Journal of Surgery and Trauma
Volume:2 Issue: 1, Spring 2014

Postoperative shivering is one of the common problems following general anesthesia and may lead to multiple complications. This study aimed to compare the impact of Ketamine and Pethidine on postoperative shivering. In a randomized clinical trial, one hundred and thirty-five patients undergoing elective abdominal surgery were recruited for the study. The patients were randomly divided to groups received Normal Saline, Ketamine or Pethidine at the end of surgery. The frequency of shivering was determined immediately after surgery, and at 10. 20. And 30 minutes, postoperatively. In zero time the rate of shivering was more severe than other times in the three groups. Also the rate of postoperative shivering was significance less different in the pethedine and Ketamine groups than the Normal Saline group. However, no significant difference was seen between the pethedine and Ketamine groups. The result of this study showed that exactly after operation, the rate of postoperative shivering was more severe than other times in 3 groups. Ketamine and Pethidine might reduce postoperative shivering with no significant difference.

shorter hospital stay and less pain in comparison to open surgery considered to be major benefits for laparoscopic cholecystectomy. We compared the effect of intraperitoneal hydrocortisone plus bupivacaine with bupivacaine alone on pain relief following laparoscopic cholecystectomy. Sixty two patients participated in this double-blind, randomized clinical trial. Patients randomly received intraperitoneal instillation of either 100 mg bupivacaine in 250 ml normal saline (n=32) or 100 mg hydrocortisone plus 100 mg bupivacaine in 250 ml normal saline (n=30) before insufflation of CO2 into the peritoneum. Abdominal and shoulder pain were evaluated using VAS postoperatively. The patients were also followed for postoperative analgesic requirements, nausea and vomiting, and return of bowel function. We used independent Student t-test and Chi-square test and Mann-Whitney U tests with SPSS software to compare quantitative and qualitative variables, respectively. P value less than 0.05 was considered significant. Sixty patients completed the study. Patients in the hydrocortisone plus bupivacaine group had significantly lower abdominal and shoulder pain scores (11.72 vs 8.92 in the bupivacaine and bupivacaine plus hydrocortisone group, respectively; P<0.01). The patients were similar regarding analgesic requirements. The patients were similar with respect to return of bowel function, nausea and vomiting. No adverse reaction was observed in either group. Intraperitoneal administrations of hydrocortisone plus bupivacaine can alleviate pain after laparoscopic cholecystectomy better than intraperitoneal bupivacaine alone.

Transhiatal esophagectomy is a widely accepted approach for palliative resection of subcarinal esophageal cancers. This study was designed to evaluate the necessity of routine thoracostomy tube insertion in this technique. This descriptive study was conducted on 123 consecutive patients with esophageal cancers undergoing transhiatal esophagectomy from March 2001 to February 2005. Chest tube insertion was performed according to our defined criteria. Thoracostomy tube would be inserted intraoperatively, if the estimated amount of bleeding was more than 200 ml. In patients with unilateral or bilateral diffuse haziness in chest-x-ray representative of considerable fluid collection, and symptomatic patients with each amount of pleural fluid, it would be inserted postoperatively. Thoracostomy tube was intraoperatively inserted in 41 cases (33.3%). Among other 82 patients only 19 cases (15.4%) required chest tube during admission period. There was significant relation between intraoperatively and postoperatively inserted thoracostomy tubes (p<0.001). There was no statistically relation between chest tube insertion and hospital mortality (p=0.71). The mortality rate didn’t show a significant relation with the amount of chest tube drainage (p=0.056). Routine intraoperative chest tube insertion is not necessary for all patients following THE, and it should be limited to the patients with significant intrathoracic bleeding.

ntroduction: Electrocautery device is one of the most widely used electronic devices in operating rooms; despite its advantages in operations, production risks such as the halo of smoke above the operating position. The smoke with hazardous substances,cause to transmitting HIV, HPV and hepatitis and complications such as respiratory distress, nausea and vomiting, eye irritation, headache, and so on; The purpose of the present study was to determine Surgical Team'' Knowledge of electrocautery smoke complications in the Educational hospitals in Birjand, 2011. In this descriptive and cross-sectional study Surgical Team in Birjand Educational hospitals who were available were selected. After ensuring that they were content with and cooperate in the study, a researcher designed questionnaire was filled. The questionnaire included demographic questions (4 items) and knowledge questions (21 items) of electrocautery smoke complications. The obtained data was analyzed by SPSS software (V: 16), using Kruskal-Wallis and Mann-Whitney at the significant level P<0.05. Mean score Surgical Team '' knowledge of electrocautery smoke complications were 9.0±4.88 (of the total 21 points); that is, 57% of them had low knowledge of electrocautery smoke complications. Given the low level of knowledge about electrocautery smoke complications in Surgical Team, planning to enhance their knowledge through workshops and continuing education programs and training is essential.

