Postpartum depression is a common disabling psychosocial disorder that could have adverse effects on the life of the mother, infant, and family. The present study was conducted to evaluate the effect of ketamine on preventing postpartum depression in women undergoing caesarian sections considering the relatively known positive effect of ketamine on major depression. The present double-blind, randomized clinical trial was conducted on 134 women undergoing scheduled caesarian sections. Participants were randomly allocated into two groups of control and intervention. To induce anesthesia, 1–2 mg/kg of body weight of Nesdonal and 0.5 mg/kg of body weight of ketamine were used in the intervention group, while only 3–5 mg/kg of body weight Nesdonal was administered in the control group. Data were gathered using the Edinburgh Postnatal Depression Scale (EPDS) in three stages: before the caesarian section and two and four weeks after the caesarian section. Data were analyzed using variance analysis with repeated measures and the Chi-square test. Results of the present study showed that the mean (± standard deviation) of the depression score in the intervention and control groups were 13.78±3.87 and 13.79±4.78(p = 0.98) before the caesarian section, 11.82±3.41 and 14.34±4.29 (p < 0.001) two weeks after and 10.84±3.48 and 13.09±3.79 (p = 0.001) four weeks after the caesarian section, respectively. Using ketamine in the induction of general anesthesia could be effective in preventing postpartum depression. However, further studies are required to strengthen these findings.
Perioperative effects of oral midazolam premedication in children undergoing skin laser treatment. A double-blinded randomized placebo-controlled trial
1Efeitos peroperatórios da premedicação oral de midazolam em crianças submetidas a tratamento de pele por laser. Estudo duplo-cego randomizado e controlado.
Mehrdad Shoroghi
ABSTRACT Purpose:To investigate and compare the efficacy of oral midazolam with two different dosages in orange juice on perioperative hemodynamics and behavioral changes in children who underwent skin laser treatment in an academic educational Hospital. Methods: Ninety children, candidates for skin laser treatment were randomly assigned to 1 of 3 groups of 30 each: the placebo group received 0.1 ml/kg orange flavored juice, group 2 and 3 receiving 0.5 and 1 mg/kg of injectable midazolam mixed with an equal volume of orange juice, respectively. The main outcome measures included the mask acceptance, patients' behavioral scales and postoperative events. Results: There were no significant differences in heart rate, respiratory rate, and systolic blood pressure among the three groups. However, arterial oxygen saturation was significantly reduced in those given 1 mg.kg -1 midazolam. The median scores of anxiety, separation from parent, preparing an intravenous line, acceptance of the oxygen mask, good sedation, crying reduction and consciousness level were better in midazolam group. Postoperative agitation and re-crying were also more frequent in placebo receivers. Those given 1 mg.kg -1 midazolam were significantly more optimal for sedation, crying, consciousness, preparing an intravenous line, and postoperative re-crying compared with 0.5 mg.kg -1 midazolam receivers. Conclusion: As a preanaesthetic medication, the 1 mg.kg -1 dose of orally given midazolam especially in a volume of orange juice and can optimize the children's behavior during skin laser treatment with no serious adverse effects, enhancing their parents' satisfactions about the sedative protocol. Key words: Midazolam. Premedication. Anesthesia. Laser Therapy. Skin.
RESUMO Objetivo:Investigar e comparar a eficácia do uso oral de midazolam com duas diferentes doses de suco de laranja na hemodinâmica peropeatória e mudanças de desempenho em crianças submetidas tratamento de pele por laser em Hospital educacional e acadêmico. Métodos: Noventa crianças candidatas a tratamento de pele por laser foram distribuídas aleatóriamente em três grupos de 30 cada: o grupo placebo recebeu 0.1mg/kg de suco de laranja, grupos dois e três receberam 0.5 e 1mg/kg de midazolam injetável misturado em igual volume de suco de laranja respectivamente. Os principais registros incluíam a aceitação da máscara, escalas de comportamento e eventos pós-operatórios. Resultados: Não houve diferenças significantes cardíacas, respiratórias e pressão sanguinea sistólica nos três grupos. Contudo, o nível de saturação de oxigênio foi reduzido significantemente nos que receberam 1mg.kg -1 de midazolam. Os níveis médios de ansiedade, separação dos pais, preparo intraveno...
Supplemental oxygen effectively prevents postoperative nausea and vomiting after inguinal hernia surgery: the higher the arterial oxygen saturation, the less frequent PONV.
Pretreatment with thiopentone immediately before succinylcholine administration can decrease the duration and severity of fasciculation more than thiopentone injection 30 seconds before succinylcholine administration.
PURPOSE: To investigate anesthesia recovery and hemodynamic status in patients under thiopental infusion or halothane maintenance anesthesia undergoing ocular surgery. METHODS: Fifty-nine voluntary patients undergoing ocular surgery in Farabi hospital were allocated to one of two maintenance anesthesia groups: inhaled halothane, 0.8 to 1 per cent, (group I, n=37) and thiopental infusion, 10 to 12 mg/kg/hour, (group II, n=22). Hemodynamic parameters were recorded at the time of patient entrance to the operation room and at the 1, 2, 5, 10, 15, 20, 25, 30, 35, and 40 minutes following anesthesia. Anesthesia recovery variables were also compared between the two groups. RESULTS: In group I, arterial blood pressure at 10 to 40 min and heart rate at 1 and 25 min after the administration of anesthetics were significantly lower when compared with group II (W ²= 25.10, p= 0.005). Arterial oxygen saturation was similar in the two groups over the whole points of time. The time intervals between the end of surgery and beginning of the first body movements and respiratory efforts were significantly longer in group received halothane (p<0.001). CONCLUSION: Continuous infusion of thiopental can be applied effectively and safely for maintenance of anesthesia. In comparison with halothane, it is associated with lower changes of intraoperative hemodynamics and faster anesthesia recovery.
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