Introduction: The estimation of blood loss rate during surgery for prediction of transfusion of blood or blood products requirement is important for surgeon and anesthesiologist. In regard to various results and lack ...Introduction: The estimation of blood loss rate during surgery for prediction of transfusion of blood or blood products requirement is important for surgeon and anesthesiologist. In regard to various results and lack of definite index for start of transfusion in operating rooms, the assessment of blood loss reduction is necessary. The aim of study was evaluation of hemoglobin (Hb) value and hemorrhage estimation rate. Methods and materials: 48 cases underwent major orthopedic surgery with high probability of intraoperative blood loss rate was included in study. Hb, hematocrit (Hct) and basic vital signs were measured preoperatively and blood loss rate was estimated by using of blood volume in suction, bloody gases and blood loss in operation field and recorded. The blood sample per 100 mL blood loss was sent to laboratory. For transfusion deciding based on Hb, we did not any intervention. Results: 26 males and 22 females were included in study. Our results showed that Hb value of males was higher significantly of females in preoperative period. After beginning of blood loss, Hb and Hct values declined with fixed slope and there was high negative correlation between them. First, intraoperative systolic and diastolic pressures declined with high slope and then reduced with mild slope. Hb value reduced significantly per 100 mL blood loss. During survey, no alteration in urine output did not be observed. Conclusion: Present study showed that much more intraoperative blood loss could reduce Hb with high correlation coefficient and measurement of it is efficient on transfusion.展开更多
Introduction: The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, thus the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting i...Introduction: The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, thus the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, but many studies have showed that guidelines were not considered in clinical practice. The aim of this study was to evaluate the adjustment of preoperative NPO time with fasting guidelines in adult elective ophthalmic surgeries in a university educational ophthalmology hospital in Tabriz, Iran. Methods: In 3 months period, this descriptive study was conducted on 250 patients who scheduled for elective eye surgery. The investigator interviewed with patients before beginning of anesthesia and evaluated fasting duration for heavy meal, light meal and clear liquids and his or her satisfaction from NPO time and also investigated which staff recommended NPO time before anesthesia induction. Results: Fasting duration from heavy and light meal and clear liquids was 14.31 hours (8 - 23 hours), 12.46 hours (6 - 21 hours) and 11.54 hours (3 - 18 hours), respectively, that was not consistent with ASA guidelines. The discontent of the patients from prolonged NPO time was 60.8%. The most complaint was thirsty (42%). Ward nurses were the personnel who had the primary role in patients fasting time period (47.6%). Conclusion: Preoperative fasting duration for heavy and light meal and clear liquids for elective ophthalmic surgery in this teaching hospital was very long and not consistent with ASA guidelines. Ward nurses had the major role in this malpractice. Thus it seems that personnel education may be very helpful.展开更多
Introduction: Post-varicocelectomy pain is a considerable pain with probability of promotion toward chronicity. Some reasons, including surgical technique or nerve injury and inappropriate attention to treatment of ac...Introduction: Post-varicocelectomy pain is a considerable pain with probability of promotion toward chronicity. Some reasons, including surgical technique or nerve injury and inappropriate attention to treatment of acute pain play role in the emergence of acute pain. The pain could lead to limitation in movement and working, patient dissatisfaction and waste of medical resources. Transcutaneous electrical nerve stimulation (TENS) therapy as the patient control analgesia (PCA) is associated with reduction of pain intensity and analgesic consumptions. This study aimed to evaluate the effect of TENS therapy on reducing the acute and chronic pain following varicocelectomy. Methods and Materials: The study was conducted after obtaining the approval of the local Institute Ethics Committee and written informed consent from all of the patients. Eighty patients scheduled for undergoing varicocelectomy, were randomly classified according to a randomization list prepared using online software at a 1:1 ratio to Groups A (intervention group) and B (placebo group). In postoperative and recovery period, Group A received TENS therapy for 30 minutes in parallel to surgical scar with high frequency by sensory level. Group B was treated with off-device. The treatment course was replicated for the two groups at 2, 6, 12 and 24 hours after operation. Then, postoperative pain was measured by VAS (visual analogue scale) at the same time and after 1 week and 1, 2 and 3 months. The amount of used analgesics was recorded. Results: The results showed that based on the VAS, pain significantly decreased after intervention in 2 hours (25% with VAS = 5 versus 32.5% with VAS = 8 in control group). The differences among, amount of used analgesics at 2, 6 and 12 hours were significant with p-value = 0.001, <0.0001 and =0.02, respectively. Conclusion: TENS therapy could efficiently decrease pain degree for hours, weeks and months after varicocelectomy;this was associated with decreased post-operation analgesic requirements.展开更多
文摘Introduction: The estimation of blood loss rate during surgery for prediction of transfusion of blood or blood products requirement is important for surgeon and anesthesiologist. In regard to various results and lack of definite index for start of transfusion in operating rooms, the assessment of blood loss reduction is necessary. The aim of study was evaluation of hemoglobin (Hb) value and hemorrhage estimation rate. Methods and materials: 48 cases underwent major orthopedic surgery with high probability of intraoperative blood loss rate was included in study. Hb, hematocrit (Hct) and basic vital signs were measured preoperatively and blood loss rate was estimated by using of blood volume in suction, bloody gases and blood loss in operation field and recorded. The blood sample per 100 mL blood loss was sent to laboratory. For transfusion deciding based on Hb, we did not any intervention. Results: 26 males and 22 females were included in study. Our results showed that Hb value of males was higher significantly of females in preoperative period. After beginning of blood loss, Hb and Hct values declined with fixed slope and there was high negative correlation between them. First, intraoperative systolic and diastolic pressures declined with high slope and then reduced with mild slope. Hb value reduced significantly per 100 mL blood loss. During survey, no alteration in urine output did not be observed. Conclusion: Present study showed that much more intraoperative blood loss could reduce Hb with high correlation coefficient and measurement of it is efficient on transfusion.
文摘Introduction: The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, thus the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, but many studies have showed that guidelines were not considered in clinical practice. The aim of this study was to evaluate the adjustment of preoperative NPO time with fasting guidelines in adult elective ophthalmic surgeries in a university educational ophthalmology hospital in Tabriz, Iran. Methods: In 3 months period, this descriptive study was conducted on 250 patients who scheduled for elective eye surgery. The investigator interviewed with patients before beginning of anesthesia and evaluated fasting duration for heavy meal, light meal and clear liquids and his or her satisfaction from NPO time and also investigated which staff recommended NPO time before anesthesia induction. Results: Fasting duration from heavy and light meal and clear liquids was 14.31 hours (8 - 23 hours), 12.46 hours (6 - 21 hours) and 11.54 hours (3 - 18 hours), respectively, that was not consistent with ASA guidelines. The discontent of the patients from prolonged NPO time was 60.8%. The most complaint was thirsty (42%). Ward nurses were the personnel who had the primary role in patients fasting time period (47.6%). Conclusion: Preoperative fasting duration for heavy and light meal and clear liquids for elective ophthalmic surgery in this teaching hospital was very long and not consistent with ASA guidelines. Ward nurses had the major role in this malpractice. Thus it seems that personnel education may be very helpful.
文摘Introduction: Post-varicocelectomy pain is a considerable pain with probability of promotion toward chronicity. Some reasons, including surgical technique or nerve injury and inappropriate attention to treatment of acute pain play role in the emergence of acute pain. The pain could lead to limitation in movement and working, patient dissatisfaction and waste of medical resources. Transcutaneous electrical nerve stimulation (TENS) therapy as the patient control analgesia (PCA) is associated with reduction of pain intensity and analgesic consumptions. This study aimed to evaluate the effect of TENS therapy on reducing the acute and chronic pain following varicocelectomy. Methods and Materials: The study was conducted after obtaining the approval of the local Institute Ethics Committee and written informed consent from all of the patients. Eighty patients scheduled for undergoing varicocelectomy, were randomly classified according to a randomization list prepared using online software at a 1:1 ratio to Groups A (intervention group) and B (placebo group). In postoperative and recovery period, Group A received TENS therapy for 30 minutes in parallel to surgical scar with high frequency by sensory level. Group B was treated with off-device. The treatment course was replicated for the two groups at 2, 6, 12 and 24 hours after operation. Then, postoperative pain was measured by VAS (visual analogue scale) at the same time and after 1 week and 1, 2 and 3 months. The amount of used analgesics was recorded. Results: The results showed that based on the VAS, pain significantly decreased after intervention in 2 hours (25% with VAS = 5 versus 32.5% with VAS = 8 in control group). The differences among, amount of used analgesics at 2, 6 and 12 hours were significant with p-value = 0.001, <0.0001 and =0.02, respectively. Conclusion: TENS therapy could efficiently decrease pain degree for hours, weeks and months after varicocelectomy;this was associated with decreased post-operation analgesic requirements.