Breast cancer is the most common cancer and the second cause of death in women. It is essential to have the highest level of confidence in axillary staging assessment. Many surgeons and pathologists believe that fewer lymph nodes are present in axillary dissection specimens of women treated by neoadjuvant chemotherapy. Consequently, the purpose of this study was to compare the lymph node counts of axillary dissection specimens from patients having received neoadjuvant chemotherapy with those of patients treated with primary operation. This descriptive study was conducted on 100 women with invasive breast cancer who underwent level I and II axillary lymph node dissections from 2012 through 2013 in Quaem hospital surgery department. these patients dichotomized into two categories: Women from the neoadjuvant chemotherapy group (n=50) were compared with those from the primary surgery group (n=50). The total number of lymph nodes harvested was compared, the obtained data was analyzed by SPSS software (V: 16), using Kruskal-Wallis and Mann-Whitney at the significant level P<0/05. range of age in Neoadjuvant and Surgery group respectively was 23–68 and 26–89 years. The median number of lymph nodes retrieved in the neoadjuvant chemotherapy group was 14.0 (range 5 to 25) compared with 16 (range 5 to 32) in Surgery-first group, although there was not statistically significant difference between the two groups (P=0.122). Tumor stage and nodal stage were significantly higher in the neoadjuvant group (p≤0.001). This study suggests that administration of neoadjuvant chemotherapy to breast cancer patient's results in a reduced number of lymph nodes retrieved in the axillary dissection specimens.

A growing number of children around the world are being born by surgical delivery, or cesarean section. Concerns about the steep increase in cesarean deliveries have been raised because of the possibility that surgical delivery is associated with greater maternal and infant mortality and morbidity than vaginal delivery. The purpose of the present study was to determine Prevalence of cesarean section and related causes of in women referring to Vali-e-Asr and tamin -e-ejtemaee hospitals in Birjand, 2010. In this descriptive study, which cross-sectionally was carried out, 293 pregnant women referring to Vali-e-Asr and tamin -e-ejtemaee hospitals were studied. A questionnaire in 2 portions was filled out at mothers’ bed, in delivery room, operation room, and women's ward. The obtained data was analyzed by SPSS software, using chi square test at the significant level P<0/05. From 293 pregnant women in this study 147 (50.2%) had a normal delivery and 146 (49.8%) by Cesarean. The most common causes for caesarean were cephalopelvic disproportion (22.4%), malpresentation (21.7%) and Failure to progress (16.8%). In this study, the prevalence of caesarean section is more than the WHO standard. In order decrease the number of unnecessary cesarean, teaching the young pregnant mothers about the disadvantages of cesarean is necessary.

Inguinal mass is a common clinical finding or even symptom in childhood while the most common diagnosis is inguinal hernia that may proceed with prompt surgical but there are a vast variety of different entities that may manifest as an inguinal mass and in some instances, surgical approach is not indicated or may need further preoperative assessments to determine a correct therapeutic plan. In this article, we discuss about an example of unusual case of extrarenal Wilms tumor in inguinal region which was presented as an inguinal mass and also review differential diagnosis for childhood inguinal mass.

Nasogastric tube (NG) insertion is a usual technique in any neonatal intensive care unit. This procedure is undertaken for the children who are in need of invasive care. Sometimes, the insertion of nasogastric tube in infants with esophagus friable anatomy tissues may have some dangerous side effect, but such problems are not very common. Esophageal perforation is a rare but known complication of these procedures. In this study, we present the case of an infant with esophageal perforation. This infant was diagnosed incidentally on X-rays. This problem is usually associated with critically ill patients in the NICU.