Alireza Abdollahzadeh Baghaei; Hashem Jarineshin; fereydoon Fekrat; Nasim Abdi
Volume 25, Issue 11 , 2023
Abstract
Background: Pain control is one of the most important issues in femoral fractures. One of the most effective methods is the fascia iliaca compartment block.
Objectives: The aim of this study was to compare the efficacy of the addition of dexmedetomidine to bupivacaine on the quality of ultrasound guided ...
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Background: Pain control is one of the most important issues in femoral fractures. One of the most effective methods is the fascia iliaca compartment block.
Objectives: The aim of this study was to compare the efficacy of the addition of dexmedetomidine to bupivacaine on the quality of ultrasound guided blockade of the fascia iliaca compartment in adults undergoing femoral shaft fracture surgery.
Methods: This study was a double-blind clinical trial. We studied 60 adults who were hospitalized for a femoral shaft fracture. The patients were divided into two equal groups receiving either bupivacaine alone or bupivacaine and dexmedetomidine for compartment blockade of the iliac fascia. Group allocation was based on the method of randomization from concealed envelopes. Primary outcomes were pain intensity, sedation and analgesic consumption assessed at 1, 2, 6 and 24 hours after surgery in two groups. Data were analyzed using SPSS software.
Results: Pain intensity was lower in the dexmedetomidine group 1, 2, 6 and 24 hours after surgery (p<0.05). The sedation score was also higher in the dexmedetomidine group 6 and 24 hours after surgery (p<0.05). The dose of analgesics used by the dexmedetomidine group was significantly lower 6 and 24 h after treatment. No hypotension, respiratory depressionand bradycardia occurred in the patients participating in this study.
Conclusion: The addition of dexmedetomidine to bupivacaine during ultrasound-guided blockade of the fascia-iliac compartment is associated with reduced pain intensity and improved sedation in patients undergoing femoral fracture surgery.
Saeid Kashani; Hashem Jarineshin; Fereydoon Fekrat; Maryam Moradi Shahdadi; Neda Soltani Shahabadi
Volume 20, Issue 5 , 2018, Pages 1-11
Abstract
Background: The prevalence of ventricular fibrillation after removal of the aortic cross - clamp in patients undergoing coronary artery bypass surgery is about 74% - 96%. Defibrillation shock and different types of agents are used to treat ventricular fibrillation (VF). Objectives: This study was aimed ...
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Background: The prevalence of ventricular fibrillation after removal of the aortic cross - clamp in patients undergoing coronary artery bypass surgery is about 74% - 96%. Defibrillation shock and different types of agents are used to treat ventricular fibrillation (VF). Objectives: This study was aimed to compare the effects of combining Lidocaine + Magnesium Sulfate with Amiodarone + Magne- sium Sulfate in the prevention of reperfusion - induced ventricular fibrillation.Methods: This randomized, double- blinded clinical study included 74 ASA class II and III patients undergoing coronary artery by- pass grafting (CABG) in a university - affiliated hospital, Bandar Abbas, Iran, in the years 2015 - 2016. Patients were divided into two groups based on a random sample table of the lock. Both groups received Magnesium Sulfate through the cardiopulmonary bypass pump. Lidocaine 2% (100 mg) and Amiodarone (300 mg) were injected respectively to group Lidocaine + Magnesium Sulfate (LM) and group Amiodarone + Magnesium Sulfate (AM) patients before aortic cross - clamp release. The incidences of arrhythmias were recorded within 30 minutes after release of the aortic cross - clamp (ACC). Additionally, the defibrillation shocks (frequency and level of Joules delivered), amount of inotrope agent, and the hemodynamic and arterial blood gas parameters were recorded up to 24 hours postoperatively.Results: There was no significant difference between the two groups in terms of demographic characteristics, ejection fraction, and ASA class. The prevalence of ventricular fibrillation (VF) and atrial fibrillation (Af) 30 minutes after ACC release were 46.7% and 53.3% (P = 0.240) vs. 33.3% and 66.7% (P > 0.999); while, up to 24 hours post - operatively were 60% and 20.0% vs. 0.0% and 0.0% in groups LM and AM respectively. The number of defibrillations in the Lidocaine + Magnesium Sulfate group was significantly higher; 57.9% vs. 25% in groups LM and AM respectively (P = 0.004).Conclusions: The use of Amiodarone + Magnesium Sulfate reduces the number of defibrillation following the release of the Aortic cross - clamp compared with Lidocaine + Magnesium Sulfate.
