of surgery, it is possible to use Ketorolac at a dose of 60 mg during septorhinoplasty surgery to control pain due to the lower side effects of Ketorolac compared to morphine Used after surgery.

Gastrointestinal endoscopy is a suitable diagnostic and therapeutic method for gastrointestinal diseases and choosing a suitable sedation method for this procedure is important. Sedation with propofol-ketamine is one of the most commonly used methods. This study was designed to evaluate intravenous lidocaine in endoscopy under sedation.

The designed study is a double-blind clinical trial that was conducted on 138 patients candidates for outpatient endoscopy after approving the proposed plan and obtaining approval from the Medical Ethics Committee of Ahvaz Jundishapur University of Medical Sciences. Patients were divided into two groups. In the first group, 0.5 mg/kg of propofol and 0.5 mg/kg of ketamine were, and in the second group, the same drugs and 1.5 mg/kg of lidocaine were injected. The level of sedation, nausea, vomiting and hemodynamic changes in the patients were recorded and compared.

The two groups were matched for age, gender, and weight. There was no significant difference in the duration of the endoscopy. . There was no significant relationship between the heart rate and mean arterial pressure in the two groups(p>0.05). There was no significant difference in recovery time between the two groups. The amount of additional propofol was significantly lower in the group receiving lidocaine The level of sedation did not differ between the two groups, and nausea and vomiting were significantly lower in the group receiving lidocaine.

Adding intravenous lidocaine to a propofol-ketamine combination improves clinical outcomes and reduces side effects.

Considering the high prevalence of cesarean section and the importance of pain control afterwards, this study investigated the effect of diclofenac sodium suppository, intravenous paracetamol and their combination on acute pain after cesarean surgery.

99 patients candidates for cesarean surgery were randomly divided into three groups. For postoperative analgesia, diclofenac sodium suppository + PCA pump containing placebo was used in group A, PCA pump containing intravenous paracetamol + placebo suppository was used in group B, and PCA pump containing intravenous paracetamol + diclofenac sodium suppository was used in group C. Postoperative pain intensity was assessed using the VAS scale at 1, 4, 12, and 24 hours, and the amount of opioid used for postoperative analgesia was recorded.

In terms of pain intensity, a significant difference was observed between groups A, B and C at 1, 4, 12 and 24 hours after the operation (p<0.05). Pain in group C was significantly less than the other two groups at all hours (p<0.0001). Comparing groups A and B, the pain in group A was less in the 1st and 4th hours after the operation, and in the 12th and 24th hours, the pain intensity in group B was less than that in group A (p<0.05). The lowest amount of morphine consumed in the postoperative period was observed in groups C, B and A respectively (p<0.05).

the combination of diclofenac suppository and paracetamol pump effectively reduces postoperative pain and the need for narcotics, in addition, diclofenac suppository has more pain relief than the paracetamol pump in hours 1 and 4, but the overall amount of intravenous narcotic consumption was lower in the paracetamol pump group. Is.