Effect of Ketofol instead of Propofol on hemodynamic stabilization for induction of Anesthesia in Laparatomy

Introduction: Hemodynamic alterations are a common complication during anesthetic induction with intravenous anesthesia. Hypotension due to propofol injection may be very severe in cardiac vascular patient. Ketamine produces the significant increasing but temporary in systematic blood stream, heartbeat, cardiac output through central sympathetic stimulation.Objective: To determine effect of ketofol and propofol for induction of anesthesia on hemodynamic changes during induction of anesthesiaMethods: In a randomized cinical trial study 96 patient who were candidate for laparotomy enrolled and divided into two random group of propofol (48 person) and ketofol (48 person). Hemodynamic changes were recorded and examined after induction, after intubation and 5 and 10 minutes after intubation.Results: Heart rate was significantly variable in propofol group compare to ketofol group. Systolic, Diastolic, and mean arterial blood pressure was not significantly changed during time period of recording in ketofol group. However, blood pressure was significantly changed during the study in propofol group.Conclusion: ketofol is a proper alternative to propofol to stabilize heart rate and blood pressure in laparatomy

Performing percutaneous dilational tracheostomy without using fiberoptic bronchoscope

Background: Percutaneous tracheostomy is an elective method that is increasingly being taken up in the intensive care unit alongside the patient's bed. In many centers, bronchoscopy is used, but the necessity of using bronchoscopy in percutaneous tracheostomy has not yet been determined. Discontinuing use of bronchoscopy can potentially reduce the cost and increase the efficiency of percutaneous tracheostomy. Therefore, in this study, we performed a percutaneous dilatational tracheostomy without using fiberoptic bronchoscopy. Materials and Methods: This study was performed as a descriptive epidemiological survey among 70 patients in Shahid Rajaei Hospital of Qazvin in 2015 and 2016. The results were assessed in the patients. Results: In this study, pneumothorax, trauma, major and minor bleeding, cuff leak and change to surgical procedures as well as accidental extubation were not seen. However, subcutaneous emphysema, mal-position and hypoxia each were seen in one patient (1.4%). Conclusion: Totally the results demonstrated that percutaneous dilatation tracheostomy without fiberoptic bronchoscopic guidance is useful and saf