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Introduction: Agitation immediately after EA operation is one of the common problems during recovery, especially in children. In general, agitation is defined as a set of physical symptoms or emotional distress that includes the following symptoms alone or together: crying, restlessness, clutching, demonstrations, verbal kicking, and purposeful or purposeless behaviors that may have a logical connection. Method: In this study, 60 patients in the age range of 20 to 50 years who were in ASA I and II categories were subjected to tracheal intubation in two groups by rapid sequence induction method. The first group received 3 μg/kg of fentanyl and 0.5 mg/kg of lidocaine for premedication and were given induction with 1 mg/kg of succinylcholine and 5 mg/kg of nesdonal. The second group received 3 μg/kg of fentanyl and 0.5 mg/kg of lidocaine for premedication and were given induction with 0.6 mg/kg of rocuronium and 5 mg/kg of nesdonal. After surgery, the incidence, intensity and duration of agitation when the patient woke up in both groups was recorded by a physician based on Riker's criteria. Also, the occurrence of myalgia and its persistence from one to 24 hours after the operation were assessed. Results: According to the results of this clinical trial, succinylcholine and rocuronium were not significantly different from each other in terms of the occurrence of agitation, its intensity and duration, but based on the results of the odds ratio, the probability that in patients who took rocuronium they found that agitation is 0.6 times less than the patients who received succinylcholine. Logistic analysis of the data also showed that in patients who received succinylcholine, the probability of agitation being more severe is 2.47 times higher than in patients who received rocuronium. The duration of agitation in patients receiving succinylcholine was also higher than in patients receiving rocuronium. In terms of the incidence and severity of myalgia, there was no significant difference in the people who received rocuronium or succinylcholine, however, a total of 50% of the patients showed agitation symptoms, showed myalgia, of which 16.6% were related to the people who received rocuronium and 33.3% were related to patients who received succinylcholine. The results of the myalgia odds ratio also showed that the probability of myalgia symptoms being observed in patients who received rocuronium is 0.5 times lower than in patients who received succinylcholine. Conclusion: In aggregate, the results of this trial showed that rocuronium can be a suitable alternative to succinylcholine in applications outside the operating room. [ABSTRACT FROM AUTHOR]

Background: Traumatic brain injury (TBI) is one of the most common neurological disorders worldwide. We aimed to investigate the efficacy of high-dose vitamin D3 on inflammatory biomarkers in patients with moderate to severe TBI. Methods: Thirty-five moderate to severe TBI patients were randomly assigned to intervention and control groups. Patients in the intervention group received a single intramuscular (IM) dose of 300,000 IU vitamin D. The primary endpoints were interleukin levels (IL-1β and IL-6), and the secondary endpoints were changes in neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), Glasgow Coma scale (GCS), and Glasgow Outcome Scale-Extended (GOS-E) scores compared between intervention and control arms of the study. The linear Generalized Estimating Equations were used for trend analysis and evaluating the association of independent factors to each outcome. Results: The results revealed a significant decrease in IL-1β levels (-2.71±3.02, in the intervention group: P=0.001 vs. -0.14±3.70, in the control group: P=0.876) and IL-6 (-88.05±148.45, in the intervention group: P=0.0001 vs. -35.54±175.79, in the control group: P=0.325) 3 days after the intervention. The improvement in the GCS score (P=0.001), reduction in NLR (P=0.001) and PLR (P=0.002), and improvement in the GOS-E score (P=0.039) was found to be greater in the vitamin D3 arm of the study than the control group. Conclusion: Administration of high-dose vitamin D3 in the acute phase of TBI could be effective in lowering the inflammatory markers and improving the level of consciousness and long-term performance outcomes. Trial registration number: IRCT20180522039777N2. [ABSTRACT FROM AUTHOR]