BackgroundThe aim of this study was to compare the volume of blood loss and hemodynamic changes in patients undergoing lumbar discopathy, after continuous infusions of dexmedetomidine versus remifentanil during anesthesia with controlled low blood pressure.MethodsIn this randomized double-blind clinical trial, 60 patients aged 20 to 65 years were randomly assigned to control and intervention groups. The intervention group received a continuous infusion of dexmedetomidine at 0.3 - 0.7 µg/kg/hour plus propofol at 50 - 100 µg/kg/minute. The control group was given a continuous infusion of remifentanil at 0.1 to 1 µg/kg/minute plus the same dose of propofol as above. The primary outcome was the amount of patient's bleeding during surgery, and secondary outcomes were changes in the patient's systolic blood pressure, diastolic blood pressure, mean arterial pressure, and urinary output.ResultsUnivariate and multivariate analyses of the main outcome in the control and intervention groups showed that there was no significant difference between the two drugs with regards to the volume of blood loss, mean arterial pressure, and systolic and diastolic blood pressure. Postoperative side effects were significantly lower in the intervention group (P = 0.002).ConclusionsAdministration of dexmedetomidine plus propofol in comparison with remifentanil plus propofol did not show any significant difference regarding blood loss and hemodynamic changes; however, it reduced some side effects after surgery and decreased analgesic requirement in the postoperative period. Taken together, the findings of this study do not support strong recommendations for dexmedetomidine infusion for all patients and the decision should be taken with caution on basis of the anesthesiologist’s expert opinion and the patient’s condition during surgery.

BackgroundCaesarean section, also known as C-section, is a very common procedure in the world. Minimum data set (MDS) is defined as a set of data elements holding information regarding a series of target entities to provide a basis for planning, management, and performance evaluation. MDS has found a great use in health care information systems. Also, it can be considered as a basis for medical information management and has shown a great potential for contributing to the provision of high quality care and disease control measures.ObjectivesThe principal aim of this research was to determine MDS and required capabilities for Anesthesia information management system (AIMS) in C-section in Iran.MethodsData items collected from several selected AIMS were studied to establish an initial set of data. The population of this study composed of 115 anesthesiologists was asked to review the proposed data elements and score them in order of importance by using a five-point Likert scale. The items scored as important or highly important by at least 75% of the experts were included in the final list of minimum data set.ResultsOverall 8 classes of data (consisted of 81 key data elements) were determined as final set. Also, the most important required capabilities were related to airway management and hypertension and hypotension management.ConclusionsIn the development of information system (IS) based on MDS and identification, because of the broad involvement of users, IS capabilities must focus on the users’ needs to form a successful system. Therefore, it is essential to assess MDS watchfully by considering the planned uses of data. Also, IS should have essential capabilities to meet the needs of its users.

: The potential for misuse, overdose, and chronic use has led researchers to look for other methods to decrease opioid consumption in patients with acute and chronic pain states. The use of peripheral nerve blocks for surgery has gained increasing popularity as it minimizes peripheral pain signals from the nociceptors of local tissue sustaining trauma and inflammation from surgery. The individualization of peripheral nerve blocks using adjuvant drugs has the potential to improve patient outcomes and reduce chronic pain. The major limitations of peripheral nerve blocks are their limited duration of action and dose-dependent adverse effects. Adjuvant drugs for peripheral nerve blocks show increasing potential as a solution for postoperative and chronic pain with their synergistic effects to increase the duration of action and decrease the required dosage of local anesthetic. N-methyl-d-aspartate (NMDA) receptor antagonists are a viable option for patients with opioid resistance and neuropathic pain due to their affinity to the neurotransmitter glutamate, which is released when patients experience a noxious stimulus. Neostigmine is a cholinesterase inhibitor that exerts its effect by competitively binding at the active site of acetylcholinesterase, which prevents the hydrolysis of acetylcholine and subsequently retaining acetylcholine at the nerve terminal. Epinephrine, also known as adrenaline, can potentially be used as an adjuvant to accelerate and prolong analgesic effects in digital nerve blocks. The theorized role of sodium bicarbonate in local anesthetic preparations is to increase the pH of the anesthetic. The resulting alkaline solution enables the anesthetic to more readily exist in its un-ionized form, which more efficiently crosses lipid membranes of peripheral nerves. However, more research is needed to show the efficacy of these adjuvants for nerve block prolongation as studies have been either mixed or have small sample sizes.

SU M M A RYAcademic achievement is one of the most important concepts in the field of education. Although emotional intelligence, as a key factor in academic achievement, has been studied in various studies, yet the results obtained are not in harmony with each other and the topic is yet under debate. In order to fill in this informational vacuum, the present research was undergone using a meta-analysis method.In order to make a thorough search to find articles within the Iranian context, key words such as "Emotional Intelligence" AND (Emotional OR Intelligence) AND "academic achievement" OR "academic status" AND "Student" AND "Iran", were used without limitation in dates or language in the following sites: Medline, Scopus, ScienceDirect, Web of Knowledge, Ovid, Wiley, Google Scholar, and Persian databases such as SID, Irandoc and Magiran. The random effect model was utilized for statistical pooling.A total of 23 articles were chosen to enter the meta-analysis. The pooled results showed a meaningful relationship between emotional intelligence and academic achievement (Pooled Correlation = 0.157; 95% CI, 0.081-0.231). The Cochran Q (Q = 145:126, p = 0.000) and I 2 = 84.84% index indicated a high heterogeneity among the articles entering the meta-analysis. In subgroup analysis, the students in state universities had more summary effect (0.177; 95% CI, 0.085 -0.267) compared to the ones studying in private ones (0.118; 95% CI, 0.024-0.255). No sign of publication bias was found.A weak correlation was seen between emotional intelligence and educational achievement in the context of Iranian university students. It seems that the relationship of these concepts may be affected by other factors in this setting, so this calls for further studies in this field.