Background: The study was aimed to evaluate the safety and efficacy of fentanyl and pethidine on the sedative quality of patients who underwent phacoemulsification cataract surgery with Propofol. Materials and Methods: In this double-blind randomized controlled clinical trial, patients who were candidates for elective phacoemulsification surgery with topical anesthesia were enrolled. The selected patients were randomly allocated into the two groups for receiving sedation with Propofol-Pethidine (PP) or propofol-fentanyl (PF) combinations. Demographic characteristics, hemodynamic parameters before, during, and after the operation, sedation and pain scores, and patients' and surgeons' satisfaction scores were compared in the two studied groups. Results: In this trial, 70 patients (35 patients in each group) have completed the study. Mean (standard deviation) operation time was 22.9 (6.8) and 25.46 (7.7) minutes in PF and PP groups ( P = 0.118).Mean pain score in PF 0.46 (0.14) was significantly higher than PP groups 0.236 (0.06) ( P = 0.011). The mean value of diastolic and systolic blood pressures, pulse rate, and mean arterial pressure dioxide were significantly decreased in both PF and PP groups ( P Time < 0.001), although there was no significant difference between groups. Conclusion: Our findings indicated the equivalence effects on hemodynamic parameters for both pethidine and fentanyl in combination with propofol in which they could provide appropriate sedation and safe anesthesia with lower complications and acceptable patients' and surgeons' satisfaction.
Background: The lack of any definitive treatment of COVID-19 has caused a great deal of stress in communities, especially for those fighting in the front line. In the present study, job stress of medical staff working in Intensive Care Units (ICUs) of patients with COVID-19 was evaluated and compared with staff working in non-COVID-19 ICUs. Methods: This study was performed in Iran with a study population of 80 staff members including nurses, paramedics, supervisors and other medical staff working in ICUs of COVID-19 and non-COVID-19 patients. The Osipow questionnaire was used to assess the job stress level. Results: The mean age of medical staff was 29.72±7.58 years old. The stress score of the male medical staff of ICUs of patients with COVID19 was significantly higher than the female staff and the average stress of employees in night shifts (190.60) was significantly higher than those in the morning and afternoon shifts. In the dimension of responsibility for COVID-19 ICU employees, working in the service department, having a history of COVID-19 infection, working in the NICU and having first-degree relatives with COVID19 caused significantly higher job stress levels. In the dimension of responsibility for non-COVID-19 ICU employees, working in the clinical ward and in the role of boundary dimension, being a supervisor caused significantly higher job stress levels compared to the rest of the staff. Conclusion: It can be concluded that ICU staff are under high pressure during the COVID-19 pandemic in different hospitals of Iran and they need more support to improve their mental health.
Background & objectives:The aim of this study was to evaluate the effects of preventive administration of ketamine, fentanyl and paracetamol on pain intensity and hemodynamic parameters after deep vitrectomy. Methods: In this clinical trial, 80 candidates of deep vitrectomy surgery were randomly assigned into 4 groups (1-4) and received 0.5 mg / kg ketamine, 2 μg / kg fentanyl, 10 mg/kg of paracetamol and equivolume of normal saline respectively intravenous infusion during the last 15 minutes of surgery. Pain intensity and hemodynamic parameters were recorded and analyzed. Results: Pain intensity was significantly higher in placebo group during the first 4 hours after operation (p<0.01), but no significant differences were observed between the study groups at 8 and 24 hours after operation in this regard. There were no significant differences between the three intervention groups in terms of pain intensity during the study. Also there were no significant differences between the 4 study groups regarding to hemodynamic parameters. Conclusion:The use of each of the three intervention drugs significantly reduced the pain intensity compared to the control group without any hemodynamic derangement.
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