Comparative Efficacy of Bispectral Index Monitoring and Clinical Assessment in The Recovery of Patients Undergoing Open Renal Surgery: A Randomized, Double-Blind Study

Background and Aims: Maintaining the sufficient depth of anesthesia with an adequate anesthetic drug dosage in patients undergoingsurgery is one of the most significant issues. Inadequate depth of anesthesia can cause significant disturbances in hemodynamicparameters. In this study, clinical assessment and bispectral (BIS) index monitoring compare the depth of general anesthesiaand recovery time in patients undergoing open renal surgery.Method: In this double-blind, randomized, controlled trial, all patients undergoingopenrenal surgery were enrolledandrandomlydivided into a BIS group and clinical assessment group (control). In the BIS group, the electrodes of BIS monitoring system wereplaced on frontal and temporal lobes of the patient. The time of eye opening, verbal response to verbal stimulation, extubation time,the duration of stay in the recovery unit, the first-time of narcotic usage, and total dosage of intravenous narcotics were assessed in2 groups.Results: A total of 96 patients were enrolled. Sex, age, BMI, duration of surgery, length of stay in the recovery room and first-timenarcotic drug usage were not significantly different in the two groups. However, the length of time from the anesthetic drug discontinuationto eye opening, verbal responses to verbal stimulation and extubation was significantly lower in the BIS group thanthe control group, respectively (P = 0.002, P = 0.007, P = 0.019).Conclusions: The evaluation of the aneasthesia status of patients based on the BIS index would be more efficient in decreasing theemergence anaesthesia including eye opening, verbal response, extubation after anesthesi

Fertility Rate and Sperm DNA Fragmentation Index following Varicocelectomy in Primary Infertile Men with Clinical Varicocele: A Prospective Longitudinal Study

Background: Varicocele is one of the most common treatable causes of male infertility, and its treatment may bebeneficial for fertility. This study aimed to evaluate fertility rate and DNA fragmentation index (DFI) following varicocelectomyin primary infertile men with clinical varicocele.Materials and Methods: This prospective longitudinal study was conducted on primary infertility men, in a tertiarycenter from December 2018 to December 2019 with one-year follow-up. Data of the semen parameters, DFI (%), andfertility rate were gathered before, as well as 4 and 12 months after undergoing varicocelectomy. For data analysis,SPSS software and analytical test were used.Results: Out of 76 patients who were analyzed, 22 (29%) became fertile and 54 (71%) remained infertile. Semenparameters and DFI (%) were improved significantly following varicocelectomy (P<0.001). Smoking history, occupationalheated exposure, body mass index (BMI), and infertility duration were determined as predictors associatedwith fertility status (P<0.05).Conclusion: Although varicocele repair improved the DFI, the fertility rate was achieved in less than one-third ofpatients; it seems that the other parameters, such as the history of smoking, occupational heated exposure, overweight,and duration of infertility should be considered as predictors of fertility status, in primary infertile men who are a candidatefor varicocelectomy