Scalp Nerve Block for Enhanced Pain Control and Analgesic Optimization in Elective Craniotomy: A Randomized Controlled Trial with Analgesia Nociception Index Monitoring.

Background: In patients who are candidates for craniotomy, scalp nerve blocks have been shown to be effective in relieving pain intensity as well as postoperative hemodynamic stability after surgery, but the results have been inconsistent. We aimed to assess the effect of scalp block on pain control, intraoperative drug use under Analgesia Nociception Index (ANI) monitoring, and postoperative pain in patients who were candidates for elective craniotomy.

Methods: In this randomized, single-blinded clinical trial study, candidates for craniotomy were randomly (using the block randomization method) divided into 2 groups before entering the operating room.

Comparison of Goal-Directed Fluid Therapy using LiDCOrapid System with Regular Fluid Therapy in Patients Undergoing Spine Surgery as a Randomised Clinical Trial.

Background: Goal-directed fluid therapy (GDFT) is a new concept to describe the cardiac output (CO) and stroke volume variation to guide intravenous fluid administration during surgery. LiDCOrapid (LiDCO, Cardiac Sensor System, UK Company Regd 2736561, VAT Regd 672475708) is a minimally invasive monitor that estimates the responsiveness of CO versus fluid infusion. We intend to find whether GDFT using the LiDCOrapid system can decrease the volume of intraoperative fluid therapy and facilitate recovery in patients undergoing posterior fusion spine surgeries in comparison to regular fluid therapy.

Cadaveric kidney transplantation in an ESRD patient with Klippel-Feil syndrome-A case report.

Klippel-Feil syndrome (KFS) is a congenital skeletal disorder with classic clinical triad consisting of short neck, low hairline, and limitation of neck movement. In addition to skeletal deformities, diagnosed cases of KFS may have other anomalies such as cardiac, neurologic, and genitourinary disorder. We report a case of KFS with associated anomalies such as short neck, limitation of neck movement, scoliosis of cervical spine, and dextrocardia who received successful cadaveric kidney transplantation.

Comparison of Intraoperative Infusion of Remifentanil Versus Fentanyl on Pain Management in Patients Undergoing Spine Surgery: A Double Blinded Randomized Clinical Trial.

Background: Remifentanil is an ultra-short-acting opioid which facilitates hemodynamic management. However, there are concerns about postoperative Remifentanil hyperalgesia because of its potent fast onset and offset.

Objectives: The aim of this study was to determine visual analog scale (VAS), postoperative pain, and morphine used in two groups after spine surgery.

Comparison of Preoperative Hypertonic Saline versus Mannitol for Intraoperative Brain Relaxation and Early Postoperative Outcome among Patients with Cerebral Low-grade Glioma: A Prospective Study.

Introduction: Hypertonic saline (HS) has an important role in the treatment of raised intracranial pressure after traumatic brain injury. This study evaluates the efficacy and safety of HS and its impact on the postoperative course of patients undergoing craniotomy for low-grade gliomas.

Materials And Methods: Sixty patients with supratentorial low-grade glioma were enrolled.

Prevalence of Abnormal Methemoglobinemia and Its Determinants in Patients Receiving Nitroglycerin During Anesthesia.

Background: One of the complications of nitroglycerin infusion during surgery is methemoglobinemia.

Objectives: The aim of this study was to investigate the prevalence of methemoglobinemia and its association with nitroglycerin infusion for the treatment of hypertension during general anesthesia.

Methods: Patients received nitroglycerin infusion at a dose of 2 μ/kg/min.

The Efficacy of Intraoperative Ketamine-Haloperidol for Prevention of Catheter-related Bladder Discomfort After Lumbar Spinal Stenosis Surgery.

Objectives: Catheterization of urinary bladder during surgery frequently leads to agitation of the patient in the recovery room, especially in those patients who remain catheterized after gaining consciousness. We hypothesized that administration of a combination of ketamine-haloperidol (KH) before urinary catheterization would reduce the incidence of catheter-related bladder discomfort (CRBD) while reducing some adverse effects of ketamine in the postoperative period.

Methods: A total of 119 male patients who underwent lumbar spinal stenosis surgery were randomized into three groups.

Low-dose preoperative pregabalin improves postoperative pain management in septorhinoplasty surgery: a double-blind randomized clinical trial.

Purpose: To evaluate the efficacy of single low dose (75 mg) preoperative pregabalin in reducing post-operative pain of septorhinoplasty.

Methods: A double blind single center Randomized controlled trial based on block randomization. In the pregabalin group (PG) 34 participants received 75 mg pregabalin orally one hour before anesthesia induction while in control group (CG) 34 participants received a placebo.

