Effect of fentanyl versus buprenorphine on the pupil size in phacoemulsification cataract surgery

Background: Despite several recent innovations in phacoemulsification surgery, importance of pupil diameter in this surgery is becoming more evident. Purpose: To compare the effect of opioid agonist (fentanyl) versus opioid agonist–antagonist (buprenorphine) on pupil diameter in cataract surgery and to choose the best opioid in high-risk phacoemulsification surgery. Methods: In this randomized double-blinded clinical trial, 60 patients who were candidates for elective phacoemulsification surgery were randomly divided into two equal groups: experimental (buprenorphine, 0.3 μg/kg) and control (fentanyl, 1 μg/kg). Pupil diameter was measured preinjection and at several times postinjection. Blood pressure was recorded at several intervals, as well as shivering, nausea and vomiting, and recovery time. Results: Mean (SD) recovery time was significantly less in the control group (19.46±5.43) than in the experimental group (33.23±10.75) (P<0.0001). The constriction effect (ie, pupillary diameter in mm) was significantly lower in the experimental group (0.53±0.45) than in the control group (1.06±0.52) (P=0.0001). The percentages of constriction effect in experimentaland control groups were 7.68% and 15.07%, respectively. The eye was two times more constricted in the control group in comparison with the experimental group after induction of anesthesia. Conclusion: Buprenorphine is a better solution to decrease pupil constriction in comparison with fentanylinhigh-risk phacoemulsification surgery

Attitude of Nurses toward the Patient Safety Culture: A Cross-Sectional Study of the Hospitals in Tehran, Iran

Introduction: Patient safety is a major component of healthcare quality, which is defined as the avoidance of causing harm to patients in providing healthcare services. The present study aimed to investigate the attitude of nurses toward the patient safety culture in the teaching general hospitals affiliated to Tehran University of Medical Sciences, Iran. Materials and Methods: This cross-sectional study was conducted in 2014. Data were collected using the adapted version of the safety attitude questionnaire (SAQ). Sample size consisted of 385 nurses, who were selected randomly. In total, 325 participants completed the questionnaire. Data analysis was performed in SPSS Version 19 using descriptive statistics, t-test, and analysis of variance (ANOVA). Results:Mean age of the participants was 36.21±6.9 years, and 92% and 8% of the respondents were female and male, respectively. In terms of the occupational status, 92.1% of the participants had a contractual job or permanent official employment. Mean percentage of the positive attitude toward the patient safety culture was 59.2±18.1, 55.6±17.0, 53.8±24.2, 49.5±16.5, and 43.0±22.4 in the dimensions of management perception, teamwork, job satisfaction, safety climate, and work conditions, respectively. In addition, a significant difference was observed in the dimension of management perception and employment status of the nurses (F=4.4; P=0.01). Conclusion: According to the results, attitude of the nurses in the selected hospitals was poor toward the dimensions of the patient safety culture. Therefore, it is strongly recommended that specific training interventions be performed to enhance the work conditions and safety climate in these hospital