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Background: Postoperative Nausea and Vomiting (PONV) is one of the most common complications of general anesthesia, moreover opioid addiction increases the risk of PONV. Hence, this study evaluates the effect of administering dexmedetomidine infusion as an intraoperative analgesic on PONV in opium-addicted patients who underwent elective laparoscopic cholecystectomy. Methods: In a randomized clinical trial, 100 opium-addicted patients who were candidates for elective laparoscopic cholecystectomy surgery under general anesthesia were studied in two groups of 50 participants. The intervention group received dexmedetomidine infusion 10 min after induction of anesthesia until the end of surgery. The placebo group received normal saline at the same time. The rate of PONV was compared between the two groups. Results: Both groups had no significant difference in terms of hemodynamic parameters during surgery, including pulse rate, systolic and diastolic blood pressure, and duration of anesthesia. In the dexmedetomidine group, patients had less PONV than the control group, and this difference was significant (p=0.0164). Conclusion: Dexmedetomidine administration during laparoscopic surgery can reduce PONV, especially in patients addicted to opium. [ABSTRACT FROM AUTHOR]

Background: Esophageal spasm is a common problem after Foreign Body Ingestion (FBI) and causes difficulties for foreign bodies' removal by endoscopic intervention. Sometimes, medication may help relieve spasms and facilitate the removal of a foreign body. In the current study, we introduce a patient with esophageal spasm due to FBI for whom intravenous nitroglycerin was used to treat the spasm. Methods: The patient was a 48-year-old man who was admitted to emergency department of Shohadaye Tajrish academic Hospital, Tehran, Iran due to FBI and following sever mid-anterior neck pain, nausea and drooling. His vital signs were normal and during endoscopic procedure, we noticed a sharp object attached to the wall of the upper third of the esophagus, causing severe spasm. After trying for an hour to remove the glass under general anesthesia, we were not able to remove it. Finally, intravenous nitroglycerin was used to relieve the spasm and it was easily removed after 2 minutes. Conclusion: Due to inconsistencies in the clinical results of nitroglycerin, and as notable lack of studies are investigating the effectiveness of the intravenous method, we aimed to share our successful experience. [ABSTRACT FROM AUTHOR]

Background: The corona pandemic has created many unpredictable challenges for the medical staff and students. In almost all countries, changes have been made in the medical education programs at all levels. The anesthesiology assistants are among the most affected groups due to the role of this specialty in the management of COVID patients. Methods: We prepared a questionnaire including demographic information, as well as 20 questions associated with work and educational issues. The questionnaire was sent to all anesthesia assistants via SMS and the answers were collected within 5 days. The 20 main questions were designed in the form of multiple-choice questions with 5 standard options. Results: Responses were immediately reported after categorization. Chi-square test was used to compare the answers among the subgroups, such as male and female, single and married and at different levels.66 anesthesia assistants out of total amount of 71 at four different levels (92.9%) answered the questions. The results showed that the majority of assistants have experienced a higher level of stress during corona pandemic and the negative effects of the pandemic on their medical education were obvious. Conclusion: According to the responses received in this study, the amount of stress in male assistants was less than females and also married assistants experienced less stress in comparison to singles. [ABSTRACT FROM AUTHOR]

Background: Although the effect of Erythropoietin (EPO) in neonatal and animal model of hypoxic ischemic encephalopathy has been previously reported, its effect on comatose patients in adult human has yet to be investigated. Methods: This study was designed to find the effect of intravenous administration of EPO on the recovery from coma in the adult patients with Cardiac Arrest (CA)-induced hypoxic ischemic encephalopathy. This randomized controlled trial study was performed on 60 CA patients who survived Cardiopulmonary Resuscitation (CPR) from April 2011 to Nov 2020. The patients were randomly divided into two equal groups including the control, received normal saline, and the EPO groups, and demographic data were recorded. The EEG and Glasgow Coma Scale (GCS) were recorded on hours 6, 12, 24, and 48 post-success CPR and interpreted by an expert neurologist. Magnetic Resonance Imaging (MRI) was done at 24 and 72 hr of post-CPR and interpreted by an expert radiologist. All patients were checked twice daily by an expert cardiologist. Results: 60 patients were included in this study. There was no significant difference between two groups in terms of demographic data. There was also no significant difference between two groups in terms of GCS and EEG at all post-CPR interval times. No significant difference was observed between both groups with respect to the frequency of pre-existing and metabolic acid-base disorders. Conclusion: The intravenous administration of EPO has no effect on the recovery from coma in the adult patients with CA-induced hypoxic ischemic encephalopathy. [ABSTRACT FROM AUTHOR]