Half Saline-Bicarbonate Solution as Intraoperative Fluid Replacement Therapy Leads to Less Acidosis and Better Early Renal Function During Deceased-Donor Transplant.

Objectives: Normal saline is the most common crystalloid solution that is used in renal transplant surgery. In this study, our aim was to determine the effects of a combination of half saline and bicarbonate versus normal saline as a routine solution.

Materials And Methods: For this double-blind random-ized clinical trial, we enrolled 100 adult patients undergoing kidney transplant.

Comparison of the Effect of Intra-Rectal Administration of Lidocaine Gel and Lidocaine Plus Fentanyl on Pain Reduction in Prostate Biopsy: A Randomized Clinical Trial.

Objectives: The aim of this study was to compare the effect of intra-rectal administration of lidocaine gel alone versus lidocaine gel plus topical fentanyl on pain reduction in prostate biopsy.

Methods: In a double-blind randomized clinical trial, 96 patients who met the inclusion criteria were randomly assigned into two groups. 1) The treatment group: Lidocaine gel (2%) 50 g and 2) the intervention group: Lidocaine gel (2%) 50 g and fentanyl gel 50 µg.

Preemptive Effect of Intraurethral Instillation of Ketamine-lidocaine Gel on Postoperative Catheter-related Bladder Discomfort after Lumbar Spine Surgery.

Background: Catheter-related bladder discomfort (CRBD) is one of the main reasons of agitation after surgery, leading to urgency and frequency during recovery. Ketamine has been used as an effective drug for reducing the signs and severity of this problem. We hypothesized that intraurethral instillation of ketamine-lidocaine gel before urinary catheterization can reduce the incidence of CRBD in the postoperative period.

Effect of Hypertonic Saline 5% on Early Graft Function and Urinary Interleukin 18 and Neutrophil Gelatinase-Associated Lipocalin in Deceased-Donor Kidney Transplantation.

Ischemia reperfusion injury (IRI) is one of the main causes of delayed graft function (DGF) in deceased-donor kidney transplantation (DDKT). Evidences suggest that hypertonic saline (HS) has beneficial effects on IRI. The objective of the present study is to determine the effect of intraoperative HS, on graft function and urinary biomarkers of interleukin 18 (IL-18) and neutrophil gelatinase-associated lipocalin (NGAL), in patients with DDKT.

Comparison of Nasal Intubations by GlideScope With and Without a Bougie Guide in Patients Who Underwent Maxillofacial Surgeries: Randomized Clinical Trial.

Background: Nasotracheal intubation is commonly performed to provide a secure airway for the maintenance of general anesthesia in maxillofacial surgeries. Routine nasotracheal intubation is performed under general anesthesia by direct laryngoscopy, frequently with the aid of Magill forceps. This method can be time-consuming and may cause bleeding in the field of view.

An Assessment of Intubation Skill Training in Novice Anesthesiology Residents of Tehran University of Medical Sciences With the Use of Mannequins.

Background: The goal of this study was to evaluate the impact of intubation skill training involving the use of mannequins on novice anesthesiology residents in a knowledge, attitudes, and practices designed study in which three different types of evaluation were implemented.

Methods: All first-year anesthesiology residents (24) of Sina Hospital, affiliated to the Tehran University of Medical Sciences, were invited to participate in an intubating skills training course. The program comprised two theoretical and three practical sessions, lasting a total of 16 hours over four days.

Predictive Values of Urinary Interleukin 18 and Neutrophil Gelatinase-Associated Lipocalin for Delayed Graft Function Diagnosis in Kidney Transplantation.

Background: Delayed graft function is a main complication after deceased donor kidney transplantation that adversely affects graft outcome. Difficulties in prediction and early detection of delayed graft function have hindered the ability to perform proper therapeutic interventions. We investigated whether measuring urinary interleukin 18 and neutrophil gelatinase-associated lipocalin as markers of ischemia reperfusion injury could predict delayed graft function in deceased donor kidney transplant patients.

Local Administration of Tranexamic Acid During Prostatectomy Surgery: Effects on Reducing the Amount of Bleeding.

Background: One of the issues in prostatectomy surgery is bleeding. Although tranexamic acid (TRA) is an antifibrinolytic agent for reducing bleeding, controversies surround its use.

Objectives: In this study, the effect of local administration of TRA on reducing bleeding during prostatectomy surgery was evaluated.

Combined Ketamine-Tramadol Subcutaneous Wound Infiltration for Multimodal Postoperative Analgesia: A Double-Blinded, Randomized Controlled Trial after Renal Surgery.

Background: Pain is an important consideration after renal surgery. A multimodal approach to postoperative pain management could enhance analgesia by risking fewer side effects after surgery.

