Integrated lecturing within clerkship course, a new learning method in nurse-anesthesia teaching

Background and purpose: The conventional lecture-based teaching method that has been used to transit theoretical knowledge to the participants is inadequate. Due to some issues with this didactic approach, it is believed that integration of this approach with an active method may be more valuable in nursing education. In this study, we hypothesized that integrating lecture-based teaching within clerkship course would enhance the knowledge of nurse-anesthesia students. Methods: This prospective randomized study was conducted on 24 students of second-year nurseanesthesia course. All students received either didactic lectures or integrated lectures within the clerkship course during a 4-month semester of their educational curriculum. Their knowledge of anesthesia course was assessed at the end of the course using the Wilcoxon Rank test. Results: The adopted integrated method improved the students’ final scores at the end of the semester (p=0.004). Moreover, their scores were much improved in taxonomy-2 questions (p=0.001). Conclusions: Incorporating a didactic lecture approach within anesthesia clerkship course improves the knowledge of the participants in the anesthesia course

Anisocoria under general anesthesia with propofol

Anisocoria during anesthesia is very rare, but may indicate life-threatening neurologic injuries and create tremendous condition. A 23-year-old male patient was anesthetized with fentanyl and propofol. Thirty minutes after inducing anesthesia, unilateral mydriasis was detected. The duration of surgery was shortened for prompt evaluation of the pupils. At the end of the operation neither vision problem nor obvious anisocoria was detected in the recovery room. Ophthalmological and neurological consultations revealed no pathological finding and the patient was discharged. Evaluation of the size of the patient's pupils before operation would mitigate the fearful condition resulted from anisocori

Effect of lidocaine jelly on the post tonsillectomy complications

Background and aim: Laryngospasm, laryngitis and bleeding are the most serious complications after tonsillectomy. In this study, the frequency of these complications and their correlation with age, sex and application of lidocaine jelly has been assessed. Method: The sample consisted of 100 patients aged from 5 to15 years undergoing tonsillectomy in Resalat hospital of Shahrekord, during 6 months. The subjects were divided randomly into two groups. Case group intubated with 2% lidocaine gel via the endotracheal tube, and control group intubated without lidocaine gel. Laryngospasm, laryngitis and bleeding were recorded during the first postoperative day. Results: The incidence of laryngospasm and laryngitis was 8% and 17% respectively. There were no correlations between these problems and age or sex. The incidence of bleeding was 16% that was higher in older and female patients. The endotracheal tube lubrication with 2% lidocaine gel attenuated laryngospasm during recovery after tonsillectomy in children but it was not effective on laryngitis and bleeding. Conclusion: The application of lidocaine gelly after tonsilectomy for prevention of laryngospasm is recomended

The effect of intramuscular ephedrine on hypotension during spinal anesthesia in Cesarean

زمینه و هدف: در مواردی جهت عمل جراحی نیاز به روشهایی غیر از بیهوشی عمومی مانند بی حسی نخاعی می باشد. اگر عمل جراحی سزارین با بیهوشی عمومی مقدور نباشد معمولاٌ از این روش جهت ایجاد بی حسی استفاده می گردد که یکی از عوارض حاد و خطیر آن برای مادر و جنین افت سریع فشارخون مادر و برادیکاردی جنین است. جهت جلوگیری از افت ناگهانی فشارخون استفاده از افدرین عضلانی قبل از عمل پیشنهاد گردیده است. لذا این مطالعه به منظور بررسی اثر افدرین عضلانی بر روی افت فشار خون پس از بی حسی نخاعی انجام شد. روش مطالعه: مطالعه از نوع کارآزمایی بالینی بر 90 بیمار 18 تا 35 ساله کاندید عمل جراحی سزارین الکتیو که به طورتصادفی به سه گروه تقسیم شدند انجام شد. گروه اول بدون دریافت افدرین عضلانی (گروه شاهد)، گروههای دوم و سوم (گروههای مورد) بترتیب 25 و 50 میلیگرم افدرین عضلانی پنج دقیقه قبل از بی حسی نخاعی دریافت کردند و فشارخون متوسط شریانی آنها پنج دقیقه قبل و یک، پنج، پانزده و سی دقیقه بعد از بی حسی نخاعی ثبت گردید. نتایج: سه گروه از نظر میانگین فشارخون متوسط شریانی پنج دقیقه قبل از بی حسی نخاعی یکسان بودند. تفاوت میانگین فشارخون متوسط شریانی در دقایق مختلف پس از بیحسی نسبت به پنج دقیقه قبل از آن درگروههای مورد نسبت به گروه شاهد تفاوت معنی داری داشت. این مطالعه نشان داد تزریق 25 و 50 میلیگرم افدرین عضلانی قبل از بی حسی نخاعی، در پیشگیری از افت فشارخون در دقایق مختلف پس از بی حسی مؤثر است. نتیجه گیری: پیشنهاد می گردد از تزریق 25 و یا 50 میلیگرم افدرین عضلانی قبل از بی حسی نخاعی به عنوان روشی مناسب جهت جلوگیری از افت فشارخون مادر و حفظ سلامت نوزاد استفاده شود

The effects of Sufentanil on duration of Lidocaine spinal anesthesia

امروزه بیحسی نخاعی با لیدوکائین از روش های معمول در بیهوشی است. جهت افزایش مدت بی حسی از داروهای تنگ کننده عروق در بیحسی با لیدوکائین استفاده می گردد. به منظور پیدا کردن روشی بهتر جهت افزایش مدت بی حسی در این مطالعه از داروی سوفنتانیل (که یک اوپیوئید کوتاه اثر و ضد درد می باشد) به عنوان کمک به داروی لیدوکائین در بیحسی نخاعی استفاده نمودیم. مطالعه بر روی دو گروه 50 نفری از بیماران در محدوده سنی 60-20 سال در کلاس بیهوشی II و I (مطابق تقسیم بندی انجمن بیهوشی آمریکا، ASA) صورت گرفت. در گروه تست از لیدوکائین 5، 100 میلی گرم و سوفنتانیل 2 میکروگرم (0.4 میلی لیتر) و در گروه شاهد از لیدوکائین 5، 100 میلی گرم و نرمال سالین 0.4 میلی لیتر به عنوان داروی بی حسی استفاده شد. مطالعه به روش تصادفی دو سو کور انجام شد و در هر گروه شروع اثر و طول مدت بی حسی با استفاده از حواس لمس، حرارت، درد و طول مدت بی حرکتی با مشاهده خم کردن پاها (Dorsiflexion) اندازه گیری شد و باهم مقایسه گردید. از نظر آماری شروع اثر بی حسی و بی حرکتی در دو گروه تفاوت قابل ملاحظه ای نداشت. طول مدت بیحسی در گروه تست نسبت به گروه شاهد افزایش داشت. مدت بی حسی در ناحیه ناف (T10) در گروه تست 58 (

The Participants' viewpoint of continuing medical education courses

Background: Continuing education is one of the most effective methods to empower the employees for challengesthey face on their jobs. Dramatic advances in medicine, rapid cultural and social changes, increasing cost of healthcare, development of diagnostic technology and a transition in the pattern of diseases, highlight the necessity ofcontinuing education in all medical groups. Purpose: To evaluate the effectiveness of continuing medical education (CME) programs in Shahr-Kord MedicalUniversityfrom 1996-2001

Oxygen saturation improvement after adenotonsillectomy in children.

The goal of this study was to establish whether adenotonsillectomy is effective on the severity of oxygen desaturation or improve oxygen saturation in children with sleep breathing disorders. Thirty-two children, aged 4-7 years, with clinical indication for adenotonsillectomy were enrolled in a non-controlled clinical trial. Pre- and postoperative nocturnal oxygen saturation monitoring was done and oxygen desaturation index as well as desaturation events were analyzed using Wilcoxon and paired Student's t-tests. Snoring was the most prevalent (87.5%) complaint before operation. The study revealed a significant improvement in the postoperative oxygen desaturation index (1.60 +/- 3.22) compared with the preoperative oxygen desaturation index (3.98 +/- 4.93) (p < 0.01). Oxygen desaturation events at the level of oxygen saturation 85-89% was significantly improved after operation (p < 0.01). No significant differences were seen in the desaturation events at the levels of oxygen saturation lower than 85%. Nocturnal oxygen saturation improves mildly after adenotonsillectomy in children with sleep breathing disorders

Citrus aurantium Blossom and Preoperative Anxiety

Akhlaghi M, Shabanian G, Rafieian-Kopaei M, Parvin N, Saadat M, Akhlaghi M - Citrus aurantium Blossom and Preoperative Anxiety. Background and objectives: Reducing anxiety is very important before operation. Preoperative visit and use of premedication are popular methods to achieve this goal, but the role of anxiolytic premedication remains unclear and postoperative side-effects may result from routine premedication. Citrus aurantium is used as an alternative medicine in some countries to treat anxiety, and recently the anxiolytic role of this medicinal plant was established in an animal model study. The aim of this study was to assess the anxiolytic effect of Citrus aurantium blossom on preoperative anxiety. Methods: We studied 60 ASA I patients undergoing minor operation. In a randomized double-blind design, two groups of 30 patients received one of the following oral premedication two hours before induction of anesthesia: 1) Citrus aurantium blossom distillate 1 mL.kg(-1), (C-group); 2) Saline solution 1 mL.kg(-1) as placebo (P-group). Anxiety was measured before and after premedication using the Spielberger state-trait anxiety inventory (STAI-state) and the Amsterdam preoperative anxiety and information scale (APAIS) before operation. Results: After premedication, both the STAI-state and the APAIS scales were decreased in C-group (p < 0.05); while exhibiting no significant changes in P-group. Conclusions: Citrus aurantium blossom may be effective in terms of reduction in preoperative anxiety before minor operation

Citrus aurantium Blossom and Preoperative Anxiety

Summary: Akhlaghi M, Shabanian G, Rafieian-Kopaei M, Parvin N, Saadat M, Akhlaghi M – Citrus aurantium Blossom and Preoperative Anxiety. Background and objectives: Reducing anxiety is very important before operation. Preoperative visit and use of premedication are popular methods to achieve this goal, but the role of anxiolytic premedication remains unclear and postoperative side-effects may result from routine premedication. Citrus aurantium is used as an alternative medicine in some countries to treat anxiety, and recently the anxiolytic role of this medicinal plant was established in an animal model study. The aim of this study was to assess the anxiolytic effect of Citrus aurantium blossom on preoperative anxiety. Methods: We studied 60 ASA I patients undergoing minor operation. In a randomized double-blind design, two groups of 30 patients received one of the following oral premedication two hours before induction of anesthesia: 1) Citrus aurantium blossom distillate 1 mL.kg-1 (C-group); 2) Saline solution 1 mL.kg-1 as placebo (P-group). Anxiety was measured before and after premedication using the Spielberger state-trait anxiety inventory (STAI-state) and the Amsterdam preoperative anxiety and information scale (APAIS) before operation. Results: After premedication, both the STAI-state and the APAIS scales were decreased in C-group (p < 0.05); while exhibiting no significant changes in P-group. Conclusions: Citrus aurantium blossom may be effective in terms of reduction in preoperative anxiety before minor operation