The present study addressed the effect of melatonin premedication on propofol induction dose for anesthesia in abdominal surgery. This is a double-blinded clinical trial in which abdominal surgery patients admitted to the Valiasr Hospital, Iran ( n = 88) were enrolled and individually randomized into two groups: melatonin and placebo groups sublingually administered 3 mg of melatonin and placebo, respectively, 50 minutes before surgery. Their anxiety, orientation, and sedation were recorded before melatonin administration, anesthesia induction, and recovery, while we also recorded the propofol induction dose required for general anesthesia. Anxiety was seen less in the melatonin group than the placebo group ( P < 0.05), whereas orientation was significantly different before anesthesia induction ( P = 0.044) and sedation was the same before the induction ( P = 0.044) and recovery ( P = 0.049) in both groups, with a better efficiency in the melatonin group in which a lower dose of propofol was used ( P = 0.002). The sedation, anxiety, and propofol dose used were lower in the melatonin group than the placebo group. The recommended dosage was 3 mg of melatonin once to achieve an anesthetic depth index or a bispectral index of 40. The study was approved by Ethical Committee of Arak University of Medical Sciences with IR.ARAKMU.REC.1395.432 code in July 2016, and the trial was registered in Iranian Registry of Clinical Trials with IRCT20141209020258N98 in September 2016.

Postoperative pain is a common problem after inguinal herniotomy. We aimed to compare the intravenous anesthesia effects of propofol and isoflurane inhalation anesthesia on postoperative pain after inguinal herniotomy. In a randomized clinical trial, 102 eligible patients were selected based on inclusion and exclusion criteria and were randomly divided in two groups. In the first group, propofol was used for the maintenance of anesthesia, while isoflurane was used in the second group. The patient’s heart rate, systolic and diastolic blood pressure and oxygen saturation before, during and after surgery, recovery time and postoperative pain were measured immediately, 2, 4 and 6 hours after surgery and compared between two groups. T-test, and repeated measurement test were used for statistical analysis. No statistically significant differences were observed in heart rate, blood pressure and oxygen saturation levels between the two groups (P > 0.05). Propofol has higher effect in easing postoperative pain of patients than isoflurane, but no difference in postoperative complications, including chills, nausea and vomiting, occurs in both two groups. Propofol is effective in declining the postoperative pain of patients after anesthesia in comparison with isoflurane. Moreover, due to the antioxidant, anti-inflammatory and analgesic properties of propofol, it is preferred to isoflurane and the authors recommended it to be used.

Background:Today, the ever-expanding technology is inevitably shadowing on all aspects of human life. This study was aimed to compare the prophylactic effects of paracetamol and dexmedetomidine for controlling hemodynamics during surgery and postoperative pain.Methods:The study population consisted of 132 patients aged 18 to 70 years and from both genders, who were candidates for emergency cholecystectomy or elective surgery. Group A consisted of 66 patients who received dexmedetomidine, and Group B included 66 patients with paracetamol administration. The amount of postoperative pain was measured on the basis of visual analog scale, arterial blood pressure, as well as heart rate at recovery and 4, 12, and 24 hours after surgery.Results:The mean age in the 2 groups was similar and almost equal to 52 years; there was no difference in the sex ratios in both groups (P > .05). Pain score in the paracetamol group was significantly lower than that in the dexmedetomidine group (P = .04); nevertheless, there were no group differences in the mean scores of pain during these hours (P > .05). The median opioid use in 24 hours after operation in the paracetamol group was lower when compared with that in the dexmedetomidine group, and the mean duration of analgesia in the paracetamol group was higher when comparing with dexmedetomidine group. Furthermore, in both groups, mean arterial pressure and preoperative PR interval were similar at various times.Conclusion:The findings demonstrated that both regimens of drugs can control the hemodynamic status of patients during laparoscopic cholecystectomy, which provides effective postoperative analgesia for pain management.

Postoperative complications of fracture are one of the main problems in older patients with hip fracture. In this study, complications were observed 48 hours after surgery in different anesthetic procedures. This prospective cross sectional study was carried out over a 12-month period. All subjects over 55 years of age undergoing hip fracture surgery were selected for study with ASA class (American Society of Anesthesiology: one, two and three). After determining the vital signs in the operating room, anesthesia type (general, spinal and epidural) and various variables were recorded. It was observed that the spinal anesthesia method had the lowest level of postoperative disturbances of consciousness and had the shortest duration in terms of duration of time. On the other hand, general anesthesia was the least in terms of blood transfusion. Finally, epidural anesthetic method showed the least amount of pain 48 hours after operation and the least changes in blood pressure and heart rate.

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IntroductionIntrauterine resuscitation has been proved to increase the oxygenation of placenta and umbilical blood flow. Lateral table tilt or a pelvic wedge are commonly used to reduce inferior vena cava compression during obstetric anesthesia in the supine position but limited studies have evaluated the role of intrauterine resuscitation by maneuvers. We compared the effects of table tilt versus pelvic tilt position on intrauterine resuscitation for caesarian section under spinal anesthesia.Material and methodsThis double blind randomized clinical trial conducted on 150 women undergoing cesarean section. Patients were randomly allocated to pelvic tilt (using a wedge under right buttock) or table tilt (15 degree left tilt of surgical table). Spinal anesthesia was performed, Sensory and motor block were evaluated every minute and time of block onset was recorded. Mean arterial blood pressure, heart rate and arterial oxygen saturation were measured every 5 minutes till the end of the operation. Fetal Apgar scores were recorded at 1st and 5th minutes after delivery. Data were analyzed using SPSS software.ResultsMAP and HR were significantly higher in table tilt group in comparison with pelvic tilt (p< 0/05). No significant difference was detected between the two groups in terms of sensory and motor block (p>0/05). Apgar scores of neonates were almost the same and no statistically significant differences between the two groups in 1st and 5th minutes Apgar score was noted(p>0/05).ConclusionsTable tilt of 15 degrees during cesarean delivery with spinal anesthesia was effective in preventing maternal hypotension and bradycardia and is favorable in intrauterine resuscitation.