Objectives: The aim of this study was to evaluate the clinical efficacy of the subcutaneous infiltration of ketamine and tramadol at the incision site to reduce postoperative pain.

Multimodal Analgesia With Ketamine or Tramadol in Combination With Intravenous Paracetamol After Renal Surgery.

Background: Opioids are generally the preferred analgesic agents during the early postoperative period.

Objectives: The present study was designed to assess and compare the multimodal analgesic effects of ketamine and tramadol in combination with intravenous acetaminophen after renal surgery.

Patients And Methods: This randomized, double-blinded, clinical trial was conducted on 80 consecutive patients undergoing various types of kidney surgeries in Sina hospital in Tehran in 2014 - 2016.

Analgesic Efficacy of Nephrostomy Tract inFiltration of Bupivacaine and Ketamine after Tubeless Percutaneous Nephrolithotomy: A Prospective Randomized Trial.

Background: Recently, the use of ketamine as a systemic and local analgesic drug in reducing post-operative pain is studied more frequently.

Objectives: The aim of the present study was to assess the analgesic efficacy of IV ketamine injection inaddition to nephrostomy tract infiltration of ketamine-bupivacaine on postoperative pain relief after tubeless percutaneous nephrolithotomy (PCNL).

Patients And Methods: Patients (n = 100), with renal stone who were candidates for PCNL were randomized to five groups with 20 cases in each: Group C, 10 mL of saline solution was infiltrated into the nephrostomy tract; Group B, 10 mL of 0.

Comparison of the Effects of Subcutaneous Versus Continuous Infusion of Heparin on Key Inflammatory Parameters Following Sepsis.

Background: Sepsis is the result of the interaction between inflammatory mediators and coagulation pathway. Unfractionated heparin may play a role as an anti-inflammatory agent beyond its anticoagulatory effect in sepsis. As a result, it may cause reduction in organ failure rate in patients with sepsis due to its impact on both inflammatory and coagulation process.

Effects of Ropivacaine on Postoperative Pain and Peak Expiratory Flow Rate in Patients Undergoing Percutaneous Nephrolithotomy.

Background: Postoperative analgesic effects of ropivacaine have been demonstrated in various surgical procedures; however, its beneficial effect on postoperative pain relief and ability to breathe out air in urological surgeries, particularly in local interventions such as percutaneous nephrolithotomy (PCNL), has remained uncertain.

Objectives: The aim of this study was to assess the efficacy of ropivacaine on postoperative pain severity and peak expiratory flow (PEF) in patients undergoing PCNL procedure.

Patients And Methods: This randomized double-blinded clinical trial was performed on 55 consecutive adult patients aged 15 to 60 years who underwent Tubeless PCNL surgery.

Comparison of aPTT and CT Parameter of the ROTEM Test to Monitor Heparin Anti-Coagulation Effect in ICU Patients: an Observational Study.

Heparin is frequently used in different clinical settings to reduce the coagulating ability of the blood. Because of probable adverse effects owing to heparin therapy and regarding variability of patients' responses to heparin, which make it very unreliable, it seems prudent to monitor meticulously its effects on the human body. There are a lot of laboratory tests to watch its effects on the body for example; aPTT and ROTEM are the most widely used tests that are performed today.

The Comparison of Procalcitonin Guidance Administer Antibiotics with Empiric Antibiotic Therapy in Critically Ill Patients Admitted in Intensive Care Unit.

The empiric antibiotic therapy can result in antibiotic overuse, development of bacterial resistance and increasing costs in critically ill patients. The aim of the present study was to evaluate the effect of procalcitonin (PCT) guide treatment on antibiotic use and clinical outcomes of patients admitted to intensive care unit (ICU) with systemic inflammatory response syndrome (SIRS). A total of 60 patients were enrolled in this study and randomly divided into two groups, cases that underwent antibiotic treatment based on serum level of PCT as PCT group (n=30) and patients who undergoing antibiotic empiric therapy as control group (n=30).

Immunomodulatory effect of hypertonic saline in hemorrhagic shock.

Multiple organ dysfunction syndrome (MODS) and nosocomial infection following trauma-hemorrhage are among the most important causes of mortality in hemorrhagic shock patients. Dysregulation of the immune system plays a central role in MODS and a fluid having an immunomodulatory effect could be advantageous in hemorrhagic shock resuscitation. Hypertonic saline (HS) is widely used as a resuscitation fluid in trauma-hemorrhagic patients.

Intrarectal Lidocaine-Diltiazem-Meperidine Gel for Transrectal Ultrasound Guided Prostate Biopsy.

Background: TRUS-guided needle biopsy of the prostate gland is the current standard method used for diagnosis of prostate cancer. Pain control during this procedure is through the use of i.